Search Results (98)

Exacerbations of Chronic Obstructive Pulmonary Disease (COPD) have a substantial effect on overall disease management, health system costs, and patient outcomes. However, exacerbations are often underdiagnosed or recognized with great delay due to several factors such as patients’ inability to differentiate between acute episodes and symptom fluctuations, delays in seeking medical assistance, and disparities in dyspnea perception. Self-management intervention plans, telehealth and smartphone-based programs provide educational material, counseling, virtual hospitals and telerehabilitation, and help COPD patients to identify exacerbations early. Moreover, biomarkers such as blood eosinophil count, fibrinogen, CRP, Serum amyloid A(SAA),together with imaging parameters such as the pulmonary artery-to-aorta diameter ratio, have emerged as potential predictors of exacerbations, yet their clinical utility is limited by variability and lack of specificity. In this review, we provide information regarding the importance of the early identification of exacerbation events in COPD patients and the available methods which can be used for this purpose. Full article

Objectives: To summarize the impact of various telerehabilitation interventions on motor function, balance, gait, activities of daily living (ADLs), and quality of life (QoL) among patients with stroke and to determine the existing telerehabilitation interventions for delivering physiotherapy sessions in clinical practice. Methods: Six electronic databases were searched to identify relevant quantitative systematic reviews (SRs). Due to substantial heterogeneity, the data were analysed narratively. Results: A total of 28 systematic reviews (n = 245 primary studies) were included that examined various telerehabilitation interventions after stroke. Motor function was the most studied outcome domain across the reviews (20 SRs), followed by ADL (18 SRs), and balance (14 SRs) domains. For primary outcomes, our findings highlight moderate- to high-quality evidence showing either a significant effect or no significant difference between telerehabilitation and other interventions. There was insufficient evidence to draw a conclusion regarding feasibility outcomes, including participant satisfaction, adherence to treatment, and cost. Most reviews under this umbrella included patients with stroke in the subacute or chronic phase (12 SRs). Simple and complex telerehabilitation interventions such as telephone calls, videoconferencing, smartphone- or tablet-based mobile health applications, messaging, virtual reality, robot-assisted devices, and 3D animation videos, either alone or in combination with other interventions, were included across reviews. Conclusions: Various telerehabilitation interventions have shown either a significant effect or no significant difference compared to other interventions in improving upper and lower limb motor function, balance, gait, ADLs, and QoL, regardless of whether simple or complex approaches were used. Further research is needed to support the delivery of rehabilitation services through telerehabilitation intervention following a stroke. Full article

An organization’s success depends on its ability to attract and retain skilled personnel. Superintendents play a critical role in overseeing project sites in the construction industry and can adapt to the increasingly complicated requirements of modern construction projects. This study examines traditional and modern personnel selection methods to determine effective tactics, essential competencies, and emerging trends regarding supervisory personnel. The research methodology follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. First, this study examines traditional and modern selection methods used by organizations and engineering firms to provide a comprehensive overview of the topic and assist in selecting appropriate staff recruitment procedures. Second, the Web of Science, Scopus, and Google Scholar databases were reviewed to identify superintendent selection approaches and competencies, over the period January 2000 to September 2024. A total of 22 relevant papers were analyzed. Superintendent selection processes included questionnaires (57%), interviews (26%), literature reviews (14%), and data-driven AI tools (3%). Forty competency criteria were identified, with the top five being knowledge, communication skills, leadership, health and safety expertise, and commitment. As a result, novel approaches employing Industry 4.0 technologies, including virtual reality (VR), wearable sensing devices (WSDs), natural language processing (NLP), blockchain, and computer vision, are recommended. These findings support a better understanding of how best to identify the most qualified supervisory personnel and provides enhanced methods for evaluating job applicants. Full article

