Nursing practice is increasingly enacted within environments structured by intelligent technologies that filter perception, generate classifications and shape clinical priorities. While nurse scholars have begun to examine moral agency in the context of artificial intelligence, much of the broader ethical discourse on AI in healthcare continues to foreground governance, safety and institutional accountability, leaving the conditions under which nurses exercise professional moral responsibility comparatively under-theorized. This paper argues that technology-mediated care constitutes a moral environment that reshapes how responsibility is distributed, interpreted and enacted in clinical practice. Drawing on nursing ethics and socio-technical thought, it distinguishes between technical delegation and moral delegation, clarifying that while intelligent systems may inform action, they cannot assume moral answerability. Nursing moral agency is reconceptualized as relationally oriented moral perception, interpretive judgement and accountable action that remains fundamentally non-delegable, even under conditions of extensive mediation. Boundary-setting is advanced as a disciplined ethical practice through which nurses delineate the limits of technological authority and sustain professional responsibility. By articulating moral agency as both situated and irreducible, this analysis contributes a conceptual framework for understanding ethical responsibility in the Fifth Industrial Revolution and re-centres the nurse as the accountable moral subject within technology-mediated care.
Background: As a crucial transitional period from campus to society, providing comprehensive undergraduate health psychological care is essential for addressing Social Anxiety Disorder (SAD). Current global healthcare research is actively exploring innovative digital interventions, with a specific focus on leveraging Augmented Reality (AR) as a transformative auxiliary tool in clinical settings. Methods: This study investigates the factors influencing the acceptance of AR-assisted Cognitive Behavioral Therapy (CBT) within student healthcare frameworks by developing a research model based on the Technology Acceptance Model (TAM). The framework incorporates key clinical and behavioral constructs: self-efficacy (SE), facilitating conditions (FC), and social influence (SI). Results: SE, FC, and SI significantly and positively impact the willingness to adopt AR technology for mental health purposes. Based on these findings, practical recommendations are provided for healthcare technology developers, therapists, and university psychological care providers to enhance the integration of AR-assisted CBT. Conclusions: Strengthening these digital pathways is vital for improving healthcare outcomes and enabling students to navigate future social and professional environments effectively. Because the sample consisted solely of Chinese undergraduate students, the findings should be interpreted within this specific cultural and educational context and require further validation in cross-cultural and multi-regional samples.
At the frontiers of X-ray and high-power laser optics, Professor Zhanshan Wang has made outstanding contributions from fundamental mechanism to fabrication technologies and high performance applications over the last 25 years. As a Professor at Tongji University, he leads the Innovative Research Group of the National Natural Science Foundation of China, pioneered a novel theoretical framework for the synergistic tailoring of spectral response, electric field distribution, irradiation damage and optical loss in thin films optics. He developed high-precision characterization methods for resolving atomic-scale defects in coatings, invented a full-process and quantitative fabrication technology for thin film optics. By establishing premier research platforms and cultivating a highly skilled scientific team, his sustained efforts have greatly improved the performance of X-ray and optical thin-film devices which have been widely applied in synchrotron radiation, high power laser facilities, and space telescope. In this interview, he reflects on the scientific concepts guiding his research on X-ray and laser optics, the philosophy behind cultivating a world-class research team, and his vision for the future of optical science and technology.
Biological computers, or 'biocomputers', are being engineered with brain organoids integrated with in silico hardware and software components. This technology promises to advance our mechanistic understanding of cognitive processes by embodying in vitro neural systems within virtual learning environments. Yet, biocomputers raise ethical and moral questions, such as whether evidence of consciousness indicates that embodied neural systems have moral status. To better understand the relationship between signs of consciousness and ethical concerns, we conducted an exploratory study to investigate public views toward biocomputers. We examined whether the public's tendency to attribute consciousness to human and non-human entities guides moral reasoning about biocomputers. We discovered a latent structure underlying public views on the distribution of consciousness. Specifically, we identified three cluster groups, characterized by opinions on the scope of consciousness. These cluster groups were highly predictive of views toward the cognitive capacities and moral status of biocomputers. Respondents in our sample exhibited strong support for research on and creation of biocomputers, and for some, support increased as biocomputers were perceived to be more conscious-a relationship that appears to conflict with conventional reasoning in moral philosophy. Future studies will help determine the prevalence of these views among stakeholders and demographically representative publics at local, national, and global scales whose ethical judgements will inform regulation, oversight, and governance of engineered neural systems.
