ABSTRACTBackgroundLaw enforcement is a common yet complicated presence in the emergency department (ED). Studies have found emergency medicine (EM) attending physicians have varied interactions with and attitudes toward law enforcement. EM resident physicians are in a uniquely formative professional period. However, the experiences and perspectives of EM resident physicians have not been previously explored in depth.MethodsWe recruited EM resident physicians from three geopolitically distinct urban academic EDs in the United States to participate in semi‐structured interviews regarding their experiences with law enforcement in the ED. We analyzed the transcripts thematically, looking for unifying concepts across institutions and latent meaning. A codebook was created and iteratively refined based on review of transcripts, after which salient themes were developed through ongoing discussions with the research team.ResultsTwenty‐four resident physicians across three sites participated. Three salient themes emerged from our study: ambiguity of authority between emergency physicians and law enforcement, concerns about the impact of law enforcement presence on patients, and disruptions to the ED team workflow. First, as trainees learning professional norms in the ED, participants reported difficulty navigating situations in which law enforcement attempted to assert authority over patient care. Second, participants perceived negative impacts of law enforcement presence on patients in custody and non‐incarcerated patients of color receiving care in the ED. Finally, participants described frequent disruptions to the ED team workflow due to the presence of law enforcement. Participants relied on hospital security, rather than law enforcement, to ensure the safety of patients and staff.ConclusionEmergency resident physicians described ambiguous boundaries and complex interactions among law enforcement, patients, and themselves in the ED. Although our study found several concerning impacts of law enforcement in the ED, these represent opportunities to clarify roles and responsibilities in the emergency physician‐law enforcement relationship and improve patient care. Further research is needed, including eliciting perspectives of law enforcement and patients, particularly those with substance use disorders, trauma, and serious mental illness.

Oropharyngeal dysphagia (OD) is a swallowing disorder that can lead to malnutrition, aspiration, and reduced quality of life if not properly managed. Effective care requires coordinated multidisciplinary team (MDT) interventions, including physicians, nurses, speech-language pathologists (SLPs), nutritionists, occupational therapists, and physiotherapists. This study evaluated health professionals’ perceptions of their involvement and the effectiveness of OD management at Bugando Medical Centre, Tanzania. A descriptive survey with a mixed-methods approach included 61 purposively sampled health professionals. Quantitative data were analyzed using descriptive statistics and cross-tabulations, while qualitative responses were thematically explored. Results showed a predominantly early- to mid-career workforce, with nurses as the largest group. Most participants had limited training in swallowing disorders, and specialized roles such as radiologists or instrumental assessments (VFS) were underrecognized. Speech therapists, nurses, physicians, and otolaryngologists were most involved in OD assessment and diagnosis. While 62.3% reported participation in MDT management, only 36.7% perceived it as effective. Barriers included inadequate staffing, limited SLP availability, insufficient training, and poor organizational coordination. ENT specialists and doctors were more engaged than nurses or general practitioners, indicating that MDT involvement was influenced more by professional role and department than formal training. In conclusion, MDT management of OD exists but is suboptimal. Strengthening MDT protocols, targeted training, and increasing specialized staff and resources are essential to improve patient care.

Automated triage in pandemics: Support vector machine for efficient patient classification.

Healthcare-associated infections (HCAIs) contribute significantly to global mortality, driven by the increasing antimicrobial resistance. Rapid, high-throughput bacterial detection is crucial for infection control and patient care. We report a real-time, multiplex lamp-based Photoionization Detector (PID) assisted by AI-image-based analysis for bacterial identification. Using four lamps with varying ionization energies, the sensor selectively ionizes VOCs emitted by bacteria, producing four distinct current curves for each target species (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae). These curves were transformed into image representations, capturing their spectral patterns for bacterial differentiation. A pre-trained ResNet-18 Convolutional Neural Network (CNN) within a Few-Shot Learning (FSL) framework extracted key features, enabling accurate (> 88%) bacterial differentiation even with limited labeled data. This sensor detected bacterial concentrations as low as 10² CFU and distinguished contamination levels. The synergistic integration of PID sensing with AI-driven analysis offers a powerful approach to rapid bacterial diagnostics, demonstrating strong potential for clinical implementation and improved patient care. This study marks an early step toward AI-based VOC sensing, where FSL acts as a proof-of-concept under data scarcity.

