Search Results (2,982)

We propose a novel clothing application technique designed for story visualization framework where various characters appear wearing a wide range of outfits. To achieve our goal, we extend a Virtual Try-On framework for synthetic garment fitting. Conventional Virtual Try-On methods are limited to generating images of a single person wearing a restricted set of clothes within a fixed style domain. To overcome these limitations, we apply an improved Virtual Try-On model trained with appropriately processed datasets, enabling the generation of upper and lower garments separately across diverse characters and producing images in four distinct styles: photorealistic, webtoon, animation, and watercolor. Our system collects character images and clothing images and performs accurate masking of garment regions. Our system takes a style-specific text prompt as input. Based on these inputs, garment-specific conditioning is applied to synthesize the clothing, followed by a cross-style diffusion process that generates Virtual Try-On images reflecting multiple visual styles. Our approach significantly enhances the adaptability and stylistic diversity of Virtual Try-On technology for story visualization applications. Full article

The rhesus macaque (Macaca mulatta) is a valuable model for pregnancy research due to its physiological similarity to humans and the ability to conduct studies in a controlled environment. Our previous work used non-invasive imaging methods to assess placental hemodynamics across gestation with correlative tissue analysis post-delivery. Here, we expand access to longitudinal timepoints from ongoing pregnancies by obtaining placental biopsies using ultrasound-guided needle aspiration. This approach aligns with New Approach Methods (NAMs) and supports animal welfare by reducing the number of animals required. We describe a chorionic villus sampling (CVS) simulation model which facilitates training to gain proficiency in technical skills prior to performing the procedure on animals. We report outcomes from three rhesus macaques that underwent CVS three times between gestational days 40 to 106 (term: 165 days). Although biopsy samples are smaller than whole placenta, tissue yields were sufficient for multiple uses. We demonstrate (1) appropriate histology from aspirated samples, (2) good RNA quality and yield, and (3) the ability to isolate trophoblast organoids, an advancement in NAMs that reduces the need for first-trimester surgical delivery. No spontaneous preterm delivery occurred following serial CVS procedures, supporting the use of this sampling method to maximize animal utilization in longitudinal pregnancy studies. Full article

Airway management is central to the care of critically ill patients, yet it remains one of the most challenging interventions in emergency departments and intensive care units. Patients often present with severe physiological instability, limited cardiopulmonary reserve, and high acuity, while clinicians often work under constraints related to time for preparation, equipment availability, trained workforce, monitoring, and access to advanced rescue techniques. These challenges are particularly pronounced in low- and middle-income countries and other resource-limited or austere environments, where the margin for error is narrow and delays or repeated attempts in airway management may rapidly precipitate hypoxemia, hemodynamic collapse, or cardiac arrest. Although contemporary airway guidelines emphasize structured preparation and rescue pathways, many assume resources that are not consistently available in such settings. This narrative review discusses pragmatic, context-adapted strategies for airway management in constrained environments, with emphasis on physiology-first preparation, appropriate oxygenation and induction techniques, simplified rapid-sequence intubation, and the judicious use of basic airway adjuncts, supraglottic devices, and video laryngoscopy, where available. Adapted difficult airway algorithms, front-of-neck access in the absence of surgical backup, human factors, team training, and ethical considerations are also addressed. This review aims to support safer and effective airway management for critically ill patients in resource-limited emergency and intensive care settings. Full article

Dogs increasingly function as relational beings, shaping their guardians’ emotional well-being and daily routines. Consequently, dog owner education has expanded beyond behaviour-focused training toward integrative approaches that address the emotional, relational, and cognitive dimensions of the human–dog relationship. Despite this shift, international comparative research on the organisation and institutionalisation of dog owner education remains limited. The study applies a qualitative exploratory comparative case study to examine systems in the United States, the United Kingdom, Germany, Japan, and Australia, identifying national patterns and shared components to inform context-appropriate frameworks, particularly in South Korea. The study examines legal and policy documents, institutional guidelines, and standardised education programmes that function as national or de facto standards using document and content analysis. It integrates within- and cross-case comparisons and interprets findings through a framework drawing on human–animal interaction, attachment, canine behaviour, and cognitive–behavioural coaching theories. The analysis reveals five shared components of behaviour change: guardian responsibility and animal welfare, science-based positive reinforcement, early socialisation and prevention, a balance between standardisation and individualisation, and guardians’ emotional and relational engagement. These findings suggest that dog owner education functions as an integrated system that supports responsible guardianship and stable human–dog relationships across sociocultural contexts. Full article

