Search Results (513)

The rapid development of generative artificial intelligence (GenAI) has revolutionized how individuals and organizations interact with technology. These systems, ranging from conversational agents to creative tools, are increasingly embedded in daily life. However, their effectiveness relies heavily on the usability of their graphical user interfaces (GUIs), which serve as the primary medium for user interaction. Moreover, the design of these interfaces must align with ethical principles such as transparency, fairness, and user autonomy to ensure responsible usage. This study evaluates the usability of GUIs for three widely-used GenAI applications, including ChatGPT (GPT-4), Gemini (1.5), and Claude (3.5 Sonnet) , using a heuristics-based and user-based testing approach (experimental-qualitative investigation). A total of 12 participants from a research organization in Australia, participated in structured usability evaluations, applying 14 usability heuristics to identify key issues and ethical concerns. The results indicate that Claude’s GUI is the most usable among the three, particularly due to its clean and minimalistic design. However, all applications demonstrated specific usability issues, such as insufficient error prevention, lack of shortcuts, and limited customization options, affecting the efficiency and effectiveness of user interactions. Despite these challenges, each application exhibited unique strengths, suggesting that while functional, significant enhancements are needed to fully support user satisfaction and ethical usage. The insights of this study can guide organizations in designing GenAI systems that are not only user-friendly but also ethically sound. Full article

Introduction: Prostate cancer is one of the most common neoplasia in men, and its clinical evolution is highly influenced by psycho-emotional factors, especially in elderly patients. Comorbidities, the perception of one’s identity and its impact on life quality become relevant variables in the therapeutic decision. Sexual dysfunction after treatment along with decreased libido, erectile dysfunction and ejaculatory dysfunction are significant problems in patients with prostate cancer. Case presentation: The present study presents the oncological evolution of an elderly patient with a dual diagnosis, prostate adenocarcinoma and lung squamous cell carcinoma, who faced a significant amount of medical and psychological challenges. Reluctance to hormone therapy was closely linked to the fear of sexual dysfunction, a very common reaction in elderly men concerned with maintaining autonomy and intimacy. The peculiarity of the case consists in the interaction between the evolution of the disease, the therapeutic decisions and the psychological impact on the patient. Discussion: Androgen deprivation therapy negatively influences multiple aspects of sexual function, significantly impairing the life quality of patients diagnosed with prostate cancer. In this context, therapy through acceptance and commitment is the appropriate one, its main purpose being to change the patient’s relationship with suffering—from struggle and rejection to active acceptance and value of the present. The intervention of the psychologist or the psychotherapist is essential in decision-making counseling, using coping techniques, the clarification of personal values and the involvement of the family in the decision-making process. Oncological psychology helps the patient redefine their life goals and priorities, not just to choose a treatment. Conclusions: Sexuality and psychological health are deeply affected by prostate cancer. Psychological flexibility and emotional support can mitigate this negative impact. The integration of therapy through acceptance and commitment in the rehabilitation after treatment increases effectiveness and patient satisfaction. Full article

This article offers a comparative analysis of authoritarian governance in Egypt and Türkiye through the lens of two pivotal state–Islamist alliances: the early partnership and eventual rupture between Gamal Abdel Nasser and the Muslim Brotherhood (MB), and the strategic collaboration followed by confrontation between Recep Tayyip Erdoğan and the Gülen Movement (GM). Despite operating in different historical and institutional settings—a postcolonial military regime in Egypt and an electoral, hybrid regime in Türkiye—both leaders allied with influential religious actors during moments of transition to gain popular support and dismantle entrenched power structures. These alliances were instrumental and temporary: once religious movements developed autonomous influence, they were recast as threats and suppressed through legal, institutional, and religious mechanisms. This study traces how religious institutions like Egypt’s al-Azhar and Türkiye’s Diyanet were co-opted to delegitimize these former allies and justify state repression. While the MB pursued overt political goals and the GM functioned through civic and technocratic channels, both were ultimately excluded from the political order once they had been considered as threats to the central authority of the regime. This comparison underscores the strategic use of religion in authoritarian statecraft and the enduring tension between religious autonomy and centralized political control in Muslim-majority polities. Full article

