Search Results (46,433)

There is minimal research concerning the role of custom-trained artificial intelligence (AI) tools in higher education, with a lack of research concerning the pedagogical qualities of an AI-based personal tutor. To fill this literature gap, we examined how a custom GPT personal tutor shapes key teaching and learning qualities. Using the mixed-methods approach, we aimed to demonstrate preliminary and exploratory empirical evidence concerning the contribution of custom-trained AI tutors to building up students’ competencies. Our research analyzed the subjective assessments of students related to the GPT tutor’s contribution to improving their competencies. Both the qualitative and quantitative empirical results confirmed the positive contribution. In addition, we triangulated the results to evaluate the potential of custom-trained AI chatbots in higher education, focusing on undergraduate business courses. However, the results of this study cannot be generalized to the entire student population of business schools, since the participation in the AI-assisted tutor program was voluntary, attracting only intrinsically motivated students. Full article

Background/Objectives: Axial spondyloarthritis (axSpA) is a chronic immune-mediated inflammatory disorder affecting the spine and sacroiliac joints, with variable clinical expression. This study assessed serum levels of inflammatory (TNF-α, IL-17A) and metabolic (leptin, adiponectin) biomarkers and their associations with disease activity, inflammation, structural damage, and comorbidities. Methods: This prospective cross-sectional study assessed 89 axSpA patients using clinical, laboratory, and radiological evaluations. Disease activity was measured using ASDAS-CRP and BASDAI scores. Radiographic damage was quantified using the Modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Serum concentrations of TNF-α, IL-17A, leptin, and adiponectin were quantified by enzyme-linked immunosorbent assay (ELISA). Clinical and imaging correlations were analyzed. Results: Serum leptin levels correlated significantly with higher disease activity scores, inflammatory markers (CRP, ESR), radiographic progression (syndesmophyte formation, mSASSS), and arterial hypertension. Adiponectin levels were inversely associated with disease activity, structural damage, and arterial hypertension, suggesting anti-inflammatory, bone- and cardio-protective properties. TNF-α levels showed an association with inflammatory markers and were higher in patients with peripheral enthesitis. IL-17A levels were weakly correlated with disease activity and structural severity and were significantly lower in patients with a history of anterior uveitis. Conclusions: Leptin and adiponectin may serve as complementary biomarkers in axSpA, reflecting both inflammatory burden and structural damage. While TNF-α and IL-17A remain key therapeutic targets, their correlation with structural changes appears limited. Biomarker profiling could support personalized disease monitoring. Longitudinal studies are needed to validate prognostic implications. Full article

This article examines the significant contributions of Helga de Alvear as a gallerist, collector, and patron, a pivotal figure in the evolution of the Spanish and international contemporary art market. Her legacy is particularly notable through the establishment of the Helga de Alvear Museum in the city of Cáceres, intended to share her vast collection of over 3000 works and foster exhibition, research, conservation, and education. The study analyzes her art collection, highlighting its substantial international minimalist art component, contextualizing its development with her personal and professional journey. Furthermore, it explores the institutionalization of her legacy, from the Helga de Alvear Foundation to the creation and evolution of the museum, its innovative architecture and museography, and its impact on Cáceres’s urban landscape. Full article

Background: Small airway dysfunction (SAD) plays a critical role in the management of severe asthma, particularly in patients at risk of requiring biological therapies (BTs). Short-term studies have shown that switching to single-inhaler triple therapy (SITT) with extrafine beclomethasone–formoterol–glycopyrronium improves outcomes and helps achieve quiet asthma, a state marked by symptom control, no exacerbations or oral steroids, reduced inflammation, and better small airway function. This study investigated whether, over one year, patients could maintain this state as Steady Quiet Asthma (SQA) and whether baseline measures could predict this sustained response. Methods: Twenty-six patients with severe asthma and SAD were transitioned from open triple-inhaler therapy to a closed, single-inhaler triple therapy containing extrafine beclomethasone–formoterol–glycopyrronium. Assessments at baseline (T0) and at one-year follow-up (T12) included clinical evaluations, spirometry, and impulse oscillometry, with a focus on Fres as a predictor for the need for BT. When prescribed, biologic therapies included mepolizumab, benralizumab, and dupilumab. Results: Of the 26 patients, 9 (34.6%) achieved SQA and did not require biologic therapy at the one-year follow-up, while 17 patients (65.4%) initiated biologic treatment. At T0, patients who required biologics had significantly higher median Fres (21 (19.47; 24.58) vs. 17.61 (15.82; 20.63); p = 0.049) compared to those who remained biologic-free. They also exhibited higher residual volume to total lung capacity ratio (%RV/TLC) values and lower forced expiratory volume in one second/forced vital capacity ratios (FEV₁/FVC). At T12, patients spared from BT showed significant reductions in Fres (p = 0.014) and improvements in small airway function (difference in airway resistance between 5 Hz and 20 Hz (R5–20), forced expiratory flow between 25% and 75% of FVC (%FEF25–75), and better asthma control (ACT). In contrast, patients on BT demonstrated less favorable changes in these parameters. Conclusions: Baseline Fres, FEV1/FVC ratio, and %FEV25–75 are valuable predictors of achieving Steady Quiet Asthma (SQA) and sparing biologic therapy. These findings support the use of SITT in severe asthma and highlight the importance of early functional assessments to guide personalized management. Full article

