Quality Health Research Articles

Assessment of oral health status and quality of life in hearing-impaired children from Syria

AimThis study aimed to evaluate the oral health status of children with hearing impairments and assess the relationship between various oral health factors and the Pediatric Oral Health-Related Quality of Life.Materials and methodsThis observational cohort study involved 90 hearing-impaired children aged 6–12 years. Diagnostic tools such as pure-tone audiometry were used to evaluate their hearing abilities. Dental health was assessed by calculating DMFT, dmft, Plaque and Gingival indices. The oral health-related quality of life was measured using the POHRQoL.ResultsThe severity of hearing impairment varied with 3% having severe hearing loss, 13% having profound hearing loss, and 83% having complete hearing loss. A high prevalence of dental cavities with 93% of children affected was found. DMFT score was similar between males and females (2.5 ± 0.3 vs. 2.3 ± 0.3 respectively). Males exhibited a higher mean dmft score (4.1 ± 0.5 vs. 3.3 ± 0.5), and a higher mean Plaque Index (1.9 ± 0.1 vs. 1.5 ± 0.1). On the other hand, females showed a higher mean Gingival Index (0.9 ± 0.1 vs. 1.1 ± 0.2). Results indicated a decreased OHRQoL with a mean POQL score of 6.4 ± 2.89. Spearman’s test revealed a significant positive correlation between POQL total score and DMFT scores (P = 0.000), dmft scores (P = 0.000), Plaque Index scores (P = 0.000), and Gingival Index scores (P = 0.038). There was a weak positive correlation between hearing impairment severity and POQL total score, it was not statistically significant.ConclusionsChildren who have hearing impairments exhibit poor oral health, and levels of dental caries, which can negatively impact their overall POHRQoL. Therefore, it is highly recommended to start specialized oral health education and comprehensive dental care programs to improve their OHRQoL.

The use of artificial intelligence in radiology: new possibilities for diagnostic imaging. A literature review

Introduction and purpose: Rapid advances in technology enable innovative solutions to be implemented in modern medicine, relieving healthcare workers by speeding up diagnosis and improving the quality of treatment. The subject of this review is Artificial Intelligence (AI), an innovative form of help in the daily practice of doctors. It offers the opportunity to relieve healthcare workers by accelerating the diagnosis process and improving the quality and effectiveness of treatment. The aim of this paper is to present the current state of knowledge, assess the effectiveness of algorithms in the recognition and interpretation of abnormalities in medical images compared to specialists in radiology and discuss the challenges associated with the implementation of AI in various medical specialties. Brief description of the state of knowledge: Artificial intelligence, especially through machine learning and deep learning techniques, has found wide application in radiology. Many facilities around the world use advanced AI systems in the day-to-day work of radiologists, including the Mayo Clinic, Massachusetts General Hospital, and the University of Tokyo Hospital. Summary: Studies show that while AI algorithms can perform worse than radiologists in some areas, they are at the forefront of others, especially in detecting subtle abnormalities. The effective implementation of artificial intelligence requires addressing regulatory, ethical, and training issues. Despite these challenges, artificial intelligence has the potential to play a key role in the future of radiology and revolutionize medical practice, opening new perspectives and improving the quality of health care.

Analisis Kualitas Pelayanan Kesehatan di Puskesmas Porong Kabupaten Sidoarjo

Public service is crucial for fulfilling community basic needs, particularly in healthcare. Puskesmas Porong, a healthcare institution in Sidoarjo District, serves as the primary focus of this study. With a vision to provide quality and professional healthcare services to the community, Puskesmas Porong plays a pivotal role as the primary healthcare center in Porong Subdistrict. Despite adequate facilities including 46 inpatient beds and coverage of 10 surrounding villages, challenges persist. High patient influx poses significant issues such as long waiting times for services, attributed to insufficient staff and resources. Moreover, limited community participation in providing feedback is a concern, hindering the identification of issues and optimal solutions for healthcare service improvement.This qualitative research aims to analyze healthcare service quality at Puskesmas Porong, employing interviews with key stakeholders including the head of the health center, medical staff, administrative personnel, and patients. Additionally, observation and documentation methods were utilized to gather comprehensive data on service provision, patient satisfaction, and facility conditions. Results reveal that while operational procedures are generally adhered to, discrepancies exist between management perceptions and patient experiences. Patients highlight shortcomings in BPJS utilization, medical equipment adequacy, and diagnostic accuracy, underscoring the need for targeted improvements to enhance service quality and community trust.

