Introduction Population aging and age-related skeletal deterioration have made low bone mineral density (BMD) and fragility fractures major public health challenges among postmenopausal women. This study evaluates the 1994-2035 trends of low BMD-related burden among postmenopausal women in China and G20 countries. Methods In this population-based ecological study, we used GBD 2023 estimates to analyze deaths, disability-adjusted life years, years lived with disability, and years of life lost attributable to low bone mineral density among women aged 55 years and older in China and G20 countries from 1994 to 2023, with projections to 2035. Joinpoint regression, decomposition analysis, Age-Period-Cohort (APC), and Bayesian APC models were employed to assess historical drivers and project future trends. Results From 1994 to 2023, absolute low BMD burdens surged, primarily driven by population aging and growth. A “rate drops, volume surges” paradox emerged in China: age-standardized mortality decreased (AAPC=-0.60), while standardized YLDs significantly increased (AAPC=0.63). The APC model revealed exponential risk increases with biological age. BAPC projections indicate a steep, continuous escalation in absolute DALYs and YLDs through 2035. Conclusion Low BMD-related health loss among postmenopausal women is characterized by declining mortality but rising disability, indicating a shift from acute fatal outcomes to prolonged chronic functional loss. These findings highlight the need for early diagnosis, fracture liaison services, and integrated management strategies in aging populations.
Introduction Creator-side analytics can characterize viewing behavior around surgical videos but cannot establish learning or educational quality. We compared advanced procedural and patient-facing videos from one orthopedic YouTube channel. Methods We performed a retrospective cross-sectional analysis of cumulative video-level YouTube Studio metrics extracted on February 5, 2026, for videos published from June 2018 through February 4, 2026. One author classified videos using predefined title and metadata criteria. Co-primary outcomes were average view duration and video-attributed net subscriber change per 1,000 engaged views. Mann–Whitney U tests and rank-biserial correlations were used. Results Among 262 included videos (175 advanced procedural; 87 patient-facing), advanced procedural videos were longer (median, 357 vs 60 seconds), had longer average view duration (107 vs 32 seconds), and had higher net subscriber change per 1,000 engaged views (8.04 vs 2.57; both p < .001). Patient-facing videos had higher average percentage viewed (61.16% vs 30.30%; p < .001). Post hoc sensitivity analyses preserved the direction and statistical significance of the comparative findings. Conclusion Within this single channel, content type corresponded to distinct and consistent within-channel engagement patterns: advanced procedural videos sustained longer absolute viewing and greater net subscriber change per 1,000 engaged views, whereas patient-facing videos were watched more completely. Because absolute and proportional engagement diverged, these dimensions should be interpreted separately. These creator-side metrics show how different orthopedic video formats are watched and how video-attributed net subscriber change varies relative to engagement across formats, providing a single-channel behavioral reference rather than a measure of educational effectiveness or learning.
Introduction The maritime sector is moving toward more diverse crew compositions. While diversity-oriented crewing models may improve safety, inclusion, and team functioning, they may also introduce new vulnerabilities if organizational systems are insufficiently prepared. This study investigates the prevalence and occupational determinants of depression, anxiety, and suicidal ideation among seafarers, with a focus on psychosocial working conditions. Methods We conducted a cross-sectional study of 1,046 seafarers from an international fleet using an online questionnaire. Anxiety, depression, and suicidal ideation were assessed using validated self-reported measures. Multivariable logistic regression analyses examined associations between mental health outcomes and occupational, interpersonal, and psychosocial factors. Results The results showed that the prevalence of anxiety, depression, and suicidal ideation was 9.2%, 7.5%, and 4.7% respectively. Exposure to psychological violence only was associated with significantly higher odds of anxiety (OR = 2.07; 95% CI: 1.08–3.96) and depression (OR = 2.30; 95% CI: 1.18–4.49), while exposure to combined psychological and physical/sexual violence further elevated the risk of anxiety (OR = 6.92; 95% CI: 2.11–22.65), depression (OR = 5.53; 95% CI: 1.64–18.67), and suicidal ideation (OR = 4.32; 95% CI: 1.03–18.17). Having a fair distribution of workload was associated with lower odds of depression (OR = 0.42; 95% CI: 0.23–0.79) and suicidal ideation (OR = 0.39; 95% CI: 0.19–0.82), while reporting good working relationships with crew members reduced the odds of depression (OR = 0.35; 95% CI: 0.13–0.95) and anxiety (OR = 0.29; 95% CI: 0.10–0.78). High perceived social support was protective against depression (OR = 0.34; 95% CI: 0.13–0.85). Conclusion Mental health outcomes are associated with workplace violence, workload distribution, working relationships, and social support. Interventions targeting leadership, bullying, workload distribution, psychological safety and reporting systems are needed.
