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Multidimensional factors influencing continuance usage intention of university library self-service systems: An empirical analysis based on an extended TAM-UTAUT

With the advancement of smart library initiatives in higher education institutions, the automation of circulation services has emerged as a critical component. Automated literature services alleviate librarians’ repetitive workloads and enhance the efficiency of faculty and student resource utilization. Existing research on the continued usage intention of library self-service systems often adopts singular sociological or technological perspectives, presenting limitations. This study integrates the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) to construct a multidimensional analytical framework. It systematically investigates the mechanisms influencing university faculty and students’ sustained use of self-service systems, encompassing system characteristics (navigation, terminology, relevance), technological readiness (retrieval knowledge), accessibility, and individual attributes.Valid questionnaire data from 365 faculty and students across Qinghai University, Qinghai Normal University, and Qinghai Minzu University were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) for path analysis and hypothesis testing. Results indicate that system characteristics, technological readiness, accessibility, perceived ease of use, and perceived usefulness significantly impact sustained system usage. Furthermore, variables including occupation, gender, ethnicity and usage frequency exhibit moderating effects within the model.This research extends the application dimensions of traditional TAMs by elucidating the interactive mechanisms of multifactorial influences on self-service system continuance usage intention. It provides actionable insights for library administrators, end-users, and system vendors, contributing valuable references for advancing smart library development. The findings refine theoretical models of user behavior in library automation and underscore the necessity of contextualizing technological interventions within diverse sociocultural and demographic landscapes.

Correction: Factorial and Network Structure of the Reynolds Adolescent Depression Scale (RADS-2) in Peruvian Adolescents

Resistance gene profiling of beta-lactamase and carbapenemase in gram-negative blood isolates: A tertiary care hospital

The global rise in antimicrobial resistance is largely driven by DNA-encoded, antibiotic-hydrolyzing enzymes. This study aimed to determine the prevalence of ESBL, AmpC-BL, MBL, and carbapenemase genes. A cross-sectional study was conducted from September 2018 to March 2019 using standard microbiological and molecular methods. Among 231 Gram-negative bacterial isolates, 176 (76.2%) carried beta-lactamase genes confirmed by PCR. ESBLs were detected in 117 (50.6%), MBLs in 50 (21.6%), carbapenemases in 46 (19.9%), and AmpC-BLs in 22 (9.5%). The most frequent carriers were Klebsiella pneumoniae , Escherichia coli , and Acinetobacter species . The dominant ESBL genes were blaCTX-M (85.2%) and blaTEM (79.5%), with blaBEL (17.2%) surpassing blaSHV (9.8%), indicating a shift in resistance patterns, while among AmpC genes, blaFOX (39.4%) and blaCITM (36.4%) were the most prevalent. The blaOXA-23 (40.6%) and blaKPC (14.5%) were the most common carbapenemase genes, while blaNDM (39.1%) and blaVIM (34.8%) dominated among MBLs. The high prevalence of blaOXA-23 in Ethiopia is a significant finding, which I have not found evidence of in similar African or Asian settings. A comparable trend in Taiwan suggests medical tourism may contribute to the spread of resistant bacteria. These findings highlight the critical importance of continuous molecular surveillance and indicate that factors like medical tourism may contribute to the international dissemination of resistant strains.

The rationalization of carbon monoxide and hemoglobin association

Background/objective Carbon monoxide (CO) is a colorless, odorless toxic gas responsible for approximately 100,000 emergency department visits and more than 420 deaths annually in the United States. Although CO–hemoglobin interactions have been extensively studied, a direct relationship between CO saturation and partial pressure has not been well established. This study aimed to derive a simple equation describing this relationship using principles analogous to the oxygen–hemoglobin association model. Methods CO saturation was defined as the fraction of hemoglobin binding sites occupied by CO. Using chemical kinetics, the concentrations of CO, O₂, and hemoglobin, together with their association constants, were incorporated into the saturation formulation. Algebraic substitution and simplification yielded a rational function with four unknown coefficients. At a fixed oxygen partial pressure of 100 mmHg, four equilibrium (PCO, CO saturation) data points were used to solve for the coefficients of a fourth-degree rational function. Results The derived CO–hemoglobin association equation reproduced the four derivation data points exactly and closely approximated additional literature values. The resulting association curve was hyperbolic. Fractional analysis demonstrated that Hb, HbCO, Hb(CO)₂, Hb(CO)₃, and Hb(CO)₄ fractions peaked at CO saturations of 0%, 25%, 50%, 75%, and 100%, respectively, with the triply bound form predominating overall. Conclusions The CO–hemoglobin association could be described by a fourth-degree rational equation, enabling estimation of either CO saturation or CO partial pressure when one is known and providing a framework extendable to varying oxygen tensions.

Exploring prenatal care experiences in Ontario, Canada: An equity-oriented qualitative study

Introduction The extent to which prenatal care is equity-oriented significantly influences patient satisfaction, care-seeking decisions, and health outcomes for both parent and newborn. The social determinants of health shape care experiences, disproportionately affecting marginalized populations (e.g., low-income, rural, racial minorities). This study explores prenatal patients’ care experiences and examines the impact of health inequities on these experiences. Methods This patient-partner-oriented, cross-sectional, qualitative study was guided by Cochrane’s PROGRESS-Plus equity framework and carried out using a pragmatist paradigm. Purposeful, maximum variation sampling recruited individuals in Ontario, Canada who had been pregnant or experienced pregnancy loss within the last 12 months. Participants completed a 5-minute sociodemographic survey and a 1-hour semi-structured interview on their prenatal care experiences and equity impacts. Analysis included descriptive statistics, and inductive and deductive content analysis. Results This study included 18 participants, half identifying as racial minorities. All participants interacted with a healthcare professional during pregnancy; most were followed by a primary care physician (n = 16), half by an obstetrician (n = 9), half by a nurse (n = 9), and/or eight by a midwife. Qualitative findings included experiences in accessing care ranging from feelings of powerlessness to continuity of care challenges, influenced by geographical and financial barriers. In addition, experiences of patient-centered care encompassed empathetic practitioners, validation of concerns, and power dynamics, influenced by discrimination and advocacy for personalized support. Conclusions This study offers an in depth understanding of experiences that have the potential to improve pregnancy care including targeted access to health services in remote areas, diminishing patient-provider hierarchies, culturally-sensitive care approaches for trust-building, and community engagement. Findings can inform healthcare professionals and policymakers about patients’ expectations of equity-oriented prenatal care.

Implementation tendencies and expert perspectives on physician-performed prehospital endotracheal intubation in Japan: Findings from the first round of a Delphi survey

Standardization of prehospital endotracheal intubation (ETI) has been shown to be essential for improving first-pass success rates and minimizing complications. In Japan, however, physician-performed prehospital ETI lacks uniform implementation. To address this gap, we conducted a Delphi study to assess expert consensus on key practices and discrepancies between perceived appropriateness and actual use. We conducted the first round of a modified two-round Delphi study using a web-based questionnaire comprising 90 recommendation statements across eight domains, derived from the literature and a pilot study. Eligible participants were physicians with at least three years of prehospital emergency care experience and a minimum of 30 prehospital ETI cases. Statements were rated for perceived appropriateness and implementation on a 4-point Likert scale, with consensus defined as a positive response rate of ≥70.0%. Free-text comments were also collected to explore areas of discrepancy. Among 58 invited physicians, 40 (69.0%) responded, of whom 65.0% had more than 15 years of prehospital experience. Consensus on appropriateness was achieved for 72 of 90 items (80.0%), whereas consensus on implementation was reached for 57 items (63.3%). At the domain level, appropriateness consensus was highest in the Confirmation domain (100%; 9/9 items) and lowest in the Environment during endotracheal intubation domain (25%; 1/4 items). Discrepancies between perceived appropriateness and implementation were observed across multiple domains, including peripheral equipment and medication-related practices. At the item level, checklist use was considered appropriate by 65.0% of respondents but reported as implemented by only 10.0%. These findings highlight gaps between perceived appropriateness and implementation of physician-performed prehospital ETI practices in Japan, underscoring the need for context-sensitive, locally adapted protocols.

Osteoarthritis in older adults: A global health challenge and the role of high BMI in shaping disease trends

Background This study aimed to estimate the global, regional, and national Osteoarthritis (OA) burden and trends in older adults from 1990 to 2021, with a particular focus on the contribution of high body mass index (BMI) to the OA burden. Methods Using 2021 Global Burden of Disease Study data, we estimated the incidence, DALYs, and trends of OA in older adults across 204 countries and territories from 1990 to 2021. Spearman’s correlation analysis was applied to investigate relationships between age-standardized rates and the sociodemographic index (SDI). We quantified the BMI-attributable contribution to the OA burden. The Bayesian Age-Period-Cohort (BAPC) model was applied to project the global OA trend in older adults up to 2040. Results From 1990 to 2021, global OA cases in older adults increased by 148.65%. Age-standardized incidence and DALY rates increased annually by 0.08% and 0.31%, respectively. East and Southeast Asia exhibited the fastest increase in age-standardized DALY rates. The OA burden peaked in the 65–69-year age group, with women compared with men experiencing a higher burden. Knee OA imposed the heaviest burden, followed by hand OA, with regional variations across four anatomical sites. The OA burden, including specific sites, positively correlated with the SDI. The attributable proportion of OA burden due to high BMI increased by 21.39%, with the knee OA burden from high BMI exceeding the hip OA burden. The BAPC model predicted that OA burden will continue to rise in the future. Conclusions OA in older adults is a major global challenge, with knee OA being the most burdensome. High BMI, a modifiable risk factor, contributes significantly to OA, particularly in the knees. To reduce the OA burden, public health strategies should prioritize obesity prevention through weight management and awareness campaigns for older adults.

Psychosocial predictors of non-adherence to antihypertensive medication among Korean adults: A nationwide cross-sectional study

The objective of this study was to examine whether depressive symptoms and social vulnerability factors—including living alone, Basic Livelihood Security Program recipient status, and lack of private health insurance—are associated with non-adherence to antihypertensive medication among Korean adults. This cross-sectional analysis used nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES), specifically the 2014 (6th cycle–2nd year), 2016 (7th–1st year), 2018 (7th–3rd year), and 2020 (8th–2nd year) cycles, the only survey years that included both depressive symptoms data and antihypertensive medication use information. Non-adherence was defined as taking prescribed medication on fewer than 20 days during the previous month. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Complex survey logistic regression models were used to evaluate associations between psychosocial factors and non-adherence. Two analytic models were applied: individual models for each psychosocial variable and a combined model adjusting for age, sex, obesity, smoking, alcohol use, physical activity, diabetes, and dyslipidemia. Subgroup analyses were performed by age (<70 and ≥70 years). Among adults aged 40 years or older taking antihypertensive medication, approximately one in ten reported non-adherence. In the fully adjusted model, none of the psychosocial factors—including depressive symptoms, living alone, Basic Livelihood Security Program recipient status, or lack of private insurance—were significantly associated with non-adherence in the overall population. However, depressive symptoms were significantly associated with non-adherence among adults aged 70 years or older, whereas no significant associations were observed in younger adults or sex-specific subgroups. These findings suggest that depressive symptoms do not uniformly influence antihypertensive medication adherence across the adult population but may play a more important role in older adults. Incorporating routine screening for depressive symptoms into hypertension management for older individuals may support more effective adherence and improved clinical outcomes.

