Search Results (193)

In South Africa, traditional healing and indigenous knowledge systems are formally recognised. However, persistent epistemological domination by the West is reflected in ambivalent attitudes towards culturally specific beliefs and practices. In South African Nguni languages such as isiZulu and isiXhosa, the word ukuthwasa refers to a call to do ancestral work or become a traditional healer. Such a call often manifests itself with symptoms that, from a Western perspective, could be interpreted as suggesting neurodivergence. In recent years, mental health attracted increasing public and media attention in South Africa, where up to one in three people is estimated to suffer from mental health issues. The people concerned are understood and represented in terms of either deficit (medical model) or deviation from the norm (social model). More recent and progressive understandings of disability foreground voice and experience as part of an affirmative model. We analyse purposively selected online texts (X, Instagram, and Facebook posts) concerning ukuthwasa. These provide evidence of social media (self) representations sourced from the accounts of traditional healers, hashtags related to specific incidents, and searches using keywords in English or isiXhosa. Through a qualitative content analysis, presented thematically, the present paper contributes with a critical and decolonial exploration of the representation of ukuthwasa as a culture-bound condition in digital media. Full article

Ultrasound-guided hydrodissection and dextrose prolotherapy have evolved into anatomically explicit but mechanistically distinct strategies for musculoskeletal pain. This State-of-the-Art narrative review aimed to synthesize major recent clinical and technical developments and to interpret them within a target-based framework. PubMed and Embase via Ovid were searched for English-language publications from 1 January 2021 through 29 July 2026, supplemented by selected pre-2021 landmark studies identified through backward citation tracking. After initial deduplication, 1662 records entered Title/Abstract screening. The final narrative synthesis cited 67 publications, including selected landmark and methodological sources. One author performed screening, and a second author reviewed the final publication selection; study selection was purposive and designed for a narrative synthesis rather than exhaustive systematic inclusion. Four questions guided the review: recent refinements in hydrodissection technique and indications; increasing condition specificity of prolotherapy evidence; areas of overlap and distinction between the two procedures; and the evidentiary status of emerging applications. Hydrodissection research remains concentrated in carpal tunnel syndrome and increasingly addresses injectate, volume, tissue-plane spread, and procedural configuration, whereas evidence beyond the carpal tunnel remains incompletely replicated. Prolotherapy research has shifted from broad claims toward condition-specific studies in tendinopathy, plantar fasciopathy, knee osteoarthritis, periarticular disorders, and temporomandibular joint pathology. Across both fields, variations in concentration, volume, anatomical site, session number, comparator, rehabilitation, and procedural expertise limit generalization. Hydrodissection is defined by observable, fluid-mediated separation of a tissue interface, whereas prolotherapy involves dextrose delivery to a symptomatic connective-tissue target without requiring immediate tissue-plane separation. The proposed framework is intended to standardize terminology, organize evidence maturity, and guide future comparative research rather than prescribe a validated treatment algorithm. Full article

Purpose: Childhood apraxia of speech (CAS) is a motor speech disorder characterized by deficits in speech planning and programming. However, current diagnostic frameworks have been developed primarily from studies of English-speaking children, raising questions regarding their applicability to other languages. This study examined the common and diagnostic speech characteristics of Hebrew-speaking children with CAS as perceived by Israeli speech–language pathologists (SLPs). Method: Two hundred Israeli SLPs with experience diagnosing and/or treating children with CAS completed an online questionnaire. Participants rated 26 speech characteristics on 7-point scales reflecting their perceived frequency and diagnostic specificity in Hebrew-speaking children with CAS. Descriptive analyses included mean ratings and the percentage of clinicians endorsing each characteristic. Results: Increased difficulty with multisyllabic words (M = 6.37) and inconsistent errors (M = 6.32) received the highest frequency ratings and were endorsed by 87.0% and 84.0% of clinicians, respectively, as common characteristics of CAS. Inconsistent errors received the highest diagnostic specificity rating (M = 6.12), followed by groping movements (M = 5.73) and difficulty sequencing syllables (M = 5.48). Prosodic features, including lexical stress errors (M = 3.72) and equal stress patterns (M = 3.73), received ratings at or below the midpoint of the scale and were endorsed by fewer than 20% of clinicians as common characteristics of CAS. Breathy voice (M = 3.11) and consistent hypernasality (M = 2.79), two control characteristics not typically associated with CAS, received the lowest ratings. Conclusions: Israeli SLPs identified syllable sequencing difficulties and inconsistency as the most salient and diagnostically informative characteristics of CAS in Hebrew-speaking children. In contrast, prosodic features, particularly lexical stress errors, were perceived as less common and less central to diagnosis than suggested by English-based diagnostic frameworks. These findings suggest that the clinical manifestation of CAS may be influenced by language-specific phonological and prosodic properties and underscore the need for direct investigation of CAS characteristics in Hebrew-speaking children. Full article

