Abstract: Introduction: The African Union and regional initiatives, such as the African Food Safety Agency and the Southern African Development Community's (SADC) food safety guidelines, introduced interventions to reduce the burden of foodborne disease. However, progress in strengthening food safety regulations for small food businesses (SFBs) across SADC remains limited. Objective: to investigate the existing food safety regulations for SFBs and their compliance levels to achieve a sustainable local food system across SADC. Methodology: The PRISMA Protocol was used to review thirty-one articles collected from online databases between 2018 and 2025. Screened with inclusion and exclusion criteria. Result: Ten national health-related food laws, acts, and regulations were identified across the 16 member states of the region; all the countries have public health law except for Comoros, 87% have animal health law, and 69% have the Standard Quality Act, Consumer Protection Law, livestock and meat law, and plant-related law. South Africa and four other countries have the highest number of food-related laws, which also include the most explicit law for SFBs, known as the Foodstuffs, Cosmetics and Disinfectants Act, 1972, revised in 2018. Conditions like poor hygienic practices, inadequate cooling and storage methods, cultural beliefs, a lack of potable water, limited consumer awareness, low technology adoption, and outdated laws for SFBs, potable water, limited consumer awareness, low technology adoption, technical know-how, and old and fragmented laws affected their compliance level. The review identified better coordination, capacity building for vendors and regulators, collaborative efforts, and digital technology adoption as best practices. Conclusion: An autonomous Food Safety Agency situated under the member state's Ministry of Health with a multisectoral board for coordination. The Food Act should be aligned with SFBs' complexities, integrating innovations and a risk-based assessment.

Abstract: Background: In healthcare, Electronic Medical Records (EMRs) offer centralized access to patient data and enable evidence-based clinical decision-making. and operational efficiency. However, they have introduced administrative burdens for the clinicians, potentially impacting job satisfaction and care quality. Despite the widespread EMR adoption in Saudi Arabia, the issue of time burden related to EMRs and the factors re-lated to it are underexplored. Objectives: To measure the average number of hours (per month and as percentage out of total monthly working hours) of EMR use among physicians and nurses, compare the mean monthly hours of EMR use between them, and identify the demographic predictors of extended hours of EMR use. Moreover, it aims to understand the perceived challenges and barriers of timely filling EMRs, and the impact of EMRs on quality of patient care. Methods: A sequential mixed-methods study was conducted at three Security Forces Hospitals in Riyadh, Dammam, and Makkah. Quantitively, a correlational cross-sectional design was used was employed with multistage stratified sampling using a validated 30-item questionnaire, and data were analyzed using differential and inferential statistics. The qualitative phase in-volved purposive sampling of ten clinicians and semi-structured interviews analyzed through thematic analysis. Results: A total of 503 professionals (162 physicians, 341 nurses) participated. Majority were females (67.2%), aged 30 to 40 years (44.9%), and non-Saudi (62%). Nurses reported significantly higher mean of EMR usage hours/day than physicians (5.43 versus 4.34 hours/day, p=0.001). Significant predictors of ex-tended EMR use include age 30-50 years, female gender, non-Saudi nationality, higher education, nursing profession, longer healthcare experience, 5-10 years EMR experi-ence, 10+ hours EMR training, and participants from Makkah. Qualitative analysis identified barriers such as infrastructure constraints, system performance and tech-nical issues, lack of IT support, and workflow and professional burden. Regarding EMR impact, they improved professional practice and patient safety, however, concerns were raised regarding adjustments in work routine Conclusion: EMR use carries con-siderable administrative burden, especially nurses when compared to physicians. Ad-dressing the identified barriers through targeted training, better system design, and improved workflows could boost efficiency and support high-quality patient care. The findings offer evidence-based insights to guide policy and system-level improvements.

Abstract: Balance training in a virtual environment (VE) simulating travel on a bumpy road, induced large reductions in body sway within the training session and further reductions between-sessions [1]. These gains were well-retained over a 12-week interval. Here, to test how much this learning depended on visual input, we tested seven young adults who practiced maintaining balance in the same platform movements, but blindfolded. We hypothesized that the balance skill acquisition time-course would be invariant to eliminating visual input (sensory input reweighting). Center of Pressure displacements (CoP-d) were analyzed for each task iteration during the training session to assess “online” learning, and at 24 hours, 4 and 12-weeks post-training, to assess “offline” gains and retention. The results were compared to the published results obtained from participants training eyes-open, in the same VE conditions. Unlike the eye-open condition, CoP-d remained unchanged throughout the training session - no “online” stability gains. However, initial blindfolded performance equaled the lowest task-related CoP-d attained, at the end of the session, when training eyes-open. Nevertheless, blindfolded practice resulted in “offline” reductions in CoP-d by 4 and 12-weeks post-training. The results suggest that blindfolded balance performance may rely on pre-established balance skills that are independent of visual input and require little, within-session, adaptation. The initial, large stability gains reported in eyes-open training may reflect minimizing of redundant anticipatory postural adjustments to specific VE scenes. However, blindfolded training on a moving platform can lead to long-lasting balance gains, via a slow post-training, “offline”, process.