Introduction Digital technologies play an increasingly important role in supporting active ageing. Although research in this area has grown rapidly, the literature remains fragmented, and its underlying knowledge structure is not well understood. This study aims to map the research landscape of digital technologies supporting active ageing and to examine how different research streams are organized and interconnected. Methods Bibliographic data were retrieved from the Web of Science Core Collection on January 2, 2026, yielding 837 publications from 2006 to 2025. Bibliographic coupling and co-word analyses were conducted using VOSviewer to examine intellectual structures and thematic patterns. Results The results indicate a substantial increase in publications after 2018, reflecting growing scholarly attention. Five major research clusters were identified, including technology adoption and enabling environments, digital lifestyle interventions, digital participation and smart environments, eHealth-based behavior change, and machine learning-based ageing assessment. Co-word analysis further reveals key themes related to digital inclusion, physical activity, health risk analytics, and quality of life. While the field is shifting toward functional ability, participation, and personalized digital support, emerging areas such as AI-based ageing assessment remain at an early stage and should be interpreted cautiously. Conclusion This study maps the research field and highlights how digital technologies are increasingly embedded within sociotechnical systems shaped by both opportunities and constraints. Given the descriptive nature of bibliometric analysis, the findings should be interpreted with caution. Future research should move beyond descriptive mapping to examine the effectiveness and contextual conditions of digital interventions in supporting active ageing.
Introduction Tigray experienced a devastating armed conflict in November 2020 that systematically dismantled one of the country’s best-performing health systems, with only 30% of hospitals and 17% of health centers remaining functional six months into the war. This study aimed to compare several count data models in analyzing postwar healthcare services utilization disparity and associated factors in Eastern Tigray, Ethiopia. Methods Repeated cross-sectional analytical study design employed secondary data from 20 facilities across 18 districts of Eastern Tigray comprising 2,040 observations. We compared many models and ZINB-GLMM was selected to handle the healthcare utilization with substantially excess zeros, unmeasured heterogeneity of facility, and potential period-specific interaction. The model considered demographic, service-related, geographic, and conflict-period factors. Model performance was compared using AIC and BIC. Results Mean utilization declined from 335 recipients prewar to 41 postwar, an 87.8% reduction. The prewar period was significantly associated with higher rate of utilization compared with the postwar period ( p < 0.001 ). The ZINB-GLMM outperformed (AIC=15,772.66, BIC=16,109.90), with the moderate variability of random intercept ( σ r i 2 = 0.16 , σ r i = 0.4 ) and ( I C C = 0.970 , 95 % C I : 0.908 – 0.986 ) indicates significant between-facility proportion of variability (97.0%) in healthcare utilization attributable to differences between facilities after accounting for fixed effects. The zero-inflation component of the model was crucial and the prewar period was significantly associated with lower odds of excess zero counts relative to the postwar period ( p < 0.001 ). Conclusions The armed war produced terrible declines in healthcare utilization with noticeable geospatial disparities. ZINB-GLMM substantially outperformed, confirming its appropriateness for overdispersion, excess zeros, unmeasured heterogeneity for clustering of facilities, and period-specific interaction effects. The findings underline the significance of strengthening resilient reproductive health systems and ensuring continuity of essential maternal health services during humanitarian crises and post-conflict recovery periods. Recovery efforts must prioritize rural and peripheral areas while rebuilding reproductive health services.