Exercise training has demonstrated potential benefits in addressing the adverse effects of cardiovascular diseases, particularly myocardial infarction (MI). This study analyzed the cardioprotective effects of moderate exercise before and after MI in rats subjected to isoproterenol (ISO)-induced heart damage. Wistar rats were assigned to five groups: controls (CTRL), isoproterenol-treated (ISO), swimming before ISO (PRE + ISO), swimming after ISO (ISO + POST), and swimming both before and after ISO (PRE + ISO + POST). Cardiac function was assessed through echocardiography, while oxidative stress markers, Heme Oxygenase-1 (HO-1) and Myeloperoxidase (MPO), were quantified using biochemical assays and enzyme-linked immunosorbent assay (ELISA). Statistical analyses were conducted by one-way analysis of variance (ANOVA), accompanied by Tukey’s post hoc test. Exercise performed post-MI and both pre- and post-MI significantly reduced ISO-induced infarct size and improved left ventricular function (stroke volume (SV), ejection fraction (EF), and Tei index). HO-1 protein concentration and HO enzyme activity were restored, while swim training reduced the activity of MPO compared to the ISO group. Moderate exercise training, when appropriately timed, provides cardioprotection against ISO-induced myocardial damage by reducing oxidative stress and cardiac dysfunction. Full article

The Atlantic slave trade was one of the most significant and violent processes in global history, and the Iberian empires played a central role in its development. Yet in Spain and Portugal, the historical and public memory of slavery remains fragmented, producing silences that contrast with its historical magnitude. This study examines these silences through two complementary lenses: the academic preparation of future history teachers and the heritage narratives presented in Iberian museums, adopting a mixed-methods design. A total of 138 pre-service teachers from eight Spanish and Portuguese universities completed a questionnaire providing quantitative data to assess how the Atlantic slave trade was addressed in their university training and which didactic and heritage resources they consider most appropriate for teaching it. In parallel, exhibitions and institutional discourses were analysed in seven national and regional museums related to America, colonisation or maritime expansion, drawing on qualitative data from written interviews with museum professionals. The findings reveal limited curricular attention to the Atlantic slave trade, uneven valuation of heritage resources, and highly variable museum narratives. These results highlight the need for coordinated educational and heritage strategies that strengthen historical understanding, support democratic and intercultural competencies, and contribute to a more inclusive and critically informed public memory. Full article

Background and Objectives: Dermatology relies on a complex terminology encompassing lesion types, distribution patterns, colors, and specialized sites such as hair and nails, while dermoscopy adds an additional descriptive framework, making interpretation subjective and challenging. Our study aims to evaluate the ability of a chatbot (Gemini 2) to generate dermatology descriptions across multiple languages and image types, and to assess the influence of prompt language on readability, completeness, and terminology consistency. Our research is based on the concept that non-English prompts are not mere translations of the English prompts but are independently generated texts that reflect medical and dermatological knowledge learned from non-English material used in the chatbot’s training. Materials and Methods: Five macroscopic and five dermoscopic images of common skin lesions were used. Images were uploaded to Gemini 2 with language-specific prompts requesting short paragraphs describing visible features and possible diagnoses. A total of 2400 outputs were analyzed for readability using LIX score and CLEAR (comprehensiveness, accuracy, evidence-based content, appropriateness, and relevance) assessment, while terminology consistency was evaluated via SNOMED CT mapping across English, French, German, and Greek outputs. Results: English and French descriptions were found to be harder to read and more sophisticated, while SNOMED CT mapping revealed the largest terminology mismatch in German and the smallest in French. English texts and macroscopic images achieved the highest accuracy, completeness, and readability based on CLEAR assessment, whereas dermoscopic images and non-English texts presented greater challenges. Conclusions: Overall, partial terminology inconsistencies and cross-lingual variations highlighted that the language of the prompt plays a critical role in shaping AI-generated dermatology descriptions. Full article