Abstract:

Thermoregulation is essential for sleep, with the nocturnal core body temperature decline triggering sleep onset and modulating sleep architecture. Disruptions to this thermal balance cause fragmented sleep and reduced sleep quality. Preliminary evidence suggests cooling may reduce hyperarousal, shorten sleep onset latency, and improve sleep continuity through multiple mechanisms, including enhanced distal-proximal skin temperature gradient, parasympathetic activation, and hypothalamic-pituitary-adrenal axis modulation. However, most studies are small (n<30), short-term (1-4 weeks), and lack standardized protocols or long-term follow-up. This narrative review evaluates evidence on cooling mechanisms (thermoregulatory and stress-related) and evaluates environmental and targeted cooling approaches (mattress systems, forehead devices) for insomnia, anxiety, post-traumatic stress disorder, and migraine. Across conditions, cooling shows promise for reducing hyperarousal and improving sleep outcomes, though evidence quality varies substantially. Critical research gaps include the absence of trials combining cooling with behavioral treatments such as Cognitive Behavioral Therapy for Insomnia, no trials in some clinical populations, limited biomarker-guided personalization, and uncertain long-term effects. Rigorous trials with active controls, objective endpoints, phenotypic stratification, and long-term follow-up are needed to establish cooling as an evidence-based intervention.

Abstract: Background: Treatment nonadherence in oncology is prevalent and often assessed by surveys that miss the qualitative reasons underpinning nonadherence or treatment discordance. We aimed to synthesize evidence from Natural Language Processing (NLP) studies, primarily sentiment analysis of patient generated content (social media, forums, blogs, review platforms, and survey free text), to identify communication-related and relational factors linked to nonadherence/concordance. Methods: We conducted a scoping review following PRISMA-ScR. Searches of PubMed, CINAHL, and Scopus (2013 early 2024) targeted NLP studies of the cancer patient experience; conventional reports were included where they clarified communication/adherence constructs. Data were charted against source, cancer type, NLP technique, and inferred adherence/concordance factors, then synthesized using discourse analysis and narrative synthesis. Results: Four patient side themes consistently emerged: (1) unmet emotional needs; (2) suboptimal information and communication; (3) unclear treatment concordance within patient/person-centred care; and (4) online misinformation dynamics (and perceptions of clinician bias). Sentiment analysis detected fine grained emotions (fear, disgust, sadness, surprise), informational gaps and trust issues that are often less visible in structured surveys. Conclusions: Patient voice data offer actionable insights for nursing practice: routine distress screening, teach back strategies, misinformation countermeasures, and explicit concordance checks. Integrating these into person-centred workflows may improve adherence and shared decision making. Registration: Not registered.

Abstract: Background/Objectives: Delirium is frequent and serious in older adults attending the emergency department (ED), but evidence on its pharmacological management in this setting is limited. This study aimed to quantify the pharmacological treatment of de-lirium in older adults in the ED and examine its association with subsequent hospital admission. Methods: An observational cross-sectional study was conducted between November 2021 and June 2022 in a Spanish ED. The sample included 153 adults aged 65 years or older with clinician-diagnosed delirium. Clinical, triage, and medication data were obtained from electronic medical records, and associations with hospital admis-sion were analysed using multivariable logistic regression. Results: Ninety-one partic-ipants (59.5%) were hospitalised. Antipsychotic, analgesic, and benzodiazepine use was associated with increased risk of hospitalisation. Absence of an underlying cause was a protective factor. The logistic regression model was significant. Conclusions: Specific drug families were associated with a higher likelihood of hospital admission in older adults with delirium in the ED. These findings support safer and more individualised pharmacological approaches and highlight the need for studies evaluating targeted interventions.

