Search Results (909)

Peru’s tax dispute system—administrative claim, Tax Court appeal, and contentious-administrative review—has increasingly migrated toward electronic files, e-invoicing, interoperable databases, and data-driven oversight. This article examines whether artificial intelligence can reduce avoidable tax litigation without weakening taxpayers’ rights and identifies the institutional conditions required to reconcile administrative efficiency with due process, reason-giving, and effective contestation. Using a legal-doctrinal and policy-analytical design, the study analyzes Peru’s tax dispute architecture, digital evidence environment, and AI-related risks in compliance and administrative litigation. The findings show that only bounded decision-support applications are institutionally appropriate, including audit triage, anomaly detection, document classification, workflow prioritization, compliance assistance, and consistency checks, provided that they do not replace legally attributable human judgment. AI is compatible with digital tax justice only when six safeguards are institutionalized: legally meaningful explainability, evidentiary and computational traceability, meaningful human oversight with override authority, lifecycle auditability, effective contestation, and distributional equality. The analysis further demonstrates that facially neutral digital requirements and risk models may generate unequal effects when disparities in connectivity, digital literacy, record-keeping capacity, and access to professional assistance translate into differences in audit exposure, compliance costs, evidentiary burdens, and practical contestability. The article proposes a rights-compatible framework for AI-supported tax enforcement in Peru. Full article

Background: A subgroup of adolescent and young adult patients (AYAs; 18 to 39 years at diagnosis) face an uncertain or poor cancer prognosis (UPCP). Previous qualitative research identified dual coping pathways in this population: engagement in life versus the reality of premature death. This study examines whether similar psychosocial profiles can be identified through quantitative data, aiming to differentiate patient experiences and identify characteristic features of each cluster. Additionally, this study examines the association between cluster membership and social support needs to understand psychosocial disparities. Methods: Eligible participants completed questionnaires assessing physical, psychosocial, and existential outcomes related to their disease and prognosis. An ensemble clustering approach was applied, including evaluation of clustering tendency and multiple algorithms, with stable clusters identified through majority voting. Associations with social support needs were analyzed using Fisher’s exact test. Results: Data from 155 AYAs with a UPCP were included. The mean age at diagnosis was 31.2 years, with glioma (34.8%) and breast cancer (17.4%) as the most common diagnoses. Two distinct clusters were identified: one (22%) characterized by poorer functional outcomes and fewer protective factors (e.g., hope, meaning in life), and another cluster (78%) with better functioning and less frequent needs for social support (p < 0.00043). Conclusions: Findings revealed divergent psychosocial profiles within the AYA-UPCP population, highlighting the importance of early identification of vulnerable subgroups. Strengthening protective factors may enhance resilience and reduce unmet support needs. Validation in larger, external datasets is needed to confirm these pathways and guide tailored supportive care strategies. Full article

Human papillomavirus (HPV) infection remains the principal etiological factor in cervical cancer development worldwide, with Eastern Europe continuing to demonstrate disproportionately high cervical cancer incidence and mortality rates. Regional disparities in screening implementation, vaccination coverage, and HPV genotype distribution contribute substantially to the persistent burden of HPV-related disease. In recent years, increasing attention has focused on molecular biomarkers and the vaginal microbiome as complementary approaches for improving cervical cancer prevention strategies. This systematic review aimed to evaluate recent evidence regarding HPV genotype distribution, molecular biomarkers, vaginal microbiome composition, and their implications for cervical cancer prevention in Eastern Europe. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Embase, and the Cochrane Library for studies published between January 2020 and May 2026. This systematic review was conducted in accordance with the PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420261391136). Studies from Eastern European populations reporting data on HPV genotype distribution, screening strategies, vaccination, molecular biomarkers, or vaginal microbiome composition were included. HPV prevalence in screening populations ranged from approximately 12% to over 20%, with HPV16 consistently identified as the predominant genotype across all included studies. However, non-16/18 high-risk genotypes, particularly HPV31, HPV51, HPV52, HPV66, and HPV68, represented a substantial proportion of infections in several Eastern European cohorts. Studies evaluating CINtec PLUS cytology and HPV E6/E7 mRNA testing demonstrated improved specificity for identifying clinically significant cervical lesions compared with HPV DNA testing alone. Emerging evidence also suggested associations between vaginal dysbiosis, increased microbial diversity, persistent high-risk HPV infection, and progression to cervical intraepithelial neoplasia. Although the 9-valent HPV vaccine provides coverage for most circulating high-risk genotypes identified in the region, vaccination uptake remains inconsistent throughout Eastern Europe. The findings of this systematic review support the growing importance of extended HPV genotyping, molecular biomarkers, and microbiome-related approaches in cervical cancer prevention strategies in Eastern Europe. Strengthening organized screening programs, expanding vaccination coverage, and improving access to molecular diagnostic technologies remain essential priorities for reducing the regional burden of HPV-related disease. Full article