As smart older adult care shifts from basic information support to more continuous algorithm-driven care, concerns have grown about whether such systems support older adults' independence or weaken their sense of autonomy. Although previous research has focused mainly on technology acceptance, less is known about how algorithmic care shapes perceived autonomy and through which psychological pathways this occurs. This study examined whether perceived algorithmic care intensity reduces older adults' perceived autonomy in community smart care settings, whether decisional substitution and perceived surveillance mediate this relationship, and whether digital literacy moderates these effects. A 3-stage design was adopted. First, a qualitative prestudy with 15 older adults was conducted to refine the focal constructs and measures. Second, a vignette-based experiment with 233 valid participants tested the effects of algorithmic care intensity on decisional substitution, perceived surveillance, and perceived autonomy. Third, a community-based survey with 298 valid participants examined the moderated mediation model in real-world smart older adult care settings. In study 1, compared with the low-intensity condition, the high-intensity condition significantly increased decisional substitution and perceived surveillance, while reducing perceived autonomy. Indirect effects through decisional substitution (effect=-0.072, 95% CI -0.144 to -0.016) and perceived surveillance (effect=-0.084, 95% CI -0.161 to -0.019) were both significant. In study 2, perceived algorithmic care intensity positively predicted decisional substitution (β=.400, P<.001) and perceived surveillance (β=.440, P<.001), and negatively predicted perceived autonomy (β=-.356, P<.001). The indirect effects through decisional substitution (effect=-0.112, 95% CI -0.172 to -0.065) and perceived surveillance (effect=-0.149, 95% CI -0.215 to -0.093) were significant. Digital literacy significantly weakened the effect of algorithmic care intensity on decisional substitution (β=-.174, P=.002), but not on perceived surveillance (β=-.071, P=.18). Algorithmic care may undermine older adults' perceived autonomy both directly and indirectly through decisional substitution and perceived surveillance. Digital literacy appears to be a selective rather than universal buffer. These findings extend smart older adult care research beyond technology acceptance and clarify the tension between empowerment and control in algorithmic care.
Mobile information technology (IT) is increasingly being used in the health care sector, and it can play a critical role in both the care of children with congenital heart disease (CHD) and the quality of life of their families. This study aimed to conduct a scoping review of the application of mobile health (mHealth) technologies in the care of children with CHD. We summarized the forms of mHealth interventions and effects on CHD to provide a reference for future research in this field. We searched PubMed; Embase; Web of Science; the Cochrane Library; CINAHL; China National Knowledge Infrastructure; Wanfang Data; the Chinese Biomedical Database; VIP Chinese Science and Technology Journal Database; National Guideline Clearinghouse of the United States; the website of the Registered Nurses' Association of Ontario, Canada; the Guidelines International Network; the American Heart Association; and the American Association of Cardiovascular and Pulmonary Rehabilitation. The search period was from the establishment of the databases to June 12, 2025. The retrieved literature was screened and analyzed. A total of 519 Chinese- and English-language articles were identified, with 44 (8.5%) studies meeting the inclusion criteria. The primary forms of mHealth interventions for patients with CHD included mobile apps, wearable devices, and remote monitoring equipment. The findings indicated that mHealth technologies could improve exercise capacity, nutritional status, psychological well-being, and quality of life in children with CHD. The application of mHealth in the care of children with CHD is feasible and demonstrates positive effects. Future research should emphasize peer education and patient privacy protection while further exploring remote education and health management based on theoretical frameworks and intelligent ITs to enhance quality of life for both children with CHD and their parents.
Understanding how lifelong learners adopt generative artificial intelligence (GenAI) is critical for effectively integrating these tools into lifelong education systems. Drawing on the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), this study employs Partial Least Squares Structural Equation Modeling (PLS-SEM) and fuzzy-set Qualitative Comparative Analysis (fsQCA) to examine GenAI adoption among 436 lifelong learners. PLS-SEM reveals that performance expectancy, effort expectancy, social influence, hedonic motivation, price value, and habit significantly predict behavioural intention, which in turn predicts usage behaviour. fsQCA identifies four types of configurational pathways to high behavioural intention and four to high usage behaviour, revealing concurrent factor combinations that are associated with adoption. These findings offer evidence-based guidance for integrating GenAI in lifelong education.
