Search Results (403)

This article posits that Islamic fairy tales function as a mystical bridge of speech, a discursive passage that, within the siyasatnama tradition, summons the subject toward ethico-political responsibility, while in Sufi narrative, it carries the seeker beyond the limits of language toward a transformative silence. Reading Indo-Persian and Ottoman siyasatnama texts alongside the Sufi classics of Attar and Rumi, the article traces this movement across both traditions. In the siyasatnama context, the fairy tale translates divine commandments into a set of virtues, such as justice, mercy, and compassion, that regulate the conduct of both ruler and subject, framing governance as an ethical response to a sacred truth. Conversely, in Sufi narrative, the fairy tale operates within a similar ethical–pedagogical grammar but directs the subject toward a fundamentally different ontological end: The dissolution of the self. Here, speech becomes a threshold to be crossed and narrative a cage to be surrendered, allowing the seeker to enter the silence in which divine love is realized. Ultimately, the article proposes that mystical transcendence does not signify a withdrawal from the ethical sphere; instead, it constitutes its most profound enactment, manifested either through the responsible exercise of power or its radical renunciation in love. Full article

The exponential growth of unstructured medical data, particularly clinical notes and diagnostic reports, presents mounting challenges for healthcare knowledge extraction and utilization. This study introduces the Digital Medical Catalog (DMC), a framework that automates the conversion of clinical narratives into an auditable, semantically structured knowledge base. The framework combines BioClinicalBERT embeddings, c-TF-IDF statistical grounding, and semantic clustering, enabling high-fidelity classification (Macro F1 = 0.877 ± 0.012), traceable topic labeling, and temporal trend analysis. By demonstrating that semantic representation methods, reinforced with statistical grounding, are essential for large-scale medical text processing, this work establishes a foundation for privacy-preserving data governance and real-time intelligence within modern healthcare infrastructures. Full article

Background: Artificial Intelligence (AI) and Generative AI (GenAI) are increasingly integrated into educational and professional settings, offering personalized learning, productivity gains, and enhanced engagement. However, excessive reliance may compromise critical thinking, autonomous problem-solving, and emotional regulation among youth (i.e., adolescents and young adults) and early-career professionals. Aim: This review examines the cognitive, educational, and behavioral impacts of AI and GenAI use in youth, highlighting implications for their responsible integration in learning and professional development. Methods: A narrative review was conducted, synthesizing empirical studies, psychometric instruments, and international policy frameworks addressing AI engagement. Emphasis was placed on cognitive, behavioral, educational, and ethical dimensions across youth and early-career professionals. Results: AI enhances learning efficiency, creativity, and professional decision-making but may also foster cognitive offloading, dependency, and addiction-like behaviors. Instruments such as the Conversational AI Dependence Scale (CAIDS) and the Problematic ChatGPT Use Scale (PCGUS) help identify maladaptive patterns. Effective strategies include structured pedagogy, human oversight, reflective practice, AI literacy, and ethical guidance. Paradoxically, higher AI competence and trust may increase reliance, underscoring the need for guided and balanced engagement. Conclusions: Responsible AI integration requires multidimensional approaches combining instructional scaffolding, metacognitive strategies, supervision, and governance to preserve autonomy, professional judgment, and cognitive development in youth. Full article

Background: Advance care planning is a strategy to define goals and preferences for future care and treatment aligned to patient values. The IMplementing Pediatric Advance Care Planning Toolkit (IMPACT) provides a holistic, family-oriented approach to involve families of children with life-limiting conditions and their clinicians in ACP, starting early in disease trajectories. This study explores how children with life-limiting conditions, and their parents and clinicians experience ACP conversations based on IMPACT. Methods: A multicenter, qualitative interview study using inductive thematic analysis was conducted. A total of 27 cases of children with life-limiting conditions were included in the study from February 2019 to December 2019. Interviews with 18 clinicians, 24 mothers, 8 fathers and 3 children were conducted. Results: Clinicians and families of children with life-limiting conditions valued to be involved in ACP conversations based on IMPACT. Although it confronted both parents and clinicians with the impact of caring for a child with a life-limiting condition, sharing the family’s narrative resulted in a stronger relation between families and clinicians. This relation was experienced as a good foundation to share values and preferences for future care and treatment. However, a shared understanding of goals of future care, and treatment based on the conversation was experienced to a limited extent. Conclusions: ACP conversations based on IMPACT facilitated family-centered conversations, and were valued by families of children with life-limiting conditions and their clinicians. The meaning of the family’s narrative in relation to goals and preferences for future care and treatment needs ongoing conversations and coaching on the job of clinicians initiating those conversations. Full article

