The global success of carbapenem-resistant Acinetobacter baumannii sequence type 2 (ST2) has been linked to extensive genomic plasticity, yet the mechanisms stabilizing resistance remain poorly defined. This study integrated bronchoalveolar lavage fluid metagenomics, whole-genome sequencing (WGS), and global phylogenomics to resolve the evolutionary architecture of carbapenem-resistant Acinetobacter baumannii. Local ST2 populations were polyclonal and uniformly exhibited chromosomal integration of the gene blaOXA-23 via the Tn2006 composite transposon. Metagenomic analyses revealed dense in situ cooccurrence networks comprising 34 resistance genes. At the global scale, Chinese isolates carried significantly higher resistance gene burdens than international counterparts. Structural analyses identified the replication-termination T1 and T2 plasmids as horizontal “shuttles” facilitating accessory gene dissemination, whereas chromosomal insertion sequences functioned as vertical “anchors” stabilizing core resistance loci. These findings supported a shuttle-and-anchor evolutionary model underlying ST2 persistence and regional endemic adaptation.
intervention in response to declining membership and subscription renewal rates. This decline in renewal rates was attributed to client dissatisfaction stemming from long queues and waiting times at National Health Insurance Authority registration and renewal centres. This study aimed to evaluate this government-sponsored mobile health intervention from the perspective of multiple stakeholders using the design-actuality gap analysis. Moreover, by comparing the intervention's design requirements to its actualisation, the study revealed gaps that should be addressed to ensure the sustainability of the intervention. The study also proposes technical and policy recommendations aimed at safeguarding the sustainability of the intervention. Besides this, the study also suggests conducting a longitudinal study to assess the social and demographic factors that may influence the adoption rate of the mobile renewal service over a prolonged period.
Sleep apnea is a common sleep disorder that requires early identification to reduce associated health risks. Polysomnography (PSG), the clinical gold standard for diagnosis, is costly and has limited availability, particularly in resource-constrained healthcare settings. This study investigates an e-health-oriented approach for sleep apnea pre-screening by integrating data from a low-cost wearable oximetry device with machine learning models in a real clinical environment in Thailand. Data were collected from 192 participants at the Thammasat Hospital Sleep Laboratory using the Wellue O2 ring, which records oxygen saturation, pulse rate, and motion during sleep. Wearable-derived physiological signals, together with demographic and clinical information, were used as inputs to machine learning models, while PSG served as the reference standard. Support vector machine (SVM), random forest (RF), and one-dimensional convolutional neural network (1D-CNN) models were evaluated. The random forest model demonstrated the most favorable balance between accuracy and feasibility, highlighting the potential of wearable-assisted machine learning to support accessible e-health sleep apnea pre-screening.
In 2018, Ghana’s National Health Insurance Authority (NHIA) introduced a mobile renewal intervention in response to declining membership and subscription renewal rates. This decline in renewal rates was attributed to client dissatisfaction stemming from long queues and waiting times at National Health Insurance Authority registration and renewal centres. This study aimed to evaluate this government-sponsored mobile health intervention from the perspective of multiple stakeholders using the design-actuality gap analysis. Moreover, by comparing the intervention’s design requirements to its actualisation, the study revealed gaps that should be addressed to ensure the sustainability of the intervention. The study also proposes technical and policy recommendations aimed at safeguarding the sustainability of the intervention. Besides this, the study also suggests conducting a longitudinal study to assess the social and demographic factors that may influence the adoption rate of the mobile renewal service over a prolonged period.
The article used the case study analysis, presenting the results of research from the perspective of two regions in Poland: Lubelskie Region and Lower Silesia Region. The research is connected to four areas: using of digital technology, using of eHealth, usefulness and effectiveness of e-Health applications – users' opinions, not using e-Health application (barriers). The questionnaires were conducted on a group of seniors. On the one hand, the data obtained from the questionnaires (from users) gave a unique overview of the strengths and weaknesses of popular applications and allowed to evaluate usefulness and effectiveness of selected applications. On the other hand, the data obtained (from non-users) highlighted the main barriers: technological, ethical, social, or connected to security.