Background and Objectives: The optimal timing of orthodontic intervention in children remains debated, particularly during the mixed dentition phase. Despite potential benefits, variability in clinical decision-making persists. This study explored orthodontists’ perceptions, clinical practices, and clinical decision-making regarding the timing of early orthodontic intervention in Saudi Arabia. Materials and Methods: An interpretive qualitative study was conducted using semi-structured interviews with nineteen licensed orthodontists practicing in Saudi Arabia. Participants were purposively sampled to ensure diversity in clinical experiences and practice settings. Interviews were conducted in English and Arabic, using detailed contemporaneous field notes that were subsequently expanded for analysis. Data were analyzed using thematic analysis following Braun and Clarke’s framework, with iterative coding supported by investigator triangulation, reflexive memoing, and participant validation. Data collection continued until thematic saturation was achieved. Results: Four major themes were identified. Early intervention was widely perceived as beneficial, particularly for functional problems, Class III malocclusions, and crossbites. However, decision-making was highly individualized, with many clinicians adopting a selective approach and deferring treatment in mild cases. Variation in clinical reasoning was observed across individual participant accounts, reflecting clinical judgment and contextual influences. Key barriers included limited parental awareness, financial constraints, and delayed referrals. System-level factors, such as variability in insurance coverage, referral pathways, and the lack of structured early screening programs, were identified as important influences on access to timely care. Conclusions: Early orthodontic intervention should be applied selectively, based on clinical indications and patient-specific factors. The context-specific findings highlight the need for appropriately tailored guidance, improved referral systems, structured early screening, and consideration of clinical, practitioner-related, and healthcare system factors to support consistent, patient-centered orthodontic care. Full article

Background/Objectives: Children with complex chronic conditions (CCCs) present profound clinical uncertainty for pediatric nurses, who must navigate unpredictable disease trajectories, ambiguous symptom presentations, and emotionally demanding care situations. This study explored the lived experiences of pediatric nurses caring for children with CCCs, with a specific focus on how they perceive, navigate, and manage clinical and emotional uncertainty in daily practice. Methods: A Gadamerian hermeneutic phenomenological study was conducted in pediatric units within tertiary hospitals in Riyadh, Saudi Arabia, using purposive, maximum-variation sampling. Fifteen pediatric nurses participated in semi-structured interviews conducted in English. Data were analysed using hermeneutic phenomenological analysis informed by the framework of Alsaigh and Coyne. Reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: Three themes emerged: navigating the unknown, reflecting nurses’ encounters with diagnostic ambiguity and unpredictable illness trajectories; the emotional weight of not knowing, capturing the psychological burden of sustained uncertainty; and finding footing in uncertainty, describing adaptive strategies including relational anchoring, peer support, and meaning-making through caregiving. Conclusions: Clinical uncertainty is an inherent and pervasive feature of pediatric chronic illness care. Pediatric nurses develop relational and meaning-making strategies, alongside more limited cognitive appraisal strategies, to manage uncertainty, yet require greater institutional recognition and support. Targeted interventions addressing uncertainty tolerance, reflective practice, and structured peer support are proposed as potential approaches, warranting future evaluation, to strengthen nursing resilience and support care quality for children with CCCs. Full article