Depression is prevalent and debilitating. Although interventions exist, they are rarely delivered in accessible, scalable ways that retain their effectiveness. Cognitive behavioral immersion (CBI) is a coach-led cognitive behavioral skills program delivered in social virtual worlds that offers a potential solution. This parallel-group, web-based randomized controlled superiority trial compared CBI accessed via virtual reality headsets (CBI-VR) or flat-screen devices (CBI-FS) to a delayed access control. Inclusion criteria included a clinical level of depression symptoms, age ≥18 years, able and willing to give informed consent, access to a computer with an internet connection, and ability to speak and read English. Eligible participants were randomized using a random number generation script in a 1:1:1 ratio to conditions. CBI consisted of 8 weekly 1-hour groups led by coaches who taught cognitive behavioral skills. The intervention lasted 8 weeks; follow-up lasted 6 months. The primary outcome was depression symptoms; secondary outcomes were anxiety symptoms and quality of life. Recruitment and study procedures were conducted online. Outcomes were assessed through electronic self-report questionnaires. The study was unblinded. Hierarchical linear modeling was used to examine differences in rates of change among conditions. We explored the sense of presence as a potential mediator of intervention response. Participants were recruited from February 2024 to January 2025; n=102 were randomized to each condition. Participants randomized to CBI-VR and CBI-FS attended an average of 5 intervention sessions. Primary analyses included all participants in the intent-to-treat sample that completed ≥2 outcome surveys to estimate within-person change (CBI-VR: n=98; CBI-FS: n=86; control: n=102). CBI-VR showed faster reductions in depressive and anxiety symptoms than either CBI-FS (depression: β=.21; 95% CI 0.02-0.40; P=.03 and anxiety: β=.20, 95% CI 0.03-0.38; P=.02) or the control (depression: β=.31, 95% CI 0.13-0.48; P<.001 and anxiety: β=.18, 95% CI 0.01-0.34; P=.03) across the 8-week intervention, with improvements largely maintained over the 6-month follow-up. CBI-VR also showed greater improvements in general quality of life (β=-1.02; 95% CI -1.63 to -0.40; P=.001) and psychological well-being (β=-1.01, 95% CI -1.44 to -0.59; P<.001) than the control from pre- to postintervention. The sense of physical presence in the environment was associated with CBI-VR's effects on depression symptoms (ab=-0.85, 95% CI -1.71 to -0.15). No adverse effects occurred in any group. This study evaluated the efficacy of an innovative coach-led cognitive behavioral skills group delivered via VR. To our knowledge, our trial is the first to demonstrate that CBI delivered via VR is effective. These findings extend prior work on digital cognitive behavioral therapy by supporting CBI-VR as an effective and viable intervention package for depression and anxiety symptoms. These findings may help inform future research on suitable technology that can help bridge mental health care gaps.
To systematically evaluate the current state of research on symptom clusters in patients with chronic obstructive pulmonary disease (COPD) and the impact of identifying symptom clusters on health-related quality of life (HRQoL) outcomes. A systematic review. Two reviewers independently screened the studies against the eligibility criteria. Studies were assessed for risk of bias using the Appraisal tool for Cross-Sectional Studies (AXIS tool). Data were extracted using a pre-developed extraction tool and thematically analysed. Databases searched included EMbase, PubMed, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database and China Science and Technology Journal Database. Searches were conducted from inception to June 12, 2025. Eighteen studies were included. Symptom clusters were identified using two tool types, including four multi-symptom and 18 single symptom evaluation tools. Common symptom clusters are respiratory-related symptom cluster, psychological-related symptom cluster, sleep-related symptom cluster and fatigue-related symptom cluster. Seven studies found significant negative associations between symptom clusters and HRQoL. Six studies reported the negative effect of each symptom cluster on HRQoL, but only one study showed no association for the sleep-related cluster. The study of COPD symptom clusters still lacked general evaluation tools and statistical methods. Robust studies are needed to deeply explore the differential impact of symptom clusters across various dimensions of HRQoL. Our findings may make symptom management strategies based on the perspective of symptom clusters possible. In clinical practice, nurses should prioritize identifying and intervening in the symptom clusters with the most significant impact on HRQoL, thereby promoting the transformation of the nursing model from 'single-symptom management' to 'multi-symptom collaborative management.' This study adheres to PRISMA and SWiM reporting guidelines. No Patient or Public Involvement because of the systematic review. PROSPERO: CRD42024606544.
