A Systematic Review of the Application of Artificial Intelligence in Nursing Care: Where are We, and What’s Next?

Suebsarn Ruksakulpiwat,1 Sutthinee Thorngthip,2 Atsadaporn Niyomyart,3 Chitchanok Benjasirisan,1 Lalipat Phianhasin,1 Heba Aldossary,4 Bootan Hasan Ahmed,5 Thanistha Samai6 1Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand; 2Department of Nursing Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 3Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 4Department of Nursing, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia; 5Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA; 6Department of Public Health Nursing, Faculty of Nursing, Mahidol University, Nakhon Pathom, ThailandCorrespondence: Suebsarn Ruksakulpiwat, Email [email protected]: Integrating Artificial Intelligence (AI) into healthcare has transformed the landscape of patient care and healthcare delivery. Despite this, there remains a notable gap in the existing literature synthesizing the comprehensive understanding of AI’s utilization in nursing care.Objective: This systematic review aims to synthesize the available evidence to comprehensively understand the application of AI in nursing care.Methods: Studies published between January 2019 and December 2023, identified through CINAHL Plus with Full Text, Web of Science, PubMed, and Medline, were included in this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines guided the identification, screening, exclusion, and inclusion of articles. The convergent integrated analysis framework, as proposed by the Joanna Briggs Institute, was employed to synthesize data from the included studies for theme generation.Results: A total of 337 records were identified from databases. Among them, 35 duplicates were removed, and 302 records underwent eligibility screening. After applying inclusion and exclusion criteria, eleven studies were deemed eligible and included in this review. Through data synthesis of these studies, six themes pertaining to the use of AI in nursing care were identified: 1) Risk Identification, 2) Health Assessment, 3) Patient Classification, 4) Research Development, 5) Improved Care Delivery and Medical Records, and 6) Developing a Nursing Care Plan.Conclusion: This systematic review contributes valuable insights into the multifaceted applications of AI in nursing care. Through the synthesis of data from the included studies, six distinct themes emerged. These findings not only consolidate the current knowledge base but also underscore the diverse ways in which AI is shaping and improving nursing care practices.Keywords: artificial intelligence, nursing care, patient care, systematic revie

Effects of Titanium–Silica Oxide on Degradation Behavior and Antimicrobial Activity of Poly (Lactic Acid) Composites

A mixed oxide of titania–silica oxides (TixSiy oxides) was successfully prepared via the sol–gel technique from our previous work. The use of TixSiy oxides to improve the mechanical properties, photocatalytic efficiency, antibacterial property, permeability tests, and biodegradability of polylactic acid (PLA) was demonstrated in this study. The influence of different types and contents of TixSiy oxides on crystallization behavior, mechanical properties, thermal properties, and morphological properties was presented. In addition, the effect of using TixSiy oxides as a filler in PLA composites on these properties was compared with the use of titanium dioxide (TiO2), silicon dioxide (SiO2), and TiO2SiO2. Among the prepared biocomposite films, the PLA/TixSiy films showed an improvement in the tensile strength and Young’s modulus (up to 5% and 31%, respectively) in comparison to neat PLA films. Photocatalytic efficiency to degrade methylene blue (MB), hydrolytic degradation, and in vitro degradation of PLA are significantly improved with the addition of TixSiy oxides. Furthermore, PLA with the addition of TixSiy oxides exhibited an excellent antibacterial effect on Gram-negative bacteria (Escherichia coli or E. coli) and Gram-positive bacteria (Staphylococcus aureus or S. aureus), indicating the improved antimicrobial effectiveness of PLA composites. Importantly, up to 5% TixSiy loading could promote more PLA degradation via the water absorption ability of mixed oxides. According to the research results, the PLA composite films produced with TixSiy oxide were transparent, capable of screening UV radiation, and exhibited superior antibacterial efficacy, making them an excellent food packaging material

Structural Characterization of Titanium–Silica Oxide Using Synchrotron Radiation X-ray Absorption Spectroscopy