Background Digital health systems can improve healthcare delivery in low-resource settings but are often constrained by unreliable electricity and inadequate infrastructure. Solar-powered energy systems offer a promising solution to improve the resilience and sustainability of digital health services. This study evaluated the opportunities, challenges, technical feasibility, economic viability, and health system readiness for implementing solar-powered digital health systems in low-resource settings. Methods A cross-sectional mixed-methods study was conducted across 12 public health facilities in rural and peri-urban areas. Quantitative data were collected through structured facility assessments and surveys, while qualitative data were obtained through key informant interviews and observational assessments. Descriptive statistics were used for quantitative analysis, and thematic analysis was applied to qualitative data. Findings were integrated to generate system-level insights. Results Although 86% of facilities were connected to the national grid, only 29% reported reliable electricity, and 83% experienced frequent power outages. Limited computing resources (29%) and unstable internet connectivity (60%) further constrained digital health operations. Most facilities (75%) reported high energy-related costs, often due to generator use. Despite these challenges, 92% of respondents supported solar-powered solutions, citing improved service continuity, reduced operational disruptions, and enhanced system performance. Qualitative findings highlighted reliance on paper-based workarounds and emphasized the interdependence of energy, connectivity, and digital infrastructure. Conclusion Solar-powered digital health systems represent a feasible and context-appropriate approach for strengthening digital health infrastructure in low-resource settings. However, successful implementation requires coordinated investments addressing technical, financial, and organizational barriers to support long-term sustainability and health system resilience.
Administration of comprehensive geriatric assessment is time-consuming and labor intensive. A new instrument, the Integrated Self-Screening Instrument for Geriatric Health Testing (INSIGHT), was developed to quickly identify common geriatric problems. The present study evaluated the clinimetric properties of the INSIGHT. Content Validity Index (CVI) was measured via expert review. Older adults (≥65 years) attending geriatric outpatient visits for the first time (N=224) completed the INSIGHT. Internal consistency was calculated using McDonald’s ω, greatest lower bound, and Cronbach’s α. Factor structure was evaluated using parallel analysis and exploratory factor analysis (EFA) based on domain scores. After two rounds of expert review, scale-level CVI/universal agreement was 0.95, and all scale-level CVIs/average were 1.00. Using the INSIGHT, 15.2% of the 224 participants had no potential health problems identified, while 14.3% had one, and over 70% had ≥ two. Internal consistency was good (> 0.8), and EFA confirmed unidimensionality with all domain factor loadings >0.3. The INSIGHT demonstrates good content validity, internal consistency, and unidimensional structure, supporting its reliability for rapid geriatric health screening.
Introduction This study examines the multifaceted impacts of the NCAA’s NIL (Name, Image, and Likeness) policy, which became effective on June 30, 2021, on the psychological well-being of Division I college athletes. The policy permits athletes to earn income from their NIL contracts, creating new roles as brand ambassadors and increasing the commercial use of social media. However, this expanded freedom can compound existing mental health challenges—including anxiety, stress, and burnout—that stem from athletic and academic commitments. Methods Employing semi-structured interviews with 14 Division I student-athletes and grounded in the Social Identity Model of Transition (SIMOT), this study examines how athletes navigate a triple identity (student, athlete, influencer), the relational environments in which NIL-related pressures are experienced, and the role of institutional support in shaping well-being outcomes. Results Findings reveal that NIL functions both as a source of motivation and a trigger for psychological strain, mediated primarily by social media demands, unequal access to NIL opportunities, and inconsistent institutional support. Conclusion Sports psychologists and counselors working with student-athletes should be attentive to NIL-related stressors as a distinct and contemporary source of identity strain, role overload, and social media anxiety, and clinical assessments for this population should include questions about NIL engagement, social media management burden, and perceived inequality relative to teammates. At the institutional level, athletic departments should integrate mental health literacy into NIL orientation programs, ensuring that athletes can identify stress responses and seek support before distress escalates into more serious psychological difficulty. Notably, it is necessary to reiterate that the findings of this study only reflect Division I athlete experiences, and studying other competition levels is highly suggested.
Introduction Seeking emergency care regarding musculoskeletal sensations is far more prevalent than limb or life-threatening pathophysiology. We studied the ability of an LLM to distinguish between urgent and nonurgent upper extremity symptoms and provide an accurate diagnosis. Methods Five LLMs (ChatGPT-4, ChatGPT-4o, Co-Pilot, Gemini, and PerplexityChat) were presented with descriptions of seven urgent and seven nonurgent symptom scenarios written below a sixth grade reading level. LLM responses were identified as appropriate if immediate urgent medical attention was recommended after an initial and ongoing inquiry (“What additional information do you need to diagnose my condition?”). Diagnoses provided were identified as correct, partially correct, or incorrect. The analysis was repeated 24 months later with the current LLM versions and results were compared. Results LLMs discerned nonurgent conditions with 97% positive predictive value (PPV) and an 89% negative predictive value (NPV) on initial query, which improved to 96% and 97% respectively after ongoing inquiry. Compartment syndrome was misidentified as nonurgent in 80% of scenarios on initial inquiry, although four of five LLMs corrected on continued inquiry. Diagnosis was correct or partially correct for 115 of 150 (82%) on initial inquiry. An updated analysis 24 months later demonstrated marked improvement in LLM ability to identify emergencies with 100% PPV and 95% NPV on initial query and 98% NPV after ongoing inquiry. Conclusion The finding that LLMs can distinguish urgent from nonurgent upper extremity conditions suggests that artificial intelligence tools could help reduce unnecessary use of high-cost emergency services, allowing those resources to be reserved for patients who require timely care.