Comprehensive insights into health services accessibility and quality of life of families with individuals with 22q11.2 deletion syndrome in Brazil

BackgroundThe 22q11.2 Deletion Syndrome (22q11.2 DS) presents unique healthcare challenges for affected individuals, families, and healthcare systems. Despite its rarity, 22q11.2 DS is the most common microdeletion syndrome in humans, emphasizing the need to understand and address the distinctive healthcare requirements of those affected. This paper examines the multifaceted issue of health service access and caregivers’ quality of life in the context of 22q11.2 DS in Brazil, a condition with diverse signs and symptoms requiring multidisciplinary care. This study employs a comprehensive approach to evaluate health service accessibility and the quality of life of caregivers of individuals with 22q11.2 DS. It utilizes a structured Survey and the WHOQOL-bref questionnaire for data collection.ResultsIndividuals with 22q11.2 DS continue to receive incomplete clinical management after obtaining the diagnosis, even in the face of socioeconomic status that enabled an average age of diagnosis that precedes that found in sample groups that are more representative of the Brazilian population (mean of 3.2 years versus 10 years, respectively). In turn, caring for individuals with 22q11.2 DS who face difficulty accessing health services impacts the quality of life associated with the caregivers' environment of residence.ConclusionsResults obtained help bridge the research gap in understanding how caring for individuals with multisystem clinical conditions such as 22q11.2 DS and difficulties in accessing health are intertwined with aspects of quality of life in Brazil. This research paves the way for more inclusive healthcare policies and interventions to enhance the quality of life for families affected by this syndrome.

Implementation and evaluation of a system for assessment of the quality of long-term management of patients at a geriatric hospital

BackgroundThe increasing aging population presents a significant challenge, accompanied by a shortage of professional caregivers, adding to the therapeutic burden. Clinical decision support systems, utilizing computerized clinical guidelines, can improve healthcare quality, reduce expenses, save time, and boost caregiver efficiency. Objectives1) Develop and evaluate an automated quality assessment (QA) system for retrospective longitudinal care quality analysis, focusing on clinical staff adherence to evidence-based guidelines (GLs). 2) Assess the system’s technical feasibility and functional capability for senior nurse use in geriatric pressure-ulcer management. MethodsA computational QA system using our Quality Assessment Temporal Patterns (QATP) methodology was designed and implemented. Our methodology transforms the GL’s procedural-knowledge into declarative-knowledge temporal-abstraction patterns representing the expected execution trace in the patient’s data for correct therapy application. Fuzzy temporal logic allows for partial compliance, reflecting individual and grouped action performance considering their values and temporal aspects. The system was tested using a pressure ulcer treatment GL and data from 100 geriatric patients’ Electronic Medical Records (EMR). After technical evaluation for accuracy and feasibility, an extensive functional evaluation was conducted by an experienced nurse, comparing QA scores with and without system support, and versus automated system scores. Time efficiency was also measured. ResultsQA scores from the geriatric nurse, with and without system’s support, did not significantly differ from those provided by the automated system (p < 0.05), demonstrating the effectiveness and reliability of both manual and automated methods. The system-supported manual QA process reduced scoring time by approximately two-thirds, from an average of 17.3 min per patient manually to about 5.9 min with the system’s assistance, highlighting the system’s efficiency potential in clinical practice. ConclusionThe QA system based on QATP, produces scores consistent with an experienced nurse’s assessment for complex care over extended periods. It enables quick and accurate quality care evaluation for multiple patients after brief training. Such automated QA systems may empower nursing staff, enabling them to manage more patients, accurately and consistently, while reducing costs due to saved time and effort, and enhanced compliance with evidence-based guidelines.