Artificial intelligence (AI) is reshaping healthcare by improving diagnosis and treatment planning, increasing operational efficiency, and streamlining administrative workflows. This paper integrates findings from an extensive PubMed search (2015-2025) with bibliometric analysis using RStudio and VOSviewer to investigate the comparative applications of AI methods in healthcare, collaborative networks, and emerging trends. A total of 1,243 records were identified through the PubMed search, and after removal of 143 duplicates, 1,100 records were screened. Following full-text assessment and exclusion of ineligible studies, 986 articles were included in the final bibliometric analysis. The main research areas included robotic-assisted surgery, predictive analytics, diagnostic imaging, and precision medicine, with particular emphasis on the prevalence of machine learning and deep learning in imaging and the increasing application of natural language processing to unstructured medical information. The review emphasizes the need for greater budgetary allocation to scalable and pragmatic AI technologies and for interdisciplinary cooperation among researchers, industry, and healthcare providers. Despite this growth, challenges such as algorithmic bias, data integration, and ethical concerns persist. The paper also highlights the importance of equitable collaboration, accountable AI, and multinational partnerships in ensuring that AI can be used ethically and efficiently in healthcare over the long term to improve patient care and biomedical innovation. It does so by mapping international and regional trends, identifying the most influential authors, institutions, and funding sources, and evaluating methodological approaches.

Introducing a pharmacist competency framework into a healthcare system has the potential to improve patient care but also poses several challenges. Assessing the readiness of all healthcare stakeholders in position of policy influence is an essential step to identify the correct implementation approach. In Austria, efforts to implement a competency framework for hospital pharmacists are ongoing, yet empirical evidence on the readiness of key healthcare stakeholders remains limited. The aim of this study was to explore the readiness of key healthcare policy stakeholders on the possible implementation of a hospital pharmacist competency framework into Austrian hospital practice. A qualitative interview study underpinned by the Consolidated Framework for Implementation Research (CFIR) with 20 key healthcare policy stakeholders was conducted across Austria. A topic guide and additional study material were developed based on the CFIR. Interview questions were validated and piloted. Interviews were audio-recorded, transcribed ad verbatim and coded in accordance with the CFIR by two researchers independently. Transcripts were analysed using thematic analysis until saturation of themes. Facilitators and barriers emerged across all five CFIR domains. Key facilitators were aspects of innovation, inner setting and implementation (e.g., relief for physicians due to reducing their workload, teamwork and communication to support implementation, etc.) while key barriers were also related to inner and outer setting, as well as the implementation, specifically the need for adequate structural and financial resources and a sensitive implementation process to not interrupt well-established workflow processes. This theory-informed study has highlighted the positive attitudes of participants stating their general readiness for implementation. Careful implementation will be necessary not to overwhelm the healthcare system by a sudden change in working structures, processes and hierarchy. These results have impacted policy and educational change for hospital pharmacists across Austria.

Understanding Fellowship Leaders' Efforts to Recruit Diverse Fellows to Pediatric Subspecialties.

Burnout is a concern among healthcare providers, linked to suboptimal patient care. Working as part of an integrated team has been identified as a mitigator and exacerbator of burnout, however, this relationship is not well understood in pediatric chronic pain care. This study assessed levels of burnout and perceptions of teamwork in a multidisciplinary group of pediatric chronic pain providers. A cross-sectional survey consisting of the Copenhagen Burnout Inventory and team functioning measures (i.e., communication/information sharing, team support, team effectiveness) was completed by N=195 providers. Pearson correlations were conducted to evaluate the association between burnout and teamwork. A K-means cluster analysis was used to group providers according to their level of burnout, and groupwise comparisons were conducted to examine differences in team functioning perceptions across established groups. Rates of personal (M=39.91, SD=16.97) and work-related (M=39.67, SD=17.75) burnout exceeded established norms. Team functioning ratings were generally positive; however, variability existed with poorer ratings in areas such as team coordination and productivity. Increased burnout was associated with poorer perceptions of team effectiveness and higher perceived room for improvement. K-means clustering identified three distinct provider groups: high, moderate, and low burnout, with significant differences in perceived team functioning across these groups. Elevated rates of burnout exist among multidisciplinary pediatric pain providers and are related to perceptions of team functioning. Research should explore directionality and causality of this relationship as well as provider experiences to support development of interventions to address team functioning and burnout and thus improve patient care.

Statin-induced myotoxicity (SIM) is a common adverse effect of simvastatin therapy, which can negatively impact patient adherence and treatment outcomes. This study aims to investigate the impacts of pharmacokinetic (PK) gene polymorphisms on SIM in Thai population treated with simvastatin. One hundred forty-eight Thai participants, including 23 with SIM and 125 tolerant controls were enrolled. The pharmacokinetic genes including, ABCB1, ABCC2, ABCG2, SLCO1B1, SLCO1B3, CYP3A4, and CYP3A5, were genotyped using MassARRAY System. Significant associations were identified for C allele of SLCO1B1 rs4149056 (c.521T>C) (OR = 1.9; 95% CI: 1.1-3.5; p = 0.02) and T allele of ABCC2 rs717620 (-24C>T) (OR = 2.2; 95% CI = 1.1-4.4; p = 0.02). Haplotype analysis of SLCO1B1 c.521T>C and c.388A>G revealed that the *15 haplotype (c.521C and c.388G) was significantly associated with SIM, with a higher frequency in SIM cases (13.0%) compared to controls (6.0%) (OR 2.8; 95% CI = 1.3-6.0; p < 0.01). Furthermore, the decreased function phenotype of OATP1B1 (SLCO1B1*1b/*5 or *1b/*15), was associated with SIM compared to normal function phenotype. Notably, patients with the decreased function phenotype using simvastatin 20-40 mg/day had a substanstially increase risk of SIM (OR = 10.0; 95% CI = 1.6-63.4; p = 0.02). These findings highlight the influence of PK gene polymorphisms on SIM risk and support the importance of genotype-guided simvastatin therapy to minimize adverse effects and improve patient care. Moreover, these also reinforce current CPIC guidelines, which recommend adjusting statins, including simvastatin, therapy based on SLCO1B1 genotype to reduce the risk of myopathy.

Burnout arises from prolonged work-related stress, leading to a chronic state of exhaustion, cynicism, and diminished professional efficacy. Previous studies have shown that ~50% of genetic counselors (GCs) experience burnout. This has negative implications for the GCs themselves, their employers, and patient care. Research in other healthcare professions has found a negative correlation between burnout and job satisfaction and a positive correlation between burnout and turnover intention. To investigate aspects of job satisfaction associated with burnout and aspects of burnout associated with turnover intention, a cross-sectional survey was administered via the listservs of three genetic counseling professional organizations. The survey included demographic questions, validated measures of burnout (the Maslach Burnout Inventory - General Survey) and job satisfaction (the Job Satisfaction Survey and select scales from the Job Satisfaction Questionnaire), a binary question assessing turnover intention, and two optional open-ended questions eliciting opinions on ways to improve job satisfaction. Of 228 respondents, 70 (30.7%) indicated that they were considering leaving their current job due to burnout. Logistic multiple regression analysis (n = 224) including subscales of burnout revealed that Exhaustion (p = 0.0004) and Cynicism (p < 0.0001) significantly predicted turnover intention. Linear multiple regression analyses (n = 206-207) including subscales of job satisfaction revealed that satisfaction with Nature of Work was a significant predictor of Exhaustion, Cynicism, and reduced Professional Efficacy (p < 0.0001). Significant predictors of Exhaustion included satisfaction with Operating Conditions (p = 0.02), Working Hours (p = 0.02), and Working Conditions (p = 0.01), while satisfaction with Empowerment and Participation (p = 0.03) was a significant predictor of Cynicism. Responses to the open-ended questions (147/228, 64.5%) revealed additional areas of job dissatisfaction. We propose several strategies to improve job satisfaction and ameliorate GC burnout at the organizational level. These strategies may increase the effectiveness of GCs in their jobs, improve patient care, promote professional longevity, and ultimately save organizations money by reducing turnover.

Artificial intelligence-enabled coronary plaque quantification for personalized risk assessment and lipid-lowering therapy: Insights from the FISH&CHIPS study✰.

Bridging the gap in implant dentistry education: Perspectives from Malaysia's graduating dental cohort.

A machine learning-based model to predict multi-time-point prognosis for acute-on-chronic hepatitis B liver failure.

In the ESPEN SIG meetings the similarities and differences between cachexia and disease-related malnutrition (DRM) were previously analyzed, as well as the role of inflammation in DRM. In the years 2023-2025, the SIG moving forward emphasized the relevance of the evolution of the cachexia definition and the advantage of considering DRM with chronic inflammation and cachexia as synonyms. We focused on the evidence regarding: i) the impact of DRM phenotypes and grade of inflammation on the efficacy of nutritional treatments, ii) the distinction between cachexia and end-of-life conditions, and iii) the identification of the barriers, facilitators and solutions for the implementation of the DRM definition among experts and non-experts in the field of nutrition. We underlined the importance of phenotyping those patients with DRM with inflammation to identify the most appropriate nutritional and metabolic interventions. Based on the role of inflammation in chronic and acute diseases, we discussed the impact of inflammation on the effectiveness of nutritional interventions. We discussed the differences between DRM with inflammation/cachexia and "end-of-life" conditions and the limited evidence on the efficacy of nutritional therapies in a palliative setting. Finally, the SIG discussed the barriers to the implementation of the concept of DRM, and suggested solutions. We emphasize the need for primary care training programs, to identify and address DRM early, and advocate for evidence-based interdisciplinary treatment strategies. The SIG recommends to enhance primary care nutritional and dietetic services, to support general practitioners and improve patient care through increased healthcare system engagement in clinical nutrition.

Systematic review of bladder exstrophy-epispadias complex definition of continence: A call for standardization.

Prognostic implications of tumour number in intrahepatic cholangiocarcinoma.