An analysis of doctoral prestige and faculty composition in Canadian mechanical engineering programs

Faculty positions at institutions of higher education are limited resources for which there is a high level of competition. Previous studies have shown that a hierarchy of prestige exists within academia which leads to 80% of those positions being filled by the doctoral graduates from only 20% of institutions. The goal of the current study is to determine whether such a hierarchy also exists within Canadian mechanical engineering programs and to consider other demographic differences within their faculty complements. Information on over 1100 faculty members from the 38 accredited Canadian mechanical engineering programs were gathered from public sources, including their doctoral training institution, their year of graduation, and the name(s) of their faculty advisor(s). It was found that 22% of institutions were responsible for the doctoral training of 78% of faculty members. A PageRank analysis, coupled with k-means clustering, identified four tiers of doctoral prestige and demonstrated that few trainees are hired by a more prestigious institution. For example, only 9% of those trained at a Tier III institution were hired by a Tier II and none by a Tier I institution. Academic advisors also played an important role; 11 unique advisors had five or more of their trainees currently employed in those 38 programs. Only 16.7% of faculty members were female-presenting, lower than the 17.5% proportion of so-called “self-hires” (i.e., those employed by the institution where they did their doctoral training). This study provides analytical tools for quantifying institutional prestige as well as a demographic snapshot of Canadian mechanical engineering faculty that can be used to analyze other fields and jurisdictions. Further research in faculty hiring will benefit students looking to pursue careers in academia, as well as guide those responsible for ensuring equitable hiring practices.

Correction: An assessment of the value of deep neural networks in genetic risk prediction for surgically relevant outcomes

Gas network value chain optimization considering compressor capacity constraints

Efficient operation of natural gas pipeline networks is essential for minimizing costs and ensuring a stable energy supply. Compressor stations are critical for maintaining pressure throughout the network and represent a substantial portion of both capital investment and operational expenditures. Optimizing compressor operations is complex due to nonlinear interactions among compression ratios, flow rates, and operational constraints such as surge and choke limits, as well as the need for discrete decisions, including bypass selection and flow direction. To address these challenges, this study introduces a Sequential Linear Programming (SLP) algorithm specifically designed for large-scale pipeline scheduling. The method accommodates compressor capacity constraints and discrete decision variables, resulting in significant improvements in computational efficiency and solution quality. Numerical experiments on extensive real-world pipeline networks in China demonstrate that the algorithm rapidly produces near-optimal solutions, indicating its suitability for practical implementation. The results underscore clear advantages in both economic performance and operational reliability.

The impact of ethical implications intertwined with tuberculosis household contact investigation: A qualitative study

Background Household contact investigation (HCI) is an effective and widely used approach to identify persons with tuberculosis (TB) disease and infection globally. Despite widespread recommendations for the use of HCI, there remains poor understanding of the impact on and value of contact investigation for participants. Further, how HCI as a practice impacts psychosocial factors, including stigma and possible unintended disclosure of illness among persons with TB, their families, and communities, is largely unknown. Methods This exploratory qualitative study nested within a randomized trial (ClinicalTrials.gov: NCT04520113, 17 August 2020) was conducted in South Africa to understand the impacts of HCI on index patients living with TB and their household contact persons in two rural districts in the Limpopo province (Vhembe and Capricorn) and Soshanguve, a peri-urban township in Gauteng province. People with TB and household members of people with TB were recruited to participate in in-depth interviews and focus group discussions using semi-structured guides. We explored individual, interpersonal, and community-level perceptions of potential impacts of household contact investigation to elucidate their perceptions of HCI. Thematic analysis identified key themes. Results Twenty-four individual interviews and six focus group discussions (n = 39 participants) were conducted. Participants viewed HCI as an effective approach to finding TB cases, helpful in educating households about TB symptoms and reducing barriers to health-related services. At the interpersonal level, HCI aided people with TB in safely disclosing their TB status to family members and facilitated family and social support for accountability. The introduction of HIV testing during HCI was reported by some participants as making household members slightly uncomfortable, decreasing interest in household members being tested for TB. HCI negatively impacted community-level TB and HIV-related stigma due to healthcare worker visibility at home. Conclusion Our data suggests varying impacts of HCI on people with TB, their families and interpersonal relationships, and communities, highlighting the importance of considering approaches that address concerns about community stigma and HIV testing to enhance acceptance of HCI. Trial registration ClinicalTrials.gov NCT 04520113