Implementation and evaluation of a system for assessment of the quality of long-term management of patients at a geriatric hospital

BackgroundThe increasing aging population presents a significant challenge, accompanied by a shortage of professional caregivers, adding to the therapeutic burden. Clinical decision support systems, utilizing computerized clinical guidelines, can improve healthcare quality, reduce expenses, save time, and boost caregiver efficiency. Objectives1) Develop and evaluate an automated quality assessment (QA) system for retrospective longitudinal care quality analysis, focusing on clinical staff adherence to evidence-based guidelines (GLs). 2) Assess the system’s technical feasibility and functional capability for senior nurse use in geriatric pressure-ulcer management. MethodsA computational QA system using our Quality Assessment Temporal Patterns (QATP) methodology was designed and implemented. Our methodology transforms the GL’s procedural-knowledge into declarative-knowledge temporal-abstraction patterns representing the expected execution trace in the patient’s data for correct therapy application. Fuzzy temporal logic allows for partial compliance, reflecting individual and grouped action performance considering their values and temporal aspects. The system was tested using a pressure ulcer treatment GL and data from 100 geriatric patients’ Electronic Medical Records (EMR). After technical evaluation for accuracy and feasibility, an extensive functional evaluation was conducted by an experienced nurse, comparing QA scores with and without system support, and versus automated system scores. Time efficiency was also measured. ResultsQA scores from the geriatric nurse, with and without system’s support, did not significantly differ from those provided by the automated system (p < 0.05), demonstrating the effectiveness and reliability of both manual and automated methods. The system-supported manual QA process reduced scoring time by approximately two-thirds, from an average of 17.3 min per patient manually to about 5.9 min with the system’s assistance, highlighting the system’s efficiency potential in clinical practice. ConclusionThe QA system based on QATP, produces scores consistent with an experienced nurse’s assessment for complex care over extended periods. It enables quick and accurate quality care evaluation for multiple patients after brief training. Such automated QA systems may empower nursing staff, enabling them to manage more patients, accurately and consistently, while reducing costs due to saved time and effort, and enhanced compliance with evidence-based guidelines.

Relevance of learning health systems to physiatrists and its synergy with implementation science: A commentary.

As health care attempts to bridge the gap between evidence and practice, the concept of the learning health system (LHS) is becoming increasingly relevant. LHS integrates evidence with health systems data, driving health care quality and outcomes through updates in policy, practice, and care delivery. In addition, LHS research is becoming critically important as there are several initiatives underway to increase research capacity, expertise, and implementation, including attempts to stimulate increasing numbers of LHS researchers. Physical Medicine & Rehabilitation (PM&R) physicians (physiatrists), nurses, therapists (physical therapists, occupational therapists, speech therapists, clinical psychologists), and scientists are affiliated with LHSs. As LHS research expands in health care systems, better awareness and understanding of LHSs and LHS research competencies are key for rehabilitation professionals including physiatrists. To address this need, the Agency of Healthcare Research and Quality (AHRQ) identified 33 core competencies, grouped into eight domains, for training LHS researchers. The domains are: (1) Systems Science; (2) Research Questions and Standards of Scientific Evidence; (3) Research Methods; (4) Informatics; (5) Ethics of Research and Implementation in Health Systems; (6) Improvement and Implementation Science; (7) Engagement, Leadership, and Research Management; and the recently added (8) Health and Healthcare Equity and Justice. The purpose of this commentary is to define LHS and its relevance to physiatrists, present the role of implementation science (IS) in LHSs and application of IS principles to design LHSs, illustrate current LHS research in rehabilitation, and discuss potential solutions to improve awareness and to stimulate interest in LHS research and IS among physiatrists in LHSs.

Expanded perspectives: integrating clinicians' insights for comprehensive patient-reported outcomes in value-based healthcare.

