Search Results (1,029)

The increasing use of artificial intelligence (AI) in athlete health monitoring and injury prediction presents both technological opportunities and complex ethical challenges. This narrative review critically examines 24 empirical and conceptual studies focused on AI-driven injury forecasting systems across diverse sports disciplines, including professional, collegiate, youth, and Paralympic contexts. Applying an IMRAD framework, the analysis identifies five dominant ethical concerns: privacy and data protection, algorithmic fairness, informed consent, athlete autonomy, and long-term data governance. While studies commonly report the effectiveness of AI models—such as those employing decision trees, neural networks, and explainability tools like SHAP and HiPrCAM—few offers robust ethical safeguards or athlete-centered governance structures. Power asymmetries persist between athletes and institutions, with limited recognition of data ownership, transparency, and the right to contest predictive outputs. The findings highlight that ethical risks vary by sport type and competitive level, underscoring the need for sport-specific frameworks. Recommendations include establishing enforceable data rights, participatory oversight mechanisms, and regulatory protections to ensure that AI systems align with principles of fairness, transparency, and athlete agency. Without such frameworks, the integration of AI in sports medicine risks reinforcing structural inequalities and undermining the autonomy of those it intends to support. Full article

Background/Objectives: Promoting access to palliative care education at all levels and in diverse contexts is essential. In Brazil, however, despite progress, awareness remains limited. The Last Aid approach provides accessible ways for the public to engage in discussions about serious illness, death, dying, and grief, while also suggesting practical actions to support. The present study aimed to investigate whether Last Aid Courses are accepted and contribute to increasing knowledge and awareness of Palliative Care to different settings in Brazil. Design/Methods: To obtain more in-depth views, a mixed methods approach was chosen, and participants from all Last Aid Courses offered in Brazil between March and November 2024 were invited to respond to a mixed qualitative–quantitative questionnaire provided after the course. Results: Thirty-two courses were offered, with 343 participants. Most of the Last Aid Courses participants came from the general public (53.2%), followed by health students (28.1%). 98.8% of all respondents indicated they had acquired new knowledge. Qualitative analysis identified four themes: death as part of life, communication about dying, dignity and respect for patients’ wishes, and the need for palliative care education. Participants highlighted autonomy, compassion, and dialogue as essential, reinforcing the urgency of expanding public education. Conclusions: The course implementation in Brazil showed positive results, indicating its potential to raise awareness about the topic, regardless of the context. Full article

The increasing decentralization of energy systems calls for robust frameworks to evaluate the technical and economic feasibility of hybrid renewable configurations at the community scale. This study presents an integrated methodology that combines Key Performance Indicators (KPIs), sensitivity analysis, and Multi-Criteria Decision-Making to assess hybrid systems in Castanheira de Pera, a small community in central Portugal. Fourteen configurations (C1–C14) integrating hydropower, solar PV, wind, and battery storage were simulated using HOMER Pro 3.16.2, PVsyst 8.0.16, Python 3.14.0, and Excel under both wet and dry hydrological conditions. A gate-controlled hydro-buffering model was applied to optimize short-term storage operation, increasing summer energy generation by 52–88% without additional infrastructure. Among all configurations, C8 achieved the highest Net Present Value (≈EUR 153,700) and a strong Internal Rate of Return (IRR), while maintaining a stable Levelized Cost of Electricity (LCOE) of around 0.042 EUR/kWh. Comparative decision scenarios highlight distinct stakeholder priorities: storage-intensive systems (C14, C11) maximize energy security, whereas medium-scale hybrids (C8, C7) offer superior economic performance. Overall, the results confirm that hybridization significantly improves community energy autonomy and resilience. Future work should extend this framework to include environmental and social indicators, enabling a more comprehensive techno-socio-economic assessment of hybrid renewable systems. Full article