Agricultural waste management is a strategic priority for reducing greenhouse gas emissions and transitioning to a circular bioeconomy. The thermochemical conversion of residual biomass into biochar offers a dual solution: waste recovery and the production of high-value functional materials. This narrative review summarizes the relationships among the composition of agricultural biomass, the conversion process parameters, and the structural properties of biochar, highlighting advanced modification strategies: controlled pyrolysis, physical and chemical activation, surface functionalization, and hybrid composite formation. Fundamental adsorption mechanisms, redox processes, and photocatalytic behavior are discussed, with a focus on applications in water treatment (heavy metals, dyes, emerging contaminants). The article proposes an integrative structure–property–performance framework and explores emerging concepts such as sequential use and post-use valorization of saturated biochar. Challenges related to reproducibility, industrial scaling, life cycle assessment, and carbon accounting are analyzed. Finally, a SWOT analysis is presented that highlights the potential of modified biochar as a strategic material in the circular economy. Full article

The perception that hormonal contraception causes weight gain is a general belief that frequently hinders the initiation and continuation of effective family planning. This narrative review analyses data from Cochrane systematic reviews and recent pharmacogenomic studies to separate patient perception from metabolic reality. Analysis of high-quality data, including Cochrane systematic reviews, indicates that the association between Combined Hormonal Contraceptives (CHCs)—including oral pills, the transdermal patch, and the vaginal ring—and weight gain is not supported by consistent high-quality evidence. Placebo-controlled trials demonstrate that these methods are weight-neutral on average. Perceived weight increases in CHC users are likely mediated in part by fluid retention linked to the estrogenic stimulation of the Renin–Angiotensin–Aldosterone System (RAAS), rather than adipose tissue accumulation. Conversely, Depot Medroxyprogesterone Acetate (DMPA) represents a verified clinical risk for weight gain, showing a demonstrated clinical association with significant fat mass accumulation. Hypothesized biological mechanisms for this increase include hypothalamic appetite stimulation and glucocorticoid-like activity. The etonogestrel implant occupies a complex middle ground. While population-level data suggests weight neutrality, recent exploratory pharmacogenomic research has identified a specific variant in the Estrogen Receptor 1 (ESR1) gene. For the minority of women carrying this variant, the implant may trigger clinically significant weight gain, suggesting a biological basis for their subjective experience despite statistical evidence. Ultimately, the persistence of the weight gain concern is fueled by the nocebo effect and the misattribution of natural age-related weight trajectories to contraceptive use. Full article

Background: Dental care for non-cooperative patients is a major clinical and organizational challenge, particularly in individuals with intellectual or neurodevelopmental disabilities and in patients with severe dental anxiety or phobia. When behavioral techniques are insufficient, conscious or deep sedation or general anesthesia may be required, but practical guidance on selection and care pathways remains fragmented. Methods: We combined a retrospective observational analysis from a single Italian academic center with a narrative review of the international literature. Forty-one sedation-assisted dental sessions were included. Demographics, indication for non-cooperation, sedation regimens, procedures, completion rates, and adverse events were descriptively analyzed. Results: The cohort included pediatric and adult patients; non-cooperation was mainly related to disability/neurodevelopmental conditions or severe dental phobia. Benzodiazepine-based oral or intravenous sedation, sometimes combined with low-dose propofol, enabled completion of all planned procedures without major adverse events or conversion to general anesthesia. The literature supports general anesthesia for profound non-cooperation or extensive treatment needs, but availability and waiting lists limit access; sedation is effective for selected cases with appropriate organizational support. Conclusions: An individualized stepped-care model integrating behavioral management, sedation, general anesthesia, and structured preventive recall may optimize access and outcomes within the Italian context and strengthen long-term post-treatment attendance. Full article