Abstract: Background: A scarcity of evidence-based study concerning the correlation between impaired lipid metabolism and the onset of cardiometabolic complications in Yemeni diabetic patients. Objective: An experimental based cross-sectional study aimed to explore the link between lipid abnormalities and glycemic control in patients with type 2 diabetes mellitus (T2DM). Methods: Out of 145 individuals diagnosed with T2DM were participated in this study. Anthropometric status of chosen patients was measured, isolated blood samples were investigated for fasting blood glucose (FBS), glycated hemoglobin A1c (HbA1c), and fasting serum lipids, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Descriptive statistics, Pearson’s correlation, and multiple logistic regression were used in data analysis. Results: T2DM patients aged from 20 to 80 years, with an average age of 54.35±8.02 years. 82 males (56.6%) and 63 females (43.4%) were grouped in gender. The majority of subjects (72.4%) were not at diabetic dyslipidemia risk, while 27.6% were counted at risk. Body mass index (BMI), FBS, and HbA1c mean values were 25.02±5.22 kg/m², 0.37±0.489, and 1.67±0.474, respectively. Statistically, a positive association was observed between HbA1c and FBS with BMI, TC, TG, and LDL-C, while negative correlations were found with HDL-C. Diabetic patients with poor glycemic control (HbA1c ≥ 6.0) had shown higher TC, TG, LDL-C, and HDL-C in comparison with subjects had good glycemic control (HbA1c < 6.0). Conclusion: The results demonstrate that HbA1c levels can serve as a predicator marker for manifesting diabetic patients at high risk, facilizing early diagnosis of dyslipidemia and aiding timely treatment with lipid-controlling therapies.

Abstract: The overlapping circulation of influenza (Flu), SARS-CoV-2 (SC2), and respiratory syncytial virus (RSV) continues to challenge clinical laboratories, particularly in settings with limited automation and fragmented healthcare coverage. This study expanded the CDC Flu-SC2 assay by incorporating a laboratory-developed test for RSV A/B detection into a fully automated quadruplex RT-qPCR (LDRA) on the Panther Fusion® Open Access™ system. The design, based on more than 8,000 RSV genomic sequences targeting the conserved M gene, achieved optimal amplification efficiencies (97–105%) and full multiplex compatibility. Analytical assessment established limits of detection between 9.6 and 37.8 copies per reaction, absence of cross-reactivity with 30 respiratory pathogens, and inclusivity for 33 viral variants. Commutability and diagnostic performance among the LDRA, CE-marked Allplex™ SARS-CoV-2/FluA/FluB/RSV, and IVD-marked Panther Fusion® SARS-CoV-2/Flu A/B/RSV Assays were evaluated using 405 nasopharyngeal UTM-conserved swabs. The LDRA demonstrated excellent concordance (overall agreement≥98%, k > 0.95), strong diagnostic accuracy, and reliable detection of mixed infections. This quadruplex provides a fully automated, rapid, and accurate solution for the simultaneous detection of influenza A, influenza B, SARS-CoV-2, and RSV viruses, enhancing molecular diagnostic capacity and supporting equitable, timely clinical decision-making in middle-income healthcare systems, such as that of the Dominican Republic.

Abstract: This study explores the spatial relationship between frequent physical distress (FPD) and socioeconomic as well as health-related factors across the contiguous United States. FPD, defined as having 14 or more physically unhealthy days within the past month, serves as an important measure of overall population health. While many studies have examined the causes of mental distress, research on the geographic variation and social context of physical distress remains limited. Using data from 2,673 U.S. counties, we analyzed how socioeconomic conditions and health indicators relate to FPD at both national and local levels. Ordinary Least Squares (OLS) multivariate regression model was first used to assess general associations, followed by Geographically Weighted Regression (GWR) and Multiscale Geographically Weighted Regression (MGWR) to identify spatially varying and scale-dependent relationships. Comparing the GWR and MGWR results revealed that several predictors of FPD operate at different spatial scales, reflecting local heterogeneity in health outcomes. Counties in the southeastern United States, particularly those with higher levels of socioeconomic disadvantage and poorer health conditions, showed elevated FPD rates. These findings highlight the importance of accounting for spatial context when addressing physical distress and suggest that locally tailored public health strategies may be more effective than uniform national approaches.