Introduction Noncommunicable diseases (NCDs) are associated with a less healthy workforce, higher medical expenditures, and worse on-the-job performance. The allocation of limited health resources between prevention and treatment is therefore critical, as it could influence both NCDs-related mortality risk and on-the-job productivity. Methods Using panel data from 38 OECD countries over the period 2000 to 2023, this study applies the system generalized method of moments (GMM) to examine (a) the nexus of prevention-cure-NCDs death probability, and (b) the possible roles of preventive and curative health services on the path of saving the economy’s production loss attributable to the risk of NCDs death for the population aged 30 to 70. Results Integrating preventive and curative health services is associated with improvements in health outcomes and economic productivity. If prevention is maintained at the current level (0.27% of GDP) and curative health spending is continually allocated at a GDP ratio of 10.2%, the probability of dying from NCDs could decrease from the current 13.94% to 13.84%. Annual earnings per worker are estimated to increase from USD 49,036.52 to USD 49,515.49, while GDP per worker is projected to rise from USD 101,727.7 to USD 103,980. Conclusions Gender disparities in NCDs mortality risk persist. The findings underscore the importance of aligning investments in both preventive and curative health interventions to address the burden of noncommunicable diseases.
Introduction Menopause is a natural life stage often accompanied by persistent symptoms, such as hot flushes, night sweats, and mood changes that can significantly affect quality of life. While symptom experiences vary across cultures, little is known about menopause-related quality of life among Qatari women. The objective of this study was to measure the association between menopause symptoms and the quality of life of Qatari women. Methods An online, self-administered cross-sectional survey was distributed to all Qatari women aged 30-64 attending Primary Health Care Corporation Centers in Qatar for any reason. Results A total of 512 women completed the Menopause-Specific Quality of Life questionnaire. The mean (SD) age of respondents was 48.8 (7.28) years, with a median of 50 years. Mean (SD) age at menopause was 48.83 (4.93) years. The most frequently experienced symptoms were feeling tired (88.0%), aching muscles/joints (87.0%), lacking energy (86.0%), decreased physical strength (84.0%), low backache (82.0%) and flatulence (80.9%). Menopause status was significantly related to hot flushes (p< 0.001), night sweats (p< 0.001), accomplishing less (p=0.042), aching muscles/joints (p=0.041), aching back/neck/head (p=0.011), decreased physical strength (p=0.028), vaginal dryness during intimacy (p=0.001), and avoiding intimacy (p=0.002). Psychosocial symptoms were reported by 63.2% of respondents, followed by vasomotor symptoms (66.3%), sexual symptoms (66.4%), and physical symptoms (75.9%). There were statistically significant differences in mean scores of vasomotor, physical, and sexual domains across the menopause groups. Conclusion Qatari women experience the onset of menopause at a younger age compared to women from other Arab and high income countries and are mostly bothered by symptoms related to physical discomfort and fatigue. Qatari women experience a high quality of life in the psychosocial domain. To improve care, health systems should prioritize menopause awareness and education, develop culturally sensitive strategies, and integrate these into primary care to enhance the wellbeing of aging women.
Introduction Effective airway suction is critical in prehospital care, yet many portable devices still provide limited suction performance and are poorly designed ergonomically. This study developed and evaluated a portable manual suction device intended to improve both operational performance and operator usability during simulated airway management. Methods In this simulation-based developmental study, all suction trials were conducted in a controlled laboratory setting using standardized simulated airway fluids and predefined environmental conditions. Suction performance was assessed using three standardized fluids. Performance outcomes included suction time, aspirated volume, and calculated efficiency. User satisfaction was measured using a validated scale ranging from 10 to 50 points. All analyses were performed using SPSS v24.0. Results The prototype suction device demonstrated significantly shorter suction times and greater aspirated volumes across all fluid types (all p < 0.001), with efficiency gains ranging from 20% to 35%. User satisfaction and ergonomic ratings were also significantly higher with the prototype device (p < 0.001). Conclusion The prototype suction device demonstrated superior mechanical performance and improved operator usability under simulated prehospital conditions. Its ergonomic design, integrated lighting, and disposable components collectively contributed to enhanced overall functionality. Further clinical studies are required to determine its impact in real-world prehospital settings.