Because LLMs are still in development, what is true today may be false tomorrow. We therefore need general strategies for debiasing LLMs that will outlive current models. Strategies developed for debiasing human decision making offer one promising approach as they incorporate an LLM-style prompt intervention designed to access additional latent knowledge during decision making. LLMs trained on vast amounts of information contain information about potential biases, counter-arguments, and contradictory evidence, but that information may only be brought to bear if appropriately prompted. Metacognitive prompts developed in the human decision making literature are designed to achieve this and, as I demonstrate here, they show promise with LLMs. The prompt I focus on is “could you be wrong?” Following an LLM response, this prompt leads LLMs to produce additional information, including why they answered as they did, identifying errors, biases, contradictory evidence, and alternatives, none of which were present in their initial response. Further, this metaknowledge often reveals that how LLMs and users interpret prompts are not aligned. I demonstrate this prompt in three cases. In the first two cases I use a set of questions taken from recent articles identifying LLM biases, including implicit discriminatory biases and failures of metacognition. “Could you be wrong” prompts the LLM to identify its own biases and produce cogent metacognitive reflection. In the last case I present an example involving convincing but incomplete information about scientific research (the too much choice effect), which is readily corrected by “could you be wrong?” In sum, this work argues that human psychology offers a valuable avenue for prompt engineering, leveraging a long history of effective prompt-based improvements to decision making. Full article

Objectives: We aimed to develop expert-informed recommendations for colleges and universities to support students with celiac disease (CeD) managing a gluten-free (GF) diet. Methods: A multidisciplinary panel of 40 stakeholders, including physicians, dietitians, a disability rights attorney, university staff, and students, was convened by the Celiac Disease Foundation to create expert-based and experience-informed recommendations. Over a 6-month period, the group conducted literature reviews, stakeholder interviews, and expert consensus discussions to identify common barriers and accommodations aligned with federal disability law. The expert panel collaboratively developed and revised an initial set of recommendations. Two rounds of structured voting were held during which panelists provided feedback to refine content and ensure clarity. All final recommendations were adopted with at least 90% of panelists voting in support. Results: The panel identified 24 accommodations across four domains: academics, housing, dining, and campus life. Academic recommendations include flexibility for illness-related absences, support for remote learning, and classroom modifications. Housing recommendations emphasize access to priority placement, appropriate appliances, and proximity to safe dining. Dining accommodations address GF food availability, ingredient transparency, staff training, and meal plan flexibility. Campus life recommendations ensure full participation in athletics, study abroad, social events, and internships, with supports for psychosocial well-being. Conclusions: This manuscript presents the first expert-informed recommendations focused specifically on the needs of college students with CeD. These recommendations are intended to support institutions as they develop strategies to enhance access to GF food, quality of life, educational supports, and student experience for those living with this chronic autoimmune condition. Full article

Any industrial application that uses convolutional neural networks (CNNs) requires initial data and resources in order to train the models. However, the selection of models must be appropriate to the quality and quantity of the available data and computational resources. This study analyses the influence of data quantity and quality on the performance of CNN models of different complexity. Image preprocessing and image transformation data augmentation techniques are applied to generate different amounts of synthetic data with which to train the aforementioned models, shedding light on the following question: does the quality and quantity of the data or the depth of the model have more influence? Different experiments are performed using the Northeastern University (NEU) Steel Surface Defects Database, which contains surface defects found in hot-rolled steel. After analyzing the results, the authors conclude that data quality and quantity have a much greater influence than model choice. As resources and time are often limited in industry and the ultimate goal is to maximize profit by increasing efficiency, the authors encourage researchers to carefully consider the industrial application at hand and analyze the available data and resources before selecting CNN models. Full article

