Search Results (907)

Background/Objectives: Artificial intelligence (AI) is increasingly integrated into everyday life, including the complex and highly regulated healthcare sector. Given healthcare’s essential role in safeguarding human life and well-being, AI deployment requires careful oversight to ensure safety, effectiveness, and ethical compliance. This paper aims to examine the current regulatory landscapes governing AI in healthcare, particularly in the European Union (EU) and the United States (USA), and to propose practical tools to support the responsible development and implementation of AI systems. Methods: The study reviews key regulatory frameworks, ethical guidelines, and expert recommendations from international bodies, professional associations, and governmental institutions in the EU and USA. Based on this analysis, the paper develops structured questionnaires tailored for AI developers and implementers to help operationalize regulatory and ethical expectations. Results: The proposed questionnaires address critical gaps in existing frameworks by providing actionable, lifecycle-oriented tools that span AI development, deployment, and clinical use. These instruments support compliance and ethical integrity while promoting transparency and accountability. Conclusions: The structured questionnaires can serve as practical tools for health technology assessments, public procurement, accreditation processes, and training initiatives. By aligning AI system design with regulatory and ethical standards, they contribute to building trustworthy, safe, and innovative AI applications in healthcare. Full article

The real estate sector is increasingly recognizing facility management (FM) as a key driver of asset value. Among emerging technologies, Building Information Modeling (BIM) and Building Management Systems (BMSs) stand out for their potential to enhance FM efficiency by integrating design data with building operations across the entire lifecycle, from construction to maintenance, performance monitoring, and renovation. While their technical applications have been widely studied, the financial impact of these tools on FM remains underexplored. This paper addresses that gap by estimating the economic value generated by implementing BIM and BMS in real estate facility management. Based on thirteen semi-structured interviews with professionals from the Italian real estate sector, we identified and quantified cost-saving factors and challenges related to digital adoption. These cost efficiencies, when recurring and quantifiable, can improve net operating income (NOI), thereby supporting higher asset valuations under income-based real estate appraisal methods. The results show that integrating BIM and BMS in facility management may generate average annual cost savings of 5.81% relative to asset value, with coordination improvements alone accounting for up to 3.28% per year. Based on a 30-year simulation, these savings correspond to a positive Net Present Value (NPV), supporting the financial viability of digital FM adoption in real estate. This study offers empirical evidence to support investment decisions in digital FM technologies and contributes to bridging the gap between innovation and financial evaluation in the real estate sector. Full article

In 2024, Europe experienced a significant upsurge in cases of Parvovirus B19 (B19V), the etiological agent of erythema infectiosum, also known as fifth disease. The prevalence of B19V in pregnant women, a particularly vulnerable population, holds critical clinical significance. Typically, B19V follows a well-documented seasonal pattern, with annual epidemics peaking in the spring and larger outbreaks occurring approximately every four years. B19V exhibits a tropism for erythroid precursor cells, potentially resulting in fetal anemia and, in the most severe scenarios, intrauterine demise. Severe in utero infections necessitate intrauterine erythrocyte transfusion (IUT), a highly specialized and technically demanding procedure that is exclusively performed in tertiary-level prenatal care units. This study delineates how the notable increase in B19V infections is also reflected in our prenatal diagnosis unit at Fondazione Policlinico Agostino Gemelli (FPG) IRCCS, Rome, Italy. According to our case series, since 2018, B19V has been identified as the second most common cause of fetal anemia during the study period (29%, 6 patients), yet it accounted for the majority of IUT procedures performed in 2024 (16 out of 19 cases, 84.2%). Given the rising incidence of severe intrauterine infections in recent epidemic cycles, healthcare professionals should maintain a high index of suspicion regarding the clinical manifestations of maternal B19V infection and its potential obstetric complications. Further research is imperative to evaluate the cost-effectiveness of routine screening for B19V immunity in pregnant women and to investigate the long-term neurodevelopmental and clinical outcomes of neonates affected by intrauterine B19V infection. Full article

