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This study examines the osteoconductive and healing capabilities of locally implanted synthetic hydroxyapatite (sHAp) derived from eggshells in the central incisor sockets of rats.

Toxicity experiments were conducted in vitro and in vivo, to testify the safety dosage of sHAp. Around 24 mature male Sprague–Dawley (SD) rats had their upper central incisors extracted. The rats were placed into three groups of eight rats each: Group 1: the sockets of extracted central incisors were left unfilled (control), Group 2: filled up with commercially available hydroxyapatite (HAp) and Group 3: implanted with sHAp locally retrieved from eggshells. After extraction, four rats from each group were sacrificed at 2nd and 4th weeks. Maxillary tissue sections were obtained and stained with hematoxylin and eosin (H&E) and Masson’s trichome (MT) staining. Anti-osteocalcin (OCN) and proliferating cell nuclear antigen (PCNA) were used primary antibodies for immunohistochemistry (IHC) special labeling.

The results showed that the locally implanted sHAp was non-toxic and safe in cell lines (human osteoblast and fibroblast) and animals. Histological analysis of H&E, MT and IHC showed that the sockets treated with locally implanted sHAp from eggshells were filled with new bone tissue of comparable thickness to other groups.

This unique technique uses locally implanted eggshell-derived sHAp with osteoconductive characteristics. In an in vivo model, sHAps increased OCN and PCNA expression to improve bone repair.

Drawing on a dynamic capability view, this study develops a decision support model that determines the most suitable configuration of strategies and challenges to adopt additive manufacturing (AM) to expedite digital transformation and performance improvement of the surgical and medical device (SMD) supply chain.

To investigate the research objective, a multi-method and multi-study research design was deployed using quality function deployment and fuzzy set qualitative comparative analysis.

The study finds that only resilience strategies or negation (i.e. minimisation) of challenges are not enough; instead, a configuration of resilience strategies and negation of challenges is highly significant in enhancing performance.

SMD supply chain decision-makers will find the decision support model presented in this study as beneficial to be resilient against various challenges in the digital transformation of service delivery process.

This study builds new knowledge of the adoption of AM technology in the SMD supply chain. The decision support model developed in this study is unique and highly effective for fostering digital transformation and enhancing SMD supply chain performance.

This study aims to measure the perception of the residents regarding peer assisted learning in emergency medicine residency program as well as assessing the psychometric properties of the questionnaire used as the research tool.

A descriptive cross-sectional study was conducted at King Abdullah Medical City, Saudi Arabia, Makkah on a Convenience sample of Emergency Medicine residents who completed peer assisted learning sessions. Data were collected through a questionnaire evaluating the residents’ perception of Peer Assisted Learning. Descriptive statistics were used and statistical significance was set at p < 0.05. The Peer Assisted Learning (PAL) satisfaction questionnaire was tested for construct validity and reliability. Exploratory Factor Analysis (EFA) was conducted. The reliability of the used questionnaire was assessed using Cronbach’s coefficient alpha.

The study showed that the PAL questionnaire yielded four factors. The four factors are labeled as the following: Factor 1: Cognitive congruence, Factor 2: Social congruence; Factor 3: Teaching skills in Peer Assisted Learning (PAL) session; and Factor 4: Professional development. These results indicated that questionnaire has a good structure validity. In addition, the study showed high internal consistency of the questionnaire. Cronbach’s alpha coefficient value for the total scale was 0.88. The perception of residents was assessed and results revealed residents’ satisfaction regarding Peer Assisted Learning.

Up to the authors’ knowledge, this is the first study which assessed the psychometric properties of a questionnaire measuring the residents’ perceptions regarding Peer Assisted Learning. The study contributed to improving information regarding the psychometric properties and usefulness of PAL questionnaire.

The emergence of the COVID-19 pandemic changed the way in which education was delivered in early 2020, and the impacts of these changes continue to be questionable. The aims of this study were to evaluate: (1) the results obtained by students of the Dentistry course in the progress test carried out both before and after the pandemic, (2) the results obtained by a specific group of students who took the test in 2019–2022, and compare their results and (3) subjects that showed a reduction in the percentage of correct answers when the two tests were compared.

The progress test consisting of 100 multiple choice questions was applied before and after the pandemic to all students in the Dentistry course. The analyses were performed using the IBM SPSS for Statistics v.26 software program. The level of significance of 5% was adopted (<0.05).