Introduction Vaccination has played a pivotal role in mitigating the burden of meningitis in the African meningitis belt. However, outbreaks have continued due to the emergence of new serogroups, and logistical barriers. This scoping review synthesizes published evidence on health impact of meningitis vaccine delivery strategies to guide policy and programmatic decision-making and maximize the impact of the new meningitis vaccines. Methods The review followed PRISMA extension for scoping reviews. Eligible studies published between 2004 and 2024 in English or with an English translation examining the use of meningitis vaccines and delivery strategies across Africa were included. A systematic search of online databases was conducted using predefined search terms, and following screening of 1,026 articles, 20 were included in the review. Data on relevant themes were extracted into an excel spreadsheet and analyzed guided by PAGER framework. Results The review found limited real-world evidence on meningitis vaccine delivery strategies, with many studies relying on modelling approaches. Findings showed that routine infant immunization and campaign-based strategies have been used to deliver meningitis vaccines in Africa. Compared to routine vaccination, campaign-based strategies were shown to achieve high coverage rates (∼95%), high risk reduction (71%) and high decline in suspected cases (82%). However, routine immunization combined with an initial catch-up campaign was cost-effective, saving USD1.3 for every USD1 invested. The use of the Controlled Temperature Chain (CTC) system for Men A conjugate vaccines enhanced accessibility and cost-effectiveness, particularly for remote facilities lacking cold chain infrastructure. Integrated campaigns were more cost-effective than stand-alone campaigns. Combining campaigns with routine immunization resulted in significant reduction of disease burden, despite potential disruptions during mass vaccination campaigns. Conclusions Combining routine and campaign-based immunization strategies will enhance the impact of the new meningitis vaccines. There is need for more real-world implementation and cost-effectiveness research from Africa.
Introduction Substance use is an important public health concern in Saudi Arabia. Coping strategies and perceived social support may be associated with substance-use patterns, but these relationships remain underexplored among individuals who report substance use in the Saudi context. This study aimed to examine substance-use patterns and their associations with coping dimensions, perceived social support, and selected sociodemographic characteristics among individuals in Saudi Arabia. Methods A cross-sectional correlational design was used with 237 individuals who reported current or past substance use. Coping was assessed using the Brief COPE subscales, and perceived social support was measured using the Multidimensional Scale of Perceived Social Support. Data were analyzed using chi-square tests, Mann–Whitney U tests, and Spearman’s correlation coefficients. Results Most participants were male (88.2%), Saudi (85.2%), single (87.3%), and aged 22–26 years (43.5%). The most commonly reported substances were tobacco cigarettes (40.5%), hashish (14.8%), heroin (11.8%), pregabalin/Lyrica (11.4%), methamphetamine (10.5%), and amphetamine (10.5%). The most frequently reported age category for first substance use was 19–23 years (35.4%). Males reported significantly higher perceived social support than females on the MSPSS total score (47.84 ± 18.19 vs. 38.00 ± 14.10, p = 0.003). Tobacco cigarette use was associated with higher problem-focused coping (18.45 ± 5.59 vs. 15.79 ± 5.81, p < 0.001), emotion-focused coping (27.54 ± 8.30 vs. 24.37 ± 8.43, p = 0.006), and avoidant coping (17.76 ± 5.18 vs. 15.21 ± 5.18, p < 0.001). Perceived social support was positively correlated with problem-focused coping (r = 0.342, p < 0.001), emotion-focused coping (r = 0.377, p < 0.001), and avoidant coping (r = 0.260, p < 0.001). Conclusion Perceived social support and coping responses were associated with substance-use patterns in this sample. Culturally responsive and gender-sensitive approaches that consider social support and coping responses may be useful in substance-use prevention and care.
