Search Results (187)

Background: Artificial intelligence (AI) and machine learning (ML) have been reshaping maternal, fetal, neonatal, and reproductive healthcare by enhancing risk prediction, diagnostic accuracy, and operational efficiency across the perinatal continuum. However, no comprehensive synthesis has yet been published. Objective: To conduct a scoping review of reviews of AI/ML applications spanning reproductive, prenatal, postpartum, neonatal, and early child-development care. Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, and Scopus through April 2025. Two reviewers independently screened records, extracted data, and assessed methodological quality using AMSTAR 2 for systematic reviews, ROBIS for bias assessment, SANRA for narrative reviews, and JBI guidance for scoping reviews. Results: Thirty-nine reviews met our inclusion criteria. In preconception and fertility treatment, convolutional neural network-based platforms can identify viable embryos and key sperm parameters with over 90 percent accuracy, and machine-learning models can personalize follicle-stimulating hormone regimens to boost mature oocyte yield while reducing overall medication use. Digital sexual-health chatbots have enhanced patient education, pre-exposure prophylaxis adherence, and safer sexual behaviors, although data-privacy safeguards and bias mitigation remain priorities. During pregnancy, advanced deep-learning models can segment fetal anatomy on ultrasound images with more than 90 percent overlap compared to expert annotations and can detect anomalies with sensitivity exceeding 93 percent. Predictive biometric tools can estimate gestational age within one week with accuracy and fetal weight within approximately 190 g. In the postpartum period, AI-driven decision-support systems and conversational agents can facilitate early screening for depression and can guide follow-up care. Wearable sensors enable remote monitoring of maternal blood pressure and heart rate to support timely clinical intervention. Within neonatal care, the Heart Rate Observation (HeRO) system has reduced mortality among very low-birth-weight infants by roughly 20 percent, and additional AI models can predict neonatal sepsis, retinopathy of prematurity, and necrotizing enterocolitis with area-under-the-curve values above 0.80. From an operational standpoint, automated ultrasound workflows deliver biometric measurements at about 14 milliseconds per frame, and dynamic scheduling in IVF laboratories lowers staff workload and per-cycle costs. Home-monitoring platforms for pregnant women are associated with 7–11 percent reductions in maternal mortality and preeclampsia incidence. Despite these advances, most evidence derives from retrospective, single-center studies with limited external validation. Low-resource settings, especially in Sub-Saharan Africa, remain under-represented, and few AI solutions are fully embedded in electronic health records. Conclusions: AI holds transformative promise for perinatal care but will require prospective multicenter validation, equity-centered design, robust governance, transparent fairness audits, and seamless electronic health record integration to translate these innovations into routine practice and improve maternal and neonatal outcomes. Full article

High-quality end-of-life care (EoLC) is a critical yet often underemphasised component of oncology care. Several shortcomings in the delivery of EoLC for oncology patients in our centre during the COVID-19 pandemic were identified in our initial 2021 audit. In 2022, we introduced a care of dying patients proforma, an EoLC quality checklist, targeted education and training for staff, and an expanded end-of-life (EoL) committee. This re-audit aimed to review how these changes impacted on the care received by patients in a tertiary cancer centre. A second retrospective re-audit of patients who died between 11 July 2022 and 30 April 2023 was performed to assess quality of EoLC using the Oxford Quality indicators. A total of 72 deaths occurred over the audit period. Quality of EoLC improved significantly when compared to the initial audit (χ² (3, n = 138) = 9.75, p = 0.021). Exploration of patients’ wishes was documented in 48.8% and referral to pastoral care was documented in 68.3%, from 24.2% and 10.6%, respectively. The proportion of patients receiving poor EoLC reduced from 21.2% to 8.3%. Our study demonstrates the benefits of simple interventions, the importance of re-audit, and the role of ongoing interdisciplinary commitment to improving EoLC for our patients. Full article

This study examines the awareness and implementation of Circular Economy (CE) principles within Chile’s mining sector, which represents the world’s leading copper producer. We employed a mixed-methods approach, combining quantitative surveys with qualitative semi-structured interviews, to evaluate perceptions and implementation levels of CE practices across diverse organizational contexts. Our findings reveal a pronounced knowledge gap: while 73.3% of mining professionals reported familiarity with CE concepts, only 57.3% could provide accurate definitions. State-owned mining companies demonstrated substantially higher CE implementation rates, with 36.5% participating in eco-industrial collaborations and 51% conducting environmental audits, compared to their private counterparts. Small enterprises (1–100 employees) exhibited particularly limited engagement, as demonstrated by 71.8% lacking established sustainability reporting mechanisms. A considerable implementation gap was also identified; although 94.8% of respondents considered CE principles integral to business ethics and 89.6% recognized CE as essential for securing a social license to operate, only 20.8% reported that their organizations maintained dedicated CE units. The research presents actionable recommendations for policymakers, including targeted financial incentives and training programs for small- and medium-sized enterprises (SMEs) in mining services, the establishment of standardized CE performance metrics for the sector, and the integration of CE principles into strategic management education to accelerate sustainable transformation within Chile’s critical mining industry. Full article

