Advancements in ambulatory care pharmacy practice in Saudi Arabia: A comprehensive review of innovations and best practices at Johns Hopkins Aramco Healthcare.

Johns Hopkins Aramco Healthcare (JHAH) is a leading healthcare organization dedicated to revolutionizing healthcare practices in Saudi Arabia. This review article features the significant strides made by the JHAH ambulatory care pharmacy to symbolize Saudi Arabia's ambitious vision of healthcare transformation. This evolving journey includes details of JHAH's adoption of modern automation tools, several technological advancements, and establishing a pharmacist role far beyond dispensing medications. Moreover, it underscores the cultivation of patient-centered care initiatives like tele-pharmacy services through pharmacy call center, systematic patient satisfaction surveys, streamlined medication home delivery services, state-of-the-art medication drive-thru pick-up facility, the efficacious Q-Matic patient queue management architecture, and the establishment of discreet individual dispensing cubicles. Key focal points encompass technological enhancements, such as the incorporation of electronic health record Epic, cutting-edge pharmacy automation systems, and the patient-centric online portal MyChart®. The article also summarizes the multifaceted ambulatory care enhancements among clinical pharmacy services offered at JHAH. This includes a pharmacist-led medication management clinic, specialized anticoagulation clinic, psychiatric and hepatitis medication management, renal dose optimization, precision-driven thyroid and benign prostatic hyperplasia patients' treatment optimization, and clinical decision support system-backed clinical interventions. All these substantial enhancements at JHAH's ambulatory pharmacy have been made to improve the quality of pharmaceutical services. Besides automation and technological advancements, these also include the establishment of pharmacy competency and continuous education programs, the development of an internal pharmacy webpage on the JHAH website, the implementation of a mechanism for formulary management by the pharmacy and therapeutic committee, and very importantly the adoption of electronic incidence reporting system Datix. The review highlights JHAH's commitment to bringing ambulatory care pharmacy practice to new heights, thereby establishing a benchmark for patient-centric care and innovative excellence within the Saudi Arabian healthcare landscape.

Transforming medical education: the impact of innovations in technology and medical devices.

INTRODUCTION: The rapid advancement of technology and the integration of innovative medical devices are significantly transforming medical education. This review examines the impact of these changes and the importance of adapting educational strategies to leverage these advancements. AREAS COVERED: This narrative review employs a qualitative approach. From an initial pool of 294 articles, researchers conducted independent screenings and identified 134 studies relevant to innovations in technology and their impact on medical education. Following a comprehensive review and consensus, studies deemed to be of low relevance were excluded, resulting in a final selection of 74 articles. An expert panel discussion was held, and the study concludes with a final section that presents the findings and offers brief, clear recommendations. EXPERT OPINION: This study indicates that the utilization of Innovative medical technologies has the potential to enhance learning outcomes. The use of simulations allows students to engage in hands-on practice without risking patient harm. Mobile devices afford students uninterrupted access to educational resources, thereby enabling efficient learning. Artificial intelligence (AI) has the potential to personalize education, enhance diagnostic skills, and foster critical thinking. Further research in this field has the potential to yield significant insights.

Charting the path to sustainable prosperity: Harnessing innovation, renewable energy, and institutional excellence for a greener tomorrow.

Climate change and global warming have led to significant economic challenges in the recent past. Currently, the economic growth strategy prevailing in the region is ineffective, which adversely affects the environment of the South Asian region through the unprecedented increase in CO2 emissions. The present study focuses on investigating the impact of technological advancements, renewable energy resources, and the strength of institutional quality on carbon emissions. Furthermore, the study focused on challenges faced in promoting renewable energy as well as governmental policies to encourage the adoption and promotion of renewable energy. We have targeted South Asian economies (Pakistan, India, Nepal, Bangladesh, and Sri Lanka) and employed a quantitative research design using data from 1990 to 2022 and employing a Random and fixed effect model. We found that technological innovation and environmental quality play a significant role in sustainability in the South Asian region. We have also applied a sensitivity analysis which shows that data are reliable and stable. In order to ensure economic growth without causing environmental destruction policymakers must prioritize the implementation and development of renewable energy sources through state-level policies. Furthermore, this could entail responsible acts like reforestation a decrease in deforestation, and the promotion of sustainable and effective practices.

