Abstract: Background: Brick kiln workers are chronically exposed to dust, combustion products, and industrial emissions that may contain toxic heavy metals. Prolonged exposure to metals such as cadmium (Cd) and Chromium (Cr) poses significant occupational health risks, including respiratory and systemic effects. This study assessed blood cadmium levels and screened for chromium exposure among brick kiln workers in Bahawalpur, Pakistan.Methods: A cross-sectional study was conducted from April to June 2023. Venous blood samples for heavy metal analysis were obtained from 14 workers selected from a total of 70 brick kiln workers based on sample availability and consent and digested using aqua regia. Cadmium concentrations were quantified using Atomic Absorption Spectrophotometry (AAS). Chromium was assessed using a colorimetric method based on 1,5‑diphenylcarbazide. Descriptive statistics were used to summarize metal concentrations and compare findings with international reference values.Results: Blood cadmium concentrations ranged from 0.24 to 5.12 µg/L, indicating elevated exposure among a substantial proportion of workers when compared with reference background levels. Chromium concentrations were below the detection limit of the colorimetric method in all analyzed samples. The observed cadmium burden suggests occupational exposure likely associated with kiln-related emissions, dust, and fuel combustion.Conclusions: Brick kiln workers in Bahawalpur exhibit elevated blood cadmium levels, reflecting significant occupational exposure. Although chromium was not detected above the analytical detection limit, methodological constraints preclude ruling out low-level exposure. These findings highlight the need for routine biomonitoring, improved workplace controls, and stricter enforcement of occupational health regulations in Pakistan.

Abstract: Introduction: Engaging in physical activity is a cornerstone of healthy aging, yet physical inactivity remains prevalent among U.S. older adults. This study aimed to develop and validate measures of perceptions, attitudes, and practices to support personalized physical activity promotion among older adults. Method: For this online cross-sectional survey, we enrolled 310 community-dwelling older adults and 11 content experts. Using the Knowledge, Attitudes, and Practices framework, we developed 14 items for the Perceived Physical Activity Benefits Scale (PBAS), seven items for the Attitudes toward Physical Activity Scale (APAS), and nine items for the Physical Activity Practice Scale (PAPS). Using a 30:70 split, derivation and replication samples were generated via simple random sampling without replacement. Content validity and item analyses were performed on the full sample, followed by exploratory and confirmatory factor analyses in the derivation and replication samples, respectively. Results: Item-level content validity indices for the PBAS, APAS, and PAPS were 0.96, 0.94, and 0.95, respectively. Internal consistencies (Cronbach’s alpha) were 0.92 for the PBAS, 0.77 for the APAS, and 0.91 for the PAPS. Exploratory factor analyses identified two subscale constructs for each measure, all demonstrating good to excellent subscale reliability. Confirmatory factor analysis fit indices ranged from 0.89–0.91 for the PBAS, 0.84–0.92 for the APAS, and 0.95–0.97 for the PAPS. Conclusion: The PBAS, APAS, and PAPS are reliable and valid instruments for assessing perceptions, attitudes, and practices related to physical activity among older adults and can support interventions aimed at promoting personalized physical activity and healthy aging.

Abstract: This scoping review represents the first concerning 2020–2025, peer-reviewed publications to investigate possible relationships among burnout, nutrition, and nutrition/food literacy during and following the COVID-19 pandemic. 9 January 2026 searches were of the keywords (burnout OR job stress) AND (nutrition OR diet OR eating pattern OR food intake) AND (nutrition literacy OR food labeling) AND (food literacy OR health literacy). Eight databases were searched (CINAHL Plus, Google Scholar, JSTOR, OVID, PubMed, Science Direct, Scopus, Web of Science). With 160 returns, the included reports from these searches were from Google Scholar alone (n = 6). The addition of four relevant reports from the 3 June 2025 searches of “burnout AND nutrition AND (nutrition literacy OR food literacy)” increased the included studies to 10. Although 2020 was the lower date limit, publication of the results was between 2023 and 2025. The finding is that research con-ducted during this period reports co-occurring issues of burnout, nutrition, and nutrition/food literacy in specific populations. The primary discovery is that assessing the relationships among these terms was not the aim of the included studies. This lack of dedicated research on this topic presents an opportunity for burnout and nutrition re-searchers to investigate these relationships intentionally.

