Search Results (9,037)

Background: Cervical cancer (CC) is the most common cancer among Ugandan women and the leading cause of cancer mortality. Screening has proven to be a cost-effective method in reducing its burden, yet uptake among women of reproductive age remains alarmingly low, with national adherence rates under 10%. Objective: This study explored healthcare workers’ (HWs) perspectives on barriers and facilitators to screening and attitudes toward implementing human papillomavirus (HPV) DNA testing with self-collection. Methods: A qualitative research design was employed. Twenty semi-structured interviews were conducted with purposively sampled healthcare providers and administrators across different cadres at a referral hospital and three peripheral health centres in Northern Uganda. Interviews were analysed thematically using the Social Ecological Model. Data collection and analysis proceeded iteratively until thematic saturation. Reporting follows the Consolidated Criteria for Reporting Qualitative Research (COREQ). Results: Participants described individual and interpersonal barriers such as limited awareness, poor preventive health-seeking, fear of results, stigma, and limited male involvement. Organisational barriers included staff shortages, weak referral practices, and stock-outs of supplies, while policy constraints included limited governmental support and competing priorities. Facilitators included targeted health education, routine referrals from all service entry points, outreach screening, and donor support. Most respondents favoured scaling up of self-collected HPV testing, citing higher acceptability and feasibility for outreach, contingent on sustained supplies, laboratory capacity, and training. Conclusions: Multi-level interventions are needed to strengthen facility workflows, staff capability, community engagement, and reliable supply chains. Expanding access to self-collected HPV testing may overcome major barriers and represents a promising strategy to increase screening uptake in Uganda and similar low resource settings. Full article

Effective transition of youth out of care has been a concern for social workers, policymakers, residential facilities, and other related stakeholders. This paper reports on the livelihood strategies and transition experiences of adolescent girls in and out of two institutions in Harare, Zimbabwe. Using the sustainable livelihood approach, this qualitative research explored and compared the livelihood strategies of 16 girls still in care with 16 who had exited. Framework analysis was used to interpret the data. The findings show that girls in institutions mainly rely on institutional support for their livelihoods, while those who leave employ a wider range of strategies including support from relatives, foster parents, institutions, and spouses. Social networks emerged as a key strategy for both financial and social security. However, differences in the resources available through these networks significantly impacted the girls’ livelihood outcomes, either positively or negatively. Overall, many adolescent girls remained unable to sustain themselves or cope with the challenges of transitioning to adulthood and life beyond institutional care. The study recommends that transition programmes that address early marriage as a means of security, expanding family and fostering care options, reducing institutional dependency, tackling economic exclusion and unemployment be developed. Full article

The accelerating global urbanization process has posed new challenges to urban planning. With the rapid advancement of artificial intelligence (AI) technology, the application of AI in urban planning has gradually emerged as a prominent research focus. This study systematically reviews the current state, development trends, and challenges of AI applications in urban planning through a combination of bibliometric analysis using Citespace, AI-assisted reading based on generative models, and predictive analysis via support vector machine (SVM) algorithms. The findings reveal the following: (1) The application of AI in urban planning has undergone three stages—namely, the budding stage (January 1984 to January 2017), the rapid development stage (January 2017 to January 2023), and the explosive growth stage (January 2023 to January 2025). (2) Research hotspots have shifted from early-stage basic data integration and fundamental technology exploration to a continuous fusion and iteration of foundational and emerging technologies. (3) Globally, China, the United States, and India are the leading contributors to research in this field, with inter-country collaborations demonstrating regional clustering. (4) High-frequency keywords such as “deep learning,” “machine learning,” and “smart city” are prevalent in the literature, reflecting the application of AI technologies across both macro and micro urban planning scenarios. (5) Based on current research and predictive analysis, the application scenarios of technologies like deep learning and machine learning are expected to continue expanding. At the same time, emerging technologies, including generative AI and explainable AI, are also projected to become focal points of future research. This study offers a technical application guide for urban planning, promotes the scientific integration of AI technologies within the field, and provides both theoretical support and practical guidance for achieving efficient and sustainable urban development. Full article

As pivotal actors in market economies, corporations are strategically positioned to enhance environmental, social, and governance (ESG) performance to advance sustainable development. The digital technology revolution has stimulated scholarly inquiry into the influence of digital technology innovation on corporate ESG performance. Nevertheless, critical questions remain unresolved regarding the multidimensional measurement of digital technology innovation quality (DTIQ) and its mechanism paths empowering ESG enhancement. Using panel data for China’s listed companies from 2012 to 2022, this study quantifies DTIQ through its depth (technology specialization) and breadth (technology diversification), empirically investigating their impacts on ESG performance and focusing on the mediating effects of digital transformation and digital technology diffusion. Empirical results reveal that both the breadth and depth of DTIQ have significantly positive impacts on ESG performance. Mechanisms analysis identifies two ways to reinforce their positive impacts: advancing corporate digital transformation and facilitating digital technology diffusion. Discussions on the heterogeneity of the effects demonstrate that in regions with strong intellectual property protection, Eastern regions, high-tech and heavily polluting industries, and among non-SOEs and large firms, the impact of DTIQ on corporate ESG performance is more pronounced. This research expands the literature on the relationship between digital technology innovation and corporate ESG performance. Full article

Background/Objectives: Pediatric mental health is a major public health concern worldwide and primary care providers struggle to meet the growing demand for mental healthcare. Child Psychiatry Access Programs have emerged to fill gaps in primary care provider (PCP) training, confidence, and workflow support. This study aimed to describe the iterative development of a Child Psychiatry Access Program and present initial findings on its reach and feasibility in supporting PCPs. Methods: The Practical, Robust Implementation and Sustainability Model (PRISM) implementation framework guided the development and evaluation of the program. Pre-implementation surveys and invested partner interviews informed the creation of a multidisciplinary program comprising three components: (1) consultation services and resource navigation, (2) education and training, and (3) provider care guides. The program was then implemented, and reach was assessed via consultation calls, attendance at education and training series, resource navigation encounters, and care guide usage. Feasibility was evaluated through pre- and post-series self-reported ratings across six learning objectives. Results: Pre-implementation evaluation indicated high provider interest across all educational modalities. The resulting program included consultation services, education and training, resource navigation, and provider care guides. Educational trainings led to significant improvements in self-reported knowledge and confidence across six learning objectives, including assessment, treatment planning, family engagement, and navigating local resources. Resource navigation primarily facilitated ongoing management within the primary care setting, with PCPs retaining care in the majority of cases. Engagement with the Colorado Care Guide demonstrated sustained reach, with over 4600 page views from 1300 active users, reflecting broad and ongoing utilization of program resources. Consultation call data mirrored these trends, highlighting both frequently addressed diagnoses and expanding program reach over time. Conclusions: Child psychiatry access programs help support access to youth mental health care in the primary care space and offer potential solutions to workforce limitations during an era of increasing mental health concerns in youth and teens. Findings from this implementation may inform adaptation of child psychiatry access programