Artificial intelligence (AI)-assisted endoscopy represents a promising approach for lesion detection, yet frequent false-positive detections impair clinical utility by disrupting examinations and diminishing physician confidence. Linked-color imaging (LCI), an image-enhanced endoscopy technique that amplifies mucosal and vascular contrast, may address this limitation. This investigation evaluated whether LCI reduces false-positive AI detections compared with white-light imaging (WLI). This retrospective study analyzed consecutive AI-assisted upper endoscopies performed between March 2024 and June 2025. WLI and LCI were performed sequentially within the same endoscopic session in each patient. False-positive AI detections were compared between modalities using two computer-aided detection (CAD) versions. Propensity score adjustment was used as a sensitivity analysis for baseline differences between CAD Versions I and II. Of 66 initially screened cases, 63 remained after excluding patients with prior gastric surgery. LCI reduced false-positive AI detections compared with WLI (median 2 vs. 5; p < 0.001). In CAD version-stratified sensitivity analyses, LCI reduced false-positive AI detections in both Version I (5 to 2; p = 0.01) and Version II (2 to 0; p = 0.03). This reduction remained consistent across atrophic grades. Both imaging modalities identified all gastric lesions, achieving 100% detection sensitivity. LCI assessment performed after WLI observation yielded fewer false-positive CAD-EYE detections while maintaining lesion detection sensitivity. However, because the observation sequence was fixed, these findings should be interpreted cautiously and require confirmation in prospective or counterbalanced studies. Trial Registration: N/A (retrospective study).
Uterine fibroids are the most common tumour of the female genital tract and represent a major cause of gynaecological morbidity. Management options have expanded in recent years, including minimally invasive surgical techniques and emerging medical and incisionless therapies. However, access to these treatments may vary geographically. This study aimed to explore current practice patterns, availability of interventions, and clinician perspectives on the future organisation of fibroid services in the United Kingdom. A pilot survey of UK gynaecologists was conducted using an online questionnaire developed by a focus group of clinicians with expertise in fibroid management. The survey assessed availability of treatment modalities, imaging preferences, surgical practices, and opinions on service organisation. The questionnaire was disseminated through the British Society for gynaecological endoscopy newsletter and at the society's 2024 annual scientific meeting. Responses were analysed using descriptive statistics. Fifty UK-based clinicians were included in the analysis. Established surgical interventions, including abdominal, laparoscopic, and hysteroscopic myomectomy, were widely available. However, access to newer technologies varied between regions. Radiofrequency ablation was available in five of nine regions represented, while high-intensity focused ultrasound was not available to any respondents. Most clinicians reported access to MRI for fibroid mapping, although specialist ultrasound availability was more variable. Minimally invasive myomectomy was performed by 60% of respondents. The majority supported referral to specialised centres when local expertise was unavailable. Most respondents favoured multidisciplinary discussion for complex cases and supported a more centralised model of fibroid care. This survey highlights variation in access to fibroid treatments across the UK and identifies support among clinicians for more structured and centralised fibroid services. These findings support the need for further national evaluation and service development to improve equitable access to comprehensive fibroid care. Uterine fibroids are non-cancerous growths of the womb and are the most common tumour in women of reproductive age. They can cause heavy bleeding, pain, pressure symptoms, infertility, and pregnancy complications. Treatments include medication, minimally invasive procedures, and surgery, but access varies across the United Kingdom.This study examined how fibroids are managed and explored doctors’ views on current and future services. An anonymous survey of UK gynaecologists gathered information on available treatments, decision-making, and service organisation.Fifty clinicians responded. Most reported good access to established surgeries such as myomectomy (surgical removal of fibroids) and hysterectomy (surgical removal of the womb). However, access to newer treatments like radiofrequency ablation (a minimally invasive, outpatient procedure that shrinks uterine fibroids without surgery) was limited, and none reported access to high-intensity focused ultrasound (a non-surgical treatment that uses sound waves to shrink painful fibroids). Many supported developing specialised centres offering a full range of treatments.These findings highlight ongoing inequalities in access and suggest that more coordinated services could improve equitable care.
Interoception, the processing and perception of internal bodily signals, regulates a wide range of psychological and somatic functions, including emotional experiences, bodily symptom perception, self-awareness and decision-making, highlighting its important role in the maintenance of bodily and mental homeostasis. Traditionally, interoception has been studied within single organ domains, with findings often generalized to interoception as a whole. However, evidence suggests interoceptive abilities may be domain-specific rather than a general ability. This pilot study investigated how perceptual and affective dimensions of interoception relate across organ systems. Thirty-three healthy adults completed comparable magnitude estimation and sustained stimulation tasks, allowing for comparisons across the respiratory, esophageal, and cardiac domain in a within-subjects design. Respiratory sensations were evoked through inspiratory resistive loads, esophageal sensations through balloon inflations, and cardiac sensations via graded cycle ergometer exercise. Interoceptive sensitivity, the ability to perceptually discriminate between stimulation levels, was quantified as the slope of intensity ratings relative to stimulation intensity. Acute affective responses were assessed through unpleasantness ratings during sustained stimulation. Results revealed no significant correlations in interoceptive sensitivity across domains, with Bayesian analyses providing anecdotal support for the null hypothesis. In contrast, acute affective responses showed partial convergence: respiratory unpleasantness ratings correlated significantly with both esophageal and cardiac ratings, whereas esophageal and cardiac ratings were not significantly correlated. These findings support a multidimensional model of interoceptive processing, where interoceptive sensitivity appears domain-specific, while acute affective responses show partial generalization across organ systems. The results caution against generalizing findings from single-organ paradigms to overall interoceptive functioning.
This pilot study aimed to explore the association between the GRACE score and right ventricular (RV) function, including ejection fraction, volumes, and stroke volume, assessed using three-dimensional echocardiography in patients with acute inferior STEMI undergoing primary PCI. This cross-sectional pilot study was conducted in the angiography department of Qaem Hospital, Mashhad, from January 2020 to June 2021. Patients with acute inferior STEMI who underwent successful primary PCI and were hemodynamically stable were included. Three-dimensional echocardiography was performed 24-48 h after PCI. The GRACE in-hospital mortality risk score was calculated at admission. Associations between GRACE score and RV parameters were analyzed using Pearson correlation and multivariable linear regression. A total of 40 patients (mean age 56.75 ± 11.31 years; 70% male) were included. Significant negative correlations were observed between GRACE score and RV end-diastolic volume (r = -0.314, p = 0.048) and stroke volume (r = -0.340, p = 0.032). Heart rate also showed significant associations with left and right ventricular functional parameters. This study demonstrates an exploratory association between GRACE score and right ventricular function in patients with acute inferior STEMI undergoing primary PCI. These findings are hypothesis-generating and require validation in larger prospective studies with clinical outcomes.
Plastic drinking straws are a visible single-use plastic product, yet selecting suitable substitutes remains challenging because literature-derived climate evidence and reported user experience are rarely evaluated together. This study develops and demonstrates an interpretable AI-enabled decision-support workflow that integrates literature-derived per-use greenhouse gas (GHG) indicators with review-derived user evidence extracted from online customer reviews using natural language processing (NLP). Drinking-straw alternatives were used as an information-rich case study. The integrated assessment combined a GHG-derived score, a user-experience feature score, and rating-based consumer approval within a transparent multi-criteria decision analysis (MCDA) under four predefined decision-priority scenarios. Among the five shortlisted materials and within the evaluated dataset, the selected per-use GHG assumptions, review-derived user evidence, normalization procedure, and scenario-specific weights resulted in Silicone achieving the highest integrated MCDA score across all four scenarios, whereas Paper ranked lowest. Silicone combined a low per-use GHG indicator with the highest user-experience feature score and high consumer approval. Paper had the highest per-use GHG indicator and a moderate user-experience feature score, while lexical analysis identified recurring functionality-related expressions in its reviews. A shallow decision tree identified a 0.081 kg CO₂e/use threshold separating Paper from the lower-per-use-GHG reusable alternatives within the evaluated decision matrix. The study is not a new process-based life-cycle assessment or comprehensive sustainability assessment. Instead, it demonstrates decision support limited to per-use GHG indicators and review-derived user evidence; broader sustainability dimensions were outside the scope. Future studies may adapt and evaluate the workflow for other product categories using product-appropriate environmental criteria and relevant user-derived evidence.
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Primary human satellite cells (SCs) are essential for skeletal muscle regeneration research, but access to tissue is constrained by the need for invasive biopsies. Post-mortem muscle represents a potential alternative, yet data on establishing expandable myogenic cultures from multiple human muscle groups are sparse. To develop a workflow for isolating, expanding, and morphologically assessing myogenic progenitor cells from embryologically distinct muscles of human body donors. Eighteen biopsies from six muscles (erector spinae, vastus lateralis, brachioradialis, masseter, extraocular muscles, diaphragm) were collected from three body donors (age 79-85 years; post-mortem intervals 13-30hours). Cells were isolated by enzymatic dissociation, enriched by fluorescence-activated cell sorting (CD31⁻/CD45⁻/CD56⁺), and cultured for six weeks. Differentiation was assessed by phase-contrast microscopy. Viable cells were isolated from all donors (median viability 10.3%). Cultures were established from one of three donors; the remaining two failed due to insufficient biopsy size (procedural) and low viability despite the shortest post-mortem interval (biological), respectively. In the successful donor, five of six muscles including somitic and non-somitic origins gave rise to adherent cultures forming structures morphologically consistent with myotubes. Culture viability increased from 11.6% to 36.7% over six weeks. Post-mortem skeletal muscle from anatomical body donors can yield cells capable of in vitro expansion and morphological myogenic differentiation across embryologically diverse muscle groups. Inter-donor variability limits consistent success. This pilot study provides a practical workflow and documents both successful and unsuccessful outcomes to inform future optimization.
Despite advances in acute stroke care, long-term disability remains prevalent, placing substantial demands on informal caregivers. As structured rehabilitation in the chronic phase of stroke wanes, caregivers face evolving emotional, social, and logistical challenges with limited support, yet accessible and sustainable models of care remain limited. This implementation-informed exploratory pilot study evaluated the feasibility, acceptability, and preliminary outcomes of a virtual stroke caregiver support group. Five participants attended weekly virtual sessions over six weeks facilitated by healthcare professionals. The virtual format addressed accessibility barriers frequently experienced by caregivers including travel time and distance, money, and caregiving responsibilities. Participants had moderate levels of loneliness and some engagement in self-care activities. Participants reported high satisfaction with and perceived benefits of the intervention, noting improved coping, increased confidence in the caregiving role, and validation for their lived experience as a caregiver. The results underscore the need for inclusive, scalable caregiver interventions and greater healthcare provider engagement in caregiver support. Furthermore, the findings of this study support the feasibility and acceptability of a virtual caregiver support group in community-based settings and its potential to promote caregiver well-being.
Residual congestion is the principal driver of heart failure readmission, and reliable serial assessment of volume status remains an unmet clinical need. This study asked whether a wrist-worn, machine-learning-based device for non-invasive venous waveform analysis in heart failure (the NIVA HF device), which produces an integer-scaled estimate of pulmonary capillary wedge pressure termed the NIVA Score, responds to acute changes in volume status. Agreement between the NIVA Score and invasively measured pulmonary capillary wedge pressure at single time points has been established in a separate prospective, multi-site study; however, such static agreement does not establish whether the measure tracks dynamic decongestion. We therefore evaluated the directional responsiveness of the locked NIVA Score in two prespecified cohorts: hospitalized adults with acute decompensated heart failure undergoing routine intravenous diuresis, and a controlled porcine model of volume overload followed by diuresis. In eleven patients contributing thirteen paired measurements (mean net fluid balance -2.1 ± 1.0 L), NIVA Scores decreased significantly after diuresis (paired t-test, P = 0.04). In five pigs contributing twenty-four paired measurements, NIVA Scores decreased significantly after intravenous furosemide following crystalloid loading (P <0.01), and the direction of change was concordant with measured urine output in every animal. Statistical significance was reached in both cohorts despite modest sample sizes, indicating a measurable NIVA Score reduction with volume removal. In an exploratory analysis, the discharge NIVA Score yielded an area under the receiver-operating-characteristic curve of 0.85 (95% confidence interval 0.575-1.00; P = 0.04) for thirty-day readmission. Together, the significant, directionally concordant NIVA Score reductions across independent clinical and preclinical cohorts demonstrate that the device tracks acute decongestion and support its use for serial, non-invasive congestion monitoring; an adequately powered prospective study is the planned next step.
Post-approval observational studies that rely on traditional data collection approaches may be burdensome for community oncology settings with limited research infrastructure. We conducted a prospective observational study using an EHR-integrated platform to evaluate its feasibility for streamlining data collection in community oncology. We were able to capture high-quality data on infusion-related reactions in patients with multiple myeloma receiving daratumumab. The EHR-integrated platform included centralized patient identification, automated EHR-to-electronic data capture system data transfer, and centralized abstraction services. Over 11 months, 82 patients enrolled at four US community oncology sites, with 30.5% identifying as Black or Hispanic. Across 4568 essential data points: missingness accounted for 0.59%, 91% of data points were eligible for automated transfer, median transfer time for structured data was 1.7 days, and query frequency was <2% with a median resolution time of 5.1 days. This pilot study demonstrated that EHR-integrated platforms can be operationalized in community oncology settings with high data completeness and rapid, diverse enrollment, expanding access to clinical trials outside traditional research centers and producing more generalizable results.
This pilot study compared the effects of load-matched isometric resistance training and dynamic resistance training on neuromuscular and sport-related performance in collegiate Kho-Kho athletes. Seventeen athletes completed the study and were included in the final analysis: nine in the isometric training group and eight in the dynamic training group. Both groups completed a five-week training program, with intensity regulated using modality-specific rating of perceived exertion scales: the Isometric Exercise Scale for the isometric group and the Borg CR-10 scale for the dynamic group. Pre- and post-intervention assessments included knee extension and flexion torque at multiple angles and velocities, squat linear sprint performance, vertical jump metrics, and reactive strength index. The isometric group showed significant within-group improvements in 75° knee-extension peak torque and jump height, and both groups improved selected strength and sprint outcomes. Significant Group × Time interactions were observed for 75° right knee-extension peak torque and initial squat-start sprint speed, suggesting greater improvement in the isometric group for these selected outcomes. However, vertical jump improvement did not show a significant Group × Time interaction, and isokinetic torque outcomes showed no clear modality-specific superiority. These preliminary findings suggest that RPE-regulated isometric training may provide short-term benefits for selected joint-angle-specific strength and initial acceleration outcomes in Kho-Kho athletes. However, definitive superiority over dynamic resistance training cannot be concluded from this exploratory pilot study.
Paediatric patients undergoing treatment for acute lymphoblastic leukaemia (ALL) frequently experience significant pain and emotional distress related to procedures. While pharmacological management remains central, integrative non-pharmacological approaches such as art-based therapy (ABT) have shown promise in enhancing psychological well-being. The objective of the study is to assess the levels of self-reported procedural pain and distress among paediatric patients with ALL during the consolidation phase of treatment and to evaluate the effectiveness of a structured ABT intervention in reducing these symptoms. In an intervention study, a single group pre-post quasi-experimental design was carried out involving 21 children between the ages of 7 and 16 who had been diagnosed with ALL. The participants underwent 10 individual ABT sessions over 4 weeks. Pain and distress were measured using the Faces Pain Scale-Revised (FPS-R) and paediatric distress thermometer (PDT), respectively. Descriptive statistics and the Wilcoxon signed-rank test were employed to analyse the data. Preintervention scores indicated mild procedural pain and moderate distress levels. Postintervention, significant reductions were observed in both procedural pain (p < 0.001, z = 4.11, r = 0.90) and distress (p < 0.001, z = 4.03, r = 0.88) scores. Qualitative observations suggested improved emotional expression and relaxation through creative engagement. ABT is a feasible, low-cost and culturally adaptable intervention that significantly reduces pain and distress among paediatric patients with ALL. These findings support the integration of ABT into paediatric oncology supportive care programs, especially in resource-limited settings.