The objective of this paper is to propose a sociological and interdisciplinary framework for analyzing the digitization of emotions in adolescence. This contribution aims to promote theoretical reflection and inform educational and political interventions in the digital age, framing adolescents’ digital experiences as emotionally embodied and socially integrated processes. These aspects are of paramount importance due to the rapid proliferation of digital technologies and artificial intelligence, which have precipitated a profound transformation in the emotional, relational, and educational experiences of adolescents. The role of digital and AI-based environments in mediating communication is expanding beyond the scope of simple facilitation. These environments are increasingly implicated in the production, modulation, and regulation of emotions, thereby influencing developmental trajectories and identity formation processes. This phenomenon is theorized as a socio-technical process, wherein emotions are embodied, narrated, and governed within digital environments. The article introduces the concept of digital emotional embodiment, drawing on the sociology of emotions, theories of embodiment, and critical perspectives on artificial intelligence. Specifically, the concept refers to the manner in which adolescents experience and express emotions through avatars, images, emojis, algorithmic feedback, and AI-mediated interactions. Therefore, it is imperative to underscore the evolution of empathy, which is progressively configured as a virtualized and datafied process, diverging from the tradition established by Hume and characterized by sympathy. In contemporary processes, shaped by the logic of platforms, recommendation systems, and emotionally reactive technologies, conventional emotional concepts have undergone deconstruction, and digital constructs are undergoing a gradual restructuring. In this context, AI systems do not merely reflect adolescents’ emotions but rather actively contribute to the construction of emotional narratives, influencing emotional regulation, social connection, and future orientation. Digital environments have been shown to encourage emotional expressiveness, experimentation, and inclusivity. Conversely, they have the capacity to encourage emotional standardization, dependency, and forms of affective vulnerability, particularly during a sensitive developmental stage such as adolescence. Full article

Heart failure (HF) is a systemic syndrome in which cardiac dysfunction is closely linked to multiorgan involvement, including the gastrointestinal tract. Increasing evidence highlights the relevance of the gut–heart axis in HF pathophysiology, whereby intestinal hypoperfusion, congestion, and barrier dysfunction promote gut microbiota dysbiosis, systemic inflammation, and adverse cardiovascular outcomes. In parallel, the advent of novel HF therapies, particularly sodium–glucose cotransporter 2 inhibitors (SGLT2i) and the angiotensin receptor–neprilysin inhibitor sacubitril/valsartan, has markedly improved clinical outcomes across HF phenotypes. Beyond their established cardiovascular benefits, these therapies may exert pleiotropic effects that extend to the intestinal environment and the gut microbiota. Through integrated actions on hemodynamics, neurohormonal activation, metabolic pathways, and inflammatory processes, recent data suggest that novel HF drugs may indirectly influence the gut-microbial composition and function. Conversely, the gut microbiota may modulate drug efficacy and result in interindividual variability in therapeutic responses, suggesting a bidirectional interaction between pharmacological treatment and the gut ecosystem. This narrative review summarizes current evidence of gut microbiota alterations in HF and critically examines emerging data on interactions between the gut microbiota and novel HF therapies, focusing on SGLT2 inhibitors and sacubitril/valsartan. Understanding this crosstalk may support the development of microbiota-informed, personalized therapeutic strategies in heart failure. Full article