Background/Objectives: Cardiac remodeling post-myocardial infarction is a critical process determining patient prognosis. Poland’s Coordinated Specialist Care program enables early cardiac rehabilitation (CSC-Infarct) during peak remodeling period. This study evaluated the safety and effectiveness of very early cardiac rehabilitation initiated during peak remodeling (mean 16.8 ± 3.4 days post- ST-elevation myocardial infarction [STEMI]) within the CSC-Infarct program. We examined outcomes following two training modalities—interval and continuous—applied according to clinical guidelines based on baseline exercise capacity. Methods: We enrolled 288 patients (135 women, 153 men, age 59.7 ± 9.8 years) after first STEMI into a 24-day rehabilitation program (5 sessions/week) within CSC-Infarct. Patients received either interval training (n = 127) or continuous training (n = 161) according to National Health Fund protocols. Hemodynamic, metabolic (metabolic equivalents [MET], maximal oxygen uptake [VO2max]), and functional parameters (6-minute walk test [6MWT]) were assessed pre- and post-rehabilitation. Results: Both groups showed significant improvement in most parameters. The continuous training group achieved higher final MET values (8.9 ± 2.5 vs. 6.5 ± 1.9; p < 0.001), VO₂max (31.0 ± 8.8 vs. 22.9 ± 6.5 mL/kg/min; p < 0.001), and 6MWT distance (530.9 ± 108.9 vs. 455.6 ± 104.3 m; p < 0.001). Significant improvement in heart rate recovery (HRR), indicating autonomic balance, was observed only in the continuous training group (p = 0.026), not in the interval group (p = 0.290). Conclusions: Early rehabilitation within CSC-Infarct (mean 16.8 days post-infarction) during intensive remodeling is safe and effective. Both training modalities produced clinically significant improvements when appropriately matched to patient baseline capacity. Continuous training showed additional benefit in autonomic balance (HRR improvement), while interval training achieved substantial relative gains (+11.8% in 6MWT) in lower-capacity patients. The CSC-Infarct program provides optimal timing for rehabilitation implementation during the critical cardiac remodeling period. Full article

Objective: Physician assistants (PAs) are frequently involved in managing acute bacterial infections in patients with documented penicillin (PCN) allergies. Inappropriate antibiotic choice in patients with existing allergies may place them at undue risk. This study aimed to assess the knowledge and confidence among PA students in managing patients with documented PCN allergies. Methods: An electronic survey was distributed to enrolled students in participating PA programs in North and South Carolina. The survey tool consisted of 20 questions with 13 focused on knowledge and confidence primarily scored on a 5-point Likert scale. Data were collected and protected via the REDCap^® database. Primary objectives were knowledge of penicillin allergies and confidence in management decisions. Sufficient knowledge was considered a score of 80% or greater; adequate knowledge was considered 70% or greater on relevant assessments. Results: Overall, 406 students from 10 unique programs completed the survey. They were predominantly female (76%) with 43% in the first year of their program. The mean student knowledge score was 25.9%, and 30% of respondents achieved adequate knowledge. Respondents reported an average cross reactivity between penicillin and beta-lactams of 29% (10–63%), cefazolin 50% (24–75), ceftriaxone 29% (11–60), and carbapenems 26% (8–50). The majority of respondents (66.5%) reported high levels of confidence in managing patients with penicillin allergies. Conclusions: The study found significant discordance between PA students’ high level of confidence in assessing patients with a PCN allergy and their comparative knowledge. PA students are likely to avoid beta-lactam antibiotics when there is a documented penicillin allergy, regardless of the documented reaction or low likelihood of cross-reactivity. Further training and education will help to encourage appropriate prescribing in these high-risk patients. Full article