Due to a complex of factors, visually impaired people are facing difficulties and increased risks during fire emergencies and evacuations from different types of buildings. Even if a lot of studies have been conducted to improve the mobility and autonomy of people with visual impairment during emergency evacuation processes, these offer only partial solutions, especially in the presence of uncertainties characteristic of fire evolution. Aiming for a more comprehensive approach to the safe evacuation of people with visual impairments, this paper proposes a support system that integrates innovative aspects related to the architecture of the application, modeling and simulation methods, and experimental realization. The system is decentralized, capable of anticipating possible fire extensions and determining, in real-time, new corresponding evacuation routes. The overall design complies with the standard norms in emergency situations. Two models, one developed in Stateflow and the other based on Delay Time Petri Nets (DTPN), were constructed to describe the dynamic behavior of the system in the presence of unexpected events that can change the initial recommended evacuation path. To test the functionality and efficiency of the proposed system, the conditions created by potential fire sources were simulated as a part of realistic scenarios. Tests were conducted with visually impaired people. Simulation and prototype testing showed that the presented system can improve evacuation times, achieving a measurable gain compared to scenarios where there is no information regarding fire evolution. Full article

The increasing complexity of the Edge–Cloud Continuum (ECC), driven by the rapid expansion of the Internet of Things (IoT) and data-intensive applications, necessitates implementing innovative methods for automated and efficient system management. In this context, recent studies focused on the utilization of self-* capabilities that can be used to enhance system autonomy and increase operational proactiveness. Separately, anomaly detection and adaptive sampling techniques have been explored to optimize data transmission and improve systems’ reliability. The integration of those techniques within a single, lightweight, and extendable self-optimization module is the main subject of this contribution. The module was designed to be well suited for distributed systems, composed of highly resource-constrained operational devices (e.g., wearable health monitors, IoT sensors in vehicles, etc.), where it can be utilized to self-adjust data monitoring and enhance the resilience of critical processes. The focus is put on the implementation of two core mechanisms, derived from the current state-of-the-art: (1) density-based anomaly detection in real-time resource utilization data streams, and (2) a dynamic adaptive sampling technique, which employs Probabilistic Exponential Weighted Moving Average. The performance of the proposed module was validated using both synthetic and real-world datasets, which included a sample collected from the target infrastructure. The main goal of the experiments was to showcase the effectiveness of the implemented techniques in different, close to real-life scenarios. Moreover, the results of the performed experiments were compared with other state-of-the-art algorithms in order to examine their advantages and inherent limitations. With the emphasis put on frugality and real-time operation, this contribution offers a novel perspective on resource-aware autonomic optimization for next-generation ECC. Full article

Background and Objectives: Parkinson’s disease is the second most common neurodegenerative disorder after Alzheimer’s disease, and its incidence increases with age, being particularly high in people over 70 years of age. For patients with this condition, medical rehabilitation can have a profound impact, helping to improve mobility, preserve functional autonomy, and enhance quality of life. Focal vibration stimulation is a promising, well-tolerated, and easy-to-apply method with potential to facilitate motor activity and support the motor learning process, making it also useful in gait reeducation for patients with various neurological conditions. This systematic review aims to analyze the existing scientific evidence on the effectiveness of focal muscle vibration therapy in managing symptoms of Parkinson’s disease. Materials and Methods: This systematic review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the protocol was registered in PROSPERO under the protocol registration number CRD420251120737. Searches were conducted in five databases (PubMed, PEDro, ScienceDirect, Cochrane Library, Web of Science). The selection criteria targeted original clinical studies, published in English between 2010 and the present, that investigated focal muscle vibration therapy in patients with Parkinson’s disease and were fully available, excluding review papers, meta-analyses, books, and articles inaccessible in full text. Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess the quality of the included studies. Results: The results of the studies were interpreted individually for each study, and the main information was synthesized in a comparative table to facilitate analysis. The final analysis included five studies that investigated the effects of focal muscle vibration in patients with Parkinson’s disease. The results suggest that this form of stimulation may offer benefits for patients with gait disorders, improving balance and stability. Among the study’s limitations are the small number of included articles (n = 5) and the restriction to English-language publications, which may limit the applicability of the results. Conclusions: Given the promising results, focal muscle vibration therapy could represent a useful option in the management of Parkinson’s disease. Integrating this method into rehabilitation plans could bring significant functional benefits, but further studies are needed to confirm its long-term effectiveness and to establish standardized application protocols. No external funding was received for the conduct of this review. Full article