Building inclusive, high-density cities requires understanding vulnerable groups’ public space usage. While green exposure significantly impacts urban health, existing research frequently overlooks females’ specific needs regarding streetscape visual quality, green space structures, and daily travel experiences. To address this, the study investigates spatial disparities in Suzhou’s historic district. Utilizing multi-source data and mixed modeling strategies, including Partial Least Squares and Ordinary Least Squares (PLS-OLS) and eXtreme Gradient Boosting (XGBoost), the research analyzes how streetscape perceptions and green space characteristics affect female life satisfaction and expressed sentiment. Results indicate three main findings. (1) Streetscape visual features fundamentally drive subjective evaluations. Safe significantly enhances well-being, whereas boring and lively negatively impact life satisfaction, reflecting females’ acute sensitivity to environmental oppressiveness during daily travel. (2) Park diversity elevates expressed sentiment, while patch density positively influences life satisfaction, demonstrating the vital value of fragmented greenery for daily public space usage. (3) Boring precipitously diminishes life satisfaction after surpassing a specific threshold, while park diversity elevates expressed sentiment only after crossing a critical interval. The study establishes an integrated analytical framework linking visual perception, green space structure, emotional response, and satisfaction. These findings provide targeted strategies for enhancing inclusive urban design and optimizing green space allocation to improve streetscape safety and alleviate visual oppressiveness, thereby advancing gender social justice for vulnerable groups in historic districts. Full article

Background/Objectives: Prostate biopsy is essential for diagnosing prostate cancer. Social determinants of health (SDOH), including socioeconomic status, race, occupation, education, and environment, affect access, outcomes, and quality of life. Recognizing disparities from technology access to complications is crucial for equitable care. A systematic review examined how SDOH impacts biopsy access, technology, and complications. Methods: A systematic search of PubMed, Web of Science, and Scopus was performed to identify eligible studies published through February 2026. We included studies that evaluated the association between one or more SDOHs and prostate biopsy. Relevant outcomes included biopsy utilization, use of specific biopsy technologies (e.g., magnetic resonance imaging (MRI)-guided, transperineal), and post-procedural complications. Results: Nine observational studies met the inclusion criteria. The findings revealed disparities across three key domains. First, access to advanced biopsy technology was uneven. Four studies showed that Black men were significantly less likely than White men to receive MRI-guided biopsies. Additionally, post-biopsy outcomes showed that Black and Hispanic men faced significantly higher rates of post-biopsy infection and hospitalization compared to White men. Lastly, patients in rural areas, those in public hospitals, and individuals with lower socioeconomic status demonstrated reduced access to modern techniques, including MRI-guided or transperineal biopsy. Conclusions: Social and economic factors influence who receives a prostate biopsy and who has access to advanced technologies. Minority and low-income patients face diagnosis barriers and higher complication rates, highlighting systemic inequities. The healthcare system often rewards access over need, and without bold policy changes, gaps in technology and resources will worsen, moving us further from truly equitable prostate cancer care. Full article

The subtropical and tropical islands of East Asia host a unique and highly endemic aquatic insect fauna threatened by a variety of anthropogenic stressors (e.g., invasive species, habitat fragmentation, pollution, and climate change). This review synthesizes the impacts of these stressors on aquatic insect diversity across this region based on 206 articles published over the past 40 years (1985–2025) to evaluate the impacts of these stressors on insular aquatic insect diversity. The islands of East Asia include all or parts of China, Japan, Taiwan, and South Korea. The annual number of publications demonstrates a steady upward trend over time and has been accelerating in the last decade. Our systematic analysis reveals a large geographic disparity. Research is heavily concentrated on major islands, with Honshu Island (42%) and Taiwan Island (24%) accounting for two-thirds of the total literature, while small islands (<10,000 km²) comprise only 20%. Furthermore, current research tends to focus on independent impacts of single stressors, largely overlooking the complex additive, synergistic, or antagonistic interactions that characterize stressors on these fragile ecosystems. These research gaps, compounded by a lack of long-term monitoring data (i.e., only ~22% of the studies span more than 3 years), hinder efforts to distinguish natural inter-annual variability from anthropogenic shifts. The extinction of cryptic or endemic species may occur before these species are identified and described. In addition, the disentanglement of these interactive impacts on aquatic insect communities in East Asian islands is critical for predicting ecosystem responses to further local and global changes. Identification of non-linear ecological tipping points through these long-term monitoring networks, coupled with proactive, science-guided habitat restoration, is essential to mitigate imminent extinctions and to rebuild the functional integrity of these imperiled freshwater ecosystems. Full article