Abstract: Background: Frozen shoulder (FS) leads to pain, reduced shoulder function, and deficits in postural stability and sensorimotor control during upper-limb weight-bearing tasks. This study investigated how an eight-week Dynamic Neuromuscular Stabilization (DNS) program affected Center of Pressure (COP) control and pain in middle-aged women with FS. Methods: Twenty-two middle-aged women with FS were randomly assigned to a DNS group (DNSG, n = 11) or a control group (CG, n = 11). The DNSG performed DNS exercises twice weekly for eight weeks, while the CG performed dynamic stretching. COP variables (distance, velocity, and root mean square (RMS) in the anterior–posterior (AP) and medial–lateral (ML) directions) were measured using a force platform under affected-side single-hand support with visual input and bilateral hand support with and without visual input. Pain was assessed using the Visual Analog Scale (VAS). All variables were analyzed using a two-way mixed ANOVA. Results: Under the affected-side single-hand support condition, significant group-by-time interaction effects were found in AP distance, AP velocity, ML velocity, and ML RMS (p < 0.05). In the bilateral hand-support conditions with and without visual input, additional COP variables also showed significant interactions (p < 0.05), and VAS-measured pain decreased over time in both groups. Conclusions: The DNS intervention demonstrated positive changes in postural stability and pain during upper-limb weight-bearing tasks in middle-aged women with FS. These findings suggest that DNS has potential as an intervention strategy to support functional recovery and enhance sensorimotor control in individuals with FS.

Abstract: Background There is a high correlation between a trauma history and development of mental health conditions. By providing safe and containing (trauma-informed) working relationships, mental health nurses can validate mental distress, reduce re-traumatisation and support recovery. Trauma informed education (TIE) has become commonplace in nurse education however, little is known about students’ experience of this and its impact on their practice. Purpose This study aimed to evaluate and explore student mental health nurses’ perspectives on TIE and its impact on their practice to contribute to the knowledge and evidence base that informs nurse and broader healthcare education. Methods This qualitative, phenomenological study used focus group interviews (n=3) with 11 mental health nursing students, reported using SRQR Checklist. Analysis Data generated was analysed using Braun and Clarke’s (2013) Reflective Thematic Analysis. Findings Three themes were identified: 1. A compass for practice; 2. Mental Health Nursing: Between paradigms; 3. Supporting personal development and wellbeing. Integrating TIE within nurse education can support students to adopt the principles of trauma-informed care (TIC) personally and in their practice. Improved self-awareness, recognition of trauma and adopting self-care strategies were valuable in supporting personal resilience and wellbeing, valuable in managing the challenges of mental health practice. Recommendations TIE has the potential to have a positive impact on wellbeing therefore integration should be considered for all healthcare programmes. Further interprofessional research is needed to establish the longer-term impact of TIE as students’ progress into their professional career. Limitations This is an initial small-scale study with self-selecting students which limits generalisability. Exploring sustained impact through longitudinal study may be valuable.

Abstract: Global population aging demands understanding the determinants of healthy cognitive aging. This study aimed to examine the interrelations among executive functions, instru-mental activities of daily living and quality of life in older adults, considering the mediat-ing role of depression. Structural equation modeling was employed to estimate direct and indirect pathways between latent and observed variables, with the inclusion of depression as covariate in a sample of 124 community-dwelling older adults from João Pessoa, Brazil. Results indicated that executive function components were interrelated and associated with instrumental activities of daily living performance but did not exert a significant di-rect effect on quality of life. Depression emerged as the strongest predictor of satisfaction with life, negatively impacting all domains and mediating the relationship between exec-utive functioning and functional autonomy. The final model explained the major variance in quality of life compared to the variance in instrumental activities of daily living, with model fit indices supporting adequacy. These findings underscore the central role of de-pression in determining the self-perceived quality of life in aging, suggesting that inter-ventions should target both cognitive and affective domains to promote autonomy and well-being in older populations.

Abstract:

We focused on a comparison of cognitive failures in nine women with anorexia nervosa and nine women of the regular population. Background/Objectives: It primarily focuses on memory, attention, psychomotor tempo, and executive function in a group of women with a diagnosis of anorexia nervosa and a group of women in the general population without a diagnosis of anorexia nervosa or other psychiatric diagnosis. The following methods were used for research purposes: the Cognitive Failure Questionnaire (CFQ), the Trail Making Test (TMT), and a semi-structured interview subsequently processed into a case study. We observed a significantly negative impact of anorexia nervosa on the cognition of respondents. Results: Through the above objective methods, it detects the significantly negative impact of mental anorexia on the cognition of female respondents. The findings from the quantitative methods are verified through the qualitative part in the form of an interview, which is also consistent with previous findings. Conclusions: We also consider it important to carry out longitudinal studies that would allow us to monitor how cognitive functions change during treatment and recovery from anorexia nervosa.