Background/Objectives: This paper introduces a pedagogically grounded framework for transforming canonical literary texts in primary education through generative AI. Guided by multiliteracies theory, Vygotskian pedagogy, and epistemic justice, the system aims to enhance interpretive literacy, developmental alignment, and cultural responsiveness among learners aged 7–12. Methods: The proposed system enables educators to perform age-specific text simplification, visual re-narration, lexical reinvention, and multilingual augmentation through a suite of modular tools. Central to the design is the Ethical–Pedagogical Validation Layer (EPVL), a GPT-powered auditing module that evaluates AI-generated content across four normative dimensions: developmental appropriateness, cultural sensitivity, semantic fidelity, and ethical transparency. Results: The framework was fully implemented and piloted with primary educators (N = 8). The pilot demonstrated high usability, curricular alignment, and perceived value for classroom application. Unlike commercial Large Language Models (LLMs), the system requires no prompt engineering and supports editable, policy-aligned controls for normative localization. Conclusions: By embedding ethical evaluation within the generative loop, the framework fosters calibrated trust in human–AI collaboration and mitigates cultural stereotyping and ideological distortion. It advances a scalable, inclusive model for educator-centered AI integration, offering a new pathway for explainable and developmentally appropriate AI use in literary education. Full article

Background/Objectives: Antimicrobial stewardship programs (ASPs) optimize antimicrobial use, improving outcomes and reducing resistance. This study assessed the impact of a ward-specific ASP. Methods: A pre/post quasi-experimental study was conducted in an internal medicine ward at a tertiary hospital in Padua, Italy. During the intervention year (September 2023–August 2024), a multidisciplinary team (infectious disease consultants, pharmacists, microbiologists, nurses, and hygienists) held bi-weekly ward-based audits, reviewing antimicrobial prescriptions and performing bedside assessments. Therapy adjustments followed guidelines and local epidemiology. Educational sessions and infection prevention and control (IPC) protocols were also reinforced. Outcomes were compared to the previous year, considering patient characteristics. The primary outcome was antimicrobial consumption (DDD/100 patient days, DDD/100PD); secondary outcomes included cost savings, length of stay (LOS), and mortality. Results: Fifty audits assessed 1074 patients and 1401 antimicrobial treatments. Patient characteristics were similar. Antibiotic suspension or de-escalation occurred in 37.9% and 22% of patients, respectively. AWARE ACCESS class use increased (+17.5%), while carbapenem (−54.4%) and fluoroquinolone (−42.0%) use significantly declined (p < 0.05). IPC and microbiological culture guidance were provided in 12.1% of cases. Antimicrobial consumption dropped from 107.7 to 84.4 DDD/100PD (p < 0.05). No significant changes in LOS or mortality were observed. Antimicrobial costs fell by 48.8% (with EUR 57,100 saved). Conclusions: ASP reduced antimicrobial consumption, improved prescription quality, and cut costs without compromising patient outcomes. Multidisciplinary collaboration, audits, and education proved essential. Future studies should assess long-term resistance trends and integrate rapid diagnostics for enhanced stewardship. Full article

This paper presents an integrated digital training twin framework for adaptive aircraft maintenance education, combining real-time competence modeling, algorithmic orchestration, and cloud–edge deployment architectures. The proposed system dynamically evaluates learner skill gaps and assigns individualized training resources through a multi-objective optimization function that balances skill alignment, Bloom’s cognitive level, fidelity tier, and time efficiency. A modular orchestration engine incorporates reinforcement learning agents for policy refinement, federated learning for privacy-preserving skill analytics, and knowledge graph-based curriculum models for dependency management. Simulation results were conducted on the Pneumatic Systems training module. The system’s validation matrix provides full-cycle traceability of instructional decisions, supporting regulatory audit-readiness and institutional reporting. The digital training twin ecosystem offers a scalable, regulation-compliant, and data-driven solution for next-generation aviation maintenance training, with demonstrated operational efficiency, instructional precision, and extensibility for future expansion. Full article

As global energy consumption continues to rise, it is essential to adopt measures that regulate electricity use while still meeting the demands of modern society. These efforts align with the United Nations Sustainable Development Goals and are supported by various organizations. This study applies a methodology that combines the implementation of a Level 2 Energy Audit with the evaluation of the Electricity Consumption Index (ECI) at the Department of English of the Multidisciplinary Academic Unit of the Altiplano Region, Universidad Autónoma de San Luis Potosí. The study identifies strategies to reduce electricity consumption related to lighting systems and equipment operation throughout the department. Additionally, it assesses the percentage of users who promote and practice energy-saving habits. Key recommendations include transitioning the lighting system to LED technology, expected to reduce electricity consumption by 15, and implementing power factor correction measures, projected to yield an additional 6.17% in energy and cost savings. Together, these strategies could result in an estimated annual electricity savings of 21.17%, making them attractive to institutional decision-makers. Furthermore, by comparing the department’s ECI with a reference index established for educational institutions in temperate climate regions of Mexico, the study determines whether the proposed strategies should be implemented immediately or planned for the medium to long term. This decision-making framework represents the main contribution of the case study. Full article

Background: Carcinoma of Unknown Primary (CUP) constitutes approximately 3% of all advanced cancer cases globally, posing a distinct and complex medical challenge due to its metastatic nature, with no identifiable primary tumour site despite comprehensive investigations. Aim: This study aimed to assess the quality of referrals to the Cancer of Unknown Primary Clinic at the Princess Margaret Cancer Centre (PMCC) by conducting a retrospective audit of initial referrals between January 2022 and March 2023. Methods: The adequacy of referrals was evaluated based on adherence to NICE guidelines, focusing on essential diagnostic investigations such as comprehensive history, physical examination, CT scans, and pathological assessment with immunohistochemistry. Our cohort consisted of 97 patients with a median age of 66 years. Results: The results indicated that only 55% of referrals met the criteria for adequacy, with significant deficiencies in computed tomography (CT) scans and immunohistochemistry (IHC). Notably, the adequacy of referrals varied by specialty, with the lowest rates in emergency medicine and family medicine, and the highest rates in medical oncology, gastroenterology, and neurosurgery. Conclusions: These findings underscore the need for improved standardization and education to enhance referral quality, ensuring that patients with CUP receive appropriate and timely care. This study marks the initial phase of the Knowledge-to-Action cycle, highlighting areas for quality improvement in the referral process to the CUP clinic. Full article

Background: Health and safety are critical pillars of functional higher education systems. In South African universities, recurring incidents have highlighted vulnerabilities, particularly concerning gender-based violence (GBV), student housing conditions, infrastructure safety, and campus crime. Methods: This study employed a document-based qualitative approach, analysing public records, police reports, campus press statements, and national media coverage of incidents reported at South African universities (2015 to 2024). The study is guided by public health and victimology frameworks to examine systemic risk factors and institutional responses. Results: The findings indicate increased reports of GBV, multiple student deaths related to substandard residence conditions, infrastructure-related fatalities, and a lack of consistent institutional safety policies. A pattern of poor infrastructure management, weak inter-institutional communication, and failure to implement recommendations following major incidents emerged across the dataset. Conclusions: South African universities remain exposed to preventable student risks. Targeted interventions, mandatory safety audits, emergency response units, and accountability structures are urgently needed to address systemic failings and protect student welfare. The study supports Sustainable Development Goals 3 and 4 by linking campus safety to student well-being and equitable access to higher education. Full article

Osteoporosis therapy is a crucial component of fragility fracture patients’ care. A Quality Improvement Project (QIP) was undertaken to review and improve such bone protection practice within a busy UK hospital orthopaedic department. Full-loop audit cycles, totalling 216 patients, were conducted before and after the implementation of a single-page checklist. This intervention significantly increased consultant-led osteoporosis plans by 37%, enhanced bone-sparing treatment administration by 20%, and eliminated unsafe prescriptions. Provision timeliness was not affected, but the communication of correct discharge information was significantly improved by 27%, and staff surveys showed the checklist was well-received, easy-to-use, and educational. Hopefully this will encourage other orthogeriatric teams to utilise a similarly effective and simple QI strategy. Full article

The integration of artificial intelligence (AI) in education highlights the growing need for AI literacy among K–12 teachers, particularly to enable effective human–machine cooperation. This study investigates Saudi K–12 educators’ AI literacy competencies across four key dimensions: awareness, ethics, evaluation, and use. Using a survey of 426 teachers and analyzing the data through descriptive statistics and structural equation modeling (SEM), this study found high overall literacy levels, with ethics scoring the highest and use slightly lower, indicating a modest gap between knowledge and application. The SEM results indicated that awareness significantly influenced ethics, evaluation, and use, positioning it as a foundational competency. Ethics also strongly predicted both evaluation and use, while evaluation contributed positively to use. These findings underscore AI literacy skills’ interconnected nature and point to the importance of integrating ethical reasoning and critical evaluation into teacher training. This study provides evidence-based guidance for educational policymakers and leaders in designing professional development programs that prepare teachers for effective and responsible AI integration in K–12 education. Full article