Pelvic inflammatory disease (PID) is a common infectious condition of the female upper genital tract that imposes a substantial global burden on women's reproductive health and overall quality of life. This narrative review aims to comprehensively synthesize current evidence on the inducing factors and complication risks of PID. We conducted a systematic literature search in PubMed, Embase, and Web of Science databases from January 2010 to December 2025, prioritizing high-quality evidence including systematic reviews, meta-analyses, large-scale population-based cohort studies, and national registry data. The review systematically categorizes PID etiologies into sexually transmitted infections, cervicovaginal dysbiosis, iatrogenic procedures (intrauterine device insertion, assisted reproductive technology, and intrauterine manipulations), anatomical abnormalities, underlying gynecological conditions, lifestyle habits, and environmental exposures, with a particular focus on the emerging role of cervicovaginal microbiota in idiopathic PID. Beyond well-established reproductive sequelae such as tubal infertility, ectopic pregnancy, and chronic pelvic pain, we also summarize evidence linking PID to a broad spectrum of under-recognized systemic complications, including ovarian and colorectal cancer, cardiovascular and metabolic disorders, intestinal obstruction, and mental health problems. The findings underscore the critical importance of early diagnosis, appropriate antimicrobial treatment, and comprehensive risk stratification for optimizing clinical outcomes and reducing the long-term burden of PID.
With the continuous increase in the global prevalence of diabetes, the prevention and treatment of diabetic retinopathy (DR) have become a global public health challenge. In China, due to population aging, lifestyle changes, and advances in medical diagnostic technology, the incidence and detection rate of DR have been increasing year by year. Therefore, exploring effective management and follow-up models for DR is of paramount importance in reducing the blindness rate caused by DR and improving the quality of life of patients. Based on the KPAI theory, a questionnaire for postoperative follow-up needs of patients with diabetic retinopathy was developed to determine the effectiveness of the questionnaire. The content of intelligent follow-up was adjusted based on the results of the needs questionnaire survey, and the changes in disease knowledge, physical, psychological, and social aspects of postoperative follow-up patients were evaluated. A total of 1372 patients with diabetic retinopathy who received treatment in our hospital's wards from January 2023 to December 2023 were selected. Among them, 278 patients underwent a postoperative follow-up needs survey, with 347 patients undergoing routine follow-up and 445 patients undergoing intelligent follow-up, with a follow-up time of one week after surgery. In the first participation of patients in intelligent follow-up, 20 patients were randomly selected for follow-up one month and three months after surgery to assess changes in patient indicators. The scale finally determined 16 items, including information acquisition, postoperative self-management, psychological emotions, and social integration, with a Cronbach's α coefficient of 0.662, I-CVI range of 0.714 to 1, and an S-CVI value of 0.929. After routine follow-up and intelligent follow-up, negative social emotions, public health positive index, and scores of depression-anxiety-stress were statistically significant (P < 0.05). The boxplots after intelligent follow-up in the first week, one month, and three months all showed an improving trend. The questionnaire for postoperative follow-up needs of patients with diabetic retinopathy based on KPAI has clinical utility. The use of an intelligent follow-up system is beneficial to the postoperative recovery of patients with diabetic retinopathy and improves the physical and mental health of patients.