Sirolimus-Coated Balloon Angioplasty for Infrainguinal Artery Disease

Community readiness for the program of all-inclusive care for the elderly (PACE): A qualitative study with Korean Americans in Los Angeles

The Program of All-Inclusive Care for the Elderly (PACE), which provides integrated medical, social, and personal healthcare to help older adults remain in their homes and communities, has been a successful long-term care services and support (LTSS) model. Yet little is known about how racial and ethnic minority communities perceive and respond to this program. Guided by the Community Readiness Model (CRM), this explorative qualitative study examined readiness for PACE in Korean American communities in Los Angeles. Data were collected from 28 participants, including two focus groups with 19 older adults (age ≥ 55) and nine individual interviews with family caregivers and health and social service providers. Four major themes emerged: (1) Awareness, (2) Perceived Benefits, (3) Perceived Barriers and Concerns, and (4) Recommendations for Implementation and Outreach. In general, awareness of PACE was low among participants, and many had unclear or incorrect understanding of the program. Perceived benefits included the ability to age in place, access to coordinated care at a single setting, opportunities for social engagement, and reduced caregiving burden. Concerns noted by participants included the need to switch physicians, possible disruption of existing services such as In-Home Supportive Services, and uncertainty about the qualifications of PACE providers. Recommendations highlighted the importance of culturally tailored outreach, a more descriptive program name, strong leadership, a cooperative interdisciplinary team culture, and staffing that combines clinical expertise with compassion and cultural sensitivity. These findings suggest that introducing PACE in the Korean American community requires intentional adaptation to address both cultural expectations and structural barriers. This study offers insights into how the PACE model can be more effectively introduced, adapted, and sustained in racial and ethnic minority communities that have not been fully engaged by LTSS outreach and delivery efforts.

Sirolimus-Eluting Technology for the Treatment of Peripheral Artery Disease

Does a degree in medicine or a specialist programme or socioeconomic status advance the career of general practitioners in primary healthcare?

Extensive studies have investigated possible mechanism to improve the career path of general practitioners (GPs) in order to ensure the primary healthcare system (PHC) functions properly. Nevertheless, this problem persists in many countries and it is aggravated by preferential policy. Against this background, the current study examined whether the diverse groups of GPs employed by the PHC system help to develop a sustainable PHC system or create a dysfunctional one. This quantitative cross-sectional survey sampled 12,767 graduates from 13 medical schools in China. Secondary data was collected on socioeconomic status (SES), career advancement, educational qualification, demographic characteristics and graduates’ employment information. The collected data was analyzed using group regression and mediation analysis. Results indicated that, among the 1,769 clinical physicians working in PHC institutions, the ratio of specialist to specialists transferred general practitioners and full general practitioners is 3:2:1, indicating a horizontal mismatch. Furthermore, medical graduates’ degree program type significantly relates to their career advancement and SES mediated the link between medical graduates’ degree program type and career advancement with an indirect effect: Internal Medicine SP-GP → SES → CA (β = 0.040, P < 0.001); Obstetrics and Gynecology SP-GP → SES → CA (β = 0.026, P < 0.001); Emergency Medicine SP-GP → SES → CA (β = 0.021, P < 0.001); Paediatrics SP-GP → SES → CA (β = 0.024, P < 0.001). This study contributes to discourse on SES and medical education by highlighting how medical education has evolved into a money-driven program in which students’ SES influences the program they select.

