Background/Objectives: Obstetrics and gynecology healthcare represents a global health concern requiring coordinated, accessible services across diverse populations. The Saudi Medical Referrals Centre (MRC) functions as a comprehensive digital health surveillance and coordination platform managing nationwide obstetrics and gynecology (OB/GYN) services. This study characterizes national OB/GYN e-referral patterns coordinated through the MRC platform to describe subspecialty utilization and inform capacity planning, and examines temporal trends in referral direction over the study period. Methods: A retrospective descriptive analysis of the MRC's digital coordination platform examined 39,526 OB/GYN referrals across Saudi Arabia's healthcare system (2023-2024). Descriptive statistics, chi-square tests, and one-way ANOVA tests were used to analyze patient demographics, subspecialty distribution, referral types, bed requirements, acceptance rates, geographic patterns, and multivariable logistic regression examined temporal trends in referral direction. Results: The platform achieved 91.81% overall acceptance rates. Platform surveillance revealed referral request distribution by subspecialty: general OB/GYN (60.68%), obstetrics and fetal medicine (16.37%), and reproductive endocrinology and infertility (14.94%). Most referral requests were for outpatient care (71.35%), though obstetrics and fetal medicine demonstrated relatively high NICU utilization (55.62%). Urgent referral requests constituted 22.05% of cases. Internal referral odds increased 1.7% monthly over the study period (OR = 1.017; p < 0.001). Conclusions: This nationwide descriptive analysis of 39,526 OB/GYN e-referrals reveals distinct subspecialty-specific referral patterns, with high overall acceptance rates and predominantly internal referral coordination. These system-level findings provide a baseline for future studies within digital referral platforms.

The role of social media, influencers, and online communities in blood donor recruitment and retention: A systematic scoping review.

ABSTRACT The reduction of the environmental impact of photocurable resins, commonly used in vat 3D printing, is an urgent request. In order to truly enable vat additive manufacturing (AM) to adopt a circular economy approach, this can be done by both selecting non‐fossil carbon feedstocks and considering the end‐of‐life and reprocessability of the resulting thermosets. Pursuing this goal, we present the study of a 3D printing‐compatible vitrimeric resin capable of dynamically reorganizing the polymeric network and exhibiting self‐repair properties following heat treatment at 160°C. For the development of the resin, microcrystalline cellulose (MCC) is extracted from aloe vera peel, the main waste from the cultivation of this plant. MCC is then functionalized and used as an added‐value crosslinker for the monofunctional monomer 2‐hydroxy‐3‐phenoxypropyl acrylate (HPPA), which is considered green as it can be obtained from renewable resources. The material studied possesses excellent printing resolution, remodeling, and self‐healing ability, leading to a significant recovery of mechanical properties after breakage. This work highlights the possibility of combining renewable raw materials, waste utilization, and vitrimeric chemistry to create sustainable, easily recyclable resins.

Fog computing, characterised by its dynamic and heterogeneous nature, necessitates efficient resource provisioning to maximise resource utilisation. Existing methods often suffer from computational overhead and scalability limitations. This research proposes a novel resource provisioning approach for fog environments to address these challenges. The user request is first transformed into a four queue model, in which very urgent and urgent requests are placed in the first and second priority queues to offload to the closest available fog resource while considering deadliness and latency. Here, the selection of a suitable fog node selection for flawless workload execution, an improved coati optimisation algorithm (ICOA) is developed. The proposed method is evaluated in terms of packet delivery ratio (PDR), processing time, end to end delay, throughput, energy consumption, and cost and acquired the value of 97.5 (%), 105.061 (ms), 44.807 (ms), 95.1826 (%), 21.2539 (Kwh), and 0.42402 ($) respectively.

Emergent abdominal wall hernia repair is associated with higher rates of morbidity and mortality compared to elective repair. Patients with significant medical comorbidities, such as morbid obesity, experience higher rates of surgical site complications and hernia recurrence. Experts recommend pre-operative optimization to minimize complication risks; however, few guidelines exist for balancing optimization with the risks of a potential emergent operation. We sought to delineate the outcomes of patients who underwent urgent hernia repair at our center with specific attention to those who attempted pre-operative optimization. We performed a retrospective chart review of all patients who required emergent or urgent abdominal wall hernia repair with the division of Minimally Invasive Surgery, as identified through emergent or urgent case requests submitted at our tertiary academic medical center from 2018 to 2023. We utilized descriptive statistics to characterize patient demographics, hernia characteristics, prior medical history, operative details, and post-operative outcomes. Of the 58 total patients enrolled, we noted multiple operative risk factors including advanced age (62years ± 14.5), high BMI (32.9kg/m2), numerous medical comorbidities, and high rates of incisional hernias. 20 (34%) patients were previously evaluated in our MIS clinic prior to their urgent repair, and 12 (60%) of these patients had surgery deferred for excess weight. Some patients attended multiple clinic visits, but there were no significant trends between the number of prior visits and weight change. 37 (64%) patients did not receive definitive mesh repair. Of these, 20 (54%) cases cited concern for a contaminated field. Of the total group, 16 (33%) patients ultimately developed a recurrent hernia, including 3 patients who underwent a mesh repair and 13 patients who did not receive a mesh repair. The timing of an abdominal wall hernia repair remains challenging, particularly in patients with morbid obesity. For these high-risk patients, recognizing decreasing gains in pre-operative weight optimization is a key for avoiding unproductive delays of definitive repair.

Abstract Introduction/Objective P and Pk are high-incidence antigens expressed on greater than 99.99% of donor RBC. The autosomal-recessive, PP1Pk-negative (p) phenotype is rare and challenging for RBC support. Methods/Case Report A 27-year-old male presented in critical condition after a car collision. In the emergency room, he received 2 units low-titer O+ whole blood and 1 unit O+ packed RBC. The patient typed A+ with a room-temperature, IgM panagglutinin. The patient was phenotyped as PP1Pk-null (p) with an anti-PP1Pk. Post-transfusion, the patient showed evidence of marked hemolysis with anemia and positive DAT. Results NA Conclusion The difficulty in finding rare p units posed a logistical challenge for the patient’s care as the surgery team could not safely operate without units available. To support the patient, several concurrent approaches were employed including: (1) directed donations from family; (2) urgent requests for p RBC through the American Rare Donor Program, (3) increasing endogenous erythropoiesis with iron and erythropoietin; and (4) minimizing iatrogenic blood loss blood via blood gases and pediatric blood tubes. This case demonstrates (1) residual risks with emergency transfusion and (2) complex coordination required between blood bank, hematology and primary care teams to ensure these patients receive necessary care while minimizing risk for hemolysis.

Correctly prioritizing purchasing requests in businesses is critical for business continuity and resource management. Many departments receive purchase requests throughout the day, and the purchasing department subjectively ranks these requests. However, due to the human control of the system, the lag of some urgent requests can hinder the proper execution of business processes. Automating this process would provide significant advantages in businesses, as it is both a subjective decision and a waste of time for personnel. In this study, the first 100 purchase requests entered by integrating three different producer artificial intelligence tools (ChatGPT, Microsoft Copilot, Google Gemini) integrated via API through the ERP purchasing module in a manufacturing enterprise were first classified as “Urgent”, “Normal” and “Not Urgent”, and then as ‘Urgent’ and “Normal”. The data obtained through the i-ERP was compared with the classification made by the purchasing personnel. The obtained metrics (accuracy, Cohen's Kappa, precision, recall, and F1-score) were analyzed. According to the findings, Copilot was more successful than the others in triple and binary classification. While all three models failed to achieve high accuracy in triple classification, successful results were obtained in binary classification. The study reveals that producers of artificial intelligence tools can be used as a decision support system in purchasing processes, especially in pre-classification, labor saving, and speed.

In home healthcare service systems, each healthcare service provider (HSP) is assigned a list of patients to be visited at their homes. We focus on generating a daily patient visit plan that selects the patients to be visited according to their priorities and locations, and determines the route of each HSP. Additionally, we address unexpected urgent patients by solving an optimization problem involving all HSPs cooperating when an urgent patient visit request arises. This problem is formulated with multiple objectives in a lexicographic optimization framework. Two approaches have been implemented: a mixed integer programming model solved within a time limit (TL-MIP) and a Greedy Randomized Adaptive Search Procedure followed by Variable Neighborhood Search (GRASP+VNS). These approaches are compared in a case study that considers serving patients, with several performance metrics analyzed through extensive simulation experiments. The results indicate that the heuristic approach (GRASP+VNS) significantly reduces run times (by approximately 85% on the average overall instances) compared to the TL-MIP approach, while providing solutions that are not far from the TL-MIP approach in terms of the total priority of visited patients, the heuristic deviates at most 2% over different types of instances. Centralized planning with cooperation among two or three service providers reduced the total travel time by 30% and 45%, respectively, and decreased the number of postponed visits by 50% compared to the non-cooperation model.

This study aims to analyze &lt;legislative-policy-precedent&gt; to narrow the &lt;technology development-time difference between legislative policies&gt; for artificial intelligence (AI) technology-based cover songs based on civil law rights capability and criminal courtism legal theory. The “Study on the Modes of Music Copyright by Technological Development,” which focuses on technological change and flexible operation of laws, can be seen as ensuring appropriateness in response to the urgent requests of the times that imitated the wise people who saw through the spirit of the times in the transition period from the Middle Ages to the modern era. Changes in existing precedents act to eliminate “simultaneous multiple risks caused by globalization” that prevent legislative gaps caused by “technology development-time difference between legislative policies”, so we intend to consider how non-human beings are entitled to their rights obligations and qualifications as subjects through various legal theories and national precedents and legislative directions, and suggest alternative measures. Inevitably, contradictions that are difficult to immediately accept, such as whether AI’ s rights and capabilities are recognized, contrary to the existing legal system, are found. In particular, creative acts, ‘author personality rights’, and ‘ creators’, which are ‘factual acts’, are rights arising from the fact that they are ‘natural people’, and most of the related laws are stipulated as mandatory regulations. It aims to protect human creative behavior by presenting alternative views to break down such legal contradictions, while preventing human technological unemployment and protecting existential values by strictly limiting the role of artificial intelligence (AI) as an auxiliary means. Through this, I would like to examine through various legal theories how non- human beings are entitled to their rights obligations and qualifications as subjects.

The article is devoted to the analysis of the present-day digital translation practice from the perspective of the human translator’s goal setting and theory of translation action. Translation dates back to the dawn of human civilization, when there emerged an urgent request for communication between different ethnic groups. Translation has always addressed the most pressing issues of societies around the world. The primary role of translation depends to a large extent on the tasks performed by States at different levels of communication from official to everyday life. At the present stage, the practice of applying digital translation is due to the increase of information flows, the speed of information exchange and messages transmission between representatives of different languages and cultures, which indicates the relevance of the ongoing research. The purpose of this paper is to identify the characteristic features of digital translation at the present stage, studied on the material of texts of sociopolitical discourse filled with neologisms, metaphors, abbreviations, culturally marked lexis and actualized linguistic units of particular importance for the life of the English-speaking society. The scientific novelty of the research consists in the analysis of the improved digital translation at the present stage from the perspective of the psycholinguistic theory of the activity approach and the scopos theory of translation action. The main methods used in the research include translation, description as well as contextual, linguo-stylistic and pragmatic analyses. The purpose of this paper is to demonstrate the features of digital translation algorithms enabling exact rendering of the transferred information from the source language to the target one. The research material consists of English-language sociopolitical texts published in media outlets, with a focus on the challenges of translating neologisms, metaphors and abbreviations acute for the contemporary English speaking society. As a result of the study, it has been concluded that the algorithm of digital translation from the English language is constantly improving, offering the user alternative translation variants, which are determined depending on the translator’s intentions and goals in terms of semantic, stylistic and pragmatic correspondence between the source and target texts.

Abstract—The Blood Donation and Life Saver Application is a digital solution designed to address the ongoing challenges associated with blood donation and emergency blood requirements. Despite the critical importance of blood in healthcare, many regions continue to face shortages due to lack of coordination, delayed communication, and limited public awareness. This application serves as a centralized platform that connects voluntary blood donors, recipients, hospitals, and blood banks in real-time.The primary objective of the application is to streamline the blood donation process by enabling users to register as donors, receive alerts about nearby blood requests, locate the nearest blood banks, and track their donation history. In emergency scenarios, the app allows patients or their families to issue urgent requests that are instantly shared with potential donors based on blood type and geographic proximity. KeyWords—Blood Donation,Life Saver Application,Patient Support,Donor Management,Real-time Alerts,Blood Availability Tracking.