Background: Total hip and knee arthroplasty are common procedures for end-stage osteoarthritis, with rehabilitation playing a central role in functional recovery. Conventional face-to-face programs are often limited by accessibility, costs, and logistical barriers. Digital telerehabilitation has been increasingly investigated as an alternative. This review aims to summarize current evidence on its effectiveness, patient-reported outcomes, satisfaction, and economic impact. Materials and Methods: A narrative review was conducted using Medline, Web of Science, and Scopus up to April 2025. Randomized controlled trials and longitudinal studies evaluating telerehabilitation after total hip or knee arthroplasty were included. Data were extracted on functional performance, pain, autonomy, quality of life, patient satisfaction, and cost-effectiveness. Results: Across multiple RCTs, telerehabilitation produced functional outcomes generally comparable to conventional rehabilitation, with some studies reporting superior short-term improvements. For example, in a retrospective trial, Timed Up and Go improved by −8.0 ± 2.6 s in the digital group versus −4.9 ± 2.5 s with standard care (p < 0.01). Tablet-assisted programs reduced Five Times Sit-to-Stand times to 11.7 s at 6 months compared with 14.7 s in controls (p = 0.05). In hip arthroplasty, digital rehabilitation resulted in higher active flexion (97.4° vs. 89.9°, p = 0.018) and abduction (51.7° vs. 43.8°, p = 0.024). Quality-of-life measures, such as EQ-5D VAS, also showed improvements (82.9 ± 4.3 vs. 68.7 ± 4.6 at 6 months). Some studies reported higher patient satisfaction, for instance, a VR-based RCT found GPE at day 15 of 4.76 ± 0.43 in the intervention group versus 3.96 ± 0.65 in controls (p < 0.001). Conclusions: Telerehabilitation after hip and knee arthroplasty appears to produce short-term functional and patient-reported outcomes comparable to conventional rehabilitation in selected populations. Evidence of superiority is limited and heterogeneous, and long-term effectiveness, equity, and cost-effectiveness remain uncertain. Heterogeneity in protocols and digital literacy barriers highlight the need for standardized guidelines and further independent validation. Full article

Population ageing and the increase in life expectancy have heightened the demand for long-term care in residential facilities. In Spain, it is projected that by 2054 the functional dependency rate among those aged 65 and over will exceed 53.0%, posing significant challenges for person-centred care. This study aims to examine institutionalised older adults’ perceptions of care in relation to their functional dependency, and how these perceptions shape their dignity and participation in residential life. A qualitative study with a phenomenological approach was conducted in a residential facility located in the north-east of Andalusia, Spain, involving eight residents with varying degrees of autonomy and dependency. Data were collected through individual semi-structured interviews and analysed using Colaizzi’s phenomenological method. The findings revealed that, as dependency increases, care is perceived as more impersonal, generating feelings of diminished dignity and greater exclusion. In addition, limitations were observed in communication and participation in residential life. Respect for privacy and personal preferences was particularly relevant for women. The study concludes that the care received is conditioned by the degree of dependency and the resources available. It is recommended to enhance staff training, increase staffing levels, and promote the active participation of residents. Full article

Background: Aphasia, a common consequence of left-hemisphere stroke, significantly impairs communication and daily functioning. Various studies have explored language recovery but only few have focused on the predictors of recovery of functional communication in patients with stroke. Objective: To identify clinical and linguistic factors associated with functional communication outcomes in patients with post-stroke aphasia. Methods: We enrolled 61 patients with aphasia due to left-hemispheric stroke, admitted to post-acute neurorehabilitation centers. Patients underwent neuropsychological, functional, and language assessments at admission (T0) and discharge (T1). Language abilities were evaluated with the Brief Exam of Language—II (BEL-II), and functional communication was measured through caregiver-rated I-CETI scores. Depression, basic (ADL) and instrumental (IADL) activities of daily living were also assessed. Correlations and regression models were used to examine predictors of functional communication recovery (ΔCETI). Results: Significant improvements were observed in all language domains, functional independence, and mood symptoms from T0 to T1 (p < 0.003). Regression analysis showed that demographic and general clinical variables (e.g., age, etiology, dysphagia) were not significant predictors of ΔCETI. However, ADL score, comprehension skills (Token test and comprehension sub-score of BEL-II) were significantly associated with functional communication recovery (β = 0.51, β = 0.68 and β = 0.75, respectively; p < 0.05). Conclusions: Functional communication recovery in post-stroke aphasia is strongly associated with initial comprehension abilities and functional autonomy in basic life activities, rather than demographic or general clinical variables. These findings highlight the need for targeted interventions aimed at improving receptive language and the importance of including ecologically valid communication assessments in post-stroke rehabilitation protocols. Full article