Introduction This study analyzed data from the 2023 Korean National Health and Nutrition Examination Survey to identify sex-specific factors associated with dietary supplement use among Korean adults. Methods The study population comprised 2,517 males and 3,275 females aged 19 years and older. Differences in participant characteristics and dietary supplement use according to sex, as well as sex-specific differences in supplement use according to participant characteristics, were examined using complex sample cross-tabulation analyses. Complex-sample logistic regression analyses were conducted separately for males and females to identify factors associated with dietary supplement use. Results Among males, marital status (OR = 1.35, 95% CI = 1.05–1.73), participation in health screenings (OR = 1.52, 95% CI = 1.19–1.93), weight control (OR = 1.35, 95% CI = 1.10–1.66), and awareness of nutrition labeling (OR = 1.29, 95% CI = 1.01–1.64) were significantly associated with dietary supplement use. Among females, education level (OR = 1.24, 95% CI = 1.01–1.54), marital status (OR = 1.47, 95% CI = 1.10–1.96), participation in health screenings (OR = 1.44, 95% CI = 1.16–1.80), stress level (OR = 1.40, 95% CI = 1.10–1.78), body shape perception (OR = 1.31, 95% CI = 1.02–1.68), weight control (OR = 1.39, 95% CI = 1.11–1.75), moderate-intensity leisure-time physical activity (OR = 1.26, 95% CI = 1.02–1.56), and breakfast frequency (OR = 1.59, 95% CI = 1.28–1.98) were significantly associated with dietary supplement use. These findings suggest that the factors associated with dietary supplement use differ by sex. Conclusion These findings may provide preliminary evidence for the development of sex-specific educational or counseling strategies regarding safe and appropriate dietary supplement use.
Aims Lower-extremity amputation is one of the most dramatic and severe complications of diabetes, with substantial human and financial repercussions. Our objective was to determine if the onset of a severe complication, such as amputation, would change a patient’s perception of their diabetes and whether the complication would alter the patient’s behavior regarding its management. Methods This qualitative research used semi-structured interviews with inductive thematic analysis. By comparing the emerging categories with the existing literature, an explanatory model was formulated in response to the research question. Results A person with diabetes progresses through multiple phases before developing new habits. Amputation, a life-changing event, can lead to a re-examination of one’s lifestyle. The risks of setback are numerous, along with a sense of discouragement which can lead to protective behaviors by allowing the individual to give up responsibility for their health. Conclusions The role of the provider is to intervene at key moments of discouragement to limit or minimize a setback in self-management behavior. Long-term support for these patients cannot be the sole responsibility of general practitioners. In a context of limited resources, maintaining organizational coherence among different providers is crucial.
Introduction/Objective Deaf sign language users face persistent barriers to equitable healthcare, yet evidence from non-Western and lower-income contexts remains limited. This study explored the lived experiences of Deaf undergraduate students in Thailand, examining how communication barriers, health literacy gaps, and system design intersect to shape their access to equitable care. Methods We conducted a qualitative study using semi-structured, in-depth interviews with ten Deaf undergraduate students (aged 18–22 years). Participants were recruited through purposive sampling and interviews were conducted in Thai Sign Language (TSL), facilitated by two professional interpreters working in tandem. Data were analyzed using Braun and Clarke’s inductive thematic analysis. Results The analysis revealed four key themes: (1) communication barriers affecting all dimensions of healthcare experience, (2) inaccessible and hearing-centered health information, (3) the critical need for a Deaf-inclusive healthcare system, (4) the lifelong impact of growing up in hearing families on health literacy. These findings highlight how systemic communication gaps directly influence the quality of care and patient empowerment. Conclusion Communication barriers and health literacy gaps are structural features of hearing-centered healthcare systems that require systemic rather than individual solutions. Deaf sign language must be reconceptualized as a central component of equitable public health communication, supported by institutional infrastructure and enforceable policy mandates. These findings contribute to the international effort to address structural determinants of health inequity among Deaf communities globally.