The National Network of STD Prevention Training Centers launched a 24 hours/7 days a week hotline pilot for consultations on syphilis during pregnancy and congenital syphilis. Most of the 28 urgent requests were from physicians (61%) in hospitals (54%), involving patients in their third trimester or recently born infants (82%).

Diagnostic performance of assays for urgent MPO, PR3 and GBM autoantibodies in suspected vasculitis

The current research aims to analyze the reality of supply chain strategies in the Oil Products Distribution Company / Middle Euphrates Distribution Authority -Babylon Branch, which is necessary to pay attention to in order to eliminate waste and achieve efficiency in the use of resources and implement customer requirements at the agreed times.Through the researcher's survey, it became clear that there is a problem represented by the small number of tankers transporting oil products, and the small storage capacity of the intermediate warehouse tanks, in addition to the fact that there is a weakness in the awareness of the respondents about the adoption of any supply chain strategy by the company under study.To achieve the research objective, a main hypothesis was formulated, and the researcher relied on the examination form as a main tool for collecting data.A purposeful sample was chosen consisting of department and division managers who have experience and knowledge in answering the paragraphs of the form.The research sought to answer questions including (Does the management of the company under study adopt one or all of the supply chain strategies when practicing its activities?)The research reached a set of conclusions, the most important of which are: The results of the analysis of the examination form showed that the answers of the respondents took the largest percentage towards Paragraphs of the hybrid supply chain strategy, which indicates that the management of the company under study adopts this strategy.In light of these conclusions, the researcher presented a set of proposals, the most important of which are: the possibility of employing workers (government drivers) through additional working hours on holidays and occasions to implement urgent requests and handle transportation cases at peak times to increase the number of shipments

Medication distribution units offer one of the most sensitive services that determine the rate of quality service for patients’ satisfaction in hospitals. In solving the issues of inefficient hospital medication distribution processes, a Hierarchical Timed Coloured Petri Nets (HTCPN) formalism was employed in this paper to model a decentralized hospital medication distribution process using Bowen University Teaching Hospital, Ogbomoso, Oyo State, Nigeria as a case study. The developed HTCPN model is made up of seven (7) modules conceptualizing medication distribution processes taking place in Children’s ward, Men’s ward, Women’s ward, Private ward, Neonatal ward, Intensive care unit and Pharmacy. These modules modelled the prescription, checking and billing, transportation and administration of medications to the patients via urgent, daily and medicine cabinet requests. The developed HTCPN model can be easily modified through it associated modules to suit any future modification in the considered process or other related ones.

Objectives:In Thailand, family physicians play a central role in palliative care, which often includes the withdrawal of mechanical ventilation (WMV) as part of life-sustaining treatment cessation. However, the rationale behind these decisions varies significantly among practitioners. This study examines key factors that influence Thai family physicians’ decisions to discontinue mechanical ventilation for terminally ill patients.Materials and Methods:We conducted an online survey from December 2021 to January 2022, employing a customised questionnaire. Its content validity and reliability were affirmed, achieving Cronbach’s alpha scores of 0.81 and 0.88 in separate sections.Results:Among 164 respondents, 123 (75%) had previously participated in WMV decisions. Key influencing factors included the involvement of family or surrogate decision-makers (SDMs), physicians’ experience with end-of-life care and patients’ explicit opposition to ventilator support. Urgent requests from families or SDMs and the imminence of patient mortality were also pivotal. A consensus on the ethical appropriateness of WMV was observed. Notably, physicians with over 3 years of experience in palliative care were significantly more likely to discontinue ventilation (odds ratio [OR] = 5.30; P = 0.001), a likelihood further increased by formal training in this area (OR = 8.97; P < 0.001).Conclusion:The decisions of Thai family physicians to cease mechanical ventilation in terminally ill patients are strongly influenced by family or SDMs’ input, their own experiential background and the expressed wishes of the patients regarding ventilator assistance.