This paper examines Ibrahim Rugova’s philosophical and theoretical contributions to literary studies, focusing on three central categories that define his aesthetics: objectification, the strategy of meaning, and aesthetic refusal. Through the reworking of phenomenological and ontological concepts, Rugova reformulates objectification as the process by which the inner world of personality becomes externalized in the literary work, thereby affirming the autonomy of art as a mode of being. His notion of the strategy of meaning, developed in dialogue with semiotics and structuralism, explains how literature generates both denotative meanings internal to the work and connotative meanings arising from interpretation. Finally, the concept of aesthetic refusal highlights the tension between literature and politics, showing how literature resists ideological and institutional pressures by affirming its autonomy. The study seeks to analyze and synthesize these concepts by examining Rugova’s theoretical–philosophical works, such as Kah teoria Strategjia e kuptimit, and Refuzimi estetik. letrare, through an interdisciplinary methodology that combines philosophical analysis, literary theory, and cultural critique. Taken together, the categories under discussion form a coherent ontology of the literary work that situates Rugova within multiple intellectual traditions that influenced him—including phenomenology, hermeneutics, information theory, structuralism, and dialectical philosophy—while simultaneously underscoring his originality in adapting these ideas to the Albanian intellectual context. The paper concludes that Rugova’s theoretical legacy, often overshadowed by his political role, offers a significant contribution to modern literary theory by defending the autonomy of literature and reaffirming its function as a distinctive mode of truth and human realization. Full article

Background/Objectives: The optimal surgical approach for stage I renal cell carcinoma (RCC) in ultra-octogenarians remains debated, especially when balancing oncologic control, renal preservation, and procedural safety. While ablative techniques and active surveillance are often favored in frail patients, robust comparative evidence supporting nephron-sparing surgery in this age group is limited. Methods: We retrospectively reviewed consecutive patients aged ≥80 years who underwent minimally invasive surgery for cT1 clear cell RCC at a high-volume tertiary-care center between July 2001 and August 2025. Patients were stratified into two cohorts: minimally invasive partial nephrectomy (MIPN, n = 51) and radical nephrectomy (MIRN, n = 26). All MIPNs were performed using an off-clamp approach. Baseline, perioperative, functional, and oncologic outcomes were compared. Kaplan–Meier analysis estimated overall survival (OS), cancer-specific survival (CSS), and progression to significant chronic kidney disease (sCKD, defined as CKD stage ≥ 3b). Results: Groups were comparable in age, comorbidities, and ASA score. MIRN patients exhibited higher tumor complexity (RENAL score: 9 vs. 7, p = 0.01) and a greater proportion of pT1b lesions (77% vs. 37.3%, p = 0.01). Perioperative transfusions occurred exclusively in the MIRN group (p = 0.01), whereas complication rates were low and similar between groups. MIPN was associated with significantly higher eGFR at follow-up (48 vs. 30.9 mL/min/1.73 m², p = 0.01) and a delayed progression to sCKD (p = 0.01), with no differences in OS or CSS at a median follow-up of 30.5 months. Conclusions: In this real-world series of ultra-octogenarians with cT1 clear cell RCC, off-clamp minimally invasive partial nephrectomy ensured superior renal function preservation and delayed progression to sCKD, without compromising oncologic control at mid-term follow-up. Beyond statistical outcomes, these results underscore the importance of tailoring surgical strategies to protect long-term functional autonomy and preserve physiological resilience in elderly patients. Full article