The manuscript explores value-based healthcare (VBHC) and its role in assessing healthcare quality beyond clinical metrics. It identifies four value types: personal, technical, allocative, and societal. Emphasizing the integration of diverse stakeholder perspectives, including patients, families, and clinicians, the study highlights the importance of patient- and family-reported measures (PROMs and PREMs) and clinician input. Clinicians' insights on treatment feasibility and effectiveness are crucial for a holistic understanding of healthcare quality. The manuscript advocates for combining machine learning with participatory approaches to enhance data analysis and continuous quality improvement in VBHC, driving better outcomes for patients and communities.

Quality, Spending, Utilization, and Outcomes Among Dual-Eligible Medicare-Medicaid Beneficiaries in Integrated Care Programs

Most dual-eligible Medicare-Medicaid beneficiaries are enrolled in bifurcated insurance programs that pay for different components of care. Therefore, policymakers are prioritizing expansion of integrated care plans (ICPs) that manage both Medicare and Medicaid benefits and spending. To review evidence of the association between ICPs and health care spending, quality, utilization, and patient outcomes among dual-eligible beneficiaries. A search was conducted of PubMed/MEDLINE (January 1, 2010, through November 1, 2023) and Google Scholar (January 1, 2010, through October 1, 2023) and augmented with reports from US federal and state government websites. Three categories of ICPs were evaluated: Programs of All-Inclusive Care for the Elderly (PACE), Medicare-Medicaid Plans (MMPs), and Fully Integrated Dual Eligible Special Needs Plans (FIDE-SNPs) and related models aligning Medicare and Medicaid coverage. The review included studies that evaluated beneficiaries dually eligible for and enrolled in full Medicaid; compared an ICP to a nonintegrated arrangement; and evaluated utilization, spending, care coordination, patient experience, or health for 100 or more beneficiaries. In all, 26 ICP evaluations met the inclusion criteria and were included in the analysis: 5 of PACE, 13 of MMPs, and 8 of FIDE-SNPs and other aligned models. Evidence generally showed associated reductions in long-term nursing home stays in PACE (3 of 4 studies) and FIDE-SNPs and related aligned models (3 of 5 studies) but was mixed in evaluations of MMPs. Four of 9 studies of MMPs and 2 of 3 studies of FIDE-SNPs found higher outpatient use, although other studies showed no difference. Evidence on Medicaid spending was limited, whereas 8 of 10 studies of MMPs showed an association between these plans and higher Medicare spending. Evidence was mixed or inconclusive regarding care coordination and hospitalizations, and it was insufficient to evaluate patient satisfaction, health, and outcomes in beneficiary subgroups (eg, those with serious mental illness). Furthermore, studies had limited ability to control for bias from unmeasured differences between enrollees of ICPs compared with nonintegrated models. This systematic review found variability and gaps in evidence regarding ICPs and spending, quality, utilization, and outcomes. Studies found some ICPs were associated with reductions in long-term nursing home admissions, and several identified increases in outpatient care. However, MMPs were primarily associated with higher Medicare spending. Evidence for other outcomes was limited or inconclusive. Research addressing these evidence gaps is needed to guide ongoing efforts to integrate coverage and care for dual-eligible beneficiaries.

Effect of Wearable Technology on Metabolic Control and the Quality of Life in Children and Adolescents with Type 1 Diabetes: A Systematic Review and Meta-Analysis