This cross-sectional study aimed to identify high-risk influencing factors associated with higher odds of physical inactivity among Chinese university students using data from the CPAHLS-CS. It further explored gender differences in these associations to provide evidence for developing differentiated intervention strategies. This cross-sectional study aimed to identify factors associated with IPAQ-derived low physical activity (LPA) among Chinese university students using data from the CPAHLS-CS and to examine whether these associations differed by gender. A cross-sectional questionnaire survey was conducted among 35,696 university students from general higher education institutions across China in 2024 using stratified cluster sampling. The questionnaire was utilized to assess the students' PA levels and collect data on demographic, psychological, behavioral, and health indicators. PA level was classified into low, moderate, and high categories according to the IPAQ scoring protocol. For binary logistic regression, LPA was used as the outcome variable, with LPA coded as 1 and moderate/high PA coded as 0. Chi-square tests, Spearman correlation analysis, sex-stratified binary logistic regression, and pooled logistic regression models with gender-by-predictor interaction terms were used to examine factors associated with physical inactivity and to formally test whether these associations differed by gender. The overall prevalence of IPAQ-derived LPA was 68.48%. When calculated within gender groups, the prevalence of LPA was 55.0% among male students and 85.5% among female students. .When calculated within each gender group, the prevalence of IPAQ-derived LPA was higher among female students than among male students. Regression analysis showed that low self-efficacy was the strongest factor associated with higher odds of LPA across genders (male students OR = 1.997, 95% CI: 1.806-2.207; female students OR = 2.169, 95% CI: 1.949-2.413). Myopia and smartphone addiction were identified as common factors associated with higher odds of LPA across genders. Depressive symptoms were a positive predictor of inactivity for both males and females. Formal interaction testing in the pooled model confirmed significant gender differences for anxiety severity and BMI. In the pooled interaction model, the associations of anxiety severity and BMI with low physical activity differed by gender. Interaction analyses showed that anxiety severity was associated with lower odds of LPA among female students, whereas higher BMI was associated with higher odds of LPA primarily among male students. The issue of IPAQ-derived LPA among Chinese university students is severe and exhibits marked gender differences. Female students are more susceptible to IPAQ-derived LPA, while the risk for male students is more closely associated with weight perception. Low self-efficacy was identified as a key high-risk influencing factor associated with higher odds of LPA, whereas depression, smartphone addiction, and myopia were core associated factors across genders. Formal interaction analyses indicated that anxiety severity and BMI were associated with physical inactivity in a gender-dependent manner.
China's Civil Code (2021) consolidates patients' right to informed consent and tightens the duty of disclosure owed by medical staff. In clinical practice, however, the substantive provisions of the Civil Code have not dissolved the persistent gap between statutory rule and everyday medical activity. This Policy and Practice Review diagnoses four interlocking practical dilemmas in the operation of the Code's informed-consent rule-covering defensive formalism, ambiguity over the decision-maker, the evidentiary architecture for consent and refusal, and the open-textured "inappropriate to explain" exception-and proposes a corresponding reconstruction along legal, cultural and technological dimensions, drawing on the reasonable-patient standard articulated in Canterbury v. Spence and Montgomery v. Lanarkshire Health Board (1, 2) and reaffirmed by the American Medical Association (3), the doctrine of therapeutic privilege as theorized by Faden and Beauchamp (4), and international guidance on informed-refusal documentation (5). By examining the institutional, cultural and technical factors contributing to these challenges, the article articulates implications for patient safety, equity for vulnerable populations, system-level trust and the dispute burden borne by clinicians and institutions, with a view to harmonizing legal compliance with humanistic, patient-centered care.
Obtaining informed consent from research participants is an ethical imperative. In mental health research, cognitive deficits can impair the ability to provide individual consent. This study explored the consenting practices of key research team members to enhance comprehension in research involving individuals with schizophrenia and bipolar affective disorder at the national referral mental health hospital in Uganda. The study was conducted at a national referral mental hospital in Uganda. In-depth interviews were conducted with 21purposively selected participants. Audio recordings were transcribed, and transcripts were managed using NVivo 14. Data were analyzed using inductive thematic analysis. Two themes emerged from the findings: (1) key considerations during the informed consent process, and (2) reported practices for enhancing participants' understanding of the research and medical terms. Researchers reported that participants' capacity to consent was maintained through follow-up to see if they still had capacity in the course of participation. They kept participants interested in consent discussions through building rapport, listening to them attentively, and dedicating more time to ensure effective interaction. Caregivers played an important role in consenting. Researchers perceived that comprehension of consent was supported through reading the consent information to participants verbatim, using iterative learning, and consultation with the community and health professionals who routinely interact with participants. Researchers reported using ongoing consent discussions, rapport building, caregiver involvement, iterative learning, and adaptation of study information to local contexts. These findings suggest the perceived value of contextual and relational factors in supporting autonomy during the consent process for persons with schizophrenia and bipolar affective disorder.