Artificial intelligence (AI) is an area of computer science that focuses on designing machines or systems that can perform operations that would typically need human intelligence. AI is a rapidly developing technology that has grabbed the interest of researchers from all across the globe in the healthcare industry. Advancements in machine learning and data analysis have revolutionized oral health diagnosis, treatment, and management, making it a transformative force in healthcare, particularly in dentistry. Particularly in dentistry, AI is becoming increasingly prevalent as it contributes to the diagnosis of oro-facial diseases, offers treatment modalities, and manages practice in the dental operatory. All dental disciplines, including oral medicine, operative dentistry, pediatric dentistry, periodontology, orthodontics, oral and maxillofacial surgery, prosthodontics, and forensic odontology, have adopted AI. The majority of AI applications in dentistry are for diagnoses based on radiographic or optical images, while other tasks are less applicable due to constraints such as data availability, uniformity, and computational power. Evidence-based dentistry is considered the gold standard for decision making by dental professionals, while AI machine learning models learn from human expertise. Dentistry AI and technology systems can provide numerous benefits, such as improved diagnosis accuracy and increased administrative task efficiency. Dental practices are already implementing various AI applications, such as imaging and diagnosis, treatment planning, robotics and automation, augmented and virtual reality, data analysis and predictive analytics, and administrative support. The dentistry field has extensively used artificial intelligence to assist less-skilled practitioners in reaching a more precise diagnosis. These AI models effectively recognize and classify patients with various oro-facial problems into different risk categories, both individually and on a group basis. The objective of this descriptive review is to review the most recent developments of AI in the field of dentistry. Full article

Introduction: Individuals experiencing homelessness have higher rates of chronic disease and face challenges accessing primary care. Virtual health care can reduce health inequity but needs user acceptance. A virtual health hub (VHH) for people experiencing homelessness in Sydney provided virtual GP and psychologist care within a crisis accommodation service. This included nursing assistance. Method: The VHH evaluation assessed the feasibility of the service specifically examining accessibility, efficiency, costs, technology, quality, and outcomes through attendance data, patient measures, stakeholder interviews, and case studies. Findings: Data indicated 40% client utilisation with high attendance for GPs and/or psychologists. All clients reported a high quality of care, appointment benefits, understanding clinicians, and treatment help, and that privacy was maintained. If the VHH was not available, one-third would not have sought treatment. The majority agreed that virtual care was the same or better than in-person care. Only a few experienced technical issues. Service provider interviews indicated the benefits of accessible and affordable care, perceived reduced hospital presentations, staff time saved, and reduced client costs. Limitations were the lack of physical examinations and lack of follow-up due to temporary accommodation. Strong stakeholder partnerships enabled implementation success. Conclusions: The VHH service is feasible and replicable with on-site assistance and stakeholder commitment. Full article

The dietary guidelines of Slovenia, ‘12 Steps to Healthy Eating’, were first published in 2000 and revised in 2011. The ‘Food Guide Pyramid’ was initially published in 2000 and subsequently revised in 2015. ‘The Healthy Plate’ was first introduced in 2007. In February 2023, the Slovenian Strategic Council for Nutrition proposed new Food-Based Dietary Guidelines (FBDGs) that integrate both health and environmental considerations. In September 2023, the creation of new FBDGs was included in the Action Plan for implementing the Resolution on the National Program on Nutrition and Physical Activity for Health 2015–2025. In October 2023, the Ministry of Health of Slovenia appointed the core working group of 10 multidisciplinary experts from fields such as nutrition, food science medicine, public health, environment, pharmacy, and agriculture led by Prof. Dr. Nataša Fidler Mis, who drafted the guidelines. In February 2024, the World Health Organization Regional Office for Europe organized a virtual international workshop to assist Slovenia in developing food-based dietary guidelines. In May 2024, an international expert meeting was organized by the Ministry of Health of Slovenia, the Ministry of the Environment, Climate, and Energy, and the National Institute of Public Health of Slovenia to present the first scientific draft of the SLO FBDG for external international peer review. The meeting included lectures from world-leading experts to present healthy diets from sustainable food systems, integrate climate and sustainability aspects into the new SLO FBDG, discuss the findings with the Slovenian core working group, extended working group of the SLO FBDG, and invited experts. The final version of SLO FBDG is expected to be released by the end of 2024. Full article