Type 1 diabetes is one of the most common chronic diseases in children. Wearable technology (insulin pumps and continuous glucose monitoring devices) that makes diabetes management relatively simple, in addition to education and follow-ups, enhances the quality of life and health of individuals with diabetes. To evaluate the impact of wearable technology on metabolic management and the quality of life in children and adolescents with type 1 diabetes. Systematic review and meta-analysis. The Preferred Reporting System for Systematic Reviews and Meta-Analyses was used to conduct a systematic review and meta-analysis. PubMed, Web of Science, MEDLINE, Cochrane Library, EBSCO, Ulakbim and Google Scholar were searched in July 2022 and July 2023 using predetermined keywords. The methodological quality of the studies was evaluated using the Joanna Briggs Institute’s Critical Appraisal Checklists for randomized controlled experimental and cross-sectional studies. The meta-analysis method was used to pool the data. Eleven studies published between 2011 and 2022 were included. The total sample size of the included studies was 1,853. The meta-analysis revealed that the decrease in hemoglobin A1C (HbA1c) level in those using wearable technology was statistically significant [mean difference (MD): -0.33, Z = 2.54, p = 0.01]. However, the technology had no effect on the quality of life [standardized mean difference (SMD): 0.44, Z = 1.72, p = 0.09]. The subgroup analyses revealed that the decrease in the HbA1c level occurred in the cross-sectional studies (MD: -0.49, Z = 2.54, p = 0.01) and the 12-19 (MD = 0.59, Z = 4.40, p < 0.001) and 4-18 age groups (MD: -0.31, Z = 2.56, p = 0.01). The subgroup analyses regarding the quality of life revealed that there was no difference according to the research design. However, the quality of life was higher in the wearable technology group than in the control group in the 8-12 and 4-18 age groups (SMD: 1.32, Z = 2.31, p = 0.02 and SMD: 1.00, Z = 5.76, p < 0.001, respectively). Wearable technology effectively reduces the HbA1c levels in children and adolescents with type 1 diabetes in some age groups. However, it does not affect the quality of life.

Relationship between diabetes health literacy, distress, burnout, social support, complications, self-care behaviors, and quality of life among patients with type 2 diabetes: a path analysis study

IntroductionImproving the quality of life (QOL) is the most important goal of early diagnosis and treatment in patients with type 2 diabetes (T2D). Numerous studies have indicated the positive effects of health literacy, social support and self-care behaviors and the negative effects of diabetes distress and burnout on the QOL of patients with T2D. Understanding these factors is crucial for people with diabetes. However, no study has investigated the simultaneous effects of these variables on QOL. In this study, our goals were to find out how these variables are related to each other, in addition, which variables play the role of mediating variables, and finally, what is the cumulative effect of these variables in predicting the QOL of patients with T2D. So, this study aimed to examine the relationship between diabetes health literacy (DHL), distress, burnout, social support, complications of diabetes, self-care behaviors, and QOL among patients with T2D by application Path analysis method.MethodsIn this study 929 participants were entered to study by cluster sampling method and finally, data were analyzed among 820 participants. Data were gathered by self-report and with seven tools of Demographic section, DHL Scale, Diabetes distress scale, Diabetes Burnout scale, Diabetes Self-Management Questionnaire (DSMQ), Perceived social support, Diabetes Quality of Life (DQOL) Questionnaire. The software’s of SPSS version 24 and AMOS version 24 were used for analysis.ResultsThe variables of DHL, social support, diabetes distress, and complications of diabetes predicted 38% variance in diabetes burnout (R2 = 0.38). Greatest impact on diabetes burnout was related to diabetes distress (estimate total effect = 0.539). The variables of DHL, social support, diabetes distress, complications of diabetes, and diabetes burnout predicted 24% variance in self- care behaviors (R2 = 0.24). Greatest impact on self- care behaviors was related to DHL (estimate total effect = 0.354). The variables of DHL, social support, diabetes distress, diabetes burnout, complications of diabetes, and self- care behaviors predicted 49% variance in DQOL (R2 = 0.49). Greatest impact on DQOL was related to variables of diabetes distress (estimate total effect = -0.613), DHL (estimate total effect = 0.225), diabetes burnout (estimate total effect = -0.202), complications of diabetes (estimate total effect = − 0.173), social support (estimate total effect = 0.149), and self -care (estimate total effect = 0.149), respectively.ConclusionTo improve QOL in patients with T2D, health care providers must develop interventions that increase DHL of diabetic. Because DHL can decrease distress and burnout, enhance self -care skills, create supportive networks, and ultimately improve QOL in patients with type 2 diabetes.