Purpose: This study provides a comprehensive bibliometric analysis of AI integration in banking, mapping research trends, intellectual structures, and performance-related themes. While AI’s growing importance in financial services has attracted scholarly attention, bibliometric studies specifically focusing on the AI-banking-performance triad remain limited. This study addresses this gap by systematically mapping the research dynamics, intellectual structure, and thematic evolution of this domain. Materials and Methods: Publications were retrieved from the Scopus database using predefined search criteria, resulting in 891 articles published between 2014 and 2024. Bibliometric indicators were employed to examine publication trends, authorship patterns, and institutional contributions. VOSviewer (version 1.6.20) and the R-based Bibliometrix (version 4.3.3) package were used to construct co-authorship networks, keyword co-occurrence maps, co-citation structures, and thematic maps. Results: Findings reveal exponential growth, particularly after 2018, with a peak of 277 articles in 2024. IEEE Access and Expert Systems with Applications are the leading sources, while Baesens B. emerges as a highly influential author. China and India dominate output, though European countries achieve higher per-article impact. Highly cited works focus on credit scoring, fraud detection, fintech, and financial inclusion. Conceptual mapping identifies five thematic clusters, with “AI in banking” as a motor theme, NLP as a niche, and credit detection as emerging. Conclusions: AI research in banking is rapidly expanding, interdisciplinary, and globally distributed. Theoretically, the findings are framed by TAM, TPB, DOI, and Dynamic Capabilities Theory, revealing that AI adoption represents a multi-level phenomenon spanning individual acceptance, institutional diffusion, and strategic reconfiguration. These theoretical lenses explain why fraud detection and credit scoring dominate as early adoptions while NLP and governance remain underdeveloped. The study highlights key contributors, emerging themes, and future research directions. However, findings are constrained by reliance on a single database (Scopus), exclusion of non-English and non-peer-reviewed sources, and inherent limitations of bibliometric methods. Full article

Indian mythological narratives contain long event chains, recurring characters, moral conflicts, interactions between human and divine agents, and source-specific narrative styles. General-purpose large language models can generate fluent text while losing character continuity, thematic relations, or source-supported events. This study presents MythoBiLLM, a parameter-efficient framework for summarization and continuation generation from Indian mythological texts. The framework combines a frozen Llama 3.2 3B-Instruct backbone, LoRA-based adaptation, and a gated BiLSTM narrative-memory adapter. A corpus of public-domain English translations from the Ramayana, Mahabharata, Bhagavad-Gita, Vishnupuranam, Harivamsha, Hindu Tales, and Indian Myth and Legend contains 3,684,838 word-level tokens and 6057 segmented passages. Evaluation covers language modeling, summarization, continuation generation, entity consistency, theme retention, component ablation, robustness, human assessment, and statistical testing. Relative to LLM+LoRA, the complete framework reduces average perplexity from 23.4 to 19.8. In controlled comparisons, the BiLSTM adapter achieves an MCS of 0.713 on both tasks, compared with 0.699 for the parameter-matched MLP adapter, 0.704 for independently trained long-context LoRA, and 0.708 for retrieval augmentation. Full MythoBiLLM reaches MCS values of 0.762 for summarization and 0.744 for continuation generation. After entity consistency and style alignment are excluded from MCS, the complete configuration retains the highest scores of 0.751 and 0.731. These findings support the complete framework on the evaluated corpus, while the controlled comparisons indicate a modest complementary contribution from the BiLSTM and do not identify it as the sole source of the performance gains. Full article

