Background and Aim: Digital skills of healthcare professionals are recognized as critical for the successful digital transformation of healthcare. The present study aims to examine the relationship between the digital skills of healthcare professionals and the organizational structures of hospitals. Methods: In this cross-sectional study, using the convenience sampling method, 857 healthcare professionals, working in Greek military and civilian hospitals, voluntarily participated. Data were collected between July and November 2021 through a structured questionnaire, based on the Digital Competence framework. Digital skills were categorized into five subscales: information, communication, content creation, problem solving, and safety skills. Statistical analysis was performed with SPSS 26.0, with p-values 0.8, indicating high reliability. Younger participants showed higher scores (p<0.001). The mean scores for information, communication, content creation, problem solving and safety skills in military hospitals were calculated as 52.1 (SD=32.3), 50.6 (SD=31.8), 48.4 (SD=33.3), 49.8 (SD =30.8) and 52.8 (SD=34.1) respectively, while in civilian hospitals they were calculated as 45.1 (SD=32.2), 44.5 (SD=29.5), 41.8 (SD=32.4), 41.5 (SD=30.8) and 47.1 (SD=34.5) respectively. Conclusions: Healthcare professionals in military hospitals exhibit higher digital competence compared to their counterparts in civilian hospitals. Identifying the organizational factors that promote greater digital competence among healthcare professionals provides essential information to policymakers and healthcare managers for implementing targeted organizational improvements.
Cardiovascular-kidney-metabolic (CKM) syndrome describes the complex, bidirectional interplay among cardiovascular, renal, and metabolic dysfunctions, where impairment in one system accelerates decline in the others. This interconnected pathophysiology significantly elevates the risk and progression of heart disease, particularly heart failure, through mechanisms involving insulin resistance, systemic inflammation, neurohormonal activation, and endothelial dysfunction. In this context, therapeutic strategies targeting heart disease must address the multifaceted drivers of CKM. Recent advances highlight the need for an integrated, patient-centered approach that combines lifestyle interventions with pharmacological treatments tailored to individual cardiovascular risk. While foundational therapies such as RAAS inhibitors and statins remain essential, novel agents now offer additional prognostic and quality-of-life benefits. SGLT2 inhibitors have emerged as a cornerstone therapy, improving outcomes in heart failure with both preserved and reduced ejection fraction, independent of glycemic control. GLP-1 receptor agonists and dual GLP-1/GIP agonists like tirzepatide demonstrate cardiometabolic and renal protection, while finerenone shows promise in diabetic kidney disease and several heart failure phenotypes. These therapies not only target glycemic control but also reduce cardiovascular mortality, hospitalizations, and renal decline. Optimizing cardiovascular outcomes in CKM syndrome requires early, multifactorial therapeutic intervention, informed by evolving evidence and a deeper understanding of the heart–kidney–metabolism axis.
Background: Nonmelanoma skin cancers (NMSCs), including basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), often occur in high-risk areas like the face, ears, and scalp. Surgical excision is standard, but achieving tumor-free margins while preserving function and appearance is challenging. This study evaluates the adequacy of arbitrary surgical margins versus histopathological clearance. Methods: A retrospective analysis was conducted on 147 patients with BCC or cSCC in high-risk areas treated at Elias Emergency University Hospital (2020–2024). Data included demographics, tumor type, size, location, excision margins, and histological clearance. Margins were grouped from 0 mm to >10 mm. Results: Most patients were male (59.2%) with a mean age of 70.6 years. BCC accounted for 70.7% of cases. Arbitrary margins averaged 5.4 mm; mean histological margins were ~2.5 mm. Complete excision was achieved in 91.2%; positive margins were most common on the nose and scalp. Discussion: Arbitrary margins in high-risk areas are often narrower than guidelines recommend, especially where tissue is limited, increasing the risk of incomplete excision. Conclusion: While aesthetic and functional considerations often necessitate smaller margins, improved intraoperative margin assessment could enhance oncological outcomes in high-risk NMSC.
Periodontal disease is a chronic pathology, resulting from the action of microbial communities that become dysbiotic, accompanied by immune response impairment in periodontal tissues, leading to an inflammatory process that promotes progressive tissue destruction. Abnormal activation of nucleotide-binding oligomerization domain (NOD-), leucine-rich repeat (LRR-), and pyrin domain (PYD)-containing protein 3 (NLRP3) promotes chronic inflammation. Research shows that leptin and oxidative stress (OS) are involved in the activation of the inflammatory pathways, including the activation of the NLRP3 inflammasome. In this context, the main objective of our study was to determine the levels of the NLRP3, leptin, and total antioxidant capacity (TAC) in the saliva of patients with periodontal disease. The present cross-sectional study included 44 patients with periodontitis, while the control group was represented by 19 clinically and biologically healthy adults. Saliva samples were collected from all participants in the study, and salivary levels of NLRP3, leptin, and TAC were determined using the Enzyme-linked immunosorbent assay (ELISA) and commercial kits. The results show that NLRP3 had statistically significantly increased levels in the study group versus the control group (p< 0.00001). Although TAC was also increased in the patients compared to the healthy subjects (p=0.491), no statistically significant differences were found. On the other hand, leptin levels were significantly lower in periodontitis patients compared to the control group (p< 0.00001). The results obtained in the present study are promising, but further studies are needed to obtain a more comprehensive understanding of the complex molecular mechanisms underlying periodontal disease.