Abstract: Economic crises characterized by financial instability, rising unemployment, and austerity measures are known to have profound social and public health consequences. While their economic impacts are widely studied, their effects on mental health across diverse populations and geographic regions remain fragmented and require synthesis. This scoping review aims to consolidate existing evidence on the relationship between economic crises and a broad range of mental health outcomes, including suicide, depression, anxiety, psychological distress, and health service utilization. Multiple databases (PubMed, EMBASE, Web of Science, Scopus, PsycINFO, EconLit) were explored for reports published between January 2000 and December 2025, following PRISMA-ScR guidelines. Totally, 122 studies met the inclusion criteria. Economic crises are consistently associated with adverse mental health outcomes. Key findings include increased suicide mortality, particularly among working-age men, with pronounced spikes during and after major crises such as the 2008 global financial crisis and the 1997 Asian financial crisis. Non-fatal suicidal behaviors (ideation, attempts, self-harm), depression, anxiety, and psychological distress also rise significantly, driven by unemployment, income loss, debt, and housing insecurity. Vulnerable groups, including the unemployed, low-income populations, youth, and those with pre-existing mental health conditions are disproportionately affected. The evidence also indicates mixed patterns in mental health service utilization, often constrained by austerity and access barriers. Social protection systems and supportive policies appear to mitigate negative mental health impacts. Economic crises exert a significant and multifaceted toll on population mental health, exacerbating inequalities and increasing the burden of mental disorders and suicidal behavior. The findings underscore the need for integrated policy responses that strengthen social safety nets, ensure accessible mental healthcare, and address the psychosocial and economic determinants of health during periods of financial instability. Research gaps remain, particularly in low- and middle-income countries and regarding long-term mental health trajectories post-crisis.

Abstract: Background/Objectives: Mental disorders are a growing public health concern in Lat-in America, particularly among marginalized populations. This study aimed to identi-fy the prevalence and associated risk factors of mental disorders in Afro-descendant communities of the Río Chota Basin, a historically excluded population facing persis-tent social and economic inequalities. Methods: A cross-sectional descriptive study was conducted in several rural communities using random sampling. A total of 557 participants were assessed for sociodemographic factors and mental health status us-ing validated instruments: the Global Mental Health Assessment Tool–Primary Care (GMHAT/PC), the International Physical Activity Questionnaire (IPAQ), and the WHO STEPS questionnaire. Data was analyzed using descriptive statistics and infer-ential tests to determine associations between psychosocial, behavioral, and socioeco-nomic variables and the presence of mental disorders. Results: The overall prevalence of mental disorders was extremely high (60.7%), exceeding national and regional esti-mates. The most prevalent conditions were major depressive disorder (15.6–17.9%), anxiety disorders (10.2–12.3%), and psychosis with depressive symptoms (8.3–11.5%), with higher rates among women. Low fruit and vegetable intake and income below the minimum wage were significantly associated with greater prevalence. Severe stress and experiences of abuse or maltreatment showed the strongest associations with mental disorders (p < 0.001). Conclusions: Afro-descendant communities in the Río Chota Basin experience a disproportionately high burden of mental illness influenced by intertwined socioeconomic, psychosocial, and behavioral determinants. Culturally sensitive interventions that promote resilience, community support, and reduction of structural inequalities are urgently needed.

Abstract: Visual impairment during adolescence can affect educational outcomes and psychosocial development, particularly in settings with limited access to comprehensive eye care. This study aimed to assess the prevalence of refractive errors and the adequacy of spectacle correction among secondary school students in Da Nang, Vietnam. A school-based cross-sectional survey was conducted among 8th-grade students at Le Do Secondary School in the Son Tra District. Visual acuity, refractive status, and spectacle use were evaluated using standard clinical procedures. Verbal consent was obtained from students, with teachers acting as guardians, and retrospective ethical approval was granted (IRB No. P01-202410-01-039). Of 350 eligible students, 315 were included in the analysis. Based on the better-seeing eye, 15.9% of students had myopia, and refractive errors were identified in 40.3% when either eye was considered. At the time of assessment, 24.8% wore spectacles; however, 41.6% required refractive correction, including 29.8% with uncorrected refractive error and 11.8% whose spectacles did not adequately correct their vision. These findings indicate gaps in both access to refractive services and the quality of provided corrections. Although limited to a single school, the results highlight the need for routine school-based vision screening and affordable, accurate spectacle provision. Larger, population-based studies are warranted to clarify the broader burden of refractive error among Vietnamese adolescents.