The Rise of Ophthalmology as a Specialty: Albrecht von Graefe's Pioneering Contributions.

Albrecht von Graefe (1828-1870) is celebrated as a pivotal figure in the evolution of ophthalmology. He is renowned for his transformative contributions that established the field as a distinct medical specialty separate from general surgery. This biography review delves into von Graefe's pioneering efforts that reshaped ophthalmology, highlighting his innovations and establishing fundamental practices that define modern ophthalmic care. von Graefe's introduction of iridectomy for glaucoma, development of specialized surgical instruments, and advocacy for the use of the ophthalmoscope marked significant advancements in treating eye disorders. Additionally, his role in founding the first ophthalmological society and journal underscored his commitment to creating a structured, scientific approach to the field. Through meticulous examination of his work and its impact, this article underscores how von Graefe's pioneering spirit and dedication fostered the growth of ophthalmology into an independent and respected medical specialty.

Challenges in Contemporary Spine Surgery: A Comprehensive Review of Surgical, Technological, and Patient-Specific Issues.

Spine surgery has significantly progressed due to innovations in surgical techniques, technology, and a deeper understanding of spinal pathology. However, numerous challenges persist, complicating successful outcomes. Anatomical intricacies at transitional junctions demand precise surgical expertise to avoid complications. Technical challenges, such as underestimation of the density of fixed vertebrae, individual vertebral characteristics, and the angle of pedicle inclination, pose additional risks during surgery. Patient anatomical variability and prior surgeries add layers of difficulty, often necessitating thorough pre- and intraoperative planning. Technological challenges involve the integration of artificial intelligence (AI) and advanced visualization systems. AI offers predictive capabilities but is limited by the need for large, high-quality datasets and the "black box" nature of machine learning models, which complicates clinical decision making. Visualization technologies like augmented reality and robotic surgery enhance precision but come with operational and cost-related hurdles. Patient-specific challenges include managing postoperative complications such as adjacent segment disease, hardware failure, and neurological deficits. Effective patient outcome measurement is critical, yet existing metrics often fail to capture the full scope of patient experiences. Proper patient selection for procedures is essential to minimize risks and improve outcomes, but criteria can be inconsistent and complex. There is the need for continued technological innovation, improved patient-specific outcome measures, and enhanced surgical education through simulation-based training. Integrating AI in preoperative planning and developing comprehensive databases for spinal pathologies can aid in creating more accurate, generalizable models. A holistic approach that combines technological advancements with personalized patient care and ongoing education is essential for addressing these challenges and improving spine surgery outcomes.

Assessing the Potential of EEG in Early Detection of Alzheimer's Disease: A Systematic Comprehensive Review (2000-2023).

Background: As the prevalence of Alzheimer's disease (AD) grows with an aging population, the need for early diagnosis has led to increased focus on electroencephalography (EEG) as a non-invasive diagnostic tool. Objective: This review assesses advancements in EEG analysis, including the application of machine learning, for detecting AD from 2000 to 2023. Methods: Following PRISMA guidelines, a search across major databases resulted in 25 studies that met the inclusion criteria, focusing on EEG's application in AD diagnosis and the use of novel signal processing and machine learning techniques. Results: Progress in EEG analysis has shown promise for early AD identification, with techniques like Hjorth parameters and signal compressibility enhancing detection capabilities. Machine learning has improved the precision of differential diagnosis between AD and mild cognitive impairment. However, challenges in standardizing EEG methodologies and data privacy remain. Conclusions: EEG stands out as a valuable tool for early AD detection, with the potential to integrate into multimodal diagnostic approaches. Future research should aim to standardize EEG procedures and explore collaborative, privacy-preserving research methods.

Climate change dynamics for global energy security and equity: Evidence from policy stringency drivers.