Background/Objectives: Health literacy (HL) is recognized as an important social determinant of health. It supports healthy behaviors and effective health management throughout one’s life. For children and adolescents, developing HL influences their well-being, development, and ability to make informed health decisions. Nurses are strategically positioned to promote HL from an early age. To our knowledge, no prior synthesis has specifically examined nurse-led HL interventions targeting pediatric populations, highlighting the originality and relevance of this scoping review. The purpose of this review was to map and characterize nursing interventions aimed at improving HL outcomes in children and adolescents. Methods: A scoping review was conducted according to the Joanna Briggs Institute methodology, using a three-step search strategy, and reported in accordance with the PRISMA-ScR guidelines. Searches were conducted in MEDLINE, CINAHL, Scopus, Web of Science, and ProQuest with no date restriction, including studies published in Portuguese, English, or Spanish. Studies involving children and adolescents (ages 0–18) in any healthcare or community setting were eligible. Data on intervention characteristics and HL outcomes were extracted and analyzed descriptively, and no critical appraisal of the included sources was conducted. Results: A total of 44 studies were included. Interventions were predominantly school-based and focused on adolescents (n = 26), with a clear gap in early childhood (n = 2). Studies of early childhood primarily used storytelling and reading activities, whereas interventions targeting older children and adolescents more often employed participatory educational strategies, group-based approaches and digital platforms. The most frequently addressed topics were chronic disease management (n = 12), mental health (n = 7), and nutrition (n = 5). HL domains mainly focused on healthcare and health promotion, with fewer studies addressing disease prevention. Most interventions were conducted in school settings (n = 24), highlighting this context over those in primary care, community, and hospital settings. Conclusions: The results revealed nursing interventions used to promote HL, particularly in the management of chronic diseases, mental health and nutrition. However, the existing body of research is still limited. Key gaps include the absence of standardized measurement tools and the scarcity of longitudinal studies evaluating long-term outcomes. These limitations constrain the comparability and generalizability of findings, highlighting the necessity of more rigorous, methodologically robust research to support evidence-based practices. This scoping review comprehensively maps nurse-led interventions that promote HL among children and adolescents, identifying key priorities to guide future research in this area. Full article

The expanding capabilities of deep learning-based media synthesis have intensified concerns regarding the authenticity of digital content and the reliability of forensic analysis tools. In response to these challenges, this work introduces DeepFakeX, a collection of 800 synthetically generated videos available under controlled access for research purposes. The dataset encompasses four distinct categories of AI-driven synthesis: facial identity replacement, audio track substitution, neural voice cloning, and combined audiovisual alteration. Unlike existing deepfake datasets that predominantly focus on facial synthesis, DeepFakeX covers a broader range of manipulation modalities, reflecting the diversity of synthetic media encountered in real-world settings. All deepfakes were generated using state-of-the-art, publicly available tools. Standardized post-processing procedures were applied to each video to ensure uniformity in terms of quality, duration and encoding format. DeepFakeX also emphasizes diversity in gender, age, ethnicity, and language. Video contexts span speeches, informational videos, movie clips, news broadcasts, and interviews that reflect content scenarios commonly encountered in real-world online environments. The dataset includes videos in both English and Urdu. The dataset’s quality and structural variability were assessed through visual and audio analyses using the Structural Similarity Index Measure (SSIM), Mel-Frequency Cepstral Coefficients (MFCCs), and Principal Component Analysis (PCA). The evaluation results revealed substantial variability within each manipulation category, along with clearly distinguishable patterns specific to each modality. DeepFakeX has been developed to facilitate rigorous and transparent research in deepfake detection, cross-modal forensic analysis, and AI-driven media forensics. It is hosted on Zenodo under controlled access for research use. Full article

This paper explores the integration of English for Specific Purposes (ESP) and Content-Based Instruction (CBI) within undergraduate accounting education in a non-Anglophone higher education setting. Adopting a qualitative case study approach, the research examines a series of task-based learning (TBL) activities designed to merge language instruction with specialised disciplinary content through authentic accounting tasks. The evidential basis of this study derives from a single-cohort case study of 36 third-year undergraduate students, organised into 10 distinct groups at a single public higher education institution. Data collection focused on content analysis of qualitative student-produced outputs and metacognitive reflections compiled from 10 group e-portfolios that documented the completion of five specific pedagogical tasks over one semester. Qualitative analysis of these e-portfolios and digital platform interactions suggests that this task-based framework appears to support students in interpreting accounting-related texts and applying technical accounting concepts in English. Furthermore, student reflections indicate an increased awareness of the language’s relevance to future professional practice. Given the localised, naturalistic design of this action-research intervention, the findings are framed as context-bound to this specific institutional cohort, offering a transparent, transferable framework for embedding communicative language practice within specialised accounting curricula. Full article