Abstract: Rabies remains a persistent zoonotic threat in Ghana despite the availability of effective countermeasures such as mass dog vaccination and timely post-exposure prophylaxis (PEP). We conducted a cross-sectional household survey (n = 450) and complementary focus group discussions to assess community knowledge, risk perception, bite-management practices, and determinants of dog vaccination across urban and rural settings. Results indicated that while 68 % of respondents had heard of rabies, only 42 % correctly identified dogs as the main source of transmission. Although 58 % perceived dog bites as dangerous, 36 % preferred traditional remedies over medical treatment, and only 31 % reported vaccinating their dogs. Educational level, urban versus rural residence, and prior exposure to dog-bite incidents significantly influenced knowledge and practices. These findings highlight gaps in awareness and preventive behaviour that hinder rabies control. Strengthening rabies elimination efforts in Ghana requires integrating community education, improved dog vaccination campaigns, accessible PEP, and coordinated One Health interventions.

Abstract: Background/Objectives: Achieving a balanced wholefood diet while stabilising glycae-mic management is challenging for many people with type 2 diabetes (T2D) due to barri-ers such as food preparation skills, time, and medication effects. Diabetes-specific nutri-tional formulas (DSNF) are nutritionally complete products designed to support glycae-mic management and overall nutritional adequacy and may complement wholefood die-tary approaches when these are not feasible or are insufficient. Despite growing clinical evidence of efficacy, practical guidance for routine use is limited. Methods: A multidisci-plinary expert working group developed a Clinical Practice Guide (CPG) for integrating DSNF into diabetes care. Development was informed by a literature review and iterative consensus among experts, including representatives of the Australian Diabetes Society, Australian Diabetes Educators Association, and the Royal Australian College of General Practitioners. Results: The CPG outlines a three-step pathway: (1) Assess suitability (clinical indications, contraindications, preferences, cultural context); (2) Tailor the approach (indi-vidual goals, dose/timing relative to weight and body composition goals and observed glycaemic patterns, integration with lifestyle care); and (3) Monitor progress (baseline, 2–4 weeks to assess initial response, then 3, 6, and 12 months for glycaemic indices, weight/body composition where available, and medication review). Conclusions: This CPG provides practical, multidisciplinary guidance for the person-centred use of DSNF as an adjunct to standard care, supporting translation of current evidence into clinical prac-tice and promoting consistent, multidisciplinary implementation.

Abstract: Introduction: Gymnastic exercises exert positive effects on chronic neck pain. Growing evidence suggests that combining cervical spine exercises with temporomandibular joint (TMJ) relax pads, may enhance outcomes on pain, discomfort and functional limitations. Objective: To evaluate the additive effect of silicone TMJ relax pads worn in the molar region during cervical spine exercises on reducing neck pain and improving function. Methods: 52 sedentary middle-aged to older adults working on video display unit (VDU) workstations were randomly assigned to two groups. Both groups performed a specific cervical spine exercise program (3x 3min/day) for three months. One group used bilateral TMJ relax pads during the sessions (EX-RP); the control group exercised without pads (EX). Neck pain intensity was assessed using a one-week pain protocol prior and after a six-week intervention. Functional assessments included cervical/thoracic spine and shoulder mobility tests, and thoracic kyphosis angle measurement. Intention-to-treat analysis with multiple imputation was performed. Results: Data from 25 EX-RP and 22 EX participants were analysed. Both groups showed reduced neck pain, but only EX-RP achieved a statistically significant reduction (p=.001). Pain reduction was greater in EX-RP than in EX (p=.046). Neck Disability Index (NDI) scores improved in both groups (p <.001), with no significant difference between groups (p =.514). EX-RP showed greater improvements in cervical extension (p=.044) and trunk rotation (p=.019). Conclusion: Combining cervical exercises with TMJ relax pads may enhance pain reduction and functional outcomes in individuals with chronic neck pain.