The article used the case study analysis, presenting the results of research from the perspective of two regions in Poland: Lubelskie Region and Lower Silesia Region. The research is connected to four areas: using of digital technology, using of eHealth, usefulness and effectiveness of e-Health applications - users' opinions, not using e-Health application (barriers). The questionnaires were conducted on a group of seniors. On the one hand, the data obtained from the questionnaires (from users) gave a unique overview of the strengths and weaknesses of popular applications and allowed to evaluate usefulness and effectiveness of selected applications. On the other hand, the data obtained (from non-users) highlighted the main barriers: technological, ethical, social, or connected to security.
Chronic kidney disease (CKD) is a medical condition characterized by impaired kidney function, which leads to inadequate blood filtration. To reduce mortality rates, recent advancements in early diagnosis and treatment have been made. However, as diagnosis is time-consuming, an automated system is necessary. Researchers have been employing various machine learning approaches to analyze extensive and complex medical data, aiding clinicians in predicting CKD and enabling early intervention. Identifying the most crucial attributes for CKD diagnosis is this paper’s primary objective. To address this gap, six nature-inspired algorithms and nine machine learning classifiers were compared to evaluate their combined effectiveness in detecting CKD. A benchmark CKD dataset from the UCI repository was utilized for this analysis. The proposed model outperforms other classifiers with a remarkable 99.5% accuracy rate; it also achieves a 58% reduction in feature dimensionality. By providing a reliable, cost-effective tool for early CKD detection, the authors aim to revolutionize patient care.
Currently, AI and AR are the most advanced technologies inspiring innovations in numerous areas. While AR provides novel, engaging user experiences, it also creates tedious and unstructured development issues like content production and marker detection. Recently, AI has been investigated to provide solutions to those AR limitations. The results from those studies inspired this work to present DeepReality, a Unity 3D plug-in that combines Deep Learning (DL) models with AR using Barracuda inference engine and AR Foundation. The ease with which DeepReality provides DL-AR integration allows developers to deploy DL-based iOS and Android mobile apps to extract visual elements and overlay AR content onto physical objects. DeepReality enhances feature-based environmental monitoring through incongruous items and semantic processing of objects. This study also presents a smart gym device that uses AIto adjust posture in real time to ensure optimal form during workouts like the chest press and to increase effectiveness. The system analyzes the violation of postures and gives audio feedback using speech recognition by recognizing the body key points through the Mediapipe framework. In addition, while creating custom training programs, diet recommendations, and motivational music playlists, user goals will be integrated into the design, meanwhile, 3D virtual trainers demonstrate exercises. This AI-powered concept merges augmented reality with real-time feedback to create long-term exercise habits and overall wellness. Evaluation of DeepReality's execution time and memory consumption prove it to be user-friendly and menial device compatible. Extensive metrics and analysis, operational validation, and modularity for DL integration are provided by this open-source toolkit available from the Unity asset store. By making the AI AR integration available for all applications on AR, developers can leverage the transformative power of AIto enhance their AR applications. Thereby, the future of AR-AI synergy is forged with DeepReality.
Multilingualism is essential for digital health communication, yet there is no comprehensive tool to assess the multilingual accessibility of health websites. This study addresses this gap by developing the Website Language Accessibility Checklist (WLAC) through a three-phase mixed-methods approach. A systematic literature review of 53 studies from Web of Science, PubMed, and CINAHL Complete identified existing criteria, which were coded through thematic analysis and validated using inter-coder reliability (kappa = 0.89). These preliminary criteria were refined by testing on 20 health websites to ensure usability and clarity. The final checklist comprises 10 criteria across two dimensions-availability and accessibility-offering an innovative framework for assessing the multilingual accessibility of health websites. This tool standardizes terminology, provides clear operational definitions, and offers practical guidance for healthcare organizations, web developers, and policymakers to enhance multilingual accessibility on digital health platforms.