Amid China’s “dual carbon” goals and technological transformation, the traditional energy–economy–environment (3E) framework fails to capture evolving urban sustainability patterns, as digitalization and innovation emerge as endogenous drivers. This study constructs an expanded five-system framework (3E-D-T: energy, economy, environment, digitalization, technology) and examines its coupling coordination. Using panel data from 13 Jiangsu cities (2015–2024), we employ entropy weighting, coupling coordination models, Dagum Gini decomposition, spatial autocorrelation, and panel Tobit regression. Results show that incorporating digitalization and technology alters coordination assessments, revealing structural disparities overlooked by the traditional framework. Significant intra-provincial heterogeneity exists across Jiangsu’s regions, with distinct spatial gradients. External factors—economic development, industrial structure, fiscal support, and environmental regulation—exert differentiated regional impacts. Contributions include: (1) expanding 3E to 3E-D-T by endogenizing digitalization and technology; (2) establishing an integrated measurement-evolution-mechanism analytical system; (3) providing empirical evidence on internal heterogeneity and differentiated governance pathways in eastern China. Full article

While rapid digital transformation has significantly optimized sectors such as finance and e-commerce, maintenance management in industrial environments has historically received lower levels of technological and capital investment. This lag creates critical gaps in operational efficiency and asset longevity, particularly within renewable energy infrastructures where sustainability and resilience are paramount. Addressing this technological disparity is essential for minimizing ecological footprints and maximizing the viability of net-zero systems. This paper introduces an advanced multi-platform digital solution designed to optimize the operation and maintenance of renewable energy systems and smart infrastructures. The platform addresses traditional management gaps by implementing standardized protocols that integrate real-time remote monitoring, sensor networks, and cloud-based data acquisition. By centralizing historical and real-time data from solar, wind, and hybrid grids, it facilitates advanced analytics, such as predictive modeling of component degradation. Real-world validation across photovoltaic plants and wind farms demonstrates significant impacts: a 30% reduction in unplanned outages and a 20% to 25% decrease in operational and maintenance costs. The results confirm that digitalizing maintenance processes is a strategic pillar for the energy transition, aligning industrial performance with global low-carbon pathways. Full article

Little is known about the vertical distribution of microplastics (MPs) in deep stratified lakes. This study investigates the MPs in the large and deep Lake Trichonis during the thermal stratification period, using two nets of different porosity (50 μm and 200 μm) in three depth strata. Fibers dominated over fragments with an average abundance of 10.63 ± 1.00 items m⁻³ and 3.10 ± 0.52 items m⁻³ respectively in the samples of the 50 μm net in the entire water column, while the respective values for the 200 μm net were 1.4 and 7.4 times greater. Fibers had the highest abundance within the thermocline, and most of them were blue with a length 1–2 mm. There were only abundance differences between the two nets and no qualitative disparities concerning color, size, shape and polymer types. There was a strong positive correlation between the abundance of fibers and the adults of the dominant copepod Eudiaptomus drieschi, which also accumulated within the thermocline. Considering that the adults of E. drieschi are among the preferred prey of Atherina boyeri, the most important commercial fish, certain issues arise concerning possible fiber bioaccumulation on the food web. The study highlights the importance of investigating MPs in connection with biotic elements. Full article

Commercial determinants of health (CDoHs) describe how corporate practices influence population health. This scoping review aimed to characterize the extant evidence base regarding how CDoH in the sugar-sweetened beverage (SSB) industry affects health and health-related outcomes among Latinx populations in the United States of America (USA). The present study was conducted in accordance with the JBI methodology for scoping reviews. Overall, 1236 references were identified and imported for screening. After duplicate removal, screening, and full-text eligibility assessment, 33 studies met all inclusion criteria. SSB marketing and advertising was the most frequently examined CDoH (61%), including advertising exposure, messaging strategies, and warning label interventions. SSB taxation studies projected reductions in consumption and obesity prevalence. Outcomes associated with health focused primarily on perceptions of marketing and purchasing intentions (94%). Additional studies examined the impact on knowledge, attitudes, beliefs, and behaviors (e.g., purchasing and consumption of SSBs) (66%), while a few studies included chronic disease (27%) or healthcare outcomes (6%). Evidence highlights several gaps in CDoH research associated with SSBs, with 94% of the included studies focused on understanding marketing exposure, signaling a need to examine other domains of CDoH, SSB industry practices, and impacts on health disparities. Findings suggest that structural policy interventions such as taxation and stronger regulation of commercial practices are necessary to address higher exposure to marketing and consumption of SSBs among Latinx populations in the USA. Full article