Background: Segmentectomy is increasingly used and is emerging as a key treatment option for early-stage non-small cell lung cancer (NSCLC). However, questions remain regarding the adequacy of lymph node evaluation, particularly differences in N1 versus N2 dissection, and the implications for staging accuracy and adjuvant therapy. Methods: This narrative review synthesizes evidence from studies published between 2019 and 2025 comparing nodal upstaging, survival outcomes, and the role of completion lobectomy following segmentectomy versus lobectomy. Results: Twelve studies, including more than 175,000 patients, were analyzed. Lobectomy was associated with a significantly higher overall nodal upstaging rate (14.5% vs. 6.6%, p < 0.001), driven primarily by increased detection of N1 disease (13.3% vs. 3.7%, p < 0.001), while N2 upstaging rates were similar between procedures (5.5% vs. 3.2%, p = 0.07). Despite lower N1 detection, adjusted analyses reported comparable survival outcomes among patients with occult pathologic N1 (pN1) or N2 (pN2) disease who received adjuvant therapy. Segmentectomy provided outcomes comparable to lobectomy, whereas wedge resection was associated with inferior survival (HR 1.23, p = 0.042). Completion lobectomy has not demonstrated a consistent survival benefit and was associated with substantial morbidity in limited retrospective series, including high rates of thoracotomy conversion and major complications. Conclusions: When performed with systematic nodal dissection, adequate surgical margins, and appropriate adjuvant therapy, segmentectomy appears to provide survival outcomes comparable to lobectomy in selected patients with early-stage NSCLC. Completion lobectomy may not be routinely required and should be considered on a case-by-case basis within a multidisciplinary context. These findings support the use of segmentectomy in carefully selected patients when high-quality surgical staging and integrated oncologic care are ensured, while highlighting the need for prospective studies addressing occult nodal disease in the modern treatment era. Full article

The place and people of Waiʻanae, Hawaiʻi, are rich in connection with ʻāina (natural environment) and culture. Counter to this strengths-based approach, metrics and narratives imposed by outside systems assess many communities like ours as “sick”, “poor”, or “unwell”. This paper details our community’s approach to defining “well-being” around the values specific to our place, overseen by a council of community leaders with decades of experience supporting youth. The development was a mixed methods process including formal focus groups, informal community conversations, review of existing models, and collaboration with a professional artist. Centering community was the priority through each phase, engaging youth, parents, cultural practitioners, healthcare providers, and educators. Our community built the Kaiona Framework around the moʻolelo (traditional story) of Kaiona who helps the lost find home through empathy and compassion. Well-being is grounded in connection to, in relationship with, and in service to ʻāina. The child is at the center of our work, but inseparable from the family, community, and wider nation of people. Wellness comprises four values vital to our community: mauli ola, a balanced state of physical, mental, emotional, spiritual, and environmental health; waiwai, abundance and prosperity; pilina, mutually sustaining relationships; and ea, self-determination and agency. Full article

The intellectual exchanges between late-Ming Jesuits and Chinese literati have long been interpreted primarily as a process of cultural accommodation aimed at “harmonizing with Confucianism” (合儒), and scholarship has tended to focus on missionary strategies, social networks, or individual conversion histories. By contrast, the question of how resources within Confucian thought made ethical dialogue with Catholicism possible—especially why the practical-learning strand (實學派) of Wang Yangming’s School (陽明學) exhibited such pronounced receptivity to Catholic ideas among late-Ming literati—remains insufficiently theorized at the level of conceptual structure. This study, therefore, shifts the analytical focus from “historical narratives of converts” to an explanation of the mechanisms that enabled Sino-Jesuit dialogue. It argues that Augustine and Wang Yangming display a notable convergence in their conceptions of good and evil (善惡論), and that this convergence created an intellectual space for engagement between Jesuits and later Yangming scholars. The Jesuits’ deliberate promotion of doctrines concerning the punishment of evil (懲惡) further facilitated the practical-learning Yangmingists’ reception of Catholic resources regarding ultimate judgment and retributive justice, especially as they confronted the problem of inadequate means to restrain or punish wrongdoing. This article situates late-Ming Sino-Western intellectual exchange within an analytical framework of “theories of good and evil—mechanisms for punishing evil—pathways for supplementing Confucianism (補儒),” thereby offering a mechanism-based explanation, grounded in theories of good and evil, for the historical interaction between Chinese Confucian thought and the ethical systems of incoming religions. Full article