Hamstring strain injuries (HSIs) are the most common time loss injury sustained in male Australian Football League (AFL) athletes, causing significant financial cost, time cost, and impaired team and individual performance. In a squad of 42 players, HSIs accounted for 4.86 new injuries sustained by players per club per AFL season in 2020. This is consistent with injury reporting over the last decade in AFL, despite best efforts to reduce the rate. This scoping review sought to firstly identify the reported hamstring injury prevention risk factors in elite AFL, discern the impact of these factors, and map the gaps in the current literature using a biopsychosocial understanding of injury prevention. The scoping review process was based on the Askey and O’Malley framework. Five relevant online databases (MEDLINE, Proquest, CINAHL, SPORTdiscuss, and EMBASE) were systematically searched using a series of Boolean and operator terms following the PRISMA-ScR protocol using the criteria: (1) assessing male professional/elite athletes in AFL; (2) written in English and peer-reviewed; (3) full text available; and (4) published after 2006. Only manuscripts that fit the search terms and inclusion criteria were retained in the scoping review. Following an initial search, 246 potential studies were identified, with 12 studies meeting the inclusion criteria after full-text screening. The risk factors examined were subclassified into modifiable and non-modifiable categories. Modifiable factors include high-speed running exposure, gluteus medius activation, eccentric hamstring strength, shorter bicep femoris fascicle length, use of interchange, and hamstring stiffness. Non-modifiable factors include previous history of HSI and limb injury, age, and size of injury on MRI. This scoping review highlights the need for continued monitoring of high-speed running volumes as rapid increases in completed distances present as a substantial risk factor. The modifiable mechanistic risk factors of eccentric hamstring strength and hamstring stiffness were identified as important components of player screening to reduce the risk of future HSI. Risk factors identified throughout will help develop comprehensive injury profiling for athletes. Further research is warranted to develop a holistic approach to injury profiling. Full article

Generative AI tools are increasingly being integrated into game design and development workflows, offering new possibilities for creativity, efficiency, and innovation. This paper explores the evolving role of these tools from the perspective of game designers and developers, focusing on the benefits and challenges they present in fostering creativity. Through a mixed-method study, we conducted an online survey (n = 42) with game design professionals, followed by in-depth online interviews (n = 9), to investigate how generative AI influences the creative process, decision-making, and artistic vision. Our findings reveal that while generative AI accelerates ideation, enhances prototyping, and automates repetitive tasks, it also raises concerns about originality, creative dependency, and undermine of human-authored content. Future work will aim to address these challenges by investigating strategies to balance leveraging AI’s capabilities with preserving the integrity of human creativity. This includes developing collaborative human-AI workflows that maintain human oversight, designing systems that support rather than replace creative decision-making, and establishing ethical guidelines to ensure transparency, accountability, and authorship in AI-assisted content creation. By doing so, we aim to contribute to a more nuanced understanding of generative AI’s role in creative practices and its implications for the game design and development lifecycle. Full article

For disciplines and professions concerned with the design and management of the physical environment, climate emergency has become an integral part of research and practice because these environmental challenges are inextricably linked to the land and how we use it. Working from an understanding of landscape as the vast infrastructure upon which we depend for everything, landscape is the setting for all matters of environmental sustainability, impacting towns, cities, and countryside, communities and well-being, economics, governance, and politics. This paper explores the extent to which landscape and landscape design are considered in professional guidance pertaining to climate emergencies and environmental sustainability. Noting a tendency for such policy and guidance in the UK to cluster around the opposite poles of generalised targets and highly detailed technological solutions, this paper raises questions about what is missing from the middle of this spectrum. Our findings show that beyond carbon and biodiversity targets and the technological solutions to meet them, policy has been slow to respond to the climate emergency in relation to the landscape level. Furthermore, policy frameworks largely fail to account for the cultural and/or intangible factors affecting carbon and sustainability measures, such as the quality of space and well-being. This research suggests that guidance and policy relating to holistic, integrated understandings of landscapes are key to addressing the climate emergency, which also provides quality places and spaces for our communities and nature alike. Full article

Prior research has reported an association between human papillomavirus (HPV) seropositivity and dementia or Alzheimer’s disease. This study aimed to cross-sectionally investigate the association between HPV seropositivity and cognitive function in older adults. The data used for this study were from the 2011–2014 National Health and Nutrition Examination Survey (NHANES) cycles. To account for the complex survey design and missing data, we applied survey-weighted regression models to each imputed dataset, using multiple imputation techniques. Across all cognitive test outcomes, no statistically significant association was observed between HPV status and cognitive performance after controlling for covariates. These findings suggest that there may not be a significant association between HPV infection and cognitive scores in this NHANES sample. Stakeholders, including policymakers and healthcare providers, should consider these findings in their professional decision-making. Future research should investigate the association between HPV seropositivity and cognition using other samples in order to further characterize the association between HPV and cognitive function in older adults. Full article

In the European Union’s Corporate Sustainability Reporting Directive (CSRD) context, organizations must increasingly integrate non-financial indicators into their reporting structures. The role of accounting information in establishing a comprehensive model for measuring corporate social responsibility (CSR) is critical due to its inherent characteristics. This study proposes a structured model for measuring CSR performance using accounting information systems (AIS) as an analytical and operational support tool. The research investigates the extent to which financial analysts and auditors use AIS to evaluate specific CSR indicators related to employee satisfaction, environmental impact, and customer relations and how these contribute to a global CSR index. The study is based on a quantitative survey conducted among accounting professionals in Romania using a structured questionnaire, analyzed through correlation-based models. The findings reveal a statistically significant association between AIS usage and the capacity to quantify CSR performance, with clear distinctions based on professional roles and areas of expertise. This article contributes to the literature by demonstrating how AIS can operationalize sustainability reporting frameworks and support the transition toward evidence-based CSR assessments. The proposed model offers a practical tool for organizations to improve transparency, stakeholder engagement, and strategic alignment with sustainability objectives. Full article