Abstract: The COVID-19 pandemic profoundly disrupted the lives of older adults, yet their experiences have remained underexplored. This paper draws on empirical evidence from a two-wave (W1 April-July 2020, W2 January-April 2021) qualitative study in the UK (n=62) and a companion study in Colombia (n=32), focusing on participants aged 60 and above. Data was analysed using constructivist grounded theory principles, leading to the development of an ecological theory of older adults' well-being at three interconnected levels: individual, community, and societal. Individual resources, such as adaptability and support systems, contributed to enhancing and maintaining their well-being. Community support and a sense of belonging were essential to meet the needs of people in later life, whilst necessary social health protection measures during the pandemic restricted social activities, further impacting well-being, mostly perceived as challenging. Cultural differences and societal support systems shaped participants' experiences. The study emphasises the interdependence of the different levels in impacting older adults' well-being, offers strategies for policy and practice, and advocates and contributes for the development of gerontological theories in the context of health crises.

Abstract: The COVID-19 pandemic created a natural experiment to assess air quality responses to emission reductions, yet evidence from Latin American coastal industrial cities remains scarce. This study examined how meteorological variability modulated the effects of COVID-19 restrictions on air quality in Ilo, a medium-sized coastal industrial city in southern Peru (~67,000 inhabitants). We analyzed daily concentrations of PM10, PM2.5, NO2, O3, and SO2 across six pandemic phases (January–December 2020) using multiple linear regression, variance decomposition, and Random Forest models. A health impact assessment translated PM2.5 changes into cardiovascular mortality estimates using Global Burden of Disease 2021 coefficients. Despite reduced anthropogenic activity, PM2.5 increased by 34% during early reopening (May–June: 16.9 vs. 12.6 µg/m³ baseline), whereas NO2 decreased consistently (13–19%), SO2 declined up to 65%, and O3 more than doubled (+108%) in austral winter. Variance decomposition revealed that O₃ variability was almost entirely meteorology-driven (98%), while PM2.5 and NO2 showed balanced contributions from meteorology and restrictions (~50% each). The PM2.5 increase corresponded to approximately 3 additional cardiovascular deaths per 100,000 population annually. Coastal meteorology can counteract emission reductions, generating counterintuitive air quality responses and underscoring the need for meteorological normalization in policy evaluation.

Abstract:

Digital mental health uses technology—like the Internet, smartphones, wearables, and immersive platforms—to improve access to care. While these resources quickly expanded post COVID-19, ongoing issues include low user retention, poor digital literacy, unclear privacy rules, and limited proof of effectiveness and safety. AI chatbots, also known as agents and assistants that act as a therapist or companion, support mental health by delivering counseling and personalized interactions through various apps and devices. AI chatbots may boost social health and lower loneliness, however, they may also increase dependence and affect emotional outcomes. Their use remains largely unregulated, with concerns about privacy, bias, and ethics. Experiences vary; some users report positive results while others doubt their safety and impact, especially in crisis response. There is a need to better protect vulnerable users and engage the underserved, with input from various individuals with lived experience on what feels safe, supportive, or harmful when interacting with AI chatbots. Proper evaluation, standardized training by digital navigators, and ethical/clinical guidelines are crucial for safe, engaging and effective adoption of AI in mental health care and support.

Abstract:

Background/Objectives: Gynecological and obstetric surgeries carry a risk of urinary tract injuries, which remain important causes of surgical morbidity. This study aimed to evaluate the incidence, etiological factors, diagnostic timing, and management outcomes of urological injuries occurring during these procedures over a 10-year period in a high-volume single-center cohort. Methods: This single-center retrospective study reviewed urinary tract injuries that occurred during gynecologic and obstetric procedures performed between January 2014 and December 2024. Among 16,100 surgeries, 223 cases were identified and analyzed regarding injury incidence, etiology, type, diagnostic timing, and management strategies. Results: Bladder injuries constituted 62.3% of cases, ureteral injuries 28.7%, and genitourinary fistulas 9.0%. Most bladder injuries (98.6%) and the majority of ureteral injuries (68.8%) were recognized intraoperatively (p < 0.001). Bladder injuries were most frequently associated with cesarean section, whereas ureteral injuries were more common in malignant gynecologic surgeries (p < 0.05). Conclusions: Early recognition and timely intervention remain critical to reducing morbidity associated with iatrogenic urinary tract injuries. These findings underscore the importance of anatomical knowledge, meticulous surgical technique, and appropriate diagnostic evaluation to optimize perioperative outcomes in gynecologic and obstetric surgery.