Serious games are increasingly recognized as powerful pedagogical tools, often offering engaging, interactive, and practical learning experiences. This paper presents the design, implementation, and evaluation of a 3D virtual serious game specifically tailored for cybersecurity governance and policy education. In particular, the nature of the game is an escape room, drawing on military training principles: players must solve a problem to escape one room before advancing to the next. Set within a virtual company environment, the game features three interactive zones that guide students through analyzing cyber risks, aligning security frameworks, and drafting appropriate policies. This structure cultivates critical thinking and decision-making skills and strengthens practical cybersecurity competencies. The primary contribution lies in the integration of game-based learning and 3D virtual technology to create robust, hands-on educational materials. The design incorporates structural features that create barriers to generative AI delegation to address challenges related to generative AI misuse, ensuring that the activities cannot be easily replicated and thereby supporting academic integrity. A post-activity perception survey (n = 20) suggests that students found this approach both engaging and effective, with participants self-reporting enhanced understanding and enthusiasm toward cybersecurity governance and policy concepts. These findings highlight the potential of gamified environments to bridge theory and practice in cybersecurity education, equipping learners with industry-relevant skills while fostering deeper engagement and active learning. Full article

The classification of breast cancer using machine learning techniques has become a critical tool in modern medical diagnostics. This study analyzes the performance of hybrid models that combine traditional machine learning algorithms (TMLAs) with a convolutional neural network (CNN)-based VGG16 model for feature extraction to improve accuracy for classifying eight breast cancer subtypes (BCS). The methodology consists of three steps. First, image preprocessing is performed on the BreakHis dataset at 400× magnification, which contains 1820 histopathological images classified into eight BCS. Second, the CNN VGG16 is modified to function as a feature extractor that converts images into representative vectors. These vectors constitute the training set for TMLAs, such as Random Forest (RF), Support Vector Machine (SVM), K-Nearest Neighbors (KNN), and Naive Bayes (NB), leveraging VGG16’s ability to capture relevant features. Third, k-fold cross-validation is applied to evaluate the model’s performance by averaging the metrics obtained across all folds. The results reveal that hybrid models leveraging a CNN-based VGG16 model for feature extraction, followed by TMLAs, achieve accuracy outstanding experimental accuracy. The KNN-based hybrid model stood out with a precision of 0.97, accuracy of 0.96, sensitivity of 0.96, specificity of 0.99, F1-score of 0.96, and ROC-AUC of 0.97. These findings suggest that, with an appropriate methodology, hybrid models based on TMLA have strong potential in classification tasks, offering a balance between performance and predictive capability. Full article

Background: Language barriers remain a major obstacle to equitable healthcare access for immigrants and refugees across Europe. Greece, as both a transit and host country, faces persistent challenges in providing linguistically and culturally appropriate care. Methods: This study presents a narrative literature review synthesizing international, European, and Greek evidence on the effects of limited language proficiency, professional interpretation, and intercultural mediation on healthcare access, patient safety, satisfaction, and clinical outcomes. Peer-reviewed studies and selected grey literature were identified through searches of PubMed, Scopus, Web of Science, and CINAHL. Results: The evidence consistently demonstrates that the absence of professional interpretation is associated with substantially higher rates of clinically significant communication errors, longer hospital stays, increased readmissions, and higher healthcare costs. In contrast, the use of trained medical interpreters and intercultural mediators improves comprehension, shared decision-making, patient satisfaction, and clinical outcomes. Comparative European data from Italy, Spain, Germany, and Sweden show that institutionalized interpretation systems outperform Greece’s fragmented, NGO-dependent approach. Greek studies further reveal that limited proficiency in Greek is associated with reduced service utilization, longer waiting times, and lower patient satisfaction. Conclusions: This narrative review highlights the urgent need for Greece to adopt a coordinated, professionally staffed interpretation and intercultural mediation framework. Strengthening linguistic support within the healthcare system is essential for improving patient safety, equity, efficiency, and the integration of migrant and refugee populations. Full article