Gray divorce, defined as the dissolution of marriages among individuals aged 50 and above, has become an increasingly significant issue in Türkiye. Official statistics in Türkiye show that between 2001 and 2024, divorces among individuals aged 50 and above increased both in absolute numbers and as a proportion of total divorces, rising nearly threefold during this period. These increases reflect broader demographic and social changes, such as population ageing, longer life expectancy, changing expectations of marriage, and shifting gender norms. Using sociological literature on modernization and family change, as well as official statistical data, this review synthesises existing knowledge and situates gray divorce within global debates on family transformation. Findings from gray divorce studies indicate that women’s increasing autonomy, life cycle transitions such as retirement or empty nest experiences, and greater societal acceptance of divorce contribute to this trend. Furthermore, gray divorces have broad implications for intergenerational relationships, care responsibilities, and social policies. Specifically in Türkiye, regional differences show that divorce among the elderly is more prevalent in western urbanized provinces, where individualism and secular values prevail, and significantly less common in eastern regions, where traditional and religious norms are stronger. The increasing prevalence of this phenomenon highlights the need for more empirical research and policy responses that are appropriate to Türkiye’s demographic, regional, and cultural transformations. Full article

Background/Objectives: Oropharyngeal dysphagia (OD) is a frequent condition among older adults in long-term care facilities, often leading to malnutrition, dehydration, and increased mortality. Modified-texture diets (MTDs) are used to address these risks, though traditional preparation methods often compromise nutritional density and standardization. The WeanCare protocol with Dysphameal^® technology introduces an innovative solution by offering IDDSI-compliant, high-density, freeze-dried meals. This study assesses its clinical effectiveness and economic impact. Methods: A six-month quasi-experimental pre–post study was conducted in two Italian nursing homes involving 13 older participants with diagnosed OD. Participants received all meals and hydration through Dysphameal^®, and data were collected on anthropometry, biochemical markers, care workload, and economic parameters. Statistical analyses included regression, correlations, and pre–post comparisons. Results: Improvements were noted in fat-free mass (FFM), skeletal muscle mass (ASMM), and basal metabolic rate (BMR) in all participants. Albumin and lymphocyte counts improved, as did participant autonomy at mealtime. Operational time per participant dropped by 44% in kitchen and by 7 min/day in wards. Supplement use decreased, leading to significant cost savings and improved staff allocation. Conclusions: The WeanCare–Dysphameal^® system improves nutritional status, reduces caregiver workload, and enhances economic efficiency in institutional settings. It represents a scalable solution for OD management, ensuring consistency, safety, and sustainability in dysphagic care. Full article

In 2013, Portugal implemented a major restructuring of Allied Health (AH) education by merging multiple separate first-cycle degree programmes into a smaller number of broader qualifications. The reform was designed to streamline curricula, increase efficiency, boost graduate employability, and align national qualifications with international standards. This study examines how Portuguese AH professionals, academics, and researchers perceive these reforms ten years on. A cross-sectional web-based survey collected 495 responses from AH stakeholders. Perceptions were quantified with a validated 21-item scale organised into three domains through exploratory factor analysis: (A) curricular change and structural effects; (B) educational quality and international harmonization; and (C) Professional Consequences of the Mergers. Differences between groups were examined by Kruskal–Wallis and Mann–Whitney U tests. There were notable differences by age, educational background, experience, and academic qualifications. Younger practitioners and post-merger graduates indicated more favourable perceptions of the reforms (Domains A and B), whereas older, pre-merger-trained, and doctoral-level respondents were more critical, especially regarding autonomy and specialization (Domain C). Views on the reform are influenced by generational, experiential, and academic factors. Individualized communication and policy-focused approaches are needed to promote stakeholder engagement and maintain the legitimacy of subsequent health education reforms in Portugal. Full article