As the life expectancy of people with multiple sclerosis (PwMS) increases, the importance of recognizing and addressing specific needs and challenges faced by those undergoing age-related sex hormone changes and hypogonadism is becoming increasingly evident. We present expert-led, practical recommendations from a consensus program that address gaps in age-related sex hormone changes and hypogonadism in PwMS not sufficiently addressed in current literature and guidelines. A multidisciplinary steering committee (SC) of 15 international experts identified 18 key clinical questions across 6 themes: climacteric symptoms in women with MS; impact of MS on the climacteric stage; impact of menopause on MS disease activity and progression; treatment and management of climacteric symptoms in women with MS; late-onset hypogonadism (LOH) in men with MS; and patient-centered care. After thorough review of the evidence from a systematic literature review, the SC formulated 18 clinical recommendations to address the questions. These recommendations were voted on by the SC and an extended faculty of 23 health care professionals from 16 countries, including 2 nurses and 1 patient association representative. Consensus was reached when ≥75% of respondents expressed agreement, with a score of 7-9 on a 9-point scale. After a single voting round, all 18 recommendations reached consensus (14 reaching consensus at 90%-100% and 4 at 80%-90%). The clinical recommendations addressed the following: the potential overlap and exacerbation of MS symptoms during the climacteric stage; the need for preventive care and screening during the menopausal transition; the potential for, and a paucity of data on, differential efficacy and tolerability of MS medications in menopausal/postmenopausal women; the complex causal interplay between hormonal and/or immunologic changes and natural aging in PwMS switching to a more progressive phase of disease; consideration of behavioral/lifestyle interventions alongside pharmacologic treatments; effects of hormonal treatments on MS symptoms; and management of LOH in men with MS. These recommendations were based on a robust modified Delphi consensus approach and present a valuable framework for improved patient care. These results emphasize the need to address critical gaps in our understanding and management of PwMS undergoing age-related sex hormone changes and hypogonadism.

irAE-GPT: leveraging large language models to identify immune-related adverse events in electronic health records and clinical trial datasets.

This study aimed to explore informal caregivers' (family members of patients) perspectives on their involvement in ongoing multidisciplinary treatment of diabetes-related foot ulcers in a highly specialised outpatient service with a multidisciplinary team structure that was still evolving. Using focus group interviews and template analysis, we identified patterns in caregivers' experiences, needs, and preferences. The findings suggest considerable potential to improve patient care through earlier caregiver involvement. While some caregivers reported positive experiences, many rarely or never attended consultations and struggled to define involvement in practical terms. However, caregivers consistently expressed a strong wish for earlier involvement-ideally at the time of diabetes diagnosis-to acquire the knowledge and skills needed to support patients between clinical visits. Caregivers play an important role in foot ulcer management, as complex regimens such as wound care, offloading, and lifestyle adjustments require ongoing support outside clinical settings. However, involvement may also create strain. Participants described emotional and practical burden, feelings of guilt, and uncertainty about their roles. The study highlights the need for structured caregiver education, clear communication, and systemic support to balance the benefits of caregiver involvement with the risk of caregiver burden.

Emergency Department Information Systems (EDIS) are essential digital technology used in Emergency Departments (ED). Modern EDIS provide electronic patient tracking, documentation, order entry and decision support, and are crucial for enabling data analytics and Artificial-Intelligence (AI)-based tools to improve patient care. However, Canada's adoption of digital-health technology is slow, and the digital functions of current Canadian EDIS are unknown. This study presents an inventory of current Canadian EDIS functions. The primary outcome is a categorization of ED-centers as either 'mostly-digital', 'hybrid-digital & handwritten' or 'mostly-handwritten.' We hypothesized that < 50% of Canadian ED-centers are mostly-digital. A national electronic survey aiming to sample the 739 total Canadian ED-centers was conducted from Jan-Sept 2024. One response representing each center was recorded. The primary outcome was EDIS functions based on an adapted version of the electronic health record system functional model (EHR-S FM). Secondary outcomes include respondent and hospital demographics, and the ED-centers' current and future-planned EDIS use. Data from 99 individuals representing 545 (74%) of the target ED-centers was obtained. The most used EDIS brands include MEDITECH (31%), EPIC Systems (21%) and Allscripts (15%). Overall, 52.4% ED-centers are mostly-digital, 47.4% are hybrid-digital & handwritten, and 0.2% are mostly handwritten. Paper-based health provider ED documentation and order entry were reported in 19.7% and 46.2% of responses. Tracking medication administration and patient vitals are paper-based in 45.6% and 21.8% of responses. Despite national expansion in digital-health technology, there is widespread use of paper-based processes for Canadian ED patient care. These findings affect strategic planning for use of electronic care supports and AI. Further infrastructure changes are needed in order for Canadian patients to equitably and practically benefit from AI and data analytics innovations in the ED. Large portions of the information these technologies use are in difficult to access formats.