Heating, Ventilating, and Air Conditioning (HVAC) systems are important and essential for use in our daily comfort, either in homes, work, or transportation. And it is crucial to study the air movement coming from the inlet diffuser for a better design to enhance thermal comfort and energy consumption. The primary objective of the presented work is to investigate the thermal comfort within a faculty office occupied by two faculty members using the Computational Fluid Dynamics (CFD) methodology. First, an independent mesh study was performed to reduce the uncertainty related to the mesh size. In addition, the presented CFD approach was validated against available experimental data from the literature. Then, the effect of inlet air temperature and velocity on air movement and temperature distribution is investigated using Ansys Fluent. To be as reasonable as possible, the persons who occupy the office, lights, windows, tables, the door, and computers are accounted for in the CFD simulation. After that, the Predicted Mean Vote (PMV) was evaluated at three different locations inside the room, and the approximate total energy consumption was obtained for the presented cases. The CFD results showed that, for the presented cases, the sensation was neutral with the lowest energy consumption when the supply air velocity was 1 m/s and the temperature was 21 °C. Full article

This study examines the impact of personal remittances on housing prices in European Union (EU) countries, while also accounting for a broader set of macroeconomic, demographic, and structural variables. Using annual data for 27 EU countries from 2007 to 2022, we employ a comprehensive panel econometric approach, including cross-sectional dependence tests, second-generation unit root tests, pooled mean group–autoregressive distributed lag (PMG-ARDL) estimation, and panel causality tests, to capture both short- and long-term dynamics. Our findings confirm that remittances significantly and positively influence long-term housing price levels, underscoring their relevance as a demand-side driver. Other key variables such as net migration, GDP, travel credit to GDP, economic freedom, and real effective exchange rates also contribute to housing price movements, while supply-side indicators, including production in construction and building permits, exert moderating effects. Moreover, real interest rates are shown to have a significant long-term negative effect on property prices. The analysis reveals key causal links from remittances, FDI, and net migration to housing prices, highlighting their structural and predictive roles. Bidirectional causality between economic freedom, housing output, and prices indicates reinforcing feedback effects. These findings position remittances as both a development tool and a key indicator of real estate dynamics. The study highlights complex interactions between international financial flows, demographic pressures, and domestic economic conditions and the need for policymakers to consider remittances and migrant investments in real estate strategies. These findings offer important implications for policymakers seeking to balance housing affordability, investment, and economic resilience in the EU context and key insights into the complexity of economic factors and real estate prices. Importantly, the analysis identifies several causal relationships, notably from remittances, FDI, and net migration toward housing prices, underscoring their predictive and structural importance. Bidirectional causality between economic freedom and house prices, as well as between housing output and pricing, reflects feedback mechanisms that further reinforce market dynamics. These results position remittances not only as a developmental instrument but also as a key signal for real estate market performance in recipient economies. Full article

Cardiovascular diseases remain a leading cause of mortality in the United States, driving the need for advanced cardiovascular devices and pharmaceuticals. Mock Circulatory Loops (MCLs) have emerged as essential tools for in vitro testing, replicating pulsatile pressure and flow to simulate various physiological and pathological conditions. While many studies focus on custom MCL designs tailored to specific applications, few have systematically reviewed their use in device testing, and none have assessed their broader utility across diverse biomedical domains. This comprehensive review categorizes MCL designs into three types: mechanical, computational, and hybrid. Applications are classified into four major areas: Cardiovascular Devices Testing, Clinical Training and Education, Hemodynamics and Blood Flow Studies, and Disease Modeling. Most existing MCLs are complex, highly specialized, and difficult to reproduce, highlighting the need for simplified, standardized, and programmable hybrid systems. Improved validation and waveform fidelity—particularly through incorporation of the dicrotic notch and other waveform parameters—are critical for advancing MCL reliability. Furthermore, integration of machine learning and artificial intelligence holds significant promise for enhancing waveform analysis, diagnostics, predictive modeling, and personalized care. In conclusion, the development of MCLs should prioritize standardization, simplification, and broader accessibility to expand their impact across biomedical research and clinical translation. Full article

