Introduction Digital transformation (DT) is reshaping dental care and clinic management by influencing clinical processes, supplier relationships, and internal organization. However, empirical assessments of DT adoption patterns in this sector remain limited. This study examines DT in dental care by developing a typology of dental clinics based on observed digitalization patterns and exploring the implications for healthcare management. Methods Based on a sample of 536 dental clinics in Spain, a two-stage cluster analysis (hierarchical followed by K-means) was conducted using 15 DT indicators that covered administrative, clinical, and communication technologies. Exploratory factor analysis was also employed to construct a synthetic index of DT to characterize the resulting clusters. Results The analysis identifies five distinct categories of dental clinics: Traditional, Low-digital, Emerging Digital, Progressive Digital, and Digitally Transformed. The findings reveal a highly polarized sector: over half of Spanish clinics (51%) lag significantly behind, grouped into Traditional (25%) and Low-digital (26%) clusters, thereby signaling major barriers to adoption. Conversely, advanced clusters display divergent modernization strategies: Progressive Digital clinics (12%) prioritize specialized dental technology, whereas Digitally Transformed clinics (16%) place greater emphasis on core ICT infrastructure. Conclusion The proposed typology provides valuable insights into the heterogeneous patterns of digitalization among dental clinics in Spain. These insights can help healthcare managers navigate strategic technology choices and contribute to a better empirical understanding of DT in healthcare management.
Introduction This study aimed to evaluate the spread of Mpox (monkeypox) during the 2022 outbreak in six countries across the Americas—Brazil, Chile, Colombia, Mexico, Peru, and the USA, using a simplified and accessible retrospective approach based on Microsoft Excel and non-expert analytical tools. Methods Weekly confirmed Mpox case data were obtained from the Our World in Data repository between May and September 2022. For each country, Microsoft Excel was used to apply three trendline models, linear, quadratic, and exponential, to visualize and statistically assess case progression. Model fit and performance were rigorously evaluated using a comprehensive suite of evaluation metrics, including the coefficient of determination ( R 2 ), Mean Squared Error (MSE), Chi-square goodness-of-fit, and p -values. Results Across the selected observation windows, the quadratic trendline provided the best in-sample fit among the three candidate functional forms in most countries in terms of R 2 values. For instance, in Mexico, the quadratic model achieved an R 2 of 0.987 compared to 0.882 (linear) and 0.888 (exponential). Similar trends were observed in the USA (R 2 = 0.986 for quadratic vs. 0.852 linear, and 0.813), Brazil (0.978 vs. 0.816 vs. 0.752), and Colombia (0.947 vs. 0.795 vs. 0.725). The chi-squared and Mean Squared Error (MSE) values supported these findings, with the quadratic model yielding lower errors and greater statistical significance in most cases (p < 0.001). Conclusions Across the selected observation windows, the quadratic trendline provided the best in-sample fit among the three candidate functional forms in most countries. These retrospective comparisons of descriptive curve fit findings provide practical value of the approach, in its accessibility and transparency for rapid trend characterization, though, is not a substitution for formally evaluated epidemic forecasting frameworks.
Introduction Gastrointestinal cancers (GICs) impose substantial health loss in low- and middle-income countries (LMICs). We examined long-term burden patterns and temporal changes from 1990 to 2023. Methods This ecological secondary analysis used Global Burden of Disease 2023 estimates of disability-adjusted life years (DALYs) and age-standardised DALY rates (ASDRs) for six GIC types in 130 LMICs from 1990 to 2023. Joinpoint regression described temporal trends, and decomposition analysis separated population growth, population aging, and changes in age-specific DALY rates. Results From 1990 to 2023, total GIC-related DALYs increased from 34.72 to 43.16 million in upper-middle-income countries (UMCs), from 7.20 to 19.76 million in lower-middle-income countries (LMCs), and from 1.88 to 4.69 million in low-income countries (LCs). In UMCs, ASDRs for all GICs except pancreatic cancer declined, especially for esophageal and stomach cancers. In LMCs and LCs, ASDRs for stomach and liver cancers declined, whereas the other four subtypes increased. The shares of global DALYs occurring in UMCs increased for colorectal and pancreatic cancers but decreased for stomach and liver cancers. In contrast, DALYs rose for all six subtypes in LMCs and LCs. Decomposition analysis indicated that population growth and aging were important demographic contributors to the increase in DALYs, whereas the epidemiological changes was negative in UMCs and counterbalanced part of the demographic contribution. Conclusion The overall DALY burden of GICs increased across LMICs, whereas ASDR trends were heterogeneous across cancer subtypes. These findings support country- and cancer-specific prevention and care priorities.
Introduction Malnutrition is common among children awaiting liver transplantation and may compromise perioperative outcomes. This study aimed to determine the prevalence of preoperative malnutrition and identify associated factors among pediatric liver transplant candidates. Methods A cross-sectional study with prospective data collection was conducted among 300 children admitted to the liver transplantation center of a tertiary hospital, from January 2023 to June 2025. Demographic and clinical data were collected. Nutritional status before transplantation was assessed using the standard deviation score method based on Chinese growth standards for children younger than 7 years. Univariate analyses and multivariable logistic regression were performed to identify factors associated with malnutrition. Results The prevalence of preoperative malnutrition was 63.3%. Moderate and severe malnutrition each accounted for 31.7% of the cohort. Multivariable logistic regression showed that history of Kasai portoenterostomy, history of allergy, lower birth weight, and caregiver unemployment were independently associated with preoperative malnutrition. Children with a history of allergy had the highest odds of malnutrition, with an odds ratio of 13.015 and a 95% confidence interval of 5.364 to 31.580. Conclusions Preoperative malnutrition was highly prevalent among pediatric liver transplant candidates. Children with a history of Kasai portoenterostomy, allergy, lower birth weight, or an unemployed primary caregiver may require prioritized nutritional screening, risk stratification, and early targeted intervention before transplantation.
Introduction Postpartum family planning (PPFP) use remains low in sub-Saharan Africa, particularly in Ethiopia. Low PPFP uptake is partly due to its limited integration with maternal health services. Understanding the barriers to PPFP service integration at health facilities and strengthening engagement with service providers, postpartum women, male partners, and community stakeholders could improve PPFP integration with maternal health services. This study explored health-system and contextual barriers to integrating postpartum family planning into maternal health services in northeast Ethiopia. Methods A descriptive qualitative study was conducted from March to April 2023 in northeast Ethiopia. Data were collected from 33 participants through key informant interviews (healthcare providers and facility managers/coordinators) and focus group discussions (postpartum women, male partners, community leaders, and religious leaders). Participants were selected using heterogeneous purposive sampling to capture diverse perspectives. Semi-structured, pretested interview and discussion guides were used until data saturation was reached. Audio recordings were transcribed in Amharic, translated into English, coded, and analyzed inductively using conventional content analysis with ATLAS.ti 7 software. Results Six major categories were identified. The barriers included PPFP service-delivery barriers, poor client-centered PPFP counseling, knowledge, attitudes, and concerns about contraceptive methods, male-partner influence on family planning decisions, security problems and disruptions to reproductive health services, and community, religious, and peer support challenges for family planning services. Conclusion The study highlights the need for strengthened counselling, supply chain resilience, and conflict-sensitive programming. Health facility-focused integrated interventions and community-based information, education, and communication are needed to improve postpartum family planning integration with maternal health services.