Abstract: Background/Objectives: Clinical reasoning is an essential competency for all healthcare practitioners, particularly in the context of neurological rehabilitation, where patient management is complex and multifactorial. This paper proposes a unified framework for clinical reasoning in neurological physiotherapy, integrating the aspects of physical function with the World Health Organization’s International Classification of Functioning, Disability, and Health (ICF). Methods: The proposed framework incorporates a biopsychosocial approach, focusing on a patient-centred and goal-oriented methodology that allows for a comprehensive evaluation of the patient’s needs across multiple domains, including body functions, activities, and participation. By integrating clinical reasoning theories from various disciplines, this framework seeks to enhance the decision-making process and improve communication among healthcare professionals. Results: The model provides a systematic approach to assessing and addressing deficits in motor control, sensory functions, and other aspects of neurological rehabilitation. This work highlights the importance of interdisciplinary collaboration and emphasizes the role of physiotherapists in managing neurological impairments. Conclusions: The Biopsychosocial Reasoning Approach In Neurophysiotherapy (BRAIN) framework aims to improve functional outcomes by offering a more adaptable, multidisciplinary, and evidence-based approach to clinical reasoning in neurological physiotherapy.

Abstract: Backround: Due to the congested competition calendar and the high physical demands of elite basketball, the selection of effective recovery strategies is essential to optimize performance and reduce exercise-induced fatigue and muscle damage. This study aimed to examine the acute effects of different nutritional and physical recovery strategies on exercise performance, muscle damage, and perceived fatigue and exertion in elite basketball players. Method: Fifteen elite male basketball players participated in a randomized crossover trial and completed four recovery conditions: cold-water immersion (CWI), active recovery (ACT), protein–carbohydrate supplementation (SUP), and placebo (PLA). Following a basketball-specific fatigue protocol, creatine kinase, countermovement jump performance, isometric strength, 10 m sprint, and 4 × 10 m shuttle run test were assessed at baseline, immediately post-exercise, and 24 h post-exercise. Perceived fatigue and rate of perceived exertion were measured at baseline, immediately post-exercise, immediately after the recovery intervention, and 24 h post-exercise. Results: The three recovery methods prevented the 24h exercise-induced CK increase observed in the PLA condition (p>0.05). The CWI, SUP and ACT decreased fatigue and RPE immediately after their application (p< 0.05), while the PLA kept them elevated. CWI significantly improved 4x10mSRT time (p=0.027) 24h. Conclusion: Nutritional supplementation and physical recovery strategies effectively attenuated exercise-induced muscle damage and fatigue in elite basketball players. However, CWI demonstrated the most pronounced acute benefits for physical performance recovery.

Abstract: Background: Early childhood represents a key stage for the development of movement behaviors (MV), motor skills (MS), and executive functions (EF). Body Mass Index (BMI), defined according to World Health Organization (WHO) references, may influence these domains early in life. In this context, this cross-sectional observational study aimed to examine the associations between BMI and 24-hour MV, MS, and EF in Tunisian preschool children aged 4 to 5 years. Methods: This cross-sectional observational study included 112 Tunisian children aged 4 to 5 years (50 boys, 62 girls), recruited from kindergartens in urban and rural areas. Anthropometric measurements were used to calculate age-specific BMI z-scores and classify children into three BMI categories: below normal, normal, and above normal. 24-hour MV (physical activity (PA), sedentary behavior, and sleep) were objectively assessed using accelerometry over five consecutive days. EF (inhibition and working memory) were assessed using standardized cognitive tests, gross MS were evaluated using the Supine Timed Up and Go test (functional mobility), One-Leg Standing Balance test (postural steadiness), Hand Grip Dynamometer (upper body strength), and Standing Long Jump (lower body strength), and fine MS were assessed using the 9-Hole Pegboard Test (dexterity). All tools are validated and standardized for children. Results: Significant differences between BMI categories were observed for anthropometric variables (p < 0.05). In contrast, no significant differences were found for 24-hour MV, adherence to recommendations, EF, or most MS (p > 0.05). Only upper limb strength showed a significant difference (p = 0.035), with children of normal BMI showing slightly higher strength than those with above-normal BMI. Conclusion: In Tunisian preschool children, weight status is primarily associated with differences in physical growth, with no marked relationship to MV, EF, or MS. These findings highlight the importance of universal preventive interventions starting in early childhood.