Disambiguation resolution in speech synthesis is one of the main challenges in text-to-speech conversion. Machine learning methods and artificial neural networks have been successfully applied to this problem in synthesis systems for English, Spanish, and other common languages. For low-resource languages, the available data are insufficient to train artificial neural networks, so heuristic methods for context analysis and selection of the correct homonym for polysemantic words should be used. The purpose of this study is to develop a word sense disambiguation (WSD) method for the low-resource Chechen language and to introduce it into a speech synthesis system. The study presents the developed method and three algorithms: AWEN (based on Euclidean distance), AWA (weighted average), and AWN (weighted normalized distance) for word sense disambiguation. A corpus of Chechen texts, CheWSData, was compiled, containing 15,035 manually selected sentences derived from 5 million annotated words and reflecting the natural frequency of polysemy across grammatical categories. Experimental results show that the proposed AWN method achieves the best performance, with an F1-score of 0.78 and an accuracy of 0.80, outperforming AWA (F1: 0.74) and AWEN (F1: 0.40). For specific parts of speech, AWN reaches F1-scores of 0.82 for nouns, 0.83 for verbs, and 0.85 for adverbs. Comparative analysis with existing WSD methods for low-resource languages (Kashmiri, Hausa, Assamese, Urdu, and Vietnamese) demonstrates that AWN is competitive, ranking second after ViConBERT (F1: 0.87) and ahead of XLM-R for Hausa (F1: 0.79). The developed software module for homonym recognition was integrated into the Chechen speech synthesis system, contributing to more natural synthesized speech. Full article

The rapid expansion of English Medium Instruction (EMI) and Transnational Education (TNE) is reshaping higher education in non-Anglophone contexts. As English-taught programmes and cross-border partnerships proliferate, universities face heightened linguistic and academic demands, positioning English for Academic Purposes (EAP) as central to the university’s internationalisation agenda. Against this backdrop, understanding how language support is conceptualised and operationalised within EMI and TNE contexts is critical, given the increasing reliance on English as the medium through which these agendas are realised. However, there remains limited empirical understanding of how EAP teachers experience these shifting demands and how their roles are being reconfigured within EMI- and TNE-driven reforms. This study investigates professional development (PD) initiatives for EAP teachers in China, where EMI and TNE are rapidly expanding. Document analysis of teachers’ PD documents (n = 10) and interviews with EAP teachers (n = 20) and PD leads (n = 5) across 13 EMI institutions reveal a lack of EAP-specific training, persistent structural constraints, limited recognition within the institution, and uneven access to development pathways for EAP teachers. It highlights the need for systemic change to address the marginalisation of EAP expertise, amidst the changing higher education landscape. Positioning EAP practitioners as central to EMI and TNE policy implementation can help ensure higher education internationalisation initiatives do not remain superficial, largely symbolic and short-sighted. Full article