Stirred tank bioreactor process for chikungunya vaccine candidate VEEV-ΔC-CHIKV

Chikungunya virus (CHIKV), a mosquito-borne alphavirus with significant public health impact, has caused recurrent epidemics across Africa, Asia, and the Americas. Despite the recent approval of a live-attenuated vaccine (Chix), scalable manufacturing processes for CHIKV vaccines remain critical to meet global demand. In this context, we previously constructed a chimeric virus, VEEV-ΔC-CHIKV, by replacing the backbone of ΔC-CHIKV with that of the VEEV replicon while retaining the CHIKV antigenic glycoprotein (E3-E2-6K-E1). A series of experiments have demonstrated that the chimeric virus exhibits safety, stability, and immunogenicity, making it a promising candidate for a new attenuated live vaccine strain. Therefore, to further validate its viral properties and explore the potential for large-scale production, we developed an optimized bioreactor-based production process for VEEV-ΔC-CHIKV. Utilizing adherent Vero cells in mechanically stirred bioreactors, we systematically optimized key parameters, including carrier type selection, cell seeding density, human albumin supplementation, and nutrient modulation, to maximize viral titers while minimizing the accumulation of metabolic byproducts. Results indicated that Cytodex™ 1 microcarriers outperformed Fibra-Cel carriers, enabling 10 consecutive harvests with viral titers ≥ 10 5 PFU/mL (compared to 4 harvests for Fibra-Cel). When the initial cell density was 6.5 × 10 5 cells/mL, the total virus yield was 77% higher than at a cell density of 2.5 × 10 5 cells/mL. Adding 1.0% human albumin doubled total virus production compared to the addition of 0.5%. Nutrient modulation through the maintenance of glucose (>3 g/L) and glutamine (>0.5 g/L) in fed-batch systems enhanced peak titers to 10 6.4 PFU/mL, representing a 2.2-fold increase compared to non-fed controls. This study establishes a scalable and cost-effective bioreactor platform for the production of the CHIKV vaccine, highlighting the critical interplay between nutrient optimization and viral yield enhancement, while emphasizing the advantages of automated process control in bioreactors to facilitate large-scale, high-yield viral production.

Importance and implementation of safe nursing behaviors in nursing students’ clinical practice: Importance–Performance Analysis (IPA), the borich needs assessment model, and the locus for focus model

Background Nursing students are exposed to diverse occupational risks during clinical practicum, which may threaten both their safety and patient safety. Despite the increasing emphasis on safety education following the Patient Safety Act in South Korea, few studies have examined their performance and perceived importance of safe nursing behaviors. This study addresses this gap to provide evidence for improving nursing safety education. Methods A cross-sectional survey was conducted among 160 nursing students from two universities in South Korea who had completed their clinical practicums. Data were collected using a self-administered 29-item questionnaire developed through a literature review and expert validation. It comprises four domains: infection prevention, musculoskeletal injury prevention, chemical hazard prevention, and psychological injury prevention. Data analysis was performed using SPSS/WIN 28.0, including descriptive statistics, paired-sample t-tests, independent t-tests, and one-way ANOVA. Priority analysis was conducted using Importance-Performance Analysis (IPA), the Borich Needs Assessment model, and the Locus for Focus model. Results Importance scores were significantly higher than performance scores across most items, except for “Dispose used ampoules/needles without recapping” and “Dispose sharps into puncture-resistant containers.” IPA identified 14 items in the “Keep up the good work” quadrant and four items in the “Concentrate here” quadrant. The Borich Needs Assessment model ranked “Know the location of spill kits,” “Use devices to reduce musculoskeletal load” and “Use of goggles when biological exposure is possible” as having the highest priorities. The Locus for Focus model classified five items, including personal protective equipment (PPE) use during biological exposure, maintain posture during ergonomic risks, chemical education, and respect for personal dignity, as the top priority (HH quadrant) for educational intervention. Conclusions The assessment tool effectively evaluated nursing students’ safe nursing behaviors during clinical practicums. Four domain-specific priorities were identified: personal protective equipment (PPE) use in infection prevention, ergonomic safety practices, chemical safety knowledge, and psychological safety measures. These findings provide evidence-based guidance for designing targeted and practical nursing safety education programs to improve nursing students’ preparedness, safety, and patient safety.