Abstract: COVID-19, caused by the new type of coronavirus SARS-CoV-2, has put an unprecedented impact on health, economy and social areas around the globe. It created an urgent global need for rapid diagnostics, effective therapeutics, and scalable vaccine manufacturing. The biomanufacturing industry played a central role in meeting this challenge by accelerating the development, production, and distribution of SARS‑CoV‑2 diagnostic assays and vaccines. This review provides an integrated overview of SARS‑CoV‑2 biology, clinical manifestations, transmission mechanisms, and major viral variants, followed by a detailed examination of diagnostic technologies. We further highlight the transformative impact of mRNA vaccine technologies, emphasizing advances in lipid nanoparticle formulation, large‑scale manufacturing, and regulatory‑aligned production strategies. The review also discusses the biomanufacturing sector’s rapid mobilization to overcome supply‑chain constraints, workforce shortages, and unprecedented global demand. Collectively, this work underscores how scientific innovation, industrial agility, and cross‑sector collaboration enabled the rapid deployment of diagnostics and vaccines that were essential to controlling the COVID‑19 pandemic.

Abstract: Background: Low back pain (LBP) is a leading global cause of disability with major personal and socioeconomic impact. Limitations of purely biomedical treatment have encouraged a shift toward holistic, biopsychosocial, and evidence-based management. This systematic review examined the effects of holistic, non-surgical interventions on pain, disability, muscle strength, walking balance, and quality of life in adults with LBP. Methods: A comprehensive search of PubMed, MEDLINE, CINAHL, EMBASE, Cochrane Library, Google Scholar, and HMIC was conducted. Randomized controlled trials (RCTs) involving adults (≥18 years) receiving holistic interventions including structured exercise, patient education, psychologically informed therapy, manual therapy adjuncts, or multidisciplinary rehabilitation were included. Two reviewers independently screened studies, extracted data, and assessed quality using the PEDro scale. Of 5,326 identified records, 43 RCTs met eligibility criteria. Data were synthesized narratively and through meta-analysis following PRISMA guidelines. Results: Forty-three moderate- and high-quality RCTs involving 4,144 participants were included. Holistic interventions consistently reduced pain intensity and functional disability, with meaningful improvements across intervention types. Exercise-based therapies enhanced muscle strength, endurance, and movement function, while balance outcomes improved but varied across studies. Mind–body and psychologically informed interventions (e.g., CBT, mindfulness, yoga) showed strong positive effects on psychosocial outcomes and quality of life. Multimodal programs combining exercise, education, and psychological components produced the most comprehensive and sustained improvements, outperforming single-modality interventions. Thirty-eight RCTs (n = 1,701) contributed to the meta-analysis. Exercise-based interventions significantly reduced pain (MD = –2.45; 95% CI: –3.28 to –1.62). Technology-assisted interventions were also effective (MD = –2.24; 95% CI: –2.52 to –1.97). Manual and complementary therapies produced the largest effect (MD = –2.53; 95% CI: –4.23 to –0.82). Mind–body and psychological interventions showed no statistically significant pooled effect (MD = –0.44; 95% CI: –1.56 to 0.69). Conclusion: Holistic, evidence-based, non-surgical interventions are safe and effective for improving pain, function, and quality of life in adults with LBP. Findings reinforce current international guidelines advocating biopsychosocial, patient-centred care. Clinical practice should emphasize individualized, supervised exercise integrated with psychological strategies and education. Protocol Registration: The review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD420251166635.

Abstract: To address the critical challenges of hazardous material (HAZMAT) incidents in dense urban areas, this study develops a hybrid framework for spatial emergency response optimization tailored for Intelligent Transport Systems (ITS). Our approach integrates the Fuzzy Analytic Hierarchy Process (FAHP) with a rigorous technical benchmarking of multiple navigation APIs to improve routing decisions under volatile Bangkok traf-fic. By employing a normalized cost function (scale 0–1), we evaluated the perfor-mance of localized (Longdo) versus global (Google and OpenStreetMap) platforms across day and night scenarios. Experimental results, yielding normalized costs be-tween 0.464 and 0.748, identified Bon Kai as the optimal response node, whereas Chan Road showed the lowest efficiency. Interestingly, OpenStreetMap provided the highest temporal consistency for emergency logistics. These findings offer a practical deci-sion-support tool for authorities, proving that integrated API assessment is essential for building resilient and responsive urban mobility infrastructures.