This study investigates the dynamic interplay between financial integration, political stability, infrastructure, and global integration in enhancing Energy Security (ES) and Energy Equity (EE) across 50 economies from 2006 to 2018. It addresses gaps in understanding how socio-economic, political, and technological factors collectively influence ES and EE during the global transition from fossil fuels to renewable energy sources. The research aims to reveal the complex relationships and potential trade-offs between energy sustainability, economic growth, and equitable energy distribution. Utilizing robust panel data methods including System GMM, Fixed Effects, and Random Effects, the study examines the impacts of various determinants on ES and EE. The dataset includes annual observations on global integration, financial integration, infrastructure quality, political stability, and other relevant metrics from diverse global sources. The findings reveal that increased financial integration significantly enhances ES by easing capital flow into energy infrastructure, which is crucial for stable energy supply chains. Political stability also positively affects ES, underscoring the importance of stable governance in sustaining energy policies. Conversely, rapid urban growth and inadequate social integration pose challenges to achieving EE, highlighting disparities in energy access worsened by urbanization. Technological advancements and digital connectivity appear as positive drivers for EE, enhancing the efficiency and distribution of energy resources. This study contributes to the literature by providing a detailed examination of how integration into global financial and political systems affects energy strategies at a national level. It offers valuable insights for policymakers on fostering environments conducive to sustainable energy development and fair energy access. The research underscores the importance of incorporating socio-economic and technological advancements in energy policy frameworks to achieve balanced growth and sustainability. Future research directions include exploring the causal relationships and long-term impacts of these factors on ES and EE, particularly in the context of evolving global energy policies and technological advancements.

Current applications of three-dimensional (3D) printing in pediatric dentistry: a literature review.

Advancements in 3D printing technology are providing a new direction in pediatric dentistry by offering innovative solutions to traditional challenges. The remarkable expansion of 3D printing necessitates a comprehensive examination of its status and applications in the dental field, particularly in the pediatric dentistry. This review provides a comprehensive exploration of the applications of 3D printing in pediatric dental practices by drawing from a systematic search across databases, including PubMed/MEDLINE, Scopus, Web of Science, Scielo and the Cochrane Library. The search strategy employed a combination of keywords: "Digital dentistry and 3D printing", "3D printing technology in dentistry", "3D printing in pediatric dentistry" and "3D printing in pediatric dental procedures". The review encompasses a wide array of studies, including original research, cross-sectional analyses, case reports and reviews. A detailed overview is presented in regard to the use of 3D printing for master and educational models, space maintainers, prosthetic restorations, surgical guide, splint design and fracture treatment, fluoride application, autogenous dental transplantation, anterior teeth restoration, and pediatric endodontics and regenerative treatments. This review shows that 3D printing improves clinical outcomes through personalized and precise treatment options and enhances dental students' educational landscape. Areas lacking extensive research were also identified, which warrent further investigation to optimize the integration of 3D printing in pediatric dentistry. By mapping out the current landscape and future directions, the aim of this paper is to support pediatric dentists in recognizing the broad implications of 3D printing for improving patient care and advancing dental education.

Top Three Healthcare Trends in Orthopaedics Affecting Musculoskeletal Care in the Elderly.

Several trends toward patient-centered multi-care models employing translational research strategies are currently emerging in orthopaedics. These align seamlessly with epigenetics discussions in pain, a clinical approach to pain management that prioritizes tailoring healthcare to individual needs, preferences, and circumstances. Recognizing the unique genetic and epigenetic factors influencing pain perception, healthcare providers can integrate personalized insights into their patient-centered approach, offering more targeted and effective pain management strategies tailored to each individual's experience. Custom 3D-printing technologies may also become increasingly relevant to more effectively and reliably treat painful degenerative structural abnormalities. They are expected to go hand-in-hand with the precision medicine redefinition of musculoskeletal care. More effective analysis of surgeons' clinical decision-making and patients' perception of high-value orthopaedic care is needed. Shared Decision Making (SDM) is critical to identifying the best solution for each patient and improving stakeholders' understanding of factors influencing the diverse prioritizing values of surgical or non-surgical treatments by payers, systems, and other providers. Identifying high-value orthopaedic surgeries via effective SDM in orthopedic surgery requires more than just presenting patients with information. The Rasch analysis of patient expectations can provide this nuanced approach that involves understanding patient values, addressing misconceptions, and aligning surgical recommendations with patient-specific goals. Optimizing orthopaedic treatment within the patient-centered framework can drive innovation in reimbursement policies that support the field more broadly. Research on separating high-value from low-value orthopaedic procedures may likely impact healthcare decision- makers' resource allocation.