While research on psychedelic-assisted therapy (PAT) continues to show promise, challenges in its clinical application persist. One relevant domain includes how supervision might enhance both client and trainee outcomes. Current data suggest that, despite supervisor reports and the enthusiasm of trainees, supervision accounts for extraordinarily little variance in treatment outcome. We propose that as supervisors model relevant skills, these skills can also improve in the therapist, which should lead to enhanced alliances and improved self-care for the client, trainee, and supervisor. Thus, we propose a model of supervision that rests on key Motivational Interviewing (MI) principles and supports the integration process—a pivotal phase of PAT where clients translate psychedelic-induced insights into meaningful behavioral change. This Motivational-Interviewing-Enhanced Integration Supervision (MIE-IS) model bridges the gap between psychedelic experiences and personal growth by ensuring supervisors can effectively encourage trainees to support their clients through this crucial integration process. Supervisors would model the use of MI with trainees in supervision, who would, in turn, apply those same MI technical and relational skills to support clients’ integration experiences. Beyond enhancing client outcomes, this supervisory model could also increase each trainee’s motivation to personally engage with wellness-promoting integration behaviors, potentially enhancing professional development and minimizing burnout. By reinforcing a culture of self-care and reflective practice, this model might inspire better self-care in supervisors as well. By fostering an MI-informed supervisory relationship, the model promotes a culture of continuous learning and skill development, benefiting clients through the effective and meaningful integration of their psychedelic experiences. Full article

Background: Pain is one of the major medical and public health challenges in the world, and its prevalence is unaffected by some ‘painful’ pandemics of the past, reflecting the deep-rooted causes of other origins. Surgical conditions accounting for one-third of the global burden of disease are associated with physical pain, either as a symptom or complication. For effective perioperative pain management of culturally diverse patients, it is imperative to understand how patients view and deal with pain. Therefore, this study explored study participants’ pain experience as well as their perception of the causes, consequences, and treatment options of surgical condition-related pain. Methods: With a subjectivist research paradigm, as well as relativist and interpretivist ontological and epistemological underpinnings, a qualitative description study design was used to interview 11 patients with abdominal surgical conditions and 12 family members taking care of those patients in three hospitals. Following inductive coding, thematic analysis was employed, which resulted in four themes. Findings: Patients and their families shared various experiences and perceptions of the meanings, causes, consequences, and treatment options of pain, summarized under four emergent themes: Perception of pain meaning, causes, and consequences; sustenance for pain relief; traditional pain relievers; and conventional pain medicine. Conclusions: This study highlighted that ethnoculturally diverse surgical patients and their families may have unique perceptions of pain and use various treatment approaches at home, which might have implications on perioperative pain management. Therefore, professionals at the participating hospitals and elsewhere with similar contexts should consider these cultural phenomena during surgical pain management. Full article

Hybrid renewable energy systems (HRESs) play a key role in the decarbonization of many sectors of the economy and, thus, in achieving ambitious climate goals. Due to the complexity of the issues and the impact of many factors on the efficiency of these systems, it is necessary to ensure that they are properly designed, managed, and optimized. Many techniques and methods are used to achieve an optimal multi-source energy system. In recent years, there has been a growing interest in HRESs. Taking this into account, a comprehensive review of scientific literature was carried out, based on bibliometric analysis. Professional software was used for the research: Bibliometrix and VOSviewer. The bibliographic database was created using the international scientific platform Web of Science. The evolution of research trends and the dynamic development of research on the management and optimization of HRESs in the years 2010–2024 were presented. The results of the analysis confirmed the growing importance of integrated energy management systems and optimization strategies in the context of the global energy transformation. The analysis also indicated that, despite the growing interest in this topic, further development of advanced energy management strategies and optimization methods is necessary to effectively use renewable energy sources and enhance the stability of HRESs. Full article