This study aimed to assess patient-reported outcomes (PROs) and clinician-reported outcomes (CROs) following tooth autotransplantation, and to identify factors influencing PROs and CROs. Patients with autotransplanted teeth underwent a follow-up examination and completed visual analogue scale (VAS)-based questionnaires assessing multiple treatment domains. Corresponding items were independently evaluated by three oral surgeons and three general practitioners, based on standardized photographs, periapical radiographs, and digital scans of the region of interest. Inter-rater agreement was assessed, and associations between transplant characteristics and outcomes were analyzed. The sample comprised 33 patients with 37 autotransplanted teeth and a mean follow-up of 8.5 ± 5.8 years. Patients' satisfaction exceeded 90% for oral hygiene accessibility and fulfillment of expectations, whereas esthetic satisfaction (81%) and quality-of-life impact (60.5%) were rated lowest. CROs were significantly lower than PROs for esthetic satisfaction, oral hygiene accessibility, and fulfillment of expectations, whereas PROs were lower for quality-of-life impact (p ≤ 0.005). Inter-rater agreement among clinicians ranged from poor to fair. Infraposition significantly reduced both PROs and CROs (p ≤ 0.05). Additionally, general practitioners assigned significantly lower CROs than to oral surgeons, particularly in the presence of healing sequelae and gingival recession defects (p ≤ 0.045). Tooth autotranslantation was associated with high-long-term patient satisfaction, whereas clinicians rated outcomes more critically. Infraposition was the only variable negatively affecting both PROs and CROs. Despite more critical clinician assessments, patients reported high satisfaction following tooth autotransplantation, supporting this treatment approach as a valuable option for replacement of missing teeth.
This paper examines the discursive, emotional, and institutional dynamics embedded in the racially defensive statement, "But I love the Colored," voiced by a white nurse leader in academia. The phrase "the Colored," a US-specific designation rooted in Jim Crow-era segregation, is deliberately retained to surface how segregationist vocabulary can be effectively reactivated in contemporary academic settings. While seemingly well-intentioned, such language reveals the enduring mechanisms of whiteness in nursing academia, including benevolent racism, white emotionality, and the rhetorical deflection of accountability. Through historical, theoretical, and linguistic analyses, this paper argues that these racial speech acts function as institutional behaviors that retraumatize racialized faculty and students, cause increased workload and fatigue, silence dissent, and reproduce racial hierarchies under the guise of care. This discursive analysis, which draws on critical whiteness studies, calls for faculty to engage in racial literacy training, self-inquiry, emotional self-regulation, and racial accountability. Rather than relying on performative policies, the paper urges antiracist transformation rooted in critical reflective practice, courageous dialogue, and structural change. While the specific linguistic signifiers analyzed here are particular to the United States, the broader phenomena may manifest in distinct forms across other national contexts. Ultimately, this analysis reveals that equity must address white emotional defensiveness within nursing education and the racial harm it produces as the future of the discipline depends not on white comfort, but on institutional transformation.
Chronic spontaneous urticaria (CSU) is a burdensome skin disorder that may remain inadequately controlled with standard H1 antihistamines (H1 AHs). Evidence on adolescents with CSU is limited. This 16-week study evaluated the safety and effectiveness of omalizumab in Chinese adolescents (≥12 to <18 years) with CSU who remained symptomatic despite H1 AH treatment (treatment period: 12 weeks; safety follow-up: 4 weeks). Safety assessments and routine clinical evaluations were performed. Effectiveness and quality of life were analyzed using the weekly urticaria activity score (UAS7), weekly itch severity score (ISS7), Urticaria Control Test (UCT), and Children's Dermatology Life Quality Index (CDLQI). All 55 enrolled participants completed the study. Twenty-two participants (40.0%) experienced ≥1 treatment-emergent adverse event (TEAE). No serious adverse events, adverse events of special interest, deaths, or TEAEs leading to treatment discontinuation occurred. At Week 12, changes from baseline in ISS7 and UAS7 were -11.73 and -25.07, respectively; 70.9% participants achieved well-controlled CSU (UCT ≥ 12). The absolute mean change in CDLQI was -9.7 (relative improvement at Week 12: -81.5%). Omalizumab demonstrated a favorable safety profile and clinically meaningful effectiveness in Chinese adolescents with CSU who remained symptomatic despite H1 AH therapy and is a valuable option for this underrepresented population.