Investigating underlying molecular mechanisms, signaling pathways, emerging therapeutic approaches in pancreatic cancer.

Pancreatic adenocarcinoma, a clinically challenging malignancy constitutes a significant contributor to cancer-related mortality, characterized by an inherently poor prognosis. This review aims to provide a comprehensive understanding of pancreatic adenocarcinoma by examining its multifaceted etiologies, including genetic mutations and environmental factors. The review explains the complex molecular mechanisms underlying its pathogenesis and summarizes current therapeutic strategies, including surgery, chemotherapy, and emerging modalities such as immunotherapy. Critical molecular pathways driving pancreatic cancer development, including KRAS, Notch, and Hedgehog, are discussed. Current therapeutic strategies, including surgery, chemotherapy, and radiation, are discussed, with an emphasis on their limitations, particularly in terms of postoperative relapse. Promising research areas, including liquid biopsies, personalized medicine, and gene editing, are explored, demonstrating the significant potential for enhancing diagnosis and treatment. While immunotherapy presents promising prospects, it faces challenges related to immune evasion mechanisms. Emerging research directions, encompassing liquid biopsies, personalized medicine, CRISPR/Cas9 genome editing, and computational intelligence applications, hold promise for refining diagnostic approaches and therapeutic interventions. By integrating insights from genetic, molecular, and clinical research, innovative strategies that improve patient outcomes can be developed. Ongoing research in these emerging fields holds significant promise for advancing the diagnosis and treatment of this formidable malignancy.

A Comprehensive Review of Advancements in Diagnostic Imaging: Unveiling Oral Cavity Malignancies Using Computed Tomography.

Early detection of oral cavity malignancies is essential for improving treatment outcomes and patient survival rates. Diagnostic imaging, particularly computed tomography (CT), plays a pivotal role in the early identification and detailed assessment of these malignancies. This comprehensive review explores the advancements in CT imaging and its application in diagnosing oral cavity cancers. It discusses the anatomy and physiology of the oral cavity, the clinical characteristics of common malignancies, and the principles and protocols of CT imaging. The review highlights the diagnostic features of oral malignancies on CT, including distinguishing benign from malignant lesions and staging criteria. Emerging technologies, such as higher-resolution imaging, integration with other modalities, and the potential of artificial intelligence, are examined for their role in enhancing diagnostic accuracy. The clinical implications, challenges, and future directions in the use of CT imaging for oral cavity malignancies are also discussed. This review underscores the importance of continued research and technological advancements in optimizing the use of CT for early detection and effective management of oral cavity cancers.

Regional Anaesthesia, Contemporary Techniques, and Associated Advancements: A Narrative Review.

In particular, the application of regional anaesthesia techniques in existing medicine can be characterized as experiencing regular changes in recent decades. It is useful for obtaining accurate and efficient pain management solutions, from the basic spinal and epidural blocks to the novel ultrasound nerve blocks and constant catheter procedures. These advancements do enhance not only the value of the perioperative period but also the patient's rated optimization as enhancing satisfaction, better precision, and the safety of nerve block placement. The use of ultrasound technology makes it even easier to determine the proper positioning of the needle and to monitor nerve block placement. Moreover, the duration and efficiency of regional anaesthesia are being enhanced by state-of-the-art approaches, which come in the form of liposomal bupivacaine, and better recovery plans and protocols, which shorten recovery time and decrease the number of hospital days. As these methods develop further, more improvements in the safety, efficacy, and applicability of regional anaesthesia in contemporary medicine are anticipated through continued research and innovation.