This paper offers a critical analysis of traditional Muslim sexual morality and questions its validity in the present. It focuses on two elements: (1) nikāḥ as a legal marriage contract characterized by asymmetrical gender roles and (2) historically permitted sexual relations with enslaved women, as well as Muslim positions on sexual intercourse with minors. After a conceptual clarification of sexual autonomy, I examine the positions of different legal schools and contextualize their norms within broader social and intellectual histories. Building on the approach of “overcoming the text,” I argue that foundational religious texts can no longer serve as the normative basis for a contemporary sexual ethic. Instead, I redefine the notion of “illegitimate sexuality” (zinā) based on the principle of sexual autonomy and show how modern legal and social frameworks (rule of law, welfare state, medical evidence) render earlier functions of sexual regulation obsolete. The Qurʾanic concept of maʿrūf serves as a dynamic ethical reference point. The goal is a paradigm shift toward a Muslim sexual ethic that centers autonomy, equality, and human dignity while critically dismantling inherited structures. Full article

An increased level of autonomy is attractive above all in the framework of proximity operations, and researchers are focusing more and more on artificial intelligence techniques to improve spacecraft’s capabilities in these scenarios. This work presents an autonomous AI-based guidance algorithm to plan the path of a chaser spacecraft for the map reconstruction of an artificial uncooperative target, coupled with Model Predictive Control for the tracking of the generated trajectory. Deep reinforcement learning is particularly interesting for enabling spacecraft’s autonomous guidance, since this problem can be formulated as a Partially Observable Markov Decision Process and because it leverages domain randomization well to cope with model uncertainty, thanks to the neural networks’ generalizing capabilities. The main drawback of this method is that it is difficult to verify its optimality mathematically and the constraints can be added only as part of the reward function, so it is not guaranteed that the solution satisfies them. To this end a convex Model Predictive Control formulation is employed to track the DRL-based trajectory, while simultaneously enforcing compliance with the constraints. Two neural network architectures are proposed and compared: a recurrent one and the more recent transformer. The trained reinforcement learning agent is then tested in an end-to-end AI-based pipeline with image generation in the loop, and the results are presented. The computational effort of the entire guidance and control strategy is also verified on a Raspberry Pi board. This work represents a viable solution to apply artificial intelligence methods for spacecraft’s autonomous motion, still retaining a higher level of explainability and safety than that given by more classical guidance and control approaches. Full article

Drawing on the Technological Pedagogical Content Knowledge (TPACK) framework, this qualitative case study investigates how university English teachers integrate AI chatbots into flipped classrooms. Findings reveal that teachers employed chatbots across multiple pedagogical functions—including vocabulary support, grammar explanation, dialogue simulation, and creative content generation—embedded purposefully into both pre-class preparation and in-class collaboration. Rather than passively adopting these tools, teachers strategically positioned chatbots to enhance student autonomy, confidence, and interaction, while tailoring their use to suit specific flipped classroom designs. Meanwhile, teachers acknowledged the risks of over-reliance on AI chatbot content and the disruptions caused by vague or incorrect responses. They responded by developing structured guidance and reforming their roles as facilitators rather than content deliverers. This study contributes new insights into teacher agency in AI-mediated language education, highlighting the complex pedagogical negotiations required to meaningfully integrate emerging technologies into flipped learning environments. Full article

The growing reliance on autonomy in uncrewed aircraft systems (UASs) necessitates a real-time solution for assured contingency landing management during in-flight emergencies. This paper presents a novel gradient-guided search algorithm for risk-aware emergency landing trajectory generation with a wing-lift UAS loss-of-thrust use case. This framework integrates a compact four-dimensional discrete search space with aircraft kinematic and ground-risk cost. A multi-objective cost function is employed, combining flight envelope feasibility, optimal descent, and overflown population risk terms. To ensure discrete search convergence, a constrained hypervolume definition is introduced around the destination. A holding pattern identification algorithm is defined to minimize risk during the necessary flight path angle-constrained descent to final approach. Planner effectiveness is validated through randomly generated case studies over a region of Long Island, NY, under steady wind conditions. Benchmark comparisons with a 3D Dubins solver demonstrate the approach’s improved risk mitigation and acceptable real-time computation overhead. Future development will focus on integrating collision avoidance into the discrete search-based landing planner. Full article