Introduction Speech emotion recognition (SER), with its non-invasiveness and ease of deployment, offers an innovative solution for geriatric health monitoring. This scoping review aimed to map the evidence on speech emotion recognition, focusing on its application scenarios, core technologies, and key challenges in geriatric healthcare. Methods Following Arksey and O’Malley’s framework, a comprehensive search of PubMed, Web of Science Core Collection, IEEE Xplore databases were conducted to find studies from the inception to December 2024. Relevant data were extracted from eligible studies. Characteristics of included studies were tabulated, and a narrative synthesis was conducted to address predefined research questions. Results Thirteen studies were included. Geriatric SER was applied or proposed in home and community monitoring, long-term care, mental health assessment, dementia-related contexts, assistive systems, and methodological or benchmark development. Data sources and emotion targets were heterogeneous, including real-world older-adult speech, challenge datasets, acted or media-derived data, robot-mediated interaction data, and clinical or cognition-related datasets. Technical approaches ranged from acoustic feature extraction and conventional machine learning to deep learning, transfer learning, voice-text modelling, and multimodal fusion. Reported performance varied substantially across studies and was difficult to compare because of differences in datasets, emotion categories, modalities, validation strategies, and performance metrics. Common limitations included small or single-source datasets, inconsistent labelling procedures, limited reporting of label reliability, insufficient external validation, and incomplete reproducibility. Conclusion Geriatric SER is an emerging but methodologically heterogeneous field with potential value for non-invasive emotional and mental health monitoring. Future research should prioritize standardized elderly-specific datasets, transparent annotation and reporting protocols, participant-level and external validation, real-world deployment studies, and explainable AI approaches that connect model outputs with clinically meaningful indicators.
Introduction Perioperative nurses are exposed to high levels of occupational stress and psychological strain owing to the complexity of surgical care. Burnout in this group not only undermines individual well-being but also compromises patient safety and care quality. This study aimed to examine the relationships between Type D personality, perioperative clinical competence, occupational stress, coping strategies, and burnout, and to identify factors associated with burnout among perioperative nurses. Methods This cross-sectional, correlational study was conducted with 199 perioperative nurses recruited through an online convenience survey from tertiary hospitals in South Korea. Data were collected using self-administered online questionnaires administered between March and April, 2022. The analyses included descriptive statistics, independent t-tests, one-way ANOVA with Scheffé’s post-hoc tests, chi-square tests, Fisher’s exact tests, ANCOVA, Pearson’s correlations, and hierarchical multiple regression. Results Among the participants, 69.8% were identified with a Type D personality. The mean scores were 137.56±14.72 for perioperative clinical competence, 2.64±0.41 for occupational stress, 17.29±2.93 for problem-focused coping, 26.06±3.77 for emotion-focused coping, 28.59±4.93 for dysfunctional coping, and 64.47±11.99 for burnout. Hierarchical regression revealed that age, career length, subjective health status, Type D personality, perioperative clinical competence, occupational stress, and dysfunctional coping collectively accounted for 49.4% of the adjusted variance in burnout. Conclusion Burnout among perioperative nurses was significantly associated with Type D personality, clinical competence, occupational stress, and coping strategies. Targeted interventions addressing these modifiable factors may help reduce burnout among perioperative nurses.
IntroductionThe cardiometabolic index (CMI), a comprehensive indicator for assessing body fat distribution and serum lipid level, has been found to be associated with biological aging. But the potential relationship between CMI and incident frailty remains unclear. Herein, we designed this study to delve into the relationship between CMI and frailty incidence in adults aged 45 years or older.MethodsData were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Participants were categorized into quartiles (Q1-Q4) according to CMI levels. Multivariable logistic regression model and restricted cubic spline (RCS) analyses were performed to evaluate the connection between CMI and incident frailty risk. In addition, we conducted subgroup and interaction analyses to investigate heterogeneity across distinct subgroups.ResultsA total of 6200 participants were enrolled in our study, with an average age of 57.92 ± 8.57 years, 48.64% males. During a 7-year follow-up, 1166 (18.81%) participants developed frailty, and the incidence showed an increasing trend from Q1 to Q4. The fully adjusted odds of developing frailty increased by 1% for per 1-SD increment in CMI (OR = 1.02, 95% CI:1.00-1.03, P = 0.005). The participants with the highest CMI quartile (Q4) had a significantly elevated risk of developing frailty compared to those in the lowest CMI group (Q1) (OR = 1.06, 95% CI:1.02-1.09, P < 0.001). Subgroup analyses demonstrated consistent results across various subgroups (P for interaction > 0.05). The RCS analysis confirmed a positive association of CMI with incident frailty, and nonlinear relationship was observed (P for overall < 0.001, P for nonlinear = 0.012).ConclusionHigher CMI levels were associated with an increased likelihood of developing frailty. Given its accessibility, CMI may have potential value as a population-level marker for frailty risk assessment.