Environmental protection is one of the key challenges facing mankind today. Finding out what young people, referred to as Generation Z, think about this issue is extremely important, as they will be the first to experience the negative effects of environmental degradation. Research has shown that Generation Z has the greatest hope for solutions from the technological sphere. Thus, the economic and political spheres should support the development of technology in this area. The social sphere is rated lowest, which may reflect young people’s personal withdrawal and the delegation of responsibility for the environment’s future to engineers, entrepreneurs, and politicians. It is equally important to learn what constitutes an environmental imperative for Generation Z. It is based on new energy sources, energy producers, and the state’s pursuit of a policy of international cooperation in this area, supported by national legislative activity toward entrepreneurs and citizens. Research has demonstrated the need to raise awareness among young people, with a focus on individuals treated as subjects in their interaction with modern technology. Full article

Large Language Models (LLMs) are reshaping recommendation systems through enhanced language understanding, reasoning, and integration with structured data. This systematic review analyzes 88 studies published between 2023 and 2025, categorized into three thematic areas: data processing, technical identification, and LLM-based recommendation architectures. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review highlights key trends such as the use of knowledge graphs, Retrieval-Augmented Generation (RAG), domain-specific fine-tuning, and robustness improvements. Findings reveal that while LLMs significantly advance semantic reasoning and personalization, challenges remain in hallucination mitigation, fairness, and domain adaptation. Technical innovations, including graph-augmented retrieval methods and human-in-the-loop validation, show promise in addressing these limitations. The review also considers the broader macroeconomic implications associated with the deployment of LLM-based systems, particularly as they relate to scalability, labor dynamics, and resource-intensive implementation in real-world recommendation contexts, emphasizing both productivity gains and potential labor market shifts. This work provides a structured overview of current methods and outlines future directions for developing reliable and efficient LLM-based recommendation systems. Full article

Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have transformed the management of type 2 diabetes mellitus and obesity. However, their sustained effect on delaying gastric emptying raises new challenges in gastrointestinal endoscopy performed under sedation. This narrative review aims to summarize current evidence on the impact of GLP-1 RAs on gastric motility and to propose clinical strategies to mitigate associated procedural risks. Methods: A narrative review was conducted integrating findings from scintigraphy, capsule endoscopy, gastric ultrasound, and existing clinical guidelines. Emphasis was placed on studies reporting residual gastric content (RGC), anesthetic safety outcomes, and procedural feasibility in patients undergoing endoscopy while treated with GLP-1 RAs. Results: GLP-1 RAs significantly increase the prevalence of clinically relevant RGC, despite prolonged fasting, with potential implications for airway protection and sedation safety. Although the risk of pulmonary aspiration remains low (≤0.15%), procedural delays, modifications, or cancellations can occur in up to 30% of cases without adapted protocols. Several professional societies (AGA, ASGE, AASLD) advocate for individualized management based on procedure type, symptomatology, treatment phase, and point-of-care gastric ultrasound (POCUS), in contrast to the systematic discontinuation recommended by the ASA. Conclusions: Effective management requires personalized fasting protocols, risk-based stratification, tailored anesthetic approaches, and interprofessional coordination. We propose a clinical decision algorithm and highlight the need for training in gastrointestinal pharmacology, POCUS, and airway management for endoscopists. Future priorities include prospective validation of clinical algorithms, safety outcome studies, and the development of intersocietal consensus guidelines. Full article

Background/Objectives: Men have historically contributed significantly to mental health nursing, particularly in inpatient settings, where their presence has supported patient recovery and safety. Despite this legacy, men remain under-represented in the nursing workforce, and addressing this imbalance is critical to workforce sustainability. This study offers a novel contribution by exploring the lived experiences, motivations, and professional identities of men in mental health nursing, an area that has received limited empirical attention. The aim of the study is to examine the characteristics, qualities, and attributes of mental health nurses who are male, which contributes to their attraction to and retention within the profession. Methods: A qualitative interpretive inquiry was conducted among nurses who were male and either currently or previously employed in mental health settings. Two focus groups were conducted using semi-structured questions to explore their career pathways, motivations, professional identities, and perceived contributions. Thematic analysis was used to identify key themes and patterns in their narratives. Results: Seven participants, with 10–30 years of experience, participated. They had entered the profession through diverse pathways, expressing strong alignment between personal values and professional roles. Five themes emerged and centred on mental health being the heart of health, personal and professional fulfillment, camaraderie and teamwork, a profound respect for individuals and compassion, and overcoming and enjoying the challenge. Conclusions: Mental health nurses who are male bring unique contributions to the profession, embodying compassion, resilience, and ethical advocacy. Their experiences challenge traditional gender norms and redefine masculinity in health care. Fostering inclusive environments, mentorship, and leadership opportunities is essential to support their growth. These insights inform strategies to strengthen recruitment, retention, and the future of mental health nursing. Full article