Accurate prediction of loan defaults is essential for financial institutions seeking to minimize credit losses and maintain portfolio stability. In the vehicle financing segment of emerging markets, real-world datasets frequently exhibit extreme class imbalance ratios that far exceed those encountered in standard benchmark corpora, posing severe challenges for conventional machine learning pipelines. This study introduces a gradient boosting framework integrating Weight of Evidence (WoE) transformation, Bayesian hyperparameter optimization, and three complementary classifiers—Extreme Gradient Boosting (XGBoost), Light Gradient Boosting Machine (LightGBM), and Categorical Boosting (CatBoost)—to predict vehicle loan default risk. The methodology is evaluated on a large-scale, fully anonymized Turkish vehicle loan dataset ($N=207,572$) with an extreme imbalance ratio of 1:1133 (183 defaults versus 207,389 non-defaults). A strict three-way data partition (60% training, 20% validation, 20% test) is adopted to ensure leakage-free model selection and unbiased performance estimation. A multi-stage experimental pipeline is developed encompassing: (i) statistical feature selection via Mann–Whitney U and chi-square tests with adaptive thresholding, (ii) a comparative analysis of seven resampling strategies including Synthetic Minority Oversampling Technique (SMOTE) variants, Adaptive Synthetic Sampling (ADASYN), and focal loss weighting, (iii) a greedy forward selection ensemble procedure for heterogeneous model fusion, and (iv) a systematic training-set size sensitivity analysis across eight majority undersampling ratios. Under the leakage-free evaluation protocol, the highest-AUC individual model (LightGBM with SMOTE-ENN) achieves an Area Under the Curve (AUC) Receiver Operating Characteristic (ROC) of 0.710 (95% bootstrap CI: 0.614–0.798), while CatBoost with cost-sensitive weighting exhibits superior operational metrics (KS $=0.389$, PR-AUC $=0.011$). The greedy ensemble procedure exhibits high selection instability with only 37 validation-set positives, providing a methodological finding on the minimum sample requirements for reliable ensemble construction under extreme scarcity. Ablation results confirm that WoE encoding contributes 3.1 percentage points to the overall AUC gain. Tree SHAP-based interpretability analysis identifies the financing-to-age ratio, WoE-encoded occupation group, and log financing amount as the primary predictive drivers, with cross-model stability confirmed via Spearman rank correlation. A decision support analysis provides precision–recall curves, a Brier score of 0.0082, reliability diagrams, and threshold-dependent performance at operationally plausible review rates. Fairness evaluation across gender and marital status subgroups demonstrates that threshold-dependent metrics such as Disparate Impact Ratio and Equalized Odds Gap are inherently compromised under extreme minority scarcity, whereas rank-based subgroup AUC analysis with bootstrap 95% confidence intervals preserves meaningful discriminative assessment. These findings provide an empirically validated framework for credit default prediction in highly imbalanced and data-scarce financial environments. Full article

This paper examines how internal organizational hierarchies within large corporations shape socio-economic outcomes in territorial economic systems, using evidence from Chilean listed firms. Moving beyond board-centric approaches, firms are conceptualized as territorially embedded actors whose internal governance structures influence both firm performance and the distribution of socio-economic outcomes. Using fixed-effects panel data models for 31 IPSA-listed firms over the period 2018–2025 (248 firm-year observations), we estimate three stepwise model specifications with Tobin’s Q, ROE, and P/E ratio as dependent variables. The results show that diversity effects are strongly hierarchical. Executive-level gender diversity is positively associated with firm value, while board-level diversity shows no systematic effect. In contrast, diversity at intermediate levels is negatively associated with market valuation, consistent with limited decision-making authority and organizational frictions. Gender pay gaps are negatively related to firm performance, particularly in territorially embedded firms, suggesting that internal inequality contributes to broader socio-economic disparities within territorial systems. Overall, the findings highlight that diversity matters primarily when located in positions of effective decision-making power, and that corporate governance operates as a hierarchical mechanism through which socio-economic outcomes are shaped within territorial economic systems. Full article