Abstract: Background/Objectives: Franz Tappeiner (1816–1902) is often celebrated as a pioneer of alpine medicine and the founder of Tappeiner Promenade in Meran (South Tyrol, Italy). However, his legacy extends far beyond the scenic infrastructure. His multidisciplinary practice anticipated the principles of contemporary rehabilitation, preventive medicine, and climate-sensitive public health. Methods: This historical scientific analysis reinterprets Tappeiner’s writings, institutional engagements, and civic projects through the lens of modern public health frameworks. Drawing on primary materials (e.g., published articles, autobiographical fragments, and commemorative texts) and recent evidence from rehabilitation and environmental health research, these contributions were contextualized. Results: Tappeiner’s early focus on infectious disease prevention (e.g., cholera and tuberculosis) transitioned into a strategic emphasis on recovery and behavioral therapy through environmental design. The walking therapy model of Max Joseph Oertel, locally realized in the Tappeiner Promenade, prefigured modern concepts such as structured green rehabilitation, walkability, and urban-health citizenship. He contributed substantial personal funds to the path’s construction, embedding therapeutic gradients, curating vegetation, and promoting inclusive design to support convalescence. Contemporary research supports the intuition that green, low- to moderate-intensity walking improves cardiometabolic health, psychological well-being, and functional capacity. Moreover, his integrative ethos, merging clinical medicine, civic ethics, and spatial intervention, parallels contemporary eco-social models of public health. Conclusion: Franz Tappeiner’s career exemplifies a still-relevant model of physician leadership that is empirically grounded, socially accountable, and ecologically attuned. His work invites reflection on how medical professionals can shape not only individual care but also urban environments and collective health futures.

Abstract: Background: Chronic kidney disease (CKD) continues to place immense strain on health systems globally, with nurses at the centre of care delivery physically, emotion-ally, and relationally. In dialysis units, nurses form long-term therapeutic relationships with patients who depend on life-sustaining treatment several times a week. Objective: This study explored the lived experiences of professional nurses caring for patients with CKD in a dialysis unit, using Watson’s Theory of Human Caring as a guiding frame-work. Methods: A qualitative, exploratory, descriptive design was employed. Data were collected through in-depth face-to-face interviews with twelve professional nurses and analysed using thematic analysis. Trustworthiness was ensured through credibility, dependability, confirmability, transferability, and authenticity. Ethical approval and informed consent were obtained. Results: Three themes emerged: (1) emotional and professional experiences, (2) systemic resource constraints, and (3) recommendations for practice improvement. These findings highlight the tension between caring ideals and systemic limitations. Conclusions: Interpreted through Watson’s Theory of Human Caring, the findings demonstrate that organizational support, emotional wellbeing, and adequate resource allocation are essential to sustaining caring-healing environments and advancing equitable, high-quality CKD care in alignment with Sustainable Devel-opment Goal 3. The study concludes that dialysis nursing is profoundly meaningful yet emotionally demanding. Strengthened emotional support, improved leadership visibility, consistent resource allocation, and enhanced nephrology nursing education are critical to sustaining compassionate care. The findings offer important insights for policy, workforce development, and quality improvement efforts in CKD care.