Effect of Routine Nurse Caregiving on the Stress Responses and Behavior State in Preterm Infants: A Systematic Review.

Although routine nurse caregiving is vital for the overall health of preterm infants, variations in approaches may exert distinct effects on preterm infants' stress responses and behavior state. The purpose of this systematic review was to examine routine nurse caregiving in the neonatal intensive care unit and its effect on stress responses and behavior state in preterm infants. A systematic search was conducted using PubMed, Embase, and CINAHL for studies published between 2013 and 2023. Included studies enrolled preterm infants born <37weeks gestational age and investigated nurse caregiving practices and effects on stress responses and/or behavior state. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, data about study design, methods, findings, and limitations were extracted and summarized. Included studies were evaluated for bias using the National Health, Lung, and Blood Institute quality assessment tools. All 13 studies included in the review received a fair quality rating. Nurse caregiving activities, including suctioning, diaper changes, bathing, and weighing, were associated with increases in heart and respiratory rates, blood pressure, energy expenditure, and motor responses, lower oxygen saturations, and fewer sleep states. Adapting nurse caregiving frequency and duration, aligning caregiving with infant state, and integrating developmental care strategies may reduce infant stress responses and support behavioral rest. Further research is needed to understand how caregiving activities affect stress responses and behavior state in preterm infants, aiding in identifying modifiable caregiving stressors to promote optimal development.

Chinese and Indian migrant mothers’ perceptions and experiences of utilising maternal and early childhood healthcare services in Aotearoa New Zealand: a qualitative descriptive study

ABSTRACT Although the health system in Aotearoa New Zealand is based on universalism and equity, disparities exist in the uptake and quality of health care for ethnic-migrant mothers and their children. This qualitative descriptive study explored the perceptions and experiences of Chinese and Indian migrant mothers (N = 24) accessing maternal and early childhood healthcare services. Semi-structured interviews and focus groups were conducted and data were analysed using reflexive thematic analysis. Three themes were generated. Migrant mothers displayed limited awareness of services available for themselves and their children, and experienced difficulties navigating the complex and fragmented health system. Transnational ties influenced mothers’ expectations of care and health seeking practices for themselves and their children. Mothers shared suggestions for a system that is inclusive of migrants’ needs, such as offering orientation sessions to raise awareness and ease navigation challenges, having interpreters available and translated resources to support language challenges, and improve postpartum support as mothers adapt to motherhood. To improve health equity, it is important that national policy supports improvements to the health system to address the challenges faced by ethnic-migrant families when navigating health services.

Removal Characteristics of Gas-Phase D-Limonene in Biotrickling Filter and Stoichiometric Analysis of Biological Reaction using Carbon Mass Balance

Volatile organic compounds (VOCs) pose significant risks to human health and environmental quality, prompting stringent regulations on their emissions from various industrial processes. Among VOCs, d-limonene stands out due to its low threshold and contribution to malodorous emissions. While biofiltration presents a promising approach for VOC removal, including d-limonene, a comprehensive understanding of its performance and kinetics is lacking. This study aims to comprehensively assess the performance of a lab-scale biotrickling filter in treating gas-phase d-limonene. The experimental results indicate that the biotrickling filter efficiently removed d-limonene, achieving a critical loading rate of 19.4 g m−3 h−1 and a maximum elimination capacity of 31.8 g m−3 h−1 (correspondingly, up to 85% removal) at the condition of 94.2 s of EBRT. Microbial activity played a significant role in biotrickling filter performance, with a strong linear correlation being observed between CO2 production and substrate consumption. The Michaelis–Menten model was employed to represent enzyme-catalyzed reactions, suggesting no inhibition during biotrickling filter operation.

Objective Neighborhood-Level Disorder Versus Subjective Safety as Predictors of HIV Transmission Risk and Momentary Well-Being.