Pretarsal fullness, also known as aegyo-sal, is a critical component of periorbital aesthetics, and its absence often contributes to a fatigued or aged appearance. This retrospective study evaluated the outcomes of capsulopalpebral fascia plication combined with silicone prosthesis implantation and pretarsal fullness surgery performed at our institution between August 2021 and August 2024. A total of 68 patients (mean age, 32.6 ± 6.8 years; 91.2% female) were included. All procedures were completed without intraoperative conversion or major complications. The mean operative time was 46.3 ± 8.5 minutes, with minimal blood loss (12.4 ± 3.6 mL). Objective measurements demonstrated significant improvements in pretarsal protrusion (from 1.2 ± 0.5 mm to 2.9 ± 0.6 mm), inferior tarsal curvature (from 2.1 ± 0.7 mm to 4.3 ± 0.9 mm), and vertical eyelid aperture (from 7.8 ± 1.1 mm to 9.6 ± 1.0 mm; all P <.001). Independent evaluator scores improved from 2.1 ± 0.6 to 4.3 ± 0.5, while patient satisfaction scores for aesthetic appearance and naturalness also increased significantly. Overall, 88.2% of patients reported satisfaction, and FACE-Q quality-of-life scores improved from 44.2 ± 8.5 to 78.6 ± 9.3. Early complications, including transient edema (70.6%) and ecchymosis (32.4%), resolved spontaneously, whereas late complications, such as prosthesis displacement (2.9%), malposition (2.9%), and asymmetry (4.4%), were infrequent and manageable. These findings support the procedure as a safe, effective, and reproducible method for achieving natural pretarsal fullness and enhancing lower-eyelid contour.
Miniaturized medical robots offer a promising solution for minimally invasive measurements and interventions in the gastrointestinal (GI) tract. Clinical assessment of GI disorders is commonly guided by threshold-based physiological indicators, including pressure, temperature, and pH, which motivate event-triggered strategies for personalized medicine. However, identifying homeostatic dysregulation and enabling in-situ therapy remains challenging, because ingestible robotic systems must tightly integrate sensing, decision-making, and actuation under severe constraints of size, power, and biosafety. Inspired by the autonomy of microorganisms that operate without neural processing, this work introduces physically intelligent capsule robots (PI Capbots) that enable homeostatic monitoring and targeted delivery within the GI tract, without relying on centralized electronic control. Through embodied stimuli-responsive memory and logic, PI Capbots effectively distill rich, detailed, and redundant physiological information into a small set of decoupled and event-triggered outputs suitable for operations in in vivo environments. In each PI Capbot, multistable metamaterials encode intraluminal pressure as mechanical memory, programmable hydrogels implement orthogonal sensing and logic operations, and helical fibers enable multimodal locomotion. Ex vivo and in vivo studies in large animal models demonstrate the efficacy, robustness, and reproducibility of PI Capbots, highlighting its potential for their translational medical applications.
Digital tools such as virtual reality, mobile applications and digital devices are being implemented across various healthcare practice settings. Engagement in occupations is central to occupational therapy, supporting health and quality of life. Occupational therapists support people with disabilities to participate in occupations by enhancing their abilities or adapting tasks and environments. However, literature rarely specifies how digital technologies are used by occupational therapists, with whom they are implemented, when and where they are delivered, what occupations are addressed or the enablers and barriers that influence the uptake of digital technologies in practice. This scoping review will map and synthesise the existing evidence on how occupational therapists use digital technologies to support people with disabilities to engage in occupations. By identifying the types of technologies used, their purposes, target populations and practice contexts, this review will inform the effective use of digital technologies by occupational therapists and their clients. This review will be conducted in accordance with the Joanna Briggs Institute methodological framework for scoping reviews and reported following the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. To identify relevant evidence, we will search several electronic databases, including CINAHL Complete, MEDLINE, SPORTDiscus, Scopus, ERIC and OTseeker. Search limits will include full-text articles published in English from 2020 onwards. Title and abstract screening will be conducted independently by at least two reviewers against the inclusion and exclusion criteria followed by full-text review. Data extraction will use a structured form to capture key information such as study characteristics, types of digital technologies, country, participant information, occupation-based focus of intervention and reported outcomes. The extracted data will be analysed using both qualitative and quantitative approaches, with findings presented in tables, narrative summaries and other descriptive formats. Ethics approval is not required for this scoping review as it will synthesise evidence from existing literature. The review findings will be reported in peer-reviewed publications. https://osf.io/3dy9z.