The test was applied to 320 students in 2019 and to 272 in 2022, of whom the sample of this study was composed. The mean score values in 2019 (M = 49.10; SD = 12.03) were significantly (p = 0.026) higher than those in the year 2022 (M = 46.97; SD = 12.15), with the disciplines in the area of specific knowledge showing a greater drop in the percentage of correct answers by students. This study showed that the emergency remote education had a negative effect on the academic performance of students, based on the progress testing as an evaluation method.

Many studies that assessed the impacts of the pandemic on teaching were focused on the opinions of students. However, the great advantage of our study was the use of a theoretical assessment tool to verify student performance. The post-pandemic landscape beckons for comprehensive inquiries into these domains. This type of research would be valuable for gathering evidence relative to the performance of students after the emergency remote education.

Oral health is an integral part of general health. Different population groups have been assessed for oral health status in India, but still, many have been neglected; one such group is the prisoners. The prison population is a unique and challenging one with many health problems, including poor oral health, which may be due to lack of knowledge about good oral health practices. This study aims to assess effectiveness of oral health education on oral health knowledge, attitude and practices and oral hygiene status among the male prison inmates of central jail in Kolkata, India.

An interventional study was done among 240 male convicts. The data was elicited using a structured proforma; oral health status was assessed by recording OHI-S index, and the severity of gingivitis was assessed by recording the gingival index. Oral health education was delivered by using audio-visual aid. Oral health knowledge, attitude, practices and oral hygiene and gingival status were reassessed among the inmates before and after dental education at the end of three and six months.

A significant change in oral health knowledge, attitude and practices was seen, which in turn resulted in an appreciable decrease in the mean gingival index score (1.73 ± 0.382 to 1.20 ± 0.321) and OHI-S (3.31 ± 0.815 to 2.57 ± 0.551) in all the inmates after oral health education program over the period of time.

The oral health education with reinforcement proved to be an effective tool to instil good oral hygiene practices in the inmates.

This study demonstrates how becoming a high-reliability institution in health care is a priority, given the high-risk environment in which an error can result in harm. Literature conceptually supports the need for highly reliable health care facilities but does not show a comprehensive approach to operationalizing the concept into the daily workforce to support patients. The Veterans Health Administration closes the gap by documenting a case study that not only demonstrates specific actions and functions that create a high-reliability organization (HRO) for safety and improvement but also created a learning organization by spreading the knowledge to other facilities.

The authors instituted a methodology consisting of assessments, training and educational simulations to measure, establish and operationalize activities that identified and prevented harmful events. Visual communication boards were created to facilitate team huddles and discuss improvement ideas. Improvements were then measured and analyzed for purposeful outcomes and return on investment (ROI).

HRO can be operationalized successfully in health care systems. Measurable outcomes verified that psychological safety was achieved through the identification and participation of 3,184 process improvement projects over a five-year period, which yielded a US$2.8m ROI. Documented processes and activities were used for educational teachings, which were disseminated to other Veteran Affairs Medical Center’s through the Truman HRO Academy.

This case study is limited to one hospital in the Veterans Health Administration (VHA) network. As the VHA continues to deploy the methods outlined to other hospitals, the authors will perform incremental data collection and ongoing analysis for further validation of the HRO methods and operations. Hospitalists can adapt the methods in the case study for practical application in a health care setting outside of VHA. Although the model is rooted in health care, the methods may be adapted for use in other industries.

This case study overcomes the limitations within literature regarding operationalizing HRO by providing actual activities and demonstrations that can be implemented by other health care facilities.

The study aims to address a critical gap in existing healthcare payment schemes and care service pricing by recognizing the influential role of patients' decisions on self-management efforts. These decisions not only impact health outcomes but also shape the demand for care, subsequently influencing care costs. Despite the significance of this interplay, current payment schemes often overlook these dynamics. The research focuses on investigating the implications of a novel behavior-based payment scheme, designed to align incentives and establish a direct connection between patients' decisions and care costs. The primary objective is to comprehensively understand whether and how this innovative payment scheme structure influences key stakeholders, including patients, care providers, insurers and overall social welfare.

In this paper, we propose a game-theoretical model to incorporate the performance of self-management with the demand for healthcare service, compare the patient's effort decision for self-management and provider's price decision for healthcare service under a behavior-based scheme with that under two implemented widely payment schemes, that is, co-payment scheme and co-insurance scheme.