Effective bovine artificial insemination (AI) training requires balancing technical skill development with animal welfare considerations. Commercial simulators typically replicate Bos taurus anatomy, limiting utility in regions where Bos indicus breeds predominate. This study validates the TrAI4Nel simulator, customized for Nelore cattle AI training. Validation employed a multi-dimensional framework encompassing face, physical, content, construct, and concurrent validity, plus usability and training effectiveness assessments. Of the 85 participants in standardized AI technician courses who were randomly allocated to control (abattoir specimen-based) and experimental (simulator-integrated) groups, 61 provided feedback about TrAI4Nel (19 in the control group and 42 in the experimental group). The simulator was also independently evaluated by 14 AI experts. Trainees rated the simulator highly for anatomical realism and procedural consistency. Compared with abattoir specimens, TrAI4Nel significantly enhanced skill transfer to live animals, particularly cervical pipette navigation and semen deposition identification. The simulator increased trainee confidence, reduced anxiety, and improved perceived preparedness. Performance assessments demonstrated simulator-trained participants achieved significantly higher success rates (78.6%) versus controls (52.6%; p = 0.043), without prolonging completion times. Qualitative feedback emphasized the simulator’s pedagogical value in enhancing anatomical comprehension, skill acquisition, and learner autonomy while supporting animal welfare. Training sequence analysis indicated biological specimen exposure before simulator use may optimize learning efficiency. These findings validate TrAI4Nel as an effective, ethically sound tool for Bos indicus AI training. Simulator integration into curricula provides scalable improvement of reproductive management in zebu-dependent regions. Full article

Under the discourses of sustainable development and modernization of the Amazon, an iron triangle of governments, companies, and investors often impose large-scale infrastructure projects (LSIPs) on Indigenous peoples to facilitate commodity extraction and market transactions in a context of capitalist market expansion. Indigenous resistance to LSIPs can be understood as a power struggle against coloniality and towards decolonizing environmental justice (DEJ). This study merges DEJ and power frameworks, while involving Indigenous leaders as co-researchers to provide a critical, insider perspective on the (i) motivations, (ii) strategies, and (iii) agency of two effective Indigenous resistance processes: the luchas led by Yunguillo Indigenous Reserve against roads, and by the Mancomunidad de Comunidades de los ríos Beni, Tuichi y Quiquibey against hydroelectric dams. In both cases, motivations reflected DEJ goals: the defense of Indigenous autonomy and territorial sovereignty, as well as Indigenous ontologies and epistemologies, reflecting an alternative vision of sustainability and development. However, locals’ positions regarding the projects were convoluted, partly due to the patronizing and divisive strategies of the iron triangle. To challenge the coloniality of power, both groups applied a diverse, synergistic, and adaptative set of strategies. External and internal alliances (i.e., with other actors and within communities), as well as actions to empower themselves as groups (e.g., self-governance) and individuals (e.g., spirituality) constituted key organizational leveraging strategies to increase their power-with and power-within. The instrumental strategies of collective action, civil disobedience, and direct resistance, in a climate of highly unjust and poorly trusted official institutions, showed great effectiveness to exert pressure on the iron triangle (power-over) and halt the projects (power-to, or agency). Success, nevertheless, was partial and uncertain: one battle won in an unequal war and in a changing context. This study seeks to contribute to previous efforts to decolonize and repoliticize academia, environmentalism, and sustainability, advance debates on strategies that challenge official systems and entrenched power structures, and validate Indigenous perspectives and experiences, producing scientific evidence that contributes to their luchas. Full article

