Search Results (1,396)

Background: The rationale for strict fluid fasting for pediatric and adult patients has been questioned recently. Point-of-care tools for the evaluation of gastric content have evolved over time, often using gastric ultrasound. Usually, the gastric antral cross-sectional area (CSA) is determined. A liberal fluid fasting regimen, that is, ingestion of liquid fluids until the call for theatre, does not delay gastric emptying compared to midnight fasting, as evaluated with gastric ultrasound. Anesthesia is safe, and no adverse events result from a liberal regimen. Methods: The ethics committee of LMU Munich approved the study (21-0903). Liberal fluid fasting in a geriatric orthopedic surgery department (LFFgertrud) is a sub-study within a project investigating perioperative neurocognitive disorders (Study Registration: DRKS00026801). After obtaining informed consent from 134 geriatric patients 70 years or older, we investigated the gastric antral cross-sectional area (CSA) prior to and postimplementation of liberal fluid management, respectively. Results: After the implementation of liberal fluid fasting, fasting times for solid food and liquids decreased from 8.8 (±5.5) to 1.8 (±1.8) hours (p < 0.0001). In 39 patients where CSA was obtained, a slight increase in fluid was encountered. No critical amount of gastric content was observed, and no adverse events occurred. Conclusions: A liberal fluid fasting concept was safe even for comorbid elderly patients in orthopedic surgery. Applying a gastric ultrasound may be helpful to increase safety. According to the incidence of complications encountered in our study, it seems indispensable. Full article

Artificial intelligence has taken a seat at the executive table and is threatening the fact that human beings are the only ones who should be in a position of power. This article gives conjectures on the future of leadership in which managers will collaborate with learning algorithms in the Neural Adaptive Artificial Intelligence Leadership Model, which is informed by the transformational literature on leadership and socio-technical systems, as well as the literature on algorithmic governance. We assessed the model with thirty in-depth interviews, system-level traces of behavior, and a verified survey, and we explored six hypotheses that relate to algorithmic delegation and ethical oversight, as well as human judgment versus machine insight in terms of agility and performance. We discovered that decisions are made quicker, change is more effective, and interaction is more vivid where agile practices and good digital understanding exist, and statistical tests propose that human flexibility and definite governance augment those benefits as well. It is single-industry research that contains self-reported measures, which causes research to be limited to other industries that contain more objective measures. Practitioners are provided with a practical playbook on how to make algorithmic jobs meaningful, introduce moral fail-safes, and build learning feedback to ensure people and machines are kept in line. Socially, the practice is capable of minimizing bias and establishing inclusion by visualizing accountability in the code and practice. Filling the gap between the theory of leadership and the reality of algorithms, the study provides a model of intelligent systems leading in organizations that can be reproduced. Full article

In an era where digitalization shapes economic and social landscapes, the intersection of digital skills, ethics, and integrity plays a crucial role in understanding the vulnerability of youth classified as NEET (Not in Education, Employment, or Training). This study explores how risky internet use and digital skill gaps contribute to socio-economic exclusion, integrating a multivariate and spatial approach to assess regional disparities in Europe. This study adopts a systems thinking perspective to explore digital exclusion as an emergent outcome of multiple interrelated subsystems. The research employs logistic regression, Principal Component Analysis (PCA) with Promax rotation, and Geographic Information Systems (GIS) to examine the impact of digital behaviors on NEET status. Using Eurostat data aggregated at the country level for the period (2000–2023) across 28 European countries, this study evaluates 24 digital indicators covering social media usage, instant messaging, daily internet access, data protection awareness, and digital literacy levels. The findings reveal that low digital skills significantly increase the likelihood of being NEET, while excessive social media and internet use show mixed effects depending on socio-economic context. A strong negative correlation between digital security practices and NEET status suggests that youths with a higher awareness of online risks are less prone to socio-economic exclusion. The GIS analysis highlights regional disparities, where countries with limited digital access and lower literacy levels exhibit higher NEET rates. Digital exclusion is not merely a technological issue but a multidimensional socio-economic challenge. To reduce the NEET rate, policies must focus on enhancing digital skills, fostering online security awareness, and addressing regional disparities. Integrating GIS methods allows for the identification of territorial clusters with heightened digital vulnerabilities, guiding targeted interventions for improving youth employability in the digital economy. Full article