In this study, titania–silica oxides (TixSiy oxides) were successfully prepared via the sol–gel technique. The Ti and Si precursors were titanium (IV), isopropoxide (TTIP), and tetraethylorthosilicate (TEOS), respectively. In this work, the effects of pH and the Ti/Si atomic ratio of titanium–silicon binary oxide (TixSiy) on the structural characteristics of TixSiy oxide are reported. 29Si solid-state NMR and FTIR were used to validate the chemical structure of TixSiy oxide. The structural characteristics of TixSiy oxide were investigated using X-ray diffraction, XRF, Fe-SEM, diffraction particle size analysis, and nitrogen adsorption measurements. By applying X-ray absorption spectroscopy (XAS) obtained from synchrotron light sources, the qualitative characterization of the Ti–O–Si and Ti–O–Ti bonds in Ti–Si oxides was proposed. Some Si atoms in the SiO2 network were replaced by Ti atoms, suggesting that Si–O–Ti bonds were formed as a result of the synthesis accomplished using the sol–gel technique described in this article. Upon increasing the pH to alkaline conditions (pH 9.0 and 10.0), the nanoparticles acquired a more spherical shape, and their size distribution became more uniform, resulting in an acceptable nanostructure. TixSiy oxide nanoparticles were largely spherical in shape, and agglomeration was minimized. However, the Ti50Si50 oxide particles at pH 10.0 become nano-sized and agglomerated. The presence of a significant pre-edge feature in the spectra of Ti50Si50 oxide samples implied that a higher fraction of Ti atoms occupied tetrahedral symmetry locations, as predicted in samples where Ti directly substituted Si. The proportion of Ti atoms in a tetrahedral environment agreed with the value of 1.83 given for the Ti–O bond distance in TixSiy oxides produced at pH 9.0 using extended X-ray absorption fine structure (EXAFS) analysis. Photocatalysis was improved by adding 3% wt TiO2, SiO2, and TixSiy oxide to the PLA film matrix. TiO2 was more effective than Ti50Si50 pH 9.0, Ti50Si50 pH 10.0, Ti50Si50 pH 8.0, and SiO2 in degrading methylene blue (MB). The most effective method to degrade MB was TiO2 > Ti70Si30 > Ti50Si50 > Ti40Si60 > SiO2. Under these conditions, PLA/Ti70Si30 improved the effectiveness of the photocatalytic activity of PLA

Effect of Modified Natural Rubber on the Mechanical and Thermal Properties of Poly(Lactic Acid) and Its Composites with Nanoparticles from Biowaste

The brittle behavior of poly(lactic acid) (PLA) and PLA composites with inorganic filler limits their applications; the addition of a toughening agent, such as a rubbery phase, was selected to transform the brittle to ductile behavior for versatility in various applications. This work aims to study the properties of PLA and PLA composite with filled nanosized hydroxyapatite (nHA) after adding modified natural rubber (MoNR), which acts as a toughening agent. MoNR refers to poly(acrylic acid-co-acrylamide)-grafted deproteinized natural rubber. nHA was prepared from fish scales. Its characteristics were investigated and was confirmed to be comparable to those of commercial grade. PLA-MoNR at various MoNR contents and PLA/nHA composites with/without MoNR were prepared by melt mixing. Their morphology, mechanical, and thermal properties were observed and investigated. Samples with MoNR added showed the dispersion of spherical particles, indicating incompatibility. However, the mechanical properties of PLA-MoNR, which had MoNR added at 10 phr, showed toughening behavior (increased impact strength by more than two times compared to that of neat PLA). The PLA/nHA composite with MoNR showed the same result. The addition of MoNR in the composite increased its impact strength by 1.27 times compared to the composite without MoNR. MoNR can be a stress concentrator, resulting in toughened PLA and PLA/nHA composite

Electrospun Poly(lactic acid) and Silk Fibroin Based Nanofibrous Scaffold for Meniscus Tissue Engineering