Mental health and HIV risk behavior have been studied with ecological momentary assessment (EMA), but this approach has not been combined with tracking of activity space (where people go and what they encounter there) in people with HIV and their social relations, who may be HIV+ or HIV-. Activity space represents a modifiable risk or protective factor for behavior related to health status and quality of life, in both clinical and nonclinical populations. We conducted an observational study with 286 participants (243 HIV+ and 43 HIV-), roughly matched for socioeconomic status and neighborhood of residence via three waves of snowball sampling. Each participant carried a smartphone for up to 4weeks, making 5 randomly prompted entries and 1 end-of-day entry each day, plus self-initiated event-contingent entries for sexual activity and drug use. Responses to randomly prompted items provided subjective evaluations of the safety of the participant's current social and physical environment (the place they were and the people they were with). GPS-based location tracking-coupled with publicly available statistic indicating neighborhood-level physical disorder and socioeconomic disadvantage-provided an indicator of each participant's exposure to objective psychosocial hazard. We examined possible relationships of these objective and subjective environmental exposures with risky sexual and intravenous drug-use behavior, knowledge and utilization of antiretroviral treatment and prophylaxis, and momentary mental health (mood and stress, which relate to risky behavior and overall well-being). We found that both risky behavior and mental health were more related to participants' subjective evaluations of their activity space than to objective measures of neighborhood-level disorder, suggesting that, even within an objectively hazardous neighborhood, people who find a niche they perceive as socially and physically safe may engage in less risky behavior and have better well-being.Trial registration Clinicaltrials.gov Identifier NCT01571752.

Removal Characteristics of Gas-Phase D-Limonene in Biotrickling Filter and Stoichiometric Analysis of Biological Reaction using Carbon Mass Balance

Volatile organic compounds (VOCs) pose significant risks to human health and environmental quality, prompting stringent regulations on their emissions from various industrial processes. Among VOCs, d-limonene stands out due to its low threshold and contribution to malodorous emissions. While biofiltration presents a promising approach for VOC removal, including d-limonene, a comprehensive understanding of its performance and kinetics is lacking. This study aims to comprehensively assess the performance of a lab-scale biotrickling filter in treating gas-phase d-limonene. The experimental results indicate that the biotrickling filter efficiently removed d-limonene, achieving a critical loading rate of 19.4 g m−3 h−1 and a maximum elimination capacity of 31.8 g m−3 h−1 (correspondingly, up to 85% removal) at the condition of 94.2 s of EBRT. Microbial activity played a significant role in biotrickling filter performance, with a strong linear correlation being observed between CO2 production and substrate consumption. The Michaelis–Menten model was employed to represent enzyme-catalyzed reactions, suggesting no inhibition during biotrickling filter operation.

Moonshot. Long shot. Or sure shot. What needs to happen to realize the full potential of AI in the fertility sector?

Quality healthcare requires two critical components: patients' best interests and best decisions to achieve that goal. The first goal is the lodestar, unchanged and unchanging over time. The second component is a more dynamic and rapidly changing paradigm in healthcare. Clinical decision-making has transitioned from an opinion-based paradigm to an evidence-based and data-driven process. A realization that technology and artificial intelligence can bring value adds a third component to the decision process. And the fertility sector is not exempt. The debate about AI is front and centre in reproductive technologies. Launching the transition from a conventional provider-driven decision paradigm to a software-enhanced system requires a roadmap to enable effective and safe implementation. A key nodal point in the ascending arc of AI in the fertility sector is how and when to bring these innovations into the ART routine to improve workflow, outcomes, and bottom-line performance. The evolution of AI in other segments of clinical care would suggest that caution is needed as widespread adoption is urged from several fronts. But the lure and magnitude for the change that these tech tools hold for fertility care remain deeply engaging. Exploring factors that could enhance thoughtful implementation and progress towards a tipping point (or perhaps not) should be at the forefront of any 'next steps' strategy. The objective of this Opinion is to discuss four critical areas (among many) considered essential to successful uptake of any new technology. These four areas include value proposition, innovative disruption, clinical agency, and responsible computing.

Mothers' experiences of privacy in neonatal intensive care units: A qualitative study.