Cases of influenza are continuing to rise in the UK with pharmacies reporting a “big surge” in people asking about vaccinations, while online pharmacy chain Pharmacy2U has warned that repeat prescription requests could hit a record high in December 2025. According to the latest UK Health Security Agency (UKHSA) data, updated on 11 December 2025, […]

Emergency engineering equipment plays a key role in implementing emergency repair strategies to ensure timely and efficient maintenance of vehicles. However, random failures of this equipment may occur during operation, necessitating the development of adequate maintenance strategies and spare parts inventory management to ensure its continuous operation. Moreover, the urgency level of repair requests can vary significantly, affecting the order in which they are serviced. Existing studies rarely consider the impact of urgency levels and request priorities on the repair process. To address these gaps, this paper proposes a joint optimization model of maintenance and spare parts inventory strategies for emergency engineering equipment used in vehicle repair, taking into account request priorities. The model includes two types of equipment with different repair speeds: one provides expedited service for urgent requests, while the other handles regular service. The Markov process embedding method is employed to derive probabilistic reliability indicators of the system. To maximize system availability, the number of maintenance engineers and the spare parts inventory strategy are optimized using the branch-and-bound method. Practical examples demonstrate the effectiveness of the proposed model and methods in vehicle repair scenarios.

Humans live in an interconnected world that is increasingly featured with virtual interactions in cyberspace. That world has raised cybersecurity concerns, particularly regarding the exploitation of human trust through various means, such as phishing. Phishing remains one of the most prevalent forms of cybercrime. It exploits human trust to manipulate individuals into divulging sensitive information. This study investigates the trust development mechanisms most exploited by cybercriminals in phishing attacks. It focuses on two primary trust development processes: relationship history and future expectations. The study uses qualitative content analysis of 42 phishing messages collected from diverse secondary sources. The findings reveal that future expectations—such as promises of rewards, urgent requests, or threats of penalties—dominate phishing tactics. In contrast, relationship history mechanisms exploit existing or fabricated relationships to evoke trust and compliance. These findings provide critical insights into the psychological manipulations leveraged in phishing schemes and highlight the need to integrate behavioural and cognitive principles into cybersecurity education. Practical implications include tailored training programs for distinct user groups, such as seniors, employees, and students. The training should emphasise recognising urgency cues, emotional manipulation, and verification strategies.

Background. The search for new means that would effectively influence the pathological consequences of muscle immobilization is an urgent priority request of modern biomedicine. Previously, the positive effect of water-soluble C60 fullerenes, as strong antioxidants, was established on the background of muscle ischemia, mechanical muscle injury, and other muscle dysfunctions. These carbon nanoparticles have been shown to reliably protect muscle tissue from damage caused by oxidative stress. Materials and Methods. The biomechanical parameters of muscle soleus contraction of rats were studied by simulating non-functioning hind limbs using a clinical model – a rupture of the Achilles tendon (achillotomy). Muscle contraction parameters, namely the maximum contraction force and muscle force impulse, were determined on the 15th, 30th, and 45th days after initiation of atrophy using tensometry. As a therapeutic nanoagent, daily oral administration of C60 fullerene aqueous solution at a dose of 1 mg/kg was used throughout the experiment. Results. Previous registration of muscle soleus contraction force when applying 1 Hz stimulation lasting 1800 s with three pools revealed a decrease in maximal force responses after 15, 30, and 45 days of atrophy. The 45th day after atrophy is considered to be the limit for the fastest recovery of the muscle after immobilization, the further process takes place over several months. In all the tests performed, the therapeutic admini­stration of water-soluble C60 fullerenes (dose 1 mg/kg) an increase in biomechanical parameters was recorded (maximum force of contraction – the change in the form of the “stimulation – force contraction” dependence is a consequence of the development of the pathological process in muscle and the muscle force impulse, which allows assessing the performance of the muscular system after a long-term immobilization), by approximately 29–49±2 % for the maximum contraction force and by 21–37±2 % for the muscle force impulse compared to the atrophy group for 15, 30 and 45 days. Conclusions. The obtained results indicate the prospects of using water-soluble C60 fullerenes, which can alleviate pathological conditions in the muscular system that arise from skeletal muscle atrophy due to immobilization.