Background: With the progressive aging of the in institutionalized settings population, functional decline—manifested as reduced proprioception, joint stiffness, and muscle loss—poses a growing threat to the autonomy and quality of life of older adults. Occupational therapy plays a central role in addressing these challenges through targeted, evidence-based interventions. Objectives: This clinical trial evaluates the effectiveness of a multicomponent occupational therapy intervention that integrates balance and postural stability exercises, proprioceptive stimulation, and lower-limb strengthening with conventional gerontogymnastics. The program was designed to improve gait performance, reduce fall risk, and promote independence in institutionalized older adults. Methods: A total of 35 community-dwelling older adults were randomly assigned to three groups: gerontogymnastics intervention (n = 13), multicomponent intervention (n = 13), and control (n = 9). Participants underwent a 6-week intervention comprising two 45 min sessions per week. Pre- and post-intervention assessments focused on postural stability and balance-related functional outcomes. Results: The multicomponent group exhibited trends toward improvement in balance, proprioception, and functional mobility, although these did not reach statistical significance. Clinically meaningful improvements were defined using minimally clinically important differences (MCIDs) for functional measures such as Timed UP and Go (TUG) (>1.3 s) and Performance-Oriented Mobility Assessment (POMA) (≥3 points). The multicomponent group showed a 22.1% improvement in proprioceptive accuracy and a 13.9% improvement in mobility (TUG). Additionally, this trend may indicate a potential protective effect against age-related functional decline. Conclusions: These findings suggest that a multicomponent occupational therapy intervention may help maintain mobility and reduce functional decline in institutionalized older adults. Statistically significant gains were observed in lower-limb strength, while other improvements—such as proprioception and balance—did not reach significance but approached clinical relevance. These preliminary results support further investigation into balance-specific training within occupational therapy to promote independence and reduce fall risk. Interpretation should remain cautious due to the small sample size (n = 35) and short intervention duration, which limit statistical power and generalizability. Full article

The body–soul relationship serves as a crucial entry point for exploring the intersection of Plato’s dialogues with ancient Greek religious thought, particular Orphic doctrines. In critically inheriting and reconstructing core elements of Orphism, Plato initiates a paradigm shift from mythos to logos—transitioning from mythic narrative to philosophical reasoning. In the context of Greek religious history, Orphism was the first to articulate a dualism between soul and body, depicting the body as a “prison” that confines the divine soul. While Plato frequently references this framework in his dialogues, he simultaneously exposes its inherent contradictions. By distinguishing between the soul’s pure and embodied states, Plato rejects the Orphic notion of bodily impurity. Instead, he reinterprets the body’s negativity not as religious “original sin,” but as the interference of sensory experience and desire in rational life. He affirms that the soul maintains its rational autonomy even in embodiment, with desire and thymos (spirit) emerging naturally from this process, thereby disclosing the soul’s intrinsic structure. In place of a strict dualism, Plato introduces a tripartite model of the soul, positioning thymos as the mediating force between reason and desire. The ambiguity of thymos functions as a self-regulating mechanism that enables the soul to maintain dynamic balance. In this moral psychology, virtue is no longer defined as the soul’s rejection of the body, but as the soul’s harmonious order and natural growth within it. Plato thus adopts a complex and cautious stance toward Orphism, ultimately transcending its passive ethical outlook and transforming a mythical doctrine into a rational philosophical system. Full article

The COVID-19 pandemic has left millions worldwide with persistent cognitive difficulties, making long-term studies essential to understand their trajectory and inform rehabilitation strategies. This research is presented within the context of Long COVID, emphasizing that cognitive symptoms (including deficits in attention, memory, and executive functions) are reported even in non-hospitalized individuals, yet longitudinal evidence beyond two years remains scarce. An observational, cross-sectional, and retrospective design was applied to a sample of 297 adults with their cognition assessed, divided into mild, moderate, and severe COVID-19 groups, and evaluated using standardized cognitive tests. Findings showed that cognitive performance declined with increasing severity of COVID-19 symptoms, particularly in divided attention, working memory, executive control, verbal fluency, recognition memory, and general intelligence. Age consistently predicted lower scores across cognitive domains, especially in moderate and severe groups, whereas education level did not exert a significant protective effect. The study shows that cognitive deficits can persist at least three years after infection, affecting older adults and those with the more severe symptoms. These results highlight the need for long-term neuropsychological monitoring and individualized rehabilitation strategies to mitigate impacts on autonomy and quality of life. Full article