Background: Osteoinduction and bone regeneration are fundamental biological mechanisms enabling osseointegration and long-term durability of endosseous dental implants. In clinical practice, poor bone conditions, aesthetic demands, and peri-implant soft tissue problems commonly need the utilization of regenerative techniques targeted at optimizing both hard and soft tissue results. The purpose of this narrative review was to examine osteo-inductive and regenerative strategies currently employed in implant dentistry, with particular emphasis on the mechanobiological integration of hard–soft tissue regeneration and its implications for peri-implant tissue stability, osseointegration, and clinical predictability. Methods: A narrative literature review was done using PubMed and Scopus databases. Based on predetermined inclusion and exclusion criteria, studies published in English during the previous five years were reviewed. The core narrative analysis comprised a selection of physiologically relevant research that addressed osteo-inductive techniques, bone regeneration, osseointegration, and peri-implant soft tissue outcomes, as well as clinical studies, randomized controlled trials, systematic reviews, and narrative reviews. A narrative synthesis was carried out because of methodological variability. Special emphasis was placed on evidence addressing the biological and clinical interaction between hard- and soft-tissue regenerative strategies, reflecting the specific conceptual focus of the review. Results: The evidence presented suggests that implant surface biofunctionalization, biologically active grafting materials, guided bone regeneration, and supplementary biological treatments may have a favorable impact on implant stability and peri-implant bone healing. Several investigations also underlined the biological dependency between peri-implant bone regeneration and soft tissue architecture, stressing the significance of soft tissue thickness, keratinized mucosa, and emergence profile stability. Even in inflammatory environments, bioactive titanium surface changes showed osteogenic potential, indicating a supporting function in early osseointegration. Conclusions: By promoting osseointegration and improving peri-implant tissue outcomes, osteo-inductive and regenerative techniques are essential to modern implant dentistry; however, their greatest potential may lie in integrated hard–soft tissue regenerative approaches aimed at improving long-term clinical predictability. To further understand the clinical efficacy of combination hard–soft tissue regeneration methods, future well-designed clinical trials with standardized outcome measures are needed. Future research should further clarify the mechanobiological principles underlying these integrated regenerative approaches. Full article

The processing difficulty of subject relative clauses (SRCs) and object relative clauses (ORCs) in Mandarin Chinese has been a controversial issue in psycholinguistics. Memory-based accounts and experience-based accounts make contrastive predictions regarding the processing asymmetry. Given that older adults tend to have lower memory and richer language experience, the processing of relative clauses in older adults can reveal which theoretical account offers a more adequate explanation of sentence comprehension. The present study compared the processing of Mandarin SRCs and ORCs in older and younger adults using a self-paced reading paradigm. The results revealed that both groups showed lower accuracy for SRCs than ORCs, but this effect was larger in older adults. These age-related differences cannot be attributed to different strategic trade-off mechanisms and task experience. During online processing, older adults performed more slowly than younger adults, but no significant interaction was found between age and RC type. These findings suggest that aging affects sentence comprehension at the post-interpretive and decision processes, while online syntactic processing remains relatively preserved but globally slowed. The findings are largely consistent with memory-based accounts, indicating that age-related changes in sentence comprehension may be attributed to memory decline in older adults. Full article

Background: Effective communication improves patient satisfaction and reduces stress for both patients and physicians. Surveys consistently highlight the importance of strong communication skills among physicians, especially in oncologic settings. Yet, communication training is neither ubiquitous nor standardized in medical studies or residency, and physicians report that this task represents a burden for them. Given the limited data addressing the observations and expectations of patients with gynecologic malignancies when receiving bad news, this survey aimed to assess their perspective on this topic. Methods: We examined throughout an anonymous questionnaire how patients with gynecological and breast cancer experienced the delivery of bad news. Data were collected in Germany from July 2024 to September 2025. The questionnaire was available online and in paper form in four languages (German, English, Turkish, Arabic), with the purpose of recording culture-specific data. Results: A total of 249 patients completed the survey. Regarding the overall need for improvement in delivering bad news, 222 women (94.5%) declared that improvement was necessary, with 92 (39.1%) of them indicating that substantial improvement was required. While 67.9% of patients were content with the physician’s professional competence, 30.5% stated a lack of empathy, and 32.9% stated insufficient time for conversation. When comparing satisfied and dissatisfied patients, significant differences were observed across several aspects, such as consultation length, nonverbal communication, calmness of the setting, stress level after the conversation, and the offer to bring a trusted person or arrange a follow-up conversation. Conclusions: This patient survey highlights a persistent gap between patients’ expectations and physicians’ performance when it comes to delivering bad news. The findings underline the urgent need for the implementation of systematic training programs and structured communication protocols in gynecologic oncology. Full article