Air pollution is linked to childhood mortality and morbidity in low- and middle-income countries globally. There is growing evidence linking air pollution to asthma and other respiratory diseases in children. Studies have shown that children are likely to experience asthma due to their narrow airways and their heightened sensitivity to environmental irritants. This study aims to investigate the relationship between ambient air pollution and respiratory diseases in children under the age of 5. The study will be conducted in the informal township of Alexandra, north of Johannesburg, South Africa. A quantitative approach will be used in this cross-sectional analytical study. Data will be collected using different tools that include a questionnaire to determine the prevalence of asthma and respiratory disease and potential risk factors. While environmental air pollution will be measured using Radiello passive samplers and Gillian pumps. Data will be analyzed using the latest version of the STATANow/MP 19.5 software. Furthermore, health risk assessment will be conducted for lifetime non-carcinogenic and carcinogenic risk estimation following the USEPA framework. The study will identify environmental triggers that exacerbate asthma and other respiratory conditions in other similar community settings and will contribute to the body of knowledge in public health. Ethical approval was obtained from the Research Ethics Committee, Faculty of Health Sciences at the University of Johannesburg. Full article

Previous reviews have examined specific facets of Geographic Information Systems (GIS) in transportation planning, such as transit-focused applications and open source geospatial tools. However, this study offers the first systematic, PRISMA-guided longitudinal evaluation of GIS integration in transportation planning, spanning thematic domains, data models, methodologies, and outcomes from 2004 to 2024. This study addresses this gap through a longitudinal analysis of GIS-based transportation research from 2004 to 2024, adhering to PRISMA guidelines. By conducting a mixed-methods analysis of 241 peer-reviewed articles, this study delineates major trends, such as increased emphasis on sustainability, equity, stakeholder involvement, and the incorporation of advanced technologies. Prominent domains include land use–transportation coordination, accessibility, artificial intelligence, real-time monitoring, and policy evaluation. Expanded data sources, such as real-time sensor feeds and 3D models, alongside sophisticated modeling techniques, enable evidence-based, multifaceted decision-making. However, challenges like data limitations, ethical concerns, and the need for specialized expertise persist, particularly in developing regions. Future geospatial innovations should prioritize the responsible adoption of emerging technologies, inclusive capacity building, and environmental justice to foster equitable and efficient transportation systems. This review highlights GIS’s evolution from a supplementary tool to a cornerstone of data-driven, sustainable urban mobility planning, offering insights for researchers, practitioners, and policymakers to advance transportation strategies that align with equity and sustainability goals. Full article

This study investigated pre-service teachers’ (PTs) intentions to adopt generative AI (GenAI) tools in future classrooms by applying an extended Technology Acceptance Model (TAM). Participants were enrolled in multiple teacher-preparation programs within a single U.S. higher education institution. Through a structured GenAI-integrated activity using Khanmigo, a domain-specific AI platform for K-12 education, PTs explored AI-supported instructional tasks. Post-activity data were analyzed using PLS-SEM. The results showed that perceived usefulness (PU), perceived ease-of-use (PEU), and self-efficacy (SE) significantly predicted behavioral intention (BI) to adopt GenAI, with SE also influencing both PU and PEU. Conversely, personal innovativeness in IT and perceived cyber risk showed insignificant effects on BI or PU. The findings underscored the evolving dynamics of TAM constructs in GenAI contexts and highlighted the need to reconceptualize ease-of-use and risk within AI-mediated environments. Practically, the study emphasized the importance of preparing PTs not only to operate AI tools but also to critically interpret and co-design them. These insights inform both theoretical models and teacher education strategies, supporting the ethical and pedagogically meaningful integration of GenAI in K-12 education. Theoretical and practical implications are discussed. Full article