Conditional gene targeting using the Cre-loxP system requires validation of each Cre driver line under the specific experimental conditions to be employed, as Cre recombinase expression can cause transgene-associated pathology. The Ckmm-Cre transgenic mouse is widely used for heart- and skeletal muscle-directed conditional gene targeting, yet its phenotypic and cardiac mitochondrial response to ketogenic diet (KD) remains uncharacterized. Here we report that four-week KD feeding did not alter body weight, treadmill endurance, grip strength, locomotor activity, or rotarod performance in young male Ckmm-Cre mice. Cardiac mitochondrial oxygen consumption and hydrogen peroxide production, assessed by high-resolution respirometry, were likewise unchanged. In cardiac tissue lysates, oxidative phosphorylation subunit abundance and VDAC1 levels were maintained, with no major diet-associated changes in mitochondrial protein content. These pilot data establish a baseline reference for future conditional knockout studies employing this Cre driver under ketogenic conditions.
[This corrects the article DOI: 10.3389/fbioe.2026.1767062.].
Lower urinary tract symptoms (LUTS) from benign prostatic obstruction (BPO) are common in aging men. Surgical interventions such as TURP and laser enucleation are established treatments for drug-refractory BPO. Holmium laser enucleation (HoLEP) has demonstrated favorable long-term safety and efficacy with shorter hospitalization and catheterization times compared to standard TURP. Thulium laser enucleation (ThuLEP) emerges as an effective and safe option, potentially offering advantages including reduced blood loss and shorter catheterization periods compared to TURP. Postoperative catheterization duration following laser enucleation varies among institutions, with an increasing trend toward early catheter removal. Previous studies support the feasibility of same-day catheter removal after HoLEP in selected patients. This study aims to compare outcomes of 24-hour versus 72-hour catheterization following ThuLEP. This randomized prospective pilot study was designed to explore whether 24-hour catheterization yields comparable outcomes to 72-hour catheterization in terms of postoperative voiding dynamics (Qmax), with the aim of generating preliminary evidence for future confirmatory trials. Patients were randomly assigned preoperatively to catheter removal at 24 hours (Group 1) or 72 hours (Group 2). Validated questionnaires (SF-36, ICIQ-SF, IPSS) were administered preoperatively, before discharge, and at follow-up, with uroflowmetry performed. A total of 42 patients (21 per group) were included. No clinically significant differences were observed between groups. Postoperative complications occurred in 7 cases: 1 in the 24-hour group and 6 in the 72-hour group, including urinary leakage, hematuria, and acute urinary retention. Early catheter removal at 24 hours following ThuLEP appears to yield comparable urinary function and patient-reported outcomes to the standard 72-hour protocol in this cohort. These preliminary findings support the feasibility of early catheter removal and provide a basis for future confirmatory trials.
Bipolar membrane electrodialysis (BPMED) is a promising technology for recovering dissolved ammonia (NH3) from concentrated wastewater streams, such as scrubber effluents. To date, most research remains laboratory-scale, while existing pilot-scale studies operate at effluent concentrations of 2 g-N/L, membrane areas below 3.5 m², and current densities under 150 A/m². In this study, a pilot-scale BPMED system with an active membrane area of 21.3 m² was operated in a sequential batch mode. Real scrubber effluents (18-22 g-N/L) were treated to simultaneously recover dissolved NH₃ and regenerate citric acid. For the first time, the influence of non-ideal phenomena including proton (H⁺) competition, NH₃ back diffusion, electro-osmotic and osmotic water fluxes on NH3 recovery, was systematically investigated at current densities beyond typical laboratory values. At feed pH below 3, decreasing current efficiency and a sharply increasing energy consumption established an operating window for the pilot-scale BP-C system, irrespective of the applied current density. NH₃ concentrations in the base compartment increased with increasing current density, reaching 48 g-N/L at 500 A/m² and corresponding to treatment capacities of up to 1.8 kg-N/m²d. At 150 A/m², NH₃ recovery was limited by cyclic NH₄⁺ transport associated with NH₃ back diffusion, coinciding with increased electro-osmotic water flux. At higher current densities, NH₃ recovery was instead limited by electro-osmotic and osmotic water flux driven by current density and osmotic pressure gradients across the membrane. Despite comparable energy consumption (7-9 kWh/kg-N recovered) to previous pilot-scale studies, this work achieved higher NH3 concentrations and treatment capacities while advancing mechanistic understanding of transport limitations in BPMED systems.