The rapid integration of generative artificial intelligence (AI) into educational environments raises both opportunities and concerns regarding assessment design, academic integrity, and quality assurance. While new generation AI tools offer new modes of interactivity, feedback, and content generation, their use in assessment remains insufficiently pedagogically framed and regulated. In this study, we propose a new framework for generative AI-supported assessment in higher education, structured around the needs and responsibilities of three key stakeholders (branches): instructors, students, and control authorities. The framework outlines how teaching staff can design adaptive and AI-informed tasks and provide feedback, how learners can engage with these tools transparently, and how institutional bodies can ensure accountability through compliance standards, policies, and audits. This three-branch multi-level model contributes to the emerging discourse on responsible AI adoption in higher education by offering a holistic approach for integrating AI-based systems into assessment practices while safeguarding academic values and quality. Full article

This study examines the impact of inward foreign direct investment (FDI) on economic growth in South and Southeast Asia from 2006 to 2022, using a comprehensive panel dataset and multiple econometric techniques. The baseline estimation employs Feasible Generalized Least Squares (FGLS), with robustness checks using Fixed Effects with Driscoll–Kraay standard errors, the Common Correlated Effects Mean Group (CCEMG) estimator, and Two-Stage Least Squares (2SLS). The results consistently show that FDI and Gross Capital Formation (GCF) significantly promote growth, while the Human Capital Index (HCI), Trade Openness (TO), and Inflation (I) have limited or adverse effects. Government spending (GS) is negatively associated with growth, suggesting inefficiencies in public resource allocation. The findings underscore the importance of enhancing absorptive capacity through investments in education, institutional quality, and trade facilitation. Policy recommendations include adopting performance-based budgeting and independent audits, drawing on Malaysia’s anti-corruption and audit reforms. To address the weak impact of human capital, this study advocates for expanding public–private partnerships in technical and vocational education, modelled on Singapore’s SkillsFuture initiative. Additionally, digital investment platforms like Indonesia’s Online Single Submission (OSS) system and infrastructure upgrades are recommended to reduce trade costs and improve the investment climate. Finally, the study calls for deeper regional integration through harmonized investment regulations under the ASEAN Comprehensive Investment Agreement (ACIA) and the development of cross-border special economic zones (SEZs). These recommendations are grounded in empirical evidence and tailored to the region’s structural characteristics, offering actionable insights for policy-makers. Full article

Food waste is a significant global issue with substantial environmental, economic, and social implications. This exploratory study aimed to evaluate the impact of an educational composting program on reducing food waste generation and promoting proper waste sorting practices within multi-family housing units in San Marcos, Texas. A comprehensive methodology was employed, encompassing pre- and post-intervention waste audits, educational interventions, weekly organic waste collection, and quantitative data analyses. Nine multi-family complexes, spanning student housing, conventional family units, low-income residences, and senior living facilities, were targeted through strategic recruitment efforts and incentivization. The treatment group, consisting of 43 participants, received ongoing education throughout the eight-week implementation period, facilitated through informational resources, feedback mechanisms, and door-to-door organic waste collection. Conversely, the control group did not partake in the educational component. Statistical analyses, including descriptive statistics and paired t-tests, facilitated comparisons across various dimensions, such as housing types, treatment versus control groups, and pre- versus post-intervention periods. The findings revealed significant reductions in organic waste and compostable materials within the treatment group’s weekly landfill trash, underscoring the effectiveness of the educational program. Furthermore, insights into contamination patterns and housing-specific waste characteristics were garnered, informing targeted intervention strategies and policy recommendations for optimizing multi-family composting initiatives. Full article

Despite the emphasis on consumption and production patterns in the Sustainable Development Goals (SDGs), plastic pollution remains inadequately addressed. This research contributes to the limited literature on sustainable consumption and disposal of plastic in developing contexts and demonstrates how universities can effectively integrate sustainability competencies into a subject-specific curriculum. This study examined how teacher training programs can address plastic pollution through curriculum innovation and experiential challenge-based learning. Focusing on technology student teachers (TSTs) at a South African institution, the research explored their experiences with community-based problem-solving activities related to plastic consumption and disposal. The polymer module was restructured to combine theoretical knowledge with practical sustainability actions, engaging students in real-world environmental challenges. Data were generated via focus group interview, reflective journal, and photovoice. Working in teams across four communities, TSTs conducted plastic audits in households, shared findings with community members, and collaboratively developed sustainable solutions. This approach bridged the gap between academic learning and environmental action, addressing the critical global plastic crisis that contributes to fossil fuel depletion, ecosystem damage, and greenhouse gas emissions. The findings highlight the potential of teacher education to cultivate environmentally conscious educators who can inspire sustainable thinking and action across educational settings. The practical implications of this research extend beyond the classroom, offering a replicable model for teacher education programs to empower future educators as change agents who can facilitate sustainable community action through knowledge co-creation and context-specific environmental problem-solving. Full article