Disease progression modeling of Alzheimer’s disease based on variational probability principal component analysis

Alzheimer’s disease (AD) is a neurodegenerative disorder and the leading cause of dementia. Early diagnosis and monitoring of disease progression are crucial for effective intervention. This study presents a novel disease progression model based on Variational Probabilistic Principal Component Analysis (VPPCA), which uses a Bayesian framework for dimensionality reduction and uncertainty quantification. By analyzing 1,021 amyloid-positive patients from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database, we extracted 25 features, including CSF (ABETA, TAU, PTAU), PET (FDG, AV45), and MRI volumetrics, along with cognitive and functional assessments. VPPCA compresses these multi-modal biomarkers into a single first principal component score (VPPCA1), which serves as a measure of disease progression. To ensure biological grounding and avoid circularity, we demonstrated that a VPPCA1 model using only non-cognitive features (CSF, PET, MRI, demographics) correlates strongly with cognitive decline (r = 0.658 with ADAS-Cog13), confirming that it captures genuine pathological progression rather than simply reflecting cognitive assessments. Block-wise feature ablation revealed that multi-modal integration is essential, with cognitive features showing the highest importance (0.1064), though all modalities contribute complementarily. In classification tasks, VPPCA exhibited strong performance with ROC-AUC values of 0.990 (CN vs Dementia), 0.774 (CN vs MCI), and 0.785 (MCI vs Dementia). A Bayesian hierarchical longitudinal model effectively captured patient-specific progression trajectories, offering personalized predictions of future disease states. VPPCA outperforms Probabilistic PCA (PPCA) by providing uncertainty quantification, with patient-specific confidence levels (σ = 0.086–0.136), which correlate with data quality, enabling automatic risk stratification. This work demonstrates that VPPCA offers a robust, biologically-grounded framework for modeling AD progression, providing actionable uncertainty quantification that improves clinical decision support and facilitates personalized care.

Implementing allied healthcare professionals in transitional care for older adults with mental health needs: A scoping review

Introduction Older adults experience several transitions in care, which can be challenging and stressful. Transitional care ensures continuity of care by addressing patients’ healthcare needs before discharge and providing ongoing community support. Although transitional care improves patient outcomes and reduces hospital readmissions, its role in addressing mental health (MH) needs in older adults remains underexplored. This scoping review describes the literature on the integration of allied healthcare (AHC) professionals in transitional care for older adults with MH needs. Method Following PRISMA-ScR guidelines, we analyzed 14 peer-reviewed articles (2010–2024) on transitions for older adults with cognitive impairment, dementia, depression, or suicide risk. Thematic analysis identified key roles, lessons, and patient needs in transitional care provided by AHC professionals. Results AHC professionals, including social workers, occupational therapists, pharmacists, and physical therapists, contributed through discharge planning, physiotherapy, medication reviews, MH counseling, and resource navigation. For caregivers, they provided education on dementia care, behavior management, and psychosocial support, improving caregiver well-being and interactions with persons with dementia. Transitional care interventions reduced caregiver stress and, in some cases, hospital readmissions. Challenges included suboptimal medication management for persons with dementia. Key facilitators were flexible delivery methods (e.g., telehealth), tailored interventions, and dementia-specific education. Conclusion AHC professionals are vital to transitional care for older adults with MH needs, offering tailored support to patients and caregivers. Enhanced integration, interdisciplinary collaboration, caregiver education, and addressing systemic barriers could improve care quality. Future research should focus on standardizing interventions and optimizing medication management.