Mobility in children with motor disabilities is critical to their quality of life because it enhances participation and social inclusion in school and community settings. Recently, early childhood intervention programs have begun incorporating powered mobility devices (PMDs) to promote children’s autonomy at an earlier age than before. This study aimed to review the research on PMDs and highlight the implications for physical education and inclusion. Guided by PRISMA recommendations for scoping reviews, a synthesis of the findings from 46 articles published between 2010 and 2025 was conducted. Results indicate that the increasing use of these devices aligns with an emerging shift in professional perspectives toward technology-assisted mobility to improve participation. However, several factors influence the success of PMD implementation, including device type, children’s health status, and social, family, environmental, and attitudinal conditions. This shift presents both opportunities and challenges for schools. It is essential for physical education teachers to remain updated on innovations in this field, such as modified ride-on cars, and to strengthen collaboration between schools and early childhood intervention services to overcome physical, social, and attitudinal barriers to inclusion. Full article

To reduce fossil fuel dependency in shipping, adopting alternative fuels and innovative propulsion systems is essential. Solid Oxide Fuel Cells (SOFC), powered by hydrogen carriers, represent a promising solution. This study investigates a multi-fuel SOFC system for ocean-going vessels, capable of operating with ammonia, methanol, or hydrogen, thus enhancing bunkering flexibility. A thermodynamic model is developed to simulate the performance of a 3 kW small-scale system, subsequently scaling up to a 10 MW configuration to meet the power demand of a container ship used as the case study. Results show that methanol is the most efficient fueling option, reaching a system efficiency of 58% while ammonia and hydrogen reach slightly lower values of about 55% and 51%, respectively, due to higher auxiliary power consumption. To assess technical feasibility, two installation scenarios are considered for accommodating multiple fuel tanks. The first scenario seeks the optimal fuel share equivalent to the diesel tank’s chemical energy (17.6 GWh), minimizing mass increase. The second scenario optimizes the fuel share within the available tank volume (1646 m³), again, minimizing mass penalties. In both cases, feasibility results have highlighted that changes are needed in terms of cargo reduction, equal to 20.3%, or, alternatively, in terms of lower autonomy with an increase in refueling stops. These issues can be mitigated by the benefits of increased bunkering flexibility. Full article

Radiology is undergoing a paradigm shift from traditional single-function AI systems to sophisticated multi-agent networks capable of autonomous reasoning, coordinated decision-making, and adaptive workflow management. These agentic AI systems move beyond simple pattern recognition to encompass complex radiological workflows including image analysis, report generation, clinical communication, and care coordination. While multi-agent radiological AI promises enhanced diagnostic accuracy, improved workflow efficiency, and reduced physician burden, it simultaneously amplifies the long-standing “black box” problem. Traditional explainable AI methods, which are adequate for understanding isolated diagnostic predictions, fail when applied to multi-step reasoning processes involving multiple specialized agents coordinating across imaging interpretation, clinical correlation, and treatment planning. This paper examines how agentic AI systems in radiology create “compound opacity” layers of inscrutability from agent interactions and distributed decision-making processes. We analyze the autonomy–transparency paradox specific to radiological practice, where increasing AI capability directly conflicts with interpretability requirements essential for clinical trust and regulatory oversight. Through examination of emerging multi-agent radiological workflows, we propose frameworks for responsible implementation that preserve both diagnostic innovation and the fundamental principles of medical transparency and accountability. Full article

In recent years, there has been an ever increasing interest in UxVs and the technology surrounding them. A more recent area of interest within the UxV ecosystem is the development of UxV swarms. In these systems, multiple UxVs synchronize, continuously exchange information, and operate as a cohesive unit. This evolution requires a higher level of autonomy, enhanced coordination, and more efficient communication channels. In this survey, we present relevant research on swarms of UxVs, always considering artificial intelligence (AI) as the key technological enabler for the swarm operations. We view the swarm from three distinct perspectives; these are intelligence-wise, communication-wise, and security-wise. Our main goal is to explore in which ways and to what extent AI has been integrated in these aspects. We aim to identify which of these aspects are the most researched and which need deeper investigation, the types of AI that are mainly used, and which types of vehicles are preferred. We then discuss the results of our work and present current limitations as well as areas of future research in the realm of UxVs, AI, swarm intelligence, communications, and security. Full article