Biopolymer based scaffolds are commonly considered as suitable materials for medical application. Poly(lactic acid) (PLA) is one of the most popular polymers that has been used as a bioscaffold, but it has poor cell adhesion and slowly degrades in an in vitro environment. In this study, silk fibroin (SF) was selected to improve cell adhesion and degradability of electrospun PLA. In order to fabricate a PLA/SF scaffold that offered both biological and mechanical properties, related parameters such as solution viscosity and SF content were studied. By varying the concentration and molecular weight of PLA, the solution viscosity significantly changed. The effect of solution viscosity on the fiber forming ability and fiber morphology was elucidated. In addition, commercial (l-lactide, d-lactide PLA) and medical grade PLA (pure PLLA) were both investigated. Mechanical properties, thermal properties, biodegradability, wettability, cell viability, and gene expression of electrospun PLA and PLA/SF based nanofibrous scaffolds were examined. The results demonstrated that medical grade PLA electrospun scaffolds offered superior mechanical property, degradability, and cellular induction for meniscus tissue regeneration. However, for commercial non-medical grade PLA used in this study, it was not recommended to be used for medical application because of its toxicity. With the addition of SF in PLA based scaffolds, the in vitro degradability and hydrophilicity were improved. PLAmed50:SF50 scaffold has the potential to be used as biomimetic meniscus scaffold for scaffold augmented suture based on mechanical properties, cell viability, gene expression, surface wettability, and in vitro degradation

Preparation of Crosslinked Poly(acrylic acid-<i>co</i>-acrylamide)-<i>Grafted</i> Deproteinized Natural Rubber/Silica Composites as Coating Materials for Controlled Release of Fertilizer

The crosslinked poly(acrylic acid-co-acrylamide)-grafted deproteinized natural rubber/silica ((PAA-co-PAM)-DPNR/silica) composites were prepared and applied as coating materials for fertilizer in this work. The crosslinked (PAA-co-PAM)-DPNR was prepared via emulsion graft copolymerization in the presence of MBA as a crosslinking agent. The modified DPNR was mixed with various contents of silica (10 to 30 phr) to form the composites. The existence of crosslinked (PAA-co-PAM) after modification provided a water adsorption ability to DPNR. The swelling degree values of composites were found in the range of 2217.3 ± 182.0 to 8132.3 ± 483.8%. The addition of silica in the composites resulted in an improvement in mechanical properties. The crosslinked (PAA-co-PAM)-DPNR with 20 phr of silica increased its compressive strength and compressive modulus by 1.61 and 1.55 times compared to the unloaded silica sample, respectively. There was no breakage of samples after 80% compression strain. Potassium nitrate, a model fertilizer, was loaded into chitosan beads with a loading percentage of 40.55 ± 1.03% and then coated with the modified natural rubber/silica composites. The crosslinked (PAA-co-PAM)-DPNR/silica composites as the outer layers had the ability of holding water in their structure and retarded the release of fertilizer. These composites could be promising materials for controlled release and water retention that would have potential for agricultural application

Nano-Hydroxyapatite from White Seabass Scales as a Bio-Filler in Polylactic Acid Biocomposite: Preparation and Characterization

Nano-hydroxyapatite (nHAp) as a bio-filler used in PLA composites was prepared from fish by acid deproteinization (1DP) and a combination of acid-alkali deproteinization (2DP) followed by alkali heat treatment. Moreover, the PLA/nHAp composite films were developed using solution casting method. The mechanical and thermal properties of the PLA composite films with nHAp from different steps deproteinization and contents were compared. The physical properties analysis confirmed that the nHAp can be prepared from fish scales using both steps deproteinization. 1DP-nHAp showed higher surface area and lower crystallinity than 2DP-nHAp. This gave advantage of 1DP-nHAp for use as filler. PLA composite with 1DP-nHAp gave tensile strength of 66.41 &plusmn; 3.63 MPa and Young&rsquo;s modulus of 2.65 &plusmn; 0.05 GPa which were higher than 2DP-nHAp at the same content. The addition of 5 phr 1DP-nHAp into PLA significantly improved the tensile strength and Young&rsquo;s modulus. PLA composite solution with 1DP-nHAp at 5 phr showed electrospinnability by giving continuous fibers without beads