Surgery remains a healthcare intervention with significant risks for patients. Novel technologies can now enhance the peri-operative workflow, with artificial intelligence (AI) and extended reality (XR) to assist with pre-operative planning. This review focuses on innovation in AI, XR and imaging for hepato-biliary surgery planning. The clinical challenges in hepato-biliary surgery arise from heterogeneity of clinical presentations, the need for multiple imaging modalities and highly variable local anatomy. AI-based models have been developed for risk prediction and multi-disciplinary tumor (MDT) board meetings. The future could involve an on-demand and highly accurate AI-powered decision tool for hepato-biliary surgery, assisting the surgeon to make the most informed decision on the treatment plan, conferring the best possible outcome for individual patients. Advances in AI can also be used to automate image interpretation and 3D modelling, enabling fast and accurate 3D reconstructions of patient anatomy. Surgical navigation systems utilizing XR are already in development, showing an early signal towards improved patient outcomes when used for hepato-biliary surgery. Live visualization of hepato-biliary anatomy in the operating theatre is likely to improve operative safety and performance. The technological advances in AI and XR provide new applications in pre-operative planning with potential for patient benefit. Their use in surgical simulation could accelerate learning curves for surgeons in training. Future research must focus on standardization of AI and XR study reporting, robust databases that are ethically and data protection-compliant, and development of inter-disciplinary tools for various healthcare applications and systems. Full article

Traditional energy conservation policies have primarily relied on economic incentives and informational campaigns. However, recent insights from behavioral and social sciences indicate that subtle behavioral interventions, particularly social nudges, can significantly influence household electricity use. This paper presents a structured review of 23 recent field studies examining how social nudging strategies, such as peer comparison, group identity, and normative messaging, have contributed to measurable reductions in electricity consumption. By analyzing intervention outcomes across different regions and formats, we identify key success factors, limitations, and policy implications. Special attention is given to ethical considerations, fairness in implementation, and potential challenges in sustaining behavior change. This study offers a framework for integrating social nudges into future energy policies, emphasizing their role as low-cost, scalable tools for promoting sustainable energy behavior. Full article

This paper contends that the West’s civic crisis is, at root, a cosmological crisis: civic renewal requires metaphysical repair. It is insufficient to endorse virtue ethics and demand civic virtues without a deeper account of reality that can sustain them. What is needed is a cosmology—one informed by contemporary science—in which nature, personhood, and political community are meaningfully situated within an ordered whole. Drawing on the Platonic isomorphism between soul, city, and cosmos, I outline a hylomorphic framework with the potential to integrate key elements of neo-Aristotelian, Stoic, and Thomist metaphysics with developments in contemporary physics. Against the dominant atomistic and holistic paradigms, I argue that hylomorphism offers a more adequate account of personhood, the polis, and the cosmos itself as an intelligible whole. Full article

This study explores the potential of Intelligent Geographic Information Systems (GISs) in advancing educational practices through the integration of real-time data models. The objective is to investigate how GIS technology can enhance teaching and learning by providing interactive and dynamic learning environments. The research employs a bibliometric analysis based on the Scopus database, covering the period from 2000 to 2024, to identify key trends, the evolution of GIS applications in education, and their pedagogical impact. Findings reveal that GISs, particularly when incorporating real-time data, enable a more immersive learning experience, facilitate data-driven decision-making, and promote student engagement through project-based learning. However, challenges such as the lack of specialized training for educators and limitations in technological infrastructure remain significant barriers to widespread adoption. The study concludes that Intelligent GISs have the potential to transform education by fostering personalized, interdisciplinary learning and enhancing educational management. It emphasizes the need for further research aimed at developing user-friendly systems and addressing ethical concerns to ensure the benefits of GIS technology are accessible to all students. Future studies should examine the long-term effects of GISs on student outcomes and explore their integration into diverse educational contexts. Full article

Background/Objectives: Respectful maternity care involves privacy, dignity, and informed choice within the process of delivery as stipulated by the World Health Organization (WHO). Informed consent is a cornerstone of patient-centered care, representing not just a formal document, but an ongoing ethical and clinical process through which women are offered objective, understandable information to support autonomous, informed decision-making. Methods: This narrative review critically examines the literature on informed consent in maternity care, with particular attention to both obstetric-led and midwifery-led models of care. In addition to identifying institutional, cultural, and systemic obstacles to its successful implementation, the review examines the definition and application of informed consent in perinatal settings and evaluates its effects on women’s autonomy and satisfaction with care. Results: Important conclusions emphasize that improving women’s experiences and minimizing needless interventions require active decision-making participation, a positive provider–patient relationship, and ongoing support from medical professionals. However, significant gaps persist between legal mandates and actual practice due to provider attitudes, systemic constraints, and sociocultural influences. Women’s experiences of consent can be more effectively understood through the use of instruments such as the Mothers’ Respect (MOR) Index and the Mothers’ Autonomy in Decision Making (MADM) Scale. Conclusions: To promote genuinely informed and considerate maternity care, this review emphasizes the necessity of legislative reform and improved provider education in order to close the gap between policy and practice. Full article