The COVID-19 pandemic exacerbated mental illness, accelerated cognitive decline, and deepened social inequalities. In low and middle-income countries (LMIC) such as Panama, it is unclear as to whether, and to what extent, the pandemic lockdowns affected cognitive, mental, and physical health of older adults. This study investigated changes in cognitive function, mental health, and physical health in a sample of Panamanian older adults assessed before and during the pandemic, and examined whether sociodemographic variables were associated with cognition and mental health. Participants completed in-person interviews between 2018 and early 2020 and a follow-up telephone interview between February and May 2021. Repeated measures analyses showed no significant changes in cognitive function or depression; however, participants reported fewer chronic illnesses. Linear regression analysis indicated that higher cognitive function during the pandemic was associated with younger age, higher education, and having sufficient income. An attrition analysis compared participants who completed both interviews to those who were lost to follow-up, revealing that participants who dropped out of the study had lower socioeconomic status and greater impairment at baseline. These findings highlight the need for targeted support for vulnerable older adults during public health crises. Full article

In this paper, we propose a crossover operator for genetic algorithms with binary chromosomes populations based on the cellular automata ($\mathit{CGACell}$). After presenting the fundamental elements regarding cellular automata with specific examples for one- and two- dimensional cases, the the most widely used crossover operators in applications with genetic algorithms are described, and the crossover operator based on cellular automata is defined. Specific forms of the crossover operator based on the ECA and 2D CA cases are described and exemplified. The $\mathit{CGACell}$ crossover operator is used in the genetic structure to improved the KNN algorithm in terms of the parameter represented by the number of nearest neighbors selected by the data classification method. Validity and practical performance testing are performed on image data classification problems by optimizing the nearest-neighbors-based algorithm. The experimental study on the proposed crossover operator, by comparing a GA algorithm based on $\mathit{CGACell}$ with GA algorithms based on other crossover methods, including classical GAs and permutation-based, heuristic, and hybrid methods, attests to good qualitative performance in terms of correctness percentages in the recognition of new images, as well as in classification and recognition applications of facial image classes corresponding to several persons. Full article

Seeds of Cucurbitaceae crops represent a promising yet underexplored source of bioactive compounds with potential applications beyond nutrition, particularly in the cosmetics industry. This review examines the seeds of Citrullus lanatus (watermelon), Cucumis melo (melon), and Cucurbita pepo (pumpkin), focusing on their biochemical composition and evaluating their functional value in natural cosmetic development. Although these fruits are widely consumed, industrial processing generates substantial seed by-products that are often discarded. These seeds are rich in polyunsaturated fatty acids, proteins, carbohydrates, and phytochemicals, positioning them as sustainable raw materials for value-added applications. The incorporation of seed-derived extracts into cosmetic formulations offers multiple skin and hair benefits, including antioxidant activity, hydration, and support in managing conditions such as hyperpigmentation, acne, and psoriasis. They also contribute to hair care by improving oil balance, reducing frizz, and enhancing strand nourishment. However, challenges such as environmental instability and low dermal permeability of seed oils have prompted interest in nanoencapsulation technologies to improve delivery, stability, and efficacy. This review summarizes current scientific findings and highlights the potential of Cucurbitaceae seeds as innovative and sustainable ingredients for cosmetic and personal care applications. Full article

Background/Objectives: Older adults (65+) are the fastest growing age group in Canada, comprising 18.8% of the country’s population. During the COVID-19 pandemic, use of virtual care, including telehealth and tele-medicine, increased dramatically among older adults in Canada who often face higher health risks, mobility limitations, and many barriers to accessing healthcare. Despite the rapid expansion in virtual care, no systematic review has focused specifically on virtual care among older adults in Canada. This review aims to explore the factors influencing virtual care adoption and the experiences of older Canadians during the pandemic through a systematic review. Methods: Conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the review involved a comprehensive search of PubMed, Scopus, ESCBOHost, and Web of Science on 2 May 2025, yielding 281 unique citations. After screening and applying eligibility criteria, 15 studies employing quantitative, qualitative, or mixed-methods designs, with sample sizes ranging from 15 to 2,282,798, were included and appraised using the Mixed Methods Appraisal Tool (MMAT). Results: The review identified three domains of factors and the ways in which each factor shapes older adults’ virtual care experiences: (1) personal factors influencing virtual care use and demand (e.g., age, education, language, income, immigration status, community sizes), (2) resource factors impacting virtual care adoption (e.g., technology access, support), and (3) varying virtual care experiences among older adults (e.g., in assessment and communication efficacy, privacy, care quality, convenience, safety, and costs). Conclusions: This review highlights the complexities of virtual care engagement among older adults and underscores the need for inclusive, tailored strategies to improve the accessibility and effectiveness of virtual care delivery in both pandemic and post-pandemic contexts. Full article