Background and Objectives: The increasing prevalence of end-of-life care needs in the emergency department necessitates training for emergency staff in managing terminal symptoms, facilitating serious illness conversations and ensuring goal-concordant interventions. This study aims to evaluate the longitudinal effects of an end-of-life care educational intervention on various emergency professionals. Materials and Methods: An interrupted time series study was conducted among emergency physicians and nurses at three public healthcare institutions over two-and-a-half years. The study had three phases: Phase 1—5 pre-intervention surveys, Phase 2—intervention with an online training course, and Phase 3—5 post-intervention surveys. The impact of the intervention was scored based on staff perceptions of end-of-life care in 3 domains: 1. Knowledge of palliative care (Knowledge), 2. Quality of end-of-life care provided (Care), and 3. Ability to communicate with patients and families (Communication). Results: There were 990 participants with 6450 questionnaires distributed and an 87% response rate of completed questionnaires. Phase 3 had generally higher levels of agreement in all 3 domains compared to Phase 1, with a continued upward trend in Knowledge scores. Upward trends in the Care and Communication domains were less pronounced. Among the 631 (out of 990) participants who completed the training, test scores showed a median improvement of 37.5% (p < 0.001). Conclusions: This study supports the feasibility of online end-of-life care training tailored specifically for emergency professionals, with promising results in the Knowledge, Care, and Communication domains. The findings can help guide the further development of training programs or the adoption of similar interventions for basic palliative care training for emergency physicians and nurses.

Background: Mild traumatic brain injury (mTBI) is common and often associated with persistent symptoms, reduced quality of life, and emotional well-being, with no proven pharmacological treatments to enhance recovery. NeuroAiD (MLC901), a multi-component botanical formulation with neuroprotective and neurorestorative properties, has shown potential benefits, but evidence from individual trials remains limited and inconsistent. We aimed to systematically review and synthesise evidence on the efficacy and safety of MLC901 in adults with mTBI.Methods: We conducted a systematic review and aggregated meta-analysis of randomised placebo-controlled trials identified through searches of PubMed, Cochrane Central, Scopus, and Google Scholar to May 31, 2026. The primary outcome was post-concussion symptom burden measured by the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) at 6 months. Secondary outcomes included cognitive function, quality of life, and emotional well-being. Effect estimates were pooled using inverse-variance random-effects meta-analysis with DerSimonian–Laird estimation of between-study variance and are presented as mean differences or standardised mean differences with 95% confidence intervals.Results: 21 papers were identified through systematic literature search and two randomised placebo-controlled trials comprising 260 participants (128 assigned to MLC901 and 132 to placebo) were included in the review. At 6 months, MLC901 was associated with significantly reduced post-concussion symptoms compared with placebo (mean difference [MD] −4.39, 95% CI −6.21 to −2.57; I²=0%) and improved quality of life (QOLIBRI MD 4.80, 95% CI 1.79–7.80; I²=0%). MLC901 was also associated with significant reductions in anxiety (HADS-Anxiety MD −1.49, 95% CI −2.24 to −0.73; I²=0%) and depression (HADS-Depression MD −1.18, 95% CI −1.91 to −0.44; I²=0%). Six CNS Vital Signs cognitive domains were harmonised and pooled; however, no statistically significant pooled effects were observed for Complex Attention, Executive Function, Processing Speed, Visual Memory, Verbal Memory, or Reaction Time. Adverse events were infrequent and similar between groups (4.6% vs 7.8%; risk ratio 0.59, 95% CI 0.22–1.58), and no serious adverse events were reported.Conclusions: Among adults with mTBI, treatment with MLC901 for 6 months was associated with reductions in post-concussion symptoms, improvements in health-related quality of life, anxiety, and depression, but no change in cognition compared with placebo, and was well tolerated by participants. Although these findings were consistent across the included trials, they should be interpreted cautiously because the evidence is based on only two randomised trials and requires confirmation in larger adequately powered studies.

Background/Objectives: Hospital-at-home (HaH) programs are increasingly adopted as an alternative to inpatient care and have demonstrated cost savings and comparable clinical outcomes in Western healthcare systems. In Asia, where healthcare systems face growing hospital-bed capacity constraints, evidence on the economic impact of HaH remains limited. This systematic review aimed to appraise and synthesize evidence on costs, resource utilization, and formal cost-effectiveness evaluation, where available, of HaH programs for patients eligible for general hospital admission within Asian healthcare systems. Methods: This systematic review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251117897). Literature searches were performed in PubMed/MEDLINE, EMBASE, and the Cochrane Library from 2000 to June 2026. Studies evaluating HaH or similar home-based hospitalization models in Asian settings and reporting cost-related outcomes were included. Methodological quality was assessed using the Joanna Briggs Institute checklist for economic evaluations, and findings were synthesized using a dominance ranking matrix. Results: Of 2243 records identified, five studies from four Asian countries/regions involving 10,152 patients met the inclusion criteria. Four studies reported cost savings alongside favorable findings for selected clinical outcomes, including shorter hospital stays, although findings varied across outcomes and settings. No study reported a formal cost-effectiveness analysis. Overall, the dominance ranking matrix favored HaH in most scenarios, although one study reported less favorable outcomes. Conclusions: The limited available evidence suggested that HaH programs may reduce healthcare costs alongside favorable findings for selected clinical outcomes in some Asian healthcare settings. However, substantial heterogeneity and the absence of formal cost-effectiveness evaluations limit definitive conclusions regarding their cost-effectiveness.

Background: Post-stroke recovery varies widely, and pharmacological options to enhance rehabilitation outcomes remain limited. MLC601/MLC901 (NeuroAiD), a natural neurorestorative product, has been evaluated as an adjunct to standard care to improve functional and motor recovery after ischaemic stroke. This systematic review and meta-analysis assessed its efficacy using validated outcome measures. Methods: A systematic PubMed search identified randomised controlled trials comparing MLC601/MLC901 with placebo or active comparators in adults with ischaemic stroke. Functional outcomes included modified Rankin Scale (mRS), Barthel Index (BI), and Diagnostic Therapeutic Effects of Apoplexy (DTER) item 8 scores. Motor outcomes included Fugl–Meyer Assessment (FMA), DTER motor items, and National Institutes of Health Stroke Scale (NIHSS) motor scores. Data were pooled using fixed- and random-effects models. Odds ratios (ORs) and standardised mean differences (SMDs) were calculated. Risk of bias was assessed using the Cochrane RoB 1.0 tool. Results: Six publications reporting seven randomised clinical studies were included in the meta-analysis. Of the 7 studies, 5 were assessed as having a low risk of bias, while 2 were assessed as having an unclear risk. Altogether, 1535 participants for functional outcomes and 1774 for motor outcomes were analysed. Functional recovery significantly favoured MLC601/MLC901 at 1 month (OR 2.61; p = 0.004), 6 months (OR 1.38; p = 0.002), 12 months (OR 1.33; p = 0.03), and end-of-study (OR 1.40; p = 0.007), with benefits persisting up to 24 months. Motor recovery was assessed at months 1, 2 and 3 and at the end of the study. It also improved consistently over time, with the greatest effects during the first two months. Benefits were most evident in patients with moderately severe stroke (NIHSS 8–14). Clinical studies consistently indicate that NeuroAiD is safe and well-tolerated as an adjunct to standard ischaemic stroke care. Conclusions: MLC601/MLC901 is associated with improved functional independence and motor recovery after ischaemic stroke. Benefits appear within 1 month and may persist for up to 2 years, supporting early use alongside rehabilitation to optimise recovery.