Recent advances in technology and artificial intelligence have transformed radiology. Artificial intelligence, which uses machine learning, deep learning algorithms, and cellular neural networks, is now applicable to image analysis, enabling the analysis of large volumes of data and the early identification of lesion features, such as tumors. Integrating artificial intelligence into clinical workflows increases the efficiency of medical report generation and enables efficient prioritization of complex or urgent cases. Predictive analytics based on artificial intelligence uses extensive patient data, including demographics, medical history, tests, and imaging, to build more accurate predictive models. Among the areas where artificial intelligence is successfully implemented in radiology is the automated detection of lung nodules. In the field of neurology, artificial intelligence helps track progressive lesions through volumetric analysis of the brain and surveillance of demyelinating diseases. In oncologic radiology, artificial intelligence is used for automated image segmentation, lesion review, and standardized report generation. Therefore, in this ever-evolving landscape, radiologists must embrace emerging technological advances in order to occupy a unique position at the intersection of different diagnostic fields.
Liver pathology represents, nowadays, a major cause of mortality and morbidity worldwide. Since MRI helps in limited cases in the differential diagnosis of various pathologies concerning liver tumors, other modern diagnostic strategies should be prioritized. Besides various tumoral biomarkers, contrast-enhanced ultrasound (CEUS) plays a substantial role in differentiating various liver pathologies due to its availability and specificity. Various contrast-enhanced substances used for CEUS assist mainly in detecting focal liver lesions and differentiating their malignant character. This review focuses on the main indications and limits of this novel investigation, considering that patients presenting with various liver pathologies are more challenging. We highlighted in our review the similarities with the CT/MRI imaging methods in reference to the specificity and sensitivity of the method, in its potential ability to detect various liver tumors. Moreover, the contrast agents used by CEUS are eliminated throughout the lungs, showing no evidence of hepatotoxic, nephrotoxic, or cardiotoxic events. In conclusion, the accessibility and safety of the procedure and the absence of the use of ionizing radiation point out that CEUS could be a stand-alone technique in the diagnosis and evaluation of complex liver pathologies.
Diabetes mellitus refers to metabolic disorders whose main characteristic is chronic hyperglycaemia. The cause is either disturbed insulin secretion, insulin resistance, or usually both. MicroRNAs represent a subclass of non-coding RNA molecules that are short in length, about 17-26 nucleotides. Since they are circulant and can be tissue-specific, their use as diagnostic biomarkers or screening for different diseases is currently undergoing deeper studies. It was found that 22 miRNAs were associated with the pathophysiology of T1DM, 34 with T2DM, and 16 miRNAs were identified to be common amongst T1DM and T2DM. All of them were reconfirmed in at least two separate studies.
This narrative review examines psychotherapeutic interventions for combat soldiers who deal with post-traumatic distress and face a complex therapeutic setting where the relationships between clients and therapy providers are often conflictual. Despite available emotional aid, gaps between traumatized soldiers’ emotional needs and institutional solutions are inevitable and are challenging for clients and therapists alike. These issues are discussed through Israeli soldiers’ experiences, a population at high risk for trauma-related distress, due to this country’s ongoing security threats. Following a narrative literature review, four key themes emerged: mutual difficulties in admitting mental injury, intergenerational trauma, preserving the soldier identity upon discharge, and choosing among therapeutic opportunities. The study highlights the need and rationale for diverse biopsychosocial interventions for veterans and proposes considerations for enhancing treatment success. Results emphasize the importance of tailored approaches that address both individual and systemic factors affecting veterans’ mental health. Guidance for psychosocial interventions is provided, considering the multifaceted nature of combat-related trauma.
Today's recognition of health as a fundamental value of humanity and the spectacular digital evolution of the environment dominated by permanent and dynamic changes has brought healthcare marketing to the forefront. The trends continuously affecting medical services have generated the need for increased involvement of marketing, with all current developments in healthcare having an indispensable marketing dimension. The successful implementation of a health marketing strategy aimed at enhancing patient satisfaction and fostering a positive care recipient experience, coupled with the cost-effectiveness of the health services offered, has necessitated the development of an adaptive marketing function that harmonizes the set objectives, addresses capability gaps, accommodates cultural realities, and considers individual mentalities and situational circumstances. The direct interaction with patients has made it possible to understand the need for a new paradigm of healthcare services, the demand to comprehend patient satisfaction and positive experience, the call for creating innovative models to address the patient experience, and, above all, the requirement to communicate with the patient continuously and effectively throughout the continuum of healthcare. The challenge for the management of future health systems and organizations is encapsulated in the words of Professor Drucker, who stated that the best way to predict the future is to create it. An exploratory research on the state-of-the-art of the literature was conducted with key references to the most important aspects captured by specialists on positive patient experience and satisfaction, which contributes by highlighting the determining factors that have led to the paradigm shift in healthcare.
The impact of artificial intelligence (AI) on our lives can no longer be neglected, and thus, understanding this phenomenon and how humans interact with it is becoming more important than ever. The study emphasizes one of the psychological characteristics that helps us in accepting AI and using it to its fullest, namely the psychological resilience that each of us, and in particular emergency service workers, possesses in different proportions. The analysis of the relationship between the two dimensions (psychological resilience and AI) highlights, among other things, the importance of how organizations can use this interaction to achieve a framework for developing the psychological resources of their employees so that they are increasingly receptive to the use of AI in their work, pursuing the benefits it brings. The study is conducted on 89 emergency service workers and focuses on the positive and highly statistically significant relationship between psychological resilience and attitudes towards AI. The study also particularly emphasizes the relationship between tenacity and self-efficacy, self-confidence, ability to learn from life experiences, rapid recovery from negative events, social and family resources as dimensions of psychological resilience in relation to attitude towards IA of emergency workers.