Conventional patient monitoring methods require skin-to-skin contact, continuous observation, and long working shifts, causing physical and mental stress for medical professionals. Remote patient monitoring (RPM) assists healthcare workers in monitoring patients distantly using various wearable sensors, reducing stress and infection risk. RPM can be enabled by using the Digital Twins (DTs)-based Internet of Robotic Things (IoRT) that merges robotics with the Internet of Things (IoT) and creates a virtual twin (VT) that acquires sensor data from the physical twin (PT) during operation to reflect its behavior. However, manual navigation of PT causes cognitive fatigue for the operator, affecting trust dynamics, satisfaction, and task performance. Also, operating manual systems requires proper training and long-term experience. This research implements autonomous control in the DTs-based IoRT to remotely monitor patients with chronic or contagious diseases. This work extends our previous paper that required the user to manually operate the PT using its VT to collect patient data for medical inspection. The proposed decision-making algorithm enables the PT to autonomously navigate towards the patient’s room, collect and transmit health data, and return to the base station while avoiding various obstacles. Rather than manually navigating, the medical personnel direct the PT to a specific target position using the Menu buttons. The medical staff can monitor the PT and the received sensor information in the pre-built virtual environment (VE). Based on the operator’s preference, manual control of the PT is also achievable. The experimental outcomes and comparative analysis verify the efficiency of the proposed system. Full article

Start Strong, a 4-week culinary nutrition education and obesity prevention program designed for rural family care providers in low-income areas of Minnesota, was initially an in-person training program and was recently adapted into a virtual version. Using a quasi-experimental design, this study examined within-group and between-group (in-person versus virtual) changes in culinary skill confidence and familiarity with food assistance programs after Start Strong participation. Additionally, we examined post-program participant experiences. The in-person program (n = 12, mean age of 45 years, September 2019) took place at community locations. The virtual program (n = 27, mean age of 41 years, Fall 2021–Winter 2022) used online learning and videoconferencing. Following data collection pre- and post-program, we used t-tests to examine within-group changes after Start Strong participation, repeated measures analysis of variance tests to compare outcomes between the in-person and virtual implementations, and Fisher’s exact test to compare post-survey outcomes. The in-person and virtual programs demonstrated similar improvements in cooking skill confidence and familiarity with food assistance programs. Compared to the virtual program, in-person participants reported significantly greater connection with other providers. This evaluation is relevant to addressing disparities in obesity prevention and provides an initial model for public health and community partnerships with ECE providers. Full article

Background: Virtual surgical planning has become a well-established practice in head and neck surgery. In oncological surgery, it permits the achievement of safe margins resections and ensures functional reconstructions and optimal esthetic outcomes. This study aimed to evaluate the long-term outcomes after virtually planned mandibular microvascular reconstruction, focusing on functional and esthetic results, as well as health-related quality of life. Methods: A long-term retrospective evaluation of 17 patients with oral cavity malignancy who underwent computer-assisted mandibular resection and reconstruction was performed. Functional and esthetic outcomes were analyzed using the EORTC, QLQ-C30, H&N35, and FACE-Q questionnaires. Results: Time since reconstruction ranged from 7 to 14 years. Patients reported high functional levels on the QLQ-C30 functional scales but lower scores on H&N35. On FACE-Q, patients demonstrated higher appraisal and satisfaction with their smiles compared to their overall facial appearance. Conclusions: In this retrospective case series, patients undergoing computer-assisted mandibular reconstruction for oral malignancies achieved good long-term functional and esthetic outcomes. Although limited by the small sample size, these results support the enduring benefits of virtual planning for mandibular reconstruction. To minimize declines in function and appearance, considerations should include immediate dental implants, enhanced reconstruction of the temporomandibular joint, newer methods of radiotherapy to minimize xerostomia, and oral exercises to prevent trismus. Full article