The historical evolution of auditing reflects an increasing complexity in organizational demands, culminating in the emergence of Audit 5.0—an approach that integrates emerging technologies with professional judgment. This study aims to analyze how technological adoption influences risk assessment and materiality determination in financial auditing within a practical, real-world context. The research, qualitative in nature, combines narrative and thematic analysis of the literature, ethnography in a professional setting, and task analysis, developed over four years of experience in a firm of Chartered Accountants. The findings reveal that although digital tools enhance efficiency and accuracy, professional judgment remains essential to ensure the ethics, reliability, and contextualization of audited information. This study contributes to the advancement of understanding regarding the complementarity between technology and the human factor, proposing paths toward more robust and digitally adapted auditing practices. Full article

This paper shows that artificial intelligence is fundamentally transforming college curricula by enabling data-driven personalization, which enhances student outcomes and better aligns educational programs with evolving workforce demands. Specifically, predictive analytics, machine learning algorithms, and natural language processing were applied here, grounded in constructivist learning theory and Human–Computer Interaction principles, to evaluate student performance and identify at-risk students to propose personalized learning pathways. Results indicated that the AI-based curriculum achieved much higher course completion rates (89.72%) as well as retention (91.44%) and dropout rates (4.98%) compared to the traditional model. Sentiment analysis of learner feedback showed a more positive learning experience, while regression and ANOVA analyses proved the impact of AI on enhancing academic performance to be real. Therefore, the learning content delivery for each student was continuously improved based on individual learner characteristics and industry trends by AI-enabled recommender systems and adaptive learning models. Its advantages notwithstanding, the study emphasizes the need to address ethical concerns, ensure data privacy safeguards, and mitigate algorithmic bias before an equitable outcome can be claimed. These findings can inform institutions aspiring to adopt AI-driven models for curriculum innovation to build a more dynamic, responsive, and learner-centered educational ecosystem. Full article

In modern medical education, a robust understanding of statistics is essential for fostering critical thinking, informed clinical decision-making, and effective communication. This paper explores the synergistic value of early and continued statistical education for medical students and residents, particularly in relation to the expanding field of sports supplementation and its impact on athletic performance. Early exposure to statistical principles enhances students’ ability to interpret clinical research, avoid cognitive biases, and engage in evidence-based practice. Continued statistical learning throughout residency further refines these competencies, enabling more sophisticated analysis and application of emerging data. The paper also addresses key challenges in integrating statistics into medical curricula—such as limited curricular space, student disengagement, and resource constraints—and proposes solutions including interactive learning, case-based teaching, and the use of public datasets. A unique emphasis is placed on connecting statistical literacy to the interpretation of research in sports science, particularly regarding the efficacy, safety, and ethical considerations of sports supplements. By linking statistical education to a dynamic and relatable domain like sports performance, educators can not only enrich learning outcomes but also foster lasting interest and competence in quantitative reasoning. This integrated approach holds promise for producing more analytically proficient and clinically capable physicians. Full article

Media organizations are experiencing ongoing transformation, increasingly driven by the advancement of AI technologies. This development has begun to link journalists with generative systems and synthetic technologies. Although newsrooms worldwide are exploring AI adoption to improve information sourcing, news production, and distribution, a gap exists between resource-rich organizations and those with limited means. Since ChatGPT 3.5 was released on 30 November 2022, Greek media and journalists have gained the ability to use and explore AI technology. In this study, we examine the use of AI in Greek newsrooms, as well as journalists’ reflections and concerns. Through qualitative analysis, our findings indicate that the adoption and integration of these tools in Greek newsrooms is marked by the lack of formal institutional policies, leading to a predominantly self-directed and individualized use of these technologies by journalists. Greek journalists engage with AI tools both professionally and personally, often without organizational guidance or formal training. This issue may compromise the quality of journalism due to the absence of established guidelines. Consequently, individuals may produce content that is inconsistent with the media outlet’s identity or that disseminates misinformation. Age, gender, and newsroom roles do not constitute limiting factors for this “experimentation”, as survey participants showed familiarity with this technology. In addition, in some cases, the disadvantages of specific tools regarding qualitative results in Greek are inhibiting factors for further exploration and use. All these points to the need for immediate training, literacy, and ethical frameworks. Full article