Robust Covalent Organic Frameworks for Photosynthesis of H2O2: Advancements, Challenges and Strategies.

Since 2020, covalent organic frameworks (COFs) are emerging as robust catalysts for the photosynthesis of hydrogen peroxide (H2O2), benefiting from their distinct advantages. However, the current efficiency of H2O2 production and solar-to-chemical energy conversion efficiency (SCC) remain suboptimal due to various constraints in the reaction mechanism. Therefore, there is an imperative to propose efficiency improvement strategies to accelerate the development of this reaction system. This comprehensive review delineates recent advances, challenges, and strategies in utilizing COFs for photocatalytic H2O2 production. It explores the fundamentals and challenges (e.g., oxygen (O2) mass transfer rate, O2 adsorption capacity, response to sunlight, electron-hole separation efficiency, charge transfer efficiency, selectivity, and H2O2 desorption) associated with this process, as well as the advantages, applications, classification, and preparation strategies of COFs for this purpose. Various strategies to enhance the performance of COFs in H2O2 production are highlighted. The review aims to stimulate further advancements in utilizing COFs for photocatalytic H2O2 production and discusses potential prospects, challenges, and application areas in this field.

Rhinomanometry: A Comprehensive Review of Its Applications and Advancements in Rhinology Practice.

Rhinomanometry is a pivotal diagnostic technique in rhinology, providing a quantitative assessment of nasal airflow and resistance. This review comprehensively examines the historical development, principles and clinical applications of rhinomanometry, emphasising its role in diagnosing nasal obstructions, preoperative evaluations and monitoring therapeutic outcomes. Recent advancements, including the integration with imaging technologies and the application of artificial intelligence (AI), have significantly enhanced the accuracy and utility of rhinomanometry. Despite facing challenges such as technical limitations and the need for standardisation, rhinomanometry remains an invaluable tool in both clinical and research settings. The review also explores future directions, highlighting the potential for device miniaturisation, telemedicine integration, personalised protocols and collaborative research efforts. These advancements will likely expand the accessibility, accuracy and clinical relevance of rhinomanometry, solidifying its importance in the ongoing evolution of rhinology practice.

Recent Innovations in Footwear and the Role of Smart Footwear in Healthcare-A Survey.

Smart shoes have ushered in a new era of personalised health monitoring and assistive technologies. Smart shoes leverage technologies such as Bluetooth for data collection and wireless transmission, and incorporate features such as GPS tracking, obstacle detection, and fitness tracking. As the 2010s unfolded, the smart shoe landscape diversified and advanced rapidly, driven by sensor technology enhancements and smartphones' ubiquity. Shoes have begun incorporating accelerometers, gyroscopes, and pressure sensors, significantly improving the accuracy of data collection and enabling functionalities such as gait analysis. The healthcare sector has recognised the potential of smart shoes, leading to innovations such as shoes designed to monitor diabetic foot ulcers, track rehabilitation progress, and detect falls among older people, thus expanding their application beyond fitness into medical monitoring. This article provides an overview of the current state of smart shoe technology, highlighting the integration of advanced sensors for health monitoring, energy harvesting, assistive features for the visually impaired, and deep learning for data analysis. This study discusses the potential of smart footwear in medical applications, particularly for patients with diabetes, and the ongoing research in this field. Current footwear challenges are also discussed, including complex construction, poor fit, comfort, and high cost.

Hydrological model parameter regionalization: Runoff estimation using machine learning techniques in the Tha Chin River Basin, Thailand.