Background/Objectives: Clinical pharmacy plays a crucial role in optimizing medication use, particularly in pediatric settings where drug therapy can be complex and understudied. This study aims to assess the impact of clinical pharmacists in the Pediatric Neurology and Neurophysiology Unit of the Padova University Hospital, focusing on physician acceptance of pharmacist suggestions and the types of advice most frequently followed. Methods: A retrospective observational study was conducted over 13 weeks to describe the implementation phase of clinical pharmacists’ involvement in medication reconciliation in this setting. The study consisted of three steps. The study utilized a cluster model to categorize pharmacist suggestions and to evaluate physician acceptance rates. Results: The study included 57 hospitalized pediatric patients (53% male) with a median age of 3 years (IQR: 1–10.25). A total of 138 recommendations were shared, with an overall acceptance rate of 42%. Medication errors accounted for the largest cluster of suggestions (45%), though only 32% were accepted. Among the most frequently shared categories of suggestions, pharmaceutical form optimization (A) and drug supply (E) exhibited higher acceptance rates by clinicians (64% and 42%, respectively). The acceptance rate increased over time, peaking at 100% during weeks 7 and 11, correlating positively with enhanced collaboration between pharmacists and clinicians (R² = 0.59). Conclusions: This study highlights the importance of clinical pharmacists in pediatric care, particularly in improving medication management through targeted interventions. The findings suggest that integrating clinical pharmacists into multidisciplinary teams can enhance patient care quality by fostering collaboration and trust among healthcare professionals. Full article

Selecting the appropriate excavation support system (ESS) is critical for ensuring construction projects’ safety and cost-effectiveness. Several dynamic factors influence this decision-making process, such as the groundwater table, excavation depth, proximity to neighboring buildings, and soil characteristics. In practice, the selection often depends heavily on the subjective judgment of experienced professionals in the construction industry. Although the analytical hierarchy process (AHP) is frequently employed to evaluate alternatives using multiple criteria, it fails to adequately account for the subjectivity and uncertainty in converting the decision-maker’s intuition into exact numerical values. To overcome this challenge, this study proposes an enhanced method known as fuzzy AHP. This approach is designed to capture the subjective experiences of experts better and effectively incorporate the uncertainties present in the decision-making process, ultimately aiding in identifying the most suitable ESS. A case study of excavation projects is also included to demonstrate the practical application of the proposed model. By presenting this approach, the study aims to raise awareness within the construction industry about the critical factors to consider when selecting the best excavation support technique for specific projects. Full article

Workplace inequities disproportionately affect African American professionals, with 41% reporting discrimination in hiring, salary negotiations, and promotions due to their racial or ethnic identity. These challenges are further accentuated by gender disparities, as 48% of Black men and 36% of Black women acknowledge experiencing workplace discrimination. Comparatively, smaller proportions of Asian (25%), Hispanic (20%), and White (8%) employees report similar treatment, underscoring the systemic barriers that shape the professional trajectories of marginalized workers in the United States. Addressing these pervasive inequities necessitates a transformative framework rooted in allyship, particularly among White male leaders who occupy positions of significant power and influence. Allyship, a dynamic and relational process, requires intentional advocacy, empathy, and accountability to dismantle exclusionary practices and foster inclusion. This research employs human geography as a metaphor to explore the challenges faced by minority employees in navigating workplaces that often resemble hostile terrains characterized by bias, limited representation, and a lack of psychological safety. The climb to senior leadership for minorities parallels traversing rugged landscapes, requiring resilience and access to critical pathways such as mentorship, sponsorship, and equitable opportunities. As inclusive planners, White male allies can address these systemic barriers by leveraging their privilege to create equitable and supportive environments. Aligning allyship with principles of human geography highlights its potential to address workplace inequities and contributes to broader societal cohesion. This study underscores a pivotal lacuna in the discourse on organizational equity: the insufficient exploration of allyship as a transformative paradigm, particularly when championed by White male leaders who occupy positions of substantial authority and influence. Full article

The professional efficacy and health perceptions of physical education (PE) teachers, along with school characteristics, significantly impact their ability to navigate remote teaching challenges, maintain student engagement, and deliver inclusive, effective instruction. Remote teaching has become a widespread instructional method, particularly during the COVID-19 pandemic, but it also presents unique challenges for PE educators, requiring specialized pedagogical strategies and technological adaptation. This study aims to evaluate the professional efficacy, health perceptions, and pedagogical approaches of PE teachers in the context of remote teaching. Employing an explanatory sequential mixed-methods design, we conducted a cross-sectional web survey (N = 757) followed by in-depth interviews (N = 15). Participants were selected from a list provided by the Israeli Ministry of Education, with inclusion criteria requiring at least one year of PE teaching experience. Quantitative data analysis included chi-square tests, t-tests, Pearson correlation, and multiple regression analyses, while qualitative data were analyzed using conventional content analysis to identify emergent themes. Our analysis reveals that female with higher levels of education, research skills, and advanced knowledge in teaching technologies exhibit significantly greater teaching professional efficacy in remote settings. These findings suggest that educational institutions should develop tailored training programs that account for gender and educational differences, thereby equipping PE teachers with the necessary skills to excel in remote teaching environments. This proactive approach will better prepare PE educators to navigate future challenges in the ever-evolving landscape of education. Full article