This study examines the correlation between Hofstede's cultural dimensions and the impact of COVID-19, focusing on the role of information technology infrastructure in pandemic management. Using Hofstede's six dimensions-power distance, individualism versus collectivism, masculinity versus femininity, uncertainty avoidance, long-term orientation, and indulgence versus restraint-and and the World Health Organization (May 20, 2022-March 16, 2023), the study analyzes COVID-19 Saxons, Latin America, Muslim World, and South-East Asia. Findings reveal significant correlations, such as power distance and individualism versus collectivism in Africa, uncertainty avoidance in the Muslim World and South-East Asia, and long-term orientation in Latin America and South-East Asia. Information technology infrastructure is essential for effective COVID-19 management, providing valuable insights for future policy development.
This descriptive manuscript describes challenges, solutions, and recommendations to provide a supportive framework for clinician researchers striving to develop a clinical app. The Back2Play app aims to support youth in concussion recovery through mobile health monitoring. Developed in Phase 1 of a randomized control trial, the app intends to prevent re-injury and improve recovery by integrating evidence-based return-to-school and activity guidelines with biological monitoring. Methods outline the stages of successful app development. Identified challenges include defining app requirements, database hosting, development, and legal procedures. Results of usability testing show that the Back2Play app was highly acceptable to 66% of youth and none found it unacceptable. Successful clinical app development hinges on understanding the scope of the app, data management and exportation. Adequate funds should also be allocated for potential delays. These recommendations provide a framework for clinical researchers hoping to develop a clinical app that achieves their envisioned outcome.
Multilingualism is essential for digital health communication, yet there is no comprehensive tool to assess the multilingual accessibility of health websites. This study addresses this gap by developing the Website Language Accessibility Checklist (WLAC) through a three-phase mixed-methods approach. A systematic literature review of 53 studies from Web of Science, PubMed, and CINAHL Complete identified existing criteria, which were coded through thematic analysis and validated using inter-coder reliability (κ = 0.89). These preliminary criteria were refined by testing on 20 health websites to ensure usability and clarity. The final checklist comprises 10 criteria across two dimensions—availability and accessibility—offering an innovative framework for assessing the multilingual accessibility of health websites. This tool standardizes terminology, provides clear operational definitions, and offers practical guidance for healthcare organizations, web developers, and policymakers to enhance multilingual accessibility on digital health platforms.
This study examines the correlation between Hofstede's cultural dimensions and the impact of COVID-19, focusing on the role of information technology infrastructure in pandemic management. Using Hofstede's six dimensions—power distance, individualism versus collectivism, masculinity versus femininity, uncertainty avoidance, long-term orientation, and indulgence versus restraint—and data from the International Academy of CIO, International Institute for Management Development, and the World Health Organization (May 20, 2022–March 16, 2023), the study analyzes COVID-19 patterns across seven cultural regions: North-South-West Europe, Eastern Europe, Africa, Anglo Saxons, Latin America, Muslim World, and South-East Asia. Findings reveal significant correlations, such as power distance and individualism versus collectivism in Africa, uncertainty avoidance in the Muslim World and South-East Asia, and long-term orientation in Latin America and South-East Asia. Information technology infrastructure is essential for effective COVID-19 management, providing valuable insights for future policy development.
Diabetes self-management (DSM) is crucial for children with diabetes, especially those aged 3–7 years. With the increasing number of children with diabetes and the trend toward younger children, there is growing interest in multimedia technology-based interventions (MTBIs) to help them achieve DSM. However, T1D children face unique challenges in DSM due to their need to complete seven target behaviors: learning diabetes basics, monitoring blood glucose levels, adhering to insulin therapy, problem-solving, dietary modifications, physical activity, and psychological aspects. Over the past 20 years, MTBIs have become powerful tools to support DSM, using interactive content, digital platforms, mobile apps, and virtual coaching. This systematic literature review aims to analyze the classification and trends in MTBIs' use in self-management for T1D children, explore key challenges, and suggest future directions for advancing these technologies. This study provides a comprehensive investigation of the application of multimedia technologies for interventions in self-management for T1D children and offers research foundation and practical guidance for the later application of multimedia technologies in this area.
The prospects presented by digital transformation holds the potential of greatly increasing the capacity of medical libraries, which in turn it will make it possible for these libraries to provide better services and increasing accessibility. But how can digital technologies be adopted in transforming medical libraries' services and operations, in the digital transformation era? This study looked at the opportunities and challenges associated with implementing digital technologies in medical libraries through digital transformation. The study thus reviewed literature on digital transformation of medical libraries services, as a way to support healthcare systems in South Africa. The chapter revealed that digital transformation has the potential to enhance libraries processes, practices, performance, and to stay relevant in their increasingly competitive environment.
This systematic review aims to provide insight into ChatGPT's application in health communication. The review, based on seven academic databases, employed Boolean operators to connect keywords, refining search results. Selection criteria and quality assessment ensured a comprehensive evaluation. Fourteen articles were included, focusing on the application of ChatGPT in interpersonal health communication. Survey research methods were mostly used, revealing four main application advantages and ten application risks, such as providing inaccurate and incomplete health information. At present, ChatGPT is still not suitable for widespread application in health communication. Diverse linguistic and cultural contexts, interdisciplinary collaboration, real patient experiences, integration of ChatGPT with existing healthcare information systems, and some ethical factors must be considered to ensure ChatGPT effectively empowers health communication.
Blockchain technology presents a promising solution for healthcare, addressing key challenges like data breaches, patient control, and interoperability. This paper analyzes blockchain applications in three areas: electronic health records, pharmaceutical supply chain traceability, and clinical trials. The authors explore security concerns, regulatory compliance, and smart contract vulnerabilities, proposing solutions like advanced cryptography and improved consensus mechanisms. Real-world examples, such as Medicalchain and Chronicled's MediLedger, demonstrate enhanced transparency and security. However, adoption faces barriers like scalability, computational costs, and regulatory complexities. The study also highlights ethical issues around data ownership and suggests future research into improving interoperability and integrating technologies like artificial intelligence and internet of medical things for better healthcare outcomes.
This descriptive manuscript describes challenges, solutions, and recommendations to provide a supportive framework for clinician researchers striving to develop a clinical app. The Back2Play app aims to support youth in concussion recovery through mobile health monitoring. Developed in Phase 1 of a randomized control trial, the app intends to prevent re-injury and improve recovery by integrating evidence-based return-to-school and activity guidelines with biological monitoring. Methods outline the stages of successful app development. Identified challenges include defining app requirements, database hosting, development, and legal procedures. Results of usability testing show that the Back2Play app was highly acceptable to 66% of youth and none found it unacceptable. Successful clinical app development hinges on understanding the scope of the app, data management and exportation. Adequate funds should also be allocated for potential delays. These recommendations provide a framework for clinical researchers hoping to develop a clinical app that achieves their envisioned outcome.
Chronic kidney disease (CKD) is a medical condition characterized by impaired kidney function, which leads to inadequate blood filtration. To reduce mortality rates, recent advancements in early diagnosis and treatment have been made. However, as diagnosis is time-consuming, an automated system is necessary. Researchers have been employing various machine learning approaches to analyze extensive and complex medical data, aiding clinicians in predicting CKD and enabling early intervention. Identifying the most crucial attributes for CKD diagnosis is this paper's primary objective. To address this gap, six nature-inspired algorithms and nine machine learning classifiers were compared to evaluate their combined effectiveness in detecting CKD. A benchmark CKD dataset from the UCI repository was utilized for this analysis. The proposed model outperforms other classifiers with a remarkable 99.5% accuracy rate; it also achieves a 58% reduction in feature dimensionality. By providing a reliable, cost-effective tool for early CKD detection, the authors aim to revolutionize patient care.
The prospects presented by digital transformation holds the potential of greatly increasing the capacity of medical libraries, which in turn it will make it possible for these libraries to provide better services and increasing accessibility. But how can digital technologies be adopted in transforming medical libraries' services and operations, in the digital transformation era? This study looked at the opportunities and challenges associated with implementing digital technologies in medical libraries through digital transformation. The study thus reviewed literature on digital transformation of medical libraries services, as a way to support healthcare systems in South Africa. The chapter revealed that digital transformation has the potential to enhance libraries processes, practices, performance, and to stay relevant in their increasingly competitive environment.