Exposure to anthropogenic volatile organic compounds (VOCs) has been associated with preterm birth, yet the spatial distribution of VOC exposures within urban environments remains poorly characterized, particularly for vapor intrusion pathways. Plants have recently been used as a cost-effective, non-invasive tool to "phytoscreen" for belowground contaminants. Here, we evaluated the use of phytoscreening within a birth cohort in metro Detroit, Michigan, USA by (a) assessing participant willingness to allow sampling in residential front yards, (b) quantifying VOC concentrations across plant tissue types (leaves and twigs), and (c) testing whether VOC detections in plants are associated with proximity to brownfield sites. Of 20 pregnant participants, 18 agreed to phytoscreening and sampling was completed at 13 residences, indicating high feasibility. Across 15 plant species, five of six target VOCs (benzene, toluene, ethylbenzene, xylene, trichloroethylene, tetrachloroethylene) were detected. Specifically, toluene was detected at all 13 homes and in 68% of samples. While less common, ethylbenzene was detected in 12 samples across 3 homes and trichloroethylene was detected in one sample that exceeded Michigan's risk-based screening level for soil vapor intrusion. Additionally, VOCs were detected more frequently and at higher concentrations in leaves compared to twigs. However, VOC concentrations in plants were not associated with proximity to known or suspected brownfield sites in this small sample size. Overall, these findings demonstrate the feasibility of phytoscreening in epidemiological studies and highlight its utility for characterizing spatial patterns of VOC exposure. Incorporating plant-based sampling approaches may help identify localized hotspots of human exposure and inform targeted environmental remediation efforts.
Type 2 diabetes mellitus (T2DM) requires sustained self-management and lifestyle modification to achieve optimal glycemic control. Hybrid care models that combine digital health technologies with in-person clinical support may enhance patient engagement while improving the accessibility and scalability of diabetes care. However, evidence regarding their effectiveness and feasibility in Southeast Asian populations remains limited. This study aimed to evaluate the preliminary effectiveness and feasibility of a national hybrid digital intervention for individuals with T2DM in Brunei Darussalam. The primary objective was to evaluate the proportion of participants achieving a reduction in glycated hemoglobin (HbA1c) of ≥0.6% after 16 weeks. Secondary objectives included evaluating changes in metabolic parameters, anthropometric outcomes, and health-related quality of life (QoL). This single-arm, nonrandomized pilot trial enrolled adults with T2DM into a 16-week hybrid digital intervention integrating remote health coaching, structured digital education, self-monitoring activities, and asynchronous communication via WhatsApp. Participants attended scheduled video consultations (VCs) and submitted self-monitoring records throughout the intervention period. Clinical outcomes included changes in HbA1c, fasting blood glucose, lipid profile parameters, BMI, waist circumference, and QoL measured using the EQ-5D-5L instrument. Feasibility outcomes included intervention completion, VC attendance, participant engagement, and intervention acceptability. A total of 122 participants were enrolled, and 108 (88.5%) completed the intervention. Among 104 participants with complete HbA1c data, there was a mean reduction of 1.2% (95% CI -1.45 to -0.96; P<.001). Overall, 65.4% (68/104) of participants achieved the predefined HbA1c reduction threshold of ≥0.6%, while 84.6% (88/104) demonstrated an overall reduction in HbA1c. Significant improvements were also observed in fasting blood glucose (-1.7 mmol/L, 95% CI -2.3 to -1.2; P<.001), BMI (-0.4 kg/m², 95% CI -0.6 to -0.2; P<.001), waist circumference (-1.9 cm, 95% CI -2.9 to -0.9; P<.001), total cholesterol (-0.3 mmol/L, 95% CI -0.6 to -0.2; P<.001), triglycerides (-0.5 mmol/L, 95% CI -0.7 to -0.2; P<.001), and EuroQol Visual Analog Scale (EQ-VAS) scores (+6.7 points, 95% CI 3.9 to 9.6; P<.001). The intervention demonstrated favorable feasibility outcomes, including an 88.5% (108/122) completion rate, attendance at ≥5 VCs by 75.9% (82/108) of participants, and high participant satisfaction, with 86.9% (86/99) of respondents reporting satisfaction or extreme satisfaction with the intervention. The pilot trial demonstrated the acceptability, preliminary effectiveness, and feasibility of a national hybrid digital intervention for individuals with T2DM in Brunei Darussalam. High completion rates, sustained participant engagement, and positive participant feedback support the practicality of implementation within a national digital health ecosystem. The intervention was also associated with improvements in glycemic control, metabolic outcomes, anthropometric measures, and health-related QoL. Larger controlled studies are warranted to evaluate long-term effectiveness, scalability, and implementation outcomes.