Background/Objectives: Mental health and suicide prevention are increasingly recognized as critical components of sustainable development in the European Union (EU), particularly in light of the broader mental health challenges highlighted during the COVID-19 pandemic. This review aimed to explore suicide prevention policies and mental health strategies across selected European countries through a focused comparative analysis centered on the Republic of Cyprus. Methods: A narrative review design was applied. A purposive literature search focused on national strategies, epidemiological trends, policy papers, and peer-reviewed articles published from 2000 to January 2026 was followed. Databases searched included PubMed, Scopus, PsychInfo, Embase and Google Scholar, supplemented by grey literature from the World Health Organization (WHO), European Commission, and national health authorities. The review focused on selected European countries, i.e., the United Kingdom, Sweden, Finland, Greece, and the Republic of Cyprus, chosen to illustrate variation in suicide prevention policies, health system structures, and implementation frameworks. Evidence was critically appraised and synthesized thematically to identify commonalities and contrasts in policy, implementation and emerging challenges. Results: The review identified substantial variation in national suicide prevention strategies, monitoring systems, and policy implementation across the selected countries. Persistent gender- and age-related disparities in suicide patterns were observed, alongside the influence of socio-economic determinants, and the broader mental health effects associated with the COVID-19 pandemic. The findings also underscored the need for robust, gender-sensitive, and data-driven national strategies that are contextually grounded and equitably resourced. Conclusions: This review concludes with recommendations for enhancing mental health sustainability across Europe, emphasizing cross-sectoral coordination, improved surveillance systems, and future research priorities. Full article

Independent community pharmacies serve as critical healthcare access points in rural areas, yet they consistently underperform chain pharmacies on contraceptive access measures. This narrative commentary draws on mystery caller studies, implementation research, and policy analyses to examine pharmacy-based contraceptive access in the United States (US). Using emergency contraception (EC) as a case study, we show that independent pharmacies stock EC at dramatically lower rates than chains (e.g., 14.6% vs. 76.3% in West Virginia), provide less accurate information about purchase requirements and timing, and impose more barriers to access. Because independent pharmacies account for 76.5% of pharmacies in rural areas, this disparity concentrates contraceptive inaccessibility in communities already facing the highest rates of unintended pregnancy, maternal mortality, and maternity care deserts. This pattern extends beyond EC to pharmacist-prescribed contraception and over-the-counter daily oral contraceptives. These disparities reflect systemic barriers, such as inadequate reimbursement, limited training infrastructure, and absence of corporate support, rather than failures of individual pharmacies. Drawing on implementation research and the success of West Virginia’s COVID-19 vaccination model, this paper proposes coordinated, sector-specific strategies to transform independent pharmacies from barriers into bridges for rural women’s contraceptive access. Full article

Background/Objectives: Prostate cancer (PCa) remains a prevalent malignancy among men, often complicated by recurrence and unfavorable clinical outcomes. Consequently, precise risk stratification and timely clinical intervention are paramount. Initially, we delineated distinct expression profiles of histone modification regulators via unsupervised clustering, identifying PCa subtypes with divergent survival probabilities and biological phenotypes. Subsequently, we sought to develop a prognostic gene signature, derived from the transcriptomic variations among these regulator-defined subtypes, to predict outcomes in PCa patients following radical prostatectomy (RP). Methods: Clinical and transcriptomic data from PCa cohorts were retrieved from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) repositories for comprehensive analysis. Subtypes driven by histone modification regulators were established using unsupervised consensus clustering, followed by in-depth characterization of their molecular features and associated pathways. A risk-scoring model was then developed to evaluate its prognostic efficacy in this patient population. Results: Stratification based on histone modification regulators yielded four distinct PCa subtypes exhibiting heterogeneous survival outcomes, functional pathways, and genomic mutational landscapes. Following rigorous feature selection, a 21-gene risk signature (HIS_score)—comprising MXD3, CCDC28B, COL11A2, SLC39A5, GPT, DNASE1L2, PIF1, KRTAP5-9, TTLL10, KRTAP5-1, KRTAP5-10, HAGHL, MSLNL, AMH, NKAIN4, CCDC114, SLC9A3, SULT1E1, ALB, SLC6A14, and RPE65—was constructed. Survival analyses demonstrated that patients assigned to the high HIS_score cohort experienced significantly worse clinical outcomes compared to their low-score counterparts. Furthermore, we integrated this signature into a novel clinical nomogram to facilitate individualized prognostic assessments. Conclusions: Derived from transcriptomic disparities between extreme epigenetic subtypes, the HIS_score and its associated nomogram serve as robust prognostic instruments. These tools effectively encapsulate the downstream transcriptional sequelae of histone modification dysregulation, offering clinicians a valuable framework to accurately predict post-RP outcomes and expedite the formulation of personalized therapeutic strategies. Full article