Understanding hydrological processes necessitates the use of modeling techniques due to the intricate interactions among environmental factors. Estimating model parameters remains a significant challenge in runoff modeling for ungauged catchments. This research evaluates the Soil and Water Assessment Tool's capacity to simulate hydrological behaviors in the Tha Chin River Basin with an emphasis on runoff predictions from the regionalization of hydrological parameters of the gauged basin, Mae Khlong River Basin. Historical data of Mae Khlong River Basin from 1993 to 2017 were utilized for calibration, followed by validation using data from 2018 to 2022. •Calibration results showed the SWAT model's reasonable accuracy, with R² = 0.85, and the validation with R² of 0.64, indicating a satisfactory match between observed and simulated runoff.•Utilizing Machine Learning (ML) techniques for parameter regionalization revealed nuanced differences in model performance. The Random Forest (RF) model exhibited an R² of 0.60 and the Artificial Neural Networks (ANN) model slightly improved upon RF, showing an R² of 0.61 while the Support Vector Machine (SVM) model demonstrated the highest overall performance, with an R² of 0.63.•This study highlights the effectiveness of the SWAT and ML techniques in predicting runoff for ungauged catchments, emphasizing their potential to enhance hydrological modeling accuracy. Future research should focus on integrating these methodologies in various basins and improving data collection for better model performance.

Advancements and Innovations in the Surgical Management of Sacrococcygeal Pilonidal Sinus: A Comprehensive Review.

Sacrococcygeal pilonidal sinus (SPS) is a common condition characterized by the formation of a sinus tract or cavity in the sacrococcygeal region, often containing hair and debris. Surgical management plays a crucial role in its treatment due to its chronic and recurrent nature. This comprehensive review explores the advancements and innovations in the surgical management of SPS. The review begins with an overview of the historical perspective, anatomy, and pathophysiology of the condition, followed by a discussion of current surgical techniques, including conventional excision, flap procedures, and minimally invasive approaches. Recent advancements, such as laser therapy, radiological guidance techniques, and robotic-assisted surgery, are also examined. The key findings from outcomes research are summarized, including postoperative pain management, recurrence rates, and patient satisfaction. The implications for clinical practice are discussed, emphasizing the importance of staying updated on the latest surgical techniques and adopting a personalized approach to treatment. Recommendations for future research are provided, highlighting the need for prospective studies comparing different surgical techniques, as well as research focusing on minimally invasive approaches and predictive models for recurrence risk. Collaboration among researchers, clinicians, and industry partners is essential to drive innovation and improve outcomes for patients with SPS.

Five historical innovations that have shaped modern otolaryngological surgery.

Throughout history, many innovations have contributed to the development of modern otolaryngological surgery, improving patient outcomes and expanding the range of treatment options available to patients. This article explores five key historical innovations that have shaped modern otolaryngological surgery: Operative Microscope, Hopkins Rigid Endoscope, Laryngeal Nerve monitoring, Cochlear implants and Laser surgery. The selection of innovations for inclusion in this article was meticulously determined through expert consensus and an extensive literature review. We will review the development, impact and significance of each innovation, highlighting their contributions to the field of otolaryngological surgery and their ongoing relevance in contemporary and perioperative practice.

Metabolomics for searching validated biomarkers in cancer studies: a decade in review.

INTRODUCTION: In the dynamic landscape of modern healthcare, the ability to anticipate and diagnose diseases, particularly in cases where early treatment significantly impacts outcomes, is paramount. Cancer, a complex and heterogeneous disease, underscores the critical importance of early diagnosis for patient survival. The integration of metabolomics information has emerged as a crucial tool, complementing the genotype-phenotype landscape and providing insights into active metabolic mechanisms and disease-induced dysregulated pathways. AREAS COVERED: This review explores a decade of developments in the search for biomarkers validated within the realm of cancer studies. By critically assessing a diverse array of research articles, clinical trials, and studies, this review aims to present an overview of the methodologies employed and the progress achieved in identifying and validating biomarkers in metabolomics results for various cancer types. EXPERT OPINION: Through an exploration of more than 800 studies, this review has allowed to establish a general idea about state-of-art in the search of biomarkers in metabolomics studies involving cancer which include certain level of results validation. The potential for metabolites as diagnostic markers to reach the clinic and make a real difference in patient health is substantial, but challenges remain to be explored.