Recipient alloimmunization remains the most frequent adverse effect of transfusion therapy. Routine transfusion decisions rely heavily on clinician judgment and informal rules, which limit consistency and reproducibility. Current transfusion decision-making practices do not systematically integrate patient-specific clinical and immunohematologic factors, phenotype-level requirements, and inventory constraints within a coherent framework. This study introduces a recipient-centered integrative model that unifies patient-group-based matching criteria, quantitative compatibility scoring, and phenotype-based inventory curation to support transfusion practices aimed at reducing alloimmunization risk. The ImmunoHematology Framework (IHF) uses demographic, clinical, and laboratory data to define phenotype-based matching requirements. It quantifies recipient-donor compatibility, calculates the degree of phenotype match using all available antigen information, and ranks recipient-unit pairs for selection and allocation. IHF also classifies donor phenotypes to support curation of refrigerated and frozen inventories. The framework was operationally evaluated as an integrated system, including its quantitative compatibility logic, using de-identified operational data and curated demonstration cases across routine and rare scenarios. The IHF model produced extended phenotype matching outcomes (≥14 antigens) that demonstrated improved compatibility recommendations compared with clinician selections in the pilot evaluation, with complete agreement in 59% of cases, moderate deviation in 18%, and significant deviation in 23%. Matching 327 fully typed donors to 27 patients requiring extended antigen compatibility revealed a subset with substantially broader compatibility (median 9 vs. 4 recipients), identifying these units as candidates for long-term frozen storage. IHF formalizes recipient-specific transfusion risk associated with phenotype mismatch and quantitative compatibility as a computable construct the framework demonstrates how its logic, scoring method, donor unit allocation process, and phenotype-based inventory curation can be operationalized in real-world transfusion practice, with reproducibility confirmed by a functioning prototype.
Significant gaps in nutritional knowledge exist among haemodialysis patients, representing a critical opportunity for community nursing intervention. This study aimed to assess renal-specific nutrition knowledge among haemodialysis patients in Southern Iraq, with implications for community nursing practice. A cross-sectional study was conducted with 240 haemodialysis patients (median age 52 years) in Basrah, selected via Stratified random sampling. Knowledge was assessed using a piloted questionnaire, focusing on phosphorus, potassium and sodium intake. IBM SPSS Statistics 25 was used to analyse data. Data were summarised using means and percentages, and examined for group differences and correlations. Low knowledge levels were prevalent among haemodialysis patients (64.2%). Patients aged 40 years or older demonstrated significantly higher knowledge scores than their younger counterparts (P<0.001). Furthermore, higher income was positively correlated with greater knowledge (r=0.165, P=0.011), indicating the influence of socioeconomic status. Significant gaps in nutritional knowledge exist among haemodialysis patients, particularly younger individuals and those with lower incomes. These findings highlight a critical opportunity for community nurses and nutritionists to take a proactive role in dietary education and support. Community nurses can substantially improve dietary management and patient outcomes in renal failure by integrating routine nutritional assessments during home visits, developing tailored educational strategies for different age groups and advocating for resources to support patients with financial constraints.