Examining the privacy experiences of mothers in neonatal intensive care units (NICUs) can play a crucial role in bolstering patient privacy safeguards and elevating the overall quality of health care. However, our understanding of mothers' experiences regarding privacy issues they may face after their infants' hospitalization in the NICU is limited. This study aimed to investigate the experiences of mothers concerning privacy within NICUs to contribute valuable insights for improving infant care and privacy protection. A qualitative content analysis using a conventional approach was conducted. A total of 18 participants, with diverse sociodemographic backgrounds, were interviewed using open-ended questions. Qualitative content analysis was undertaken for data analysis. The study was conducted in the NICU of an urban teaching hospital in Iran. The study identified four main themes: 'understanding of privacy', 'fluctuating respect for privacy', 'efforts to maintain privacy' and 'privacy barriers'. Participants viewed privacy as multidimensional, influenced by cultural and religious factors. Respect for privacy varied, with instances of both adherence and violation. Mothers employed strategies to preserve privacy, emphasizing the importance of their infants' privacy. Privacy barriers included hospital attire, the physical space of the NICU, inhomogeneous human resources and insufficient supervision and training. This study, the first of its kind in the NICU context, provides valuable insights into maternal experiences of privacy. Integrating these insights into practice and future research can contribute to creating more empathetic and privacy-respecting NICU environments. Health care providers can use these findings to enhance support for mothers, potentially reshaping physical spaces and communication practices within NICUs.

Diagnosis of Brugada syndrome affects quality of life and psychological status.

Chronic diseases have a negative impact on quality of life (QOL) and psychological health. There are limited related data regarding this topic in Brugada syndrome (BrS). We evaluated the effects of the diagnosis of BrS on health-related QOL and psychological status among patients and their relatives. Patients with BrS and their relatives underwent psychological evaluation at diagnosis (T0), 1 and 2 years after diagnosis (T1 and T2) using questionnaires on mental QOL, anxiety, depression, stress, post-traumatic stress, and resilience resources. Sixty-one patients and 39 relatives were enrolled. Compared with controls, patients showed increased physical QOL (54.1 ± 6.5 vs. 50.1 ± 8.0, p = 0.014), reduced mental QOL (43.2 ± 11.8 vs. 49.6 ± 9.1, p = 0.018) and increased anxiety (9.9 ± 6.6 vs. 6.9 ± 7.7, p = 0.024) at T0; reduced resilience scores (3.69 ± 0.40 vs. 3.96 ± 0.55, p = 0.008) at T1; and reduced resilience (3.69 ± 0.35 vs. 3.96 ± 0.55, p = 0.019) and increased anxiety scores (16.4 ± 12.8 vs. 6.9 ± 7.7, p = 0.006) at T2. Relatives presented higher stress (17.63 ± 3.77 vs. 12.90 ± 6.0, p = 0.02) at T0 and higher anxiety scores at T0 (13.5 ± 7.6 vs. 6.9 ± 7.7, p < 0.001), T1 (12.0 ± 8.7 vs. 6.9 ± 7.7, p = 0.005), and T2 (16.4 ± 12.8 vs. 6.9 ± 7.7, p = 0.006) than controls. Female sex was significantly independently associated with worse mental QOL scores in patients at T0 (odds ratio = 0.10; 95% confidence interval = 0.05-0.94; p = 0.04). The diagnosis of BrS impairs the QOL and psychological status of patients and their relatives. Female sex is independently associated with worse mental QOL in patients at diagnosis.

Religiosity: Is It Mainly Linked to Mental Health or to Psychopathology?

The impact of religiosity on human mental health has been much debated over the last few decades. A large number of empirical and theoretical studies have been conducted to understand the impact of religiosity and spirituality on people’s quality of mental health. Though the vast majority of research indicates that religiosity makes a positive contribution to a person’s mental health and can give meaning to life, both the positive and some negative effects of religiosity on mental health are discussed. The impact of religiosity on people’s mental health seems to correspond to the quality of their religiosity.