Social media platforms and online gaming sites play a pervasive role in facilitating peer interaction and social development for adolescents, but they also pose potential threats to health and safety. It is crucial to tackle cyberbullying issues within these platforms to ensure the healthy social development of adolescents. Cyberbullying has been linked to adverse mental health outcomes among adolescents, including anxiety, depression, academic underperformance, and an increased risk of suicide. While cyberbullying is a concern for all adolescents, those with disabilities are particularly susceptible and face a higher risk of being targets of cyberbullying. Our research addresses these challenges by introducing a personalized online virtual companion guided by artificial intelligence (AI). The web-based virtual companion’s interactions aim to assist adolescents in detecting cyberbullying. More specifically, an adolescent with ASD watches a cyberbullying scenario in a virtual environment, and the AI virtual companion then asks the adolescent if he/she detected cyberbullying. To inform the virtual companion in real time to know if the adolescent has learned about detecting cyberbullying, we have implemented fast and lightweight cyberbullying detection models employing the T5-small and MobileBERT networks. Our experimental results show that we obtain comparable results to the state-of-the-art methods despite having a compact architecture. Full article

Recognizing the growing interests and benefits of technology-assisted interactive telerehabilitation in various populations, the aim of this review is to systematically review the effects of interactive telerehabilitation with remote monitoring and guidance for improving balance and gait performance in older adults and individuals with neurological conditions. The study protocol for this systematic review was registered with the international prospective register of systematic reviews (PROSPERO) with the unique identifier CRD42024509646. Studies written in English published from January 2014 to February 2024 in Web of Science, Pubmed, Scopus, and Google Scholar were examined. Of the 247 identified, 17 were selected after initial and eligibility screening, and their methodological quality was assessed with the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. All 17 studies demonstrated balance and gait performance improvement in older adults and in individuals with stroke, Parkinson’s disease, and multiple sclerosis following 4 or more weeks of interactive telerehabilitation via virtual reality, smartphone or tablet apps, or videoconferencing. The findings of this systematic review can inform the future design and implementation of interactive telerehabilitation technology and improve balance and gait training exercise regimens for older adults and individuals with neurological conditions. Full article

Speech intelligibility is a concern for public health, especially in non-ideal listening conditions where listeners often listen to the target speech in the presence of background noise. With advances in technology, synthetic speech has been increasingly used in lieu of actual human voices in human–machine interfaces, such as public announcement systems, answering machines, virtual personal assistants, and GPS, to interact with users. However, previous studies showed that speech generated by computer speech synthesizers was often intrinsically less natural and intelligible than natural speech produced by human speakers. In terms of noise, listening to synthetic speech is challenging for listeners with normal hearing (NH), not to mention for hearing-impaired (HI) listeners. Recent developments in speech synthesis have significantly improved the naturalness of synthetic speech. In this study, the intelligibility of speech generated by commercial synthesizers from Google, Amazon, and Microsoft was evaluated by both NH and HI listeners in different noise conditions. Compared to a natural female voice as the baseline, listeners’ listening performance suggested that some of the synthetic speech was significantly more intelligible even at rather adverse listening conditions for the NH cohort. Further acoustical analyses revealed that elongated vowel sounds and reduced spectral tilt were primarily responsible for improved intelligibility for NH, but not for HI due to their impairment at high frequencies and possible cognitive decline associated with aging. Full article