Abstract: Background: Neonatal phototherapy is the standard treatment for hyperbilirubinemia and is critical in preventing kernicterus. While its clinical effectiveness for neonates is well established, the occupational health risks to caregivers exposed to phototherapy light remain poorly explored, particularly in low- and middle-income countries. This study assessed the ocular effects of neonatal phototherapy on caregivers working in clinical settings in Tanzania. Methods: A mixed-methods study was conducted in selected urban and rural hospitals in Tanzania. Quantitative data were collected through a cross-sectional survey of 200 caregivers involved in neonatal phototherapy, assessing exposure duration, ocular symptoms, use of protective measures, and safety training. Qualitative data were obtained through semi-structured interviews with 25 caregivers and were analyzed thematically. Quantitative data were analyzed using descriptive statistics, chi-square tests, and odds ratios. Results: Overall, 75% of caregivers reported at least one ocular symptom associated with phototherapy exposure. The most frequently reported symptoms were eye strain (58%), dryness or irritation (45%), blurred vision (28%), and photophobia (21%). Caregivers exposed to phototherapy for more than four hours per day were significantly more likely to report ocular symptoms (χ2, p = 0.012). Those who did not use protective eyewear were 2.7 times more likely to experience photophobia and irritation (OR: 2.7; 95% CI: 1.8–3.9). Only 29% of caregivers reported using eye protection, and 35% had received formal safety training. Caregivers who received training were 60% less likely to report ocular symptoms (p < 0.01). Qualitative analysis identified five themes: lack of awareness and protective measures, psychological stress and burnout, institutional gaps in occupational safety, low trust in the healthcare system, and strong professional dedication despite personal health risks. Conclusions: Caregivers exposed to neonatal phototherapy in Tanzanian hospitals experience a high burden of ocular symptoms, driven by prolonged exposure, limited protective practices, and inadequate safety training. Integrating caregiver-focused occupational safety policies, mandatory use of protective eyewear, and structured training into neonatal care programs is essential to safeguard caregiver health and strengthen neonatal service delivery in resource-limited settings.

Abstract: The subject of the title is discussed from personal experience in Galicia (Spain), with a brief allusion to the beginning of NBS, indicating that without diagnosis, there can be no treatment, in luding the outstanding role played by LI Woolf, who always advocated not limiting it to PKU, and ignorance of their work, even in the hospital itself, with a footnote referring to current situations. The beginnings of NBS programs in Spain are referred to, which were born expanded, with a methodology that I cal open, chromatographic techniques, and nonspecific reagents that originate open procedures, applicable, for example, in the detection of lysosomal storage diseases, demonstrating the importance of urine in our program. The methodology used determines the pathologies to be detected, and the professionals who choose one or the other according to the criteria that are maintained today are largely responsible for the current disparities. The administrations acted on the matter sometime later when it had been rolling and running in different ways, depeending on the territory. Like others, Galicia always had an expanded program and was almost always ahead. At one point, a “Dr. BESSMAN” appeared in our administration who discovered the systematic reviews and scientific evidence, ignoring our evidence; after maneuvering in different spaces, he ried to be coercive, reducing the program without knowing the i tended purpose; a petition on the Change.org platform stopped that claim. The approach is based on a universal public social and healthcare system with competent professionals to successfully address rare diseases and, in the event of unexpected findings, to seek the best option for the patient. What has been published on the subject and the peculiarities of Spain are discussed. It is suggested that epidemiologists who are dedicated to this matter mutate into rareologists, and the situation at the beginning of the NBS is recalled when organized opposition from doctors arose, highlighting Samuel P. Bessman. It was the parents, as happened with FØling and Bickel, who got them interested in looking for the cause and treatment; now, they (parents and relatives) are changing to continue expanding the NBS programs. In Galicia, it appears that the criteria set by political leaders have changed, which has resulted in the exclusion of potential candidates such as Bessman from this role. In Spain, there are still disparities, as in Europe and many other places; the approach will have to be different depending on the social-health system of origin. Prof. F. Mayor Zaragoza took steps to address the issue within the framework of the Universal Declaration of Human Rights. If the precursors of the NBS had waited for scientific evidence at its inception in 1956 and 1957, it would not exist today. It is not possible to look for differences in the health of populations with broad and narrow NBS programs because these diseases are rare and do not significantly influence global health. Seeking equity cannot curtail programmers where no harm caused by them is appreciated. The differences between programs allow them to be compared and to progress. The appearance of biomarkers, treatments, analytic l technology, etc., requires frequent changes in the programs, and the training, criteria, and mentality of those responsible for them will depend on whether these changes are adopted.