Cholestasis in children is characterized by impaired bile flow that disrupts hepatic metabolism, nutrient homeostasis, and effects trace element balance. This narrative review summarizes current evidence on the metabolism, biological functions, and clinical implications of key trace elements—zinc, selenium, copper, and manganese—in pediatric cholestatic liver disease. The liver regulates trace element absorption, intracellular trafficking, storage, and biliary excretion; cholestasis alters these processes, leading to deficiencies or toxic accumulation. Zinc and selenium deficiencies are common and contribute to impaired growth, immune dysfunction, oxidative stress, and delayed hepatic regeneration. Conversely, reduced biliary excretion promotes copper and manganese accumulation, potentially exacerbating liver injury and causing manganese-related neurotoxicity. Recent advances in understanding metal-specific hepatic transporters and trafficking pathways have provided mechanistic insight into these alterations. Management strategies emphasize individualized supplementation, monitoring during enteral and parenteral nutrition, and prevention of deficiency and toxicity. Precision-based nutritional approaches may improve outcomes in pediatric cholestatic liver disease. Full article

Objectives: To synthesize evidence on artificial intelligence (AI)-enabled medical history taking (anamnesis)—beyond large language models (LLMs) alone—and to translate findings into implications and research priorities for head and neck surgery. Methods: We performed a PRISMA-informed narrative review. Searches from database inception to 31 December 2025 (updated 3 January 2026) were conducted in MEDLINE (PubMed), Embase, Scopus, Web of Science Core Collection, IEEE Xplore, and ACM Digital Library, supplemented by medRxiv/arXiv screening and citation chasing. We included studies evaluating or describing AI-supported history capture/summarization, conversational interviewing, symptom checker/digital triage, EHR-integrated intake-to-decision support pipelines, voice interviewing, education/training systems, and governance/ethical considerations related to digital anamnesis. Findings were synthesized by system category and by cross-cutting outcome domains, with a head and neck surgery interpretive lens. Results: Fifty studies (2014–2025) were included. Evidence most consistently suggested feasibility and acceptability of pre-consultation computer-assisted history taking and the potential to reduce documentation burden and improve structured capture. In contrast, symptom checkers and digital triage tools showed highly variable diagnostic/triage performance and prominent safety concerns, highlighting the importance of conservative red-flag escalation strategies, continuous monitoring, and clear accountability. LLM-based diagnostic dialogue demonstrated strong performance in controlled evaluations, but prospective real-world validation, governance, and workflow integration remain limited. Conclusions: AI-enabled anamnesis comprises heterogeneous tools with uneven evidence. For head and neck surgery, potential near-term applications may include structured pre-visit intake, clinician-facing summarization, and training applications, whereas autonomous triage warrants harm-oriented, specialty-calibrated validation and robust governance prior to broader clinical reliance. Full article

This article investigates narrative and storytelling as critical methods for understanding how relationships with land in Aotearoa New Zealand are shaped by colonial histories and ongoing systemic displacement of Māori (Indigenous peoples of Aotearoa). Colonialism is not a past event; it continues to structure daily life, disrupting our embodied connections to whenua (land) and reshaping what we call home. Drawing on the research project Tō mātou kāinga, tō mātou ūkaipō, Whānau conceptions of home we explore the concept of body–land, emerging from Indigenous women’s struggles and grounded knowledges, to examine how the land is not only a living genealogical ancestor but also a maker of our bodies and identities. Through narrative, we trace the ways land has been taken and commodified under colonial logics that frame it as property to be owned and extracted from, which contrasts with Indigenous ontologies that understand land as kin and relationality as central to existence. By centering Māori women’s embodied experiences, this article articulates home as a relationship rather than a fixed place and considers how these understandings open pathways toward relational, sustainable futures. This work contributes to broader conversations on decolonial praxis, Indigenous feminist theory, and the embodied politics of land and belonging. Full article