Our findings confirm that the behavior-based scheme incentives patient self-management more than current schemes while reducing their possibility of seeking healthcare service, which indirectly induces the provider to lower the price of the service. The stakeholders' utility under various payment schemes is sensitive to the cost of treatment and the perceived health utility of patients. Especially, patient health awareness is not always benefited provider profit, as it motivates patient self-management while diminishing the demand for care.

We provide a novel framework for characterizing behavior-based payment schemes. Our results confirm the need for modification of the current payment scheme to incentivize patient self-management.

The use of social media is one of the new technological options that has been recommended as a potential new strategy for delivering high-quality, high-value cancer prevention and management services. Despite the increasing use of social media, little research has been done on the use of social media in brain tumors. Therefore, this systematic review aims to provide a comprehensive review of the use of social media in brain tumor research.

A systematic search was performed in PubMed, Scopus and Web of Science from inception to August 1, 2022. English full-text articles evaluating social media use, benefit or content in brain tumor were considered.

Sixteen documents satisfied the inclusion criteria and were included in the final analysis. Most of the included studies (n = 11/16) were conducted and published by researchers in the USA. In terms of social media platform, most studies focused on Twitter (8/16, 50%) and YouTube (8/16, 50%), followed by Facebook (6/16, 37.5%) and Instagram (4/16, 25%). Most studies (n = 7/12) analyzed the content of brain tumor information provided on social media, followed by patients’ use of social media (n = 3/12) and the quality of information on social media (n = 3/12). The other three articles also examined patient recruitment, crowdfunding and caregiver use of social media.

By identifying the use, benefits and content of social media platforms in different settings, patients, clinicians and policymakers can better benefit from harnessing the power of social media in different ways, leading to improved health-care services.

To the authors knowledge, this is the first study to systematically examine social media use, benefits and content status in brain tumors.

This study aims to analyze the way Indonesian and the US laws regulate the reality and implications of legal issues regarding telemedicine, including the protection of citizens in using telemedicine.

This normative legal study used secondary data comprising primary and secondary legal materials based on the law as a norm. The normative legal method was used because the data were based on laws and regulations, reports, journals and research governing telemedicine in Indonesia and the USA.

The results showed similarities between Indonesia and the USA regarding health services as part of protecting human rights. The differences in implementing telemedicine are from a legal aspect. The legal comparison of telemedicine implementation between the two countries resulted in differences in regulation, informed consent, medical records, practice licenses and medical prescriptions.

This study discussed telemedicine’s legal aspects in Indonesia and the USA.

This study aimed to determine the implementation and guidelines used by the USA to be considered for adoption by Indonesia for legal certainty.

The results showed that legal threats could be a weakness of law in Indonesia. Therefore, the government should develop guidelines about telemedicine to accommodate citizens’ legal protection and certainty.

This study is original and could be used as a reference for policymakers in Indonesia and the USA in protecting citizens using telemedicine services. The findings provide a perspective based on Health Law in Indonesia.

The main purpose of this paper is to outline the antecedents of patient satisfaction in the field of medical tourism (MT) applying extant literature and to develop a conceptual model based on the review.

This paper presents a thorough review of prior studies related to the antecedents of patient satisfaction in the MT sector. Moreover, it provides the theoretical base that helped the researcher to identify significant relationship between the patient satisfaction and its antecedents.

The researchers identified the prominent antecedents of patient satisfaction and present the potential interrelationships between different antecedents of patient satisfaction such as treatment quality, cost attractiveness, destination image and service quality with patient satisfaction based on the review.

The results have momentous practical implications as they will help researchers to better understand the antecedents of patient satisfaction and their potential inter linkages with patient satisfaction in MT sector. The conceptual model derived from the review may guide the actions of researchers as well as practitioners in the MT industry as a whole. The present study provides insights for further research in the MT sector and thereby helps to further enrich the existing theoretical base of the MT.

The study brings together the scattered knowledge from the broad and extensive range of medical or health tourism and cognate literature which indicate ideological differences among various aspects of MT as well as potential factors determining patient satisfaction in MT sector (antecedents of satisfaction). The newly developed model incorporates a new construct called “treatment quality” as different from “service quality,” which is a widely used construct to explain customer satisfaction. The antecedents of patient satisfaction and their inter-linkages with patient satisfaction provide a sound theoretical foundation for the future studies.