Abstract: Background: Motivational text messages can encourage increased physical activity. This study aimed to assess the content validity and perceived motivational value of text messages to encourage physical activity among older adults and care partners. Methods: We designed nine motivational text messages to capture nine distinct physical activity scenarios. Using a cross-sectional design, we enrolled 14 content experts, 310 older adults, and 305 care partners. Content experts assessed the relevance, while the older adults and care partners assessed the perceived motivational value of each text message on a 5-point Likert scale. We computed the item content validity index and assessed differences in perceived motivational value among older adults and care partners using quantile regression, while adjusting for sociodemographic and health characteristics. Results: The item content validity index ranged from 0.86 to 1.00. The median (interquartile range) perceived motivational values for each text message were 4.0 (3.0–5.0), and there were no statistically significant differences in the reported motivational values between older adults and care partners. Conclusion: We present nine content-validated text messages with high motivational value for older adults and care partners, which can be integrated into technology-based intervention studies and may improve physical activity behavior among both groups.

Abstract: Background/Objectives: The diagnosis of a rare disease, such as Sturge-Weber syndrome, in a newborn has a profound emotional impact on parents and presents a significant challenge, as they must face an unexpected and unfamiliar reality. The aim of this study was to analyze the meaning of caregiving among parents of children with Sturge-Weber Syndrome, identifying the different coping styles they adopt. Methods: A cross-sectional descriptive study was conducted with 28 parents of children with Sturge-Weber Syndrome in Spain. Data were collected using the Brief COPE inventory and the Finding Meaning Through Caregiving Scale (FMTCS). Results: Responses from 28 participants were analyzed, revealing that parents experienced a sense of fulfillment in providing meaning to the care of their children, coping with the diagnosis, and assessing their child’s development. A higher sense of care was observed in families where both parents cohabited. Additionally, as the affected descendant grew older, the perceived sense of care increased. Conclusions: The most frequently used coping strategies among parents were active coping and acceptance of the disease, regardless of sociodemographic characteristics. As parents aged, they began to adopt additional strategies such as emotional venting, positive reframing, or humor.

Abstract: Digital health technologies are reshaping healthcare, yet their evaluation in low- and middle-income countries (LMICs) remains uneven. This study identified three critical pillars of technology benchmarking, digital health literacy, and social media listening as essential for assessing digital health efficacy and equity. A scoping review, guided by PRISMA, was conducted in PubMed (September 2025) to synthesize peer-reviewed studies published between January 2020 and September 2025. Eligible articles addressed at least one of the three pillars and were relevant to LMIC health systems; opinion pieces and studies focused solely on high-income settings were excluded. Data were extracted systematically, and findings were synthesized descriptively. The integration of these three pillars provides a multidisciplinary framework for evaluating digital health in LMICs, underscoring the importance of tools that are technically sound, culturally appropriate, and developed through cross-sector collaboration.

Abstract: Background: Accurate diagnosis of periprosthetic joint infection (PJI) remains challenging, particularly in culture-negative and borderline cases where current practices lead to high diagnostic uncertainty. SynTuition™, a machine-learning–based probability score integrating preoperative biomarkers, was developed to support clinical decision-making. This study compared its diagnostic performance and economic impact with standard physician practice. Methods: A total of 12 physicians provided diagnoses of 274 clinical vignettes representing suspected PJI cases. SynTuition probabilities were converted to binary Diagnostic classifications using a validated threshold. Diagnostic accuracy, agreement, indecision rates, decision-curve analysis, and misdiagnosis-related costs were evaluated. Results: SynTuition achieved an overall percent agreement of 96.0% when compared against the expert adjudicated clinical reference, outperforming the pooled physician group at 90.8%. Physicians showed high indecision (38–48%) in inconclusive 2018 ICM cases, whereas SynTuition generated a definitive diagnosis with an 86.7% agreement against expert adjudication. Decision curve analysis demonstrated higher net benefit for SynTuition across a broad range of thresholds, reducing projected unnecessary revision by up to 5.8%. Economic modeling showed a reduction in misdiagnosis-related costs from $6.9 million to $2.9 million per 1,000 suspected PJI cases, yielding estimated savings of $4,000 per suspected case. Conclusions: SynTuition demonstrated high diagnostic accuracy, lower uncertainty, and significant clinical and economic advantages over routine physician practice, supporting its integration into clinical decision-making for suspected PJI, particularly in diagnostically ambiguous cases.