Neurosurgical care in Uganda faces significant challenges due to workforce shortages, infrastructure limitations, and a lack of digital health tools. Implementing electronic medical records (EMRs) and telehealth could improve neurosurgical outcomes, but adoption remains low. This systematic review examines barriers and facilitators to EMR and telehealth implementation in Ugandan neurosurgery to identify opportunities for improvement. A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines across PubMed, Google Scholar, and Scopus to identify studies published from 2007 to 2024 evaluating EMR and telehealth adoption in Uganda. Thematic analysis categorized barriers and facilitators into 10 distinct themes. Statistical analysis for frequency and correlation with technologies were performed using χ² analysis and Pearson residual tests, with statistical significance set at P < 0.1. Key barriers include technological infrastructure inefficiencies (24%), systemic and operational limitations (16%), and technical competency and training deficits (13%). Similarly, the primary facilitators include infrastructure reliability (22%), training and education investment (13%), and community engagement (13%). Notably, telehealth adoption was more significantly impacted by human resource limitations (P < 0.05), whereas EMR implementation was hindered by systemic inefficiencies (P < 0.05). Addressing Uganda's digital health gaps requires cost-effective and scalable strategies, including mobile-based EMRs, teleconsultation frameworks, and structured workforce training. Future research should focus on developing implementation models tailored to low-resource settings, ensuring feasibility and sustainability. This study aims to contribute to the growing discourse on digital solutions for resource-limited healthcare, with a particular emphasis on innovation in global neurosurgical care.

Oxidative stress is a central component of type 1 diabetes (T1D) pathophysiology, contributing to pancreatic β-cell vulnerability and the development of chronic complications. Current therapeutic strategies are primarily focused on glycemic control and do not directly address underlying redox imbalance. Dietary polyphenols, a structurally diverse class of plant-derived compounds, have been investigated for their antioxidant and cytoprotective properties, yet their role in T1D has not been systematically defined. This systematic review evaluates the effects of polyphenols on oxidative stress and glycemic parameters in preclinical models of T1D. Across studies, polyphenols were consistently associated with attenuation of oxidative stress, as evidenced by reductions in lipid peroxidation and reactive oxygen and nitrogen species, along with restoration of endogenous antioxidant defenses, including superoxide dismutase, catalase, and glutathione. These effects were frequently linked to modulation of redox-sensitive signaling pathways, particularly Nrf2-dependent mechanisms. In contrast, glycemic outcomes were heterogeneous and influenced by compound-specific and experimental factors. Modulation of oxidative stress markers was often observed independently of changes in glycemic parameters, suggesting a primary redox-mediated mode of action. These findings provide a mechanistic rationale for prioritizing oxidative-stress-focused endpoints in future translational studies and support the evaluation of polyphenols as adjunctive strategies targeting redox imbalance in T1D.

•Leakage-free nested CV-RFE identifies a reproducible connectivity signature that characterizes the PTE-diseased state in our cohort.•Data-driven feature selection is essential for classification performance, with only four stable functional connections (from an original feature space of 4950) able to distinguish PTE from TBI with an AUC of 0.95.•We identify a specific connectivity phenotype in our PTE cohort which includes the Visual network as a hub of PTE-related changes, left-hemisphere overrepresentation and hyper-coupling, and right-hemisphere un-coupling.•The resting-state network disruptions identified by our ML paradigm went unrecognized by direct comparison between groups and traditional statistics, supporting the use of advanced data-driven methodologies for exploring functional connectivity in PTE.

Background: Rural populations face disproportionate barriers to healthcare access, often due to geographic isolation and limited provider availability. Prior studies have shown that increased travel time negatively affects appointment adherence. Telemedicine has emerged as a potential solution, but understanding its utilization in rural populations remains ongoing. Methods: This retrospective cross-sectional observational study analyzed all scheduled appointments (n=5,548) from a single rural family medicine clinic in the Pacific Northwest United States during 2024. One-way travel times were calculated using the Google Maps Distance Matrix API and categorized into Short (30 minutes) commute groups. Proportions for utilization and cancellations of both telemedicine and in-person appointments were assessed across commute groups using chi-square tests (p < 0.05 considered significant). Results: Overall, the proportion of cancellations were significantly higher among patients with Long commutes (36.2%) compared to Medium (31.0%) and Short (32.2%) commute groups (p < 0.001). Telemedicine utilization increased proportionately with commute time (7.7% for Long commute patients vs. 1.5% for Short; p < 0.001). However, telemedicine cancellation proportions did not significantly differ across groups (21.2% for Long, 13.3% for Medium, 17.0% for Short; p = 0.122), suggesting comparable telemedicine adherence regardless of distance. The proportions for in-person appointment utilization and cancellation were both greatest for the Short commute group. Conclusion: Longer travel times are associated with increased appointment cancellations for rural patients, reinforcing travel burden as a key barrier to care. Telemedicine use increases with commute distance and demonstrates consistent adherence across groups, indicating its value as a tool to address rural healthcare gaps. These findings support the continued expansion of telehealth infrastructure to improve care for geographically isolated populations.