Extended reality (XR) devices, including virtual and augmented reality head-mounted displays (HMDs), are increasingly utilised within healthcare to provide clinical interventions and education. Currently, XR devices are utilised to assist in reducing pain and improving psychological outcomes for immunocompromised patients in intensive care units, palliative care environments and surgical theatres. However, there is a paucity of research on the risks of infection from such devices in healthcare settings. Identify existing literature providing insights into the infection control risk XR HMDs pose within healthcare facilities and the efficacy of current infection control and cleaning procedures. Three databases (PubMed, Embase and CINAHL) in addition to Google Scholar were systematically searched. A total of seven studies were identified for this review. Microorganisms, including pathogenic bacteria (e.g., Staphylococcus aureus and Pseudomonas aeruginosa), were found to be present on XR HMDs. Published cleaning and infection control protocols designed to disinfect XR HMDs and protect users were heterogeneous in nature. Current cleaning protocols displayed varying levels of efficacy with microbial load affected by multiple factors, including time in use, number of users and XR HMD design features. In healthcare settings, fitting XR HMDs harbouring microorganisms near biological and mucosal entry points presents an infection control risk. An urgent revision of the Spaulding classification is required to ensure flexibility that allows for these devices to be reclassified from ‘Non-critical’ to ‘Semi-Critical’ depending on the healthcare setting and patient population (surgery, immunocompromised, burns, etc.). This review identified evidence supporting the presence of microorganisms on XR HMDs. Due to the potential for HMDs to contact mucosal entry points, devices must be re-considered within the Spaulding classification as ‘Semi-critical’. The existence of microbial contaminated XR HMDs in high-risk medical settings such as operating wards, intensive care units, emergency departments, labour and delivery wards and clinical areas with immunosuppressed patients requires urgent attention. Public health authorities have a duty of care to develop revised guidelines or new recommendations to ensure efficient sanitation of such devices. Full article

The Metaverse and Natural Language Processing (NLP) technologies have combined to fundamentally change the nature of digital sociability. Our understanding of social interaction needs to be reevaluated as the Metaverse’s influence spreads into more areas of daily life, such as AI-driven gaming, interactive training companions, museum exhibits, personalized fitness coaching, virtual mental health assistance, language translation services, virtual tour guiding, and virtual conferencing. This study analyzes how NLP is changing social relationships in these Metaverse applications. We examine how NLP algorithms influence societal norms, individual behaviors, interpersonal connections, and improve the user experience using a multi-method approach incorporating user surveys and sentiment analysis. Our study’s findings show how NLP can enhance interactive experiences while also pointing out related issues like potential bias and moral problems. Our study provides a foundational analysis, shedding light on the challenges of negotiating a social environment in the Metaverse that is molded by cutting-edge NLP. It offers stakeholders in academia and public policy essential assistance that helps them understand and manage the complex ramifications of this changing socio-technological paradigm. Full article

Introduction: Virtually all adults in aged care facilities are frail, a condition which contributes to falls, cognitive decline, hospitalisation, and mortality. Polypharmacy, malnutrition, sedentariness, and sarcopenia are risk factors amenable to intervention. The Asia–Pacific Frailty Management Guidelines recommend anabolic exercise and the optimisation of medications and nutrition. However, no study has evaluated this best practice intervention triad in aged care. Methods: The Frailty Reduction via the Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial (ANZCTR No.ACTRN12622000926730p) is a staged 6-month translational trial evaluating resident outcomes, staff/caregiver knowledge, and institutional implementation in a Townsville aged care facility. Residents received high-intensity resistance exercise and balance training and medication and nutrition optimisation co-implemented by investigators (exercise physiologist, geriatrician, pharmacist, and nutritionist) and facility staff. Staff and caregivers completed comprehensive education modules and training. We report the trial protocol and recruitment results. Results: 29 residents (21 female, age: 88.6 ± 6.3 years) were recruited. At baseline, the residents were frail (frailty scale nursing home (FRAIL-NH); 6.3 ± 2.4/14), cognitively impaired (Montreal Cognitive Assessment; 13.8 ± 6.8/30), functionally impaired (Short Physical Performance Battery; 4.9 ± 3.1/12, 6 min walk distance; 222.2 ± 104.4 m), and were prescribed numerous medications (15.5 ± 5.9). Two residents died and one withdrew before the intervention’s commencement. Thirty family members and 19 staff (carers, allied health assistants, nurse managers, registered nurses, lifestyle–leisure officers, kitchen/hospitality staff, and senior leadership) were recruited to receive frailty education modules. Conclusions: The FRIEND trial is currently being implemented with results expected in mid-2024. This is the first trial to evaluate the implementation of the best practice frailty guidelines including anabolic exercise and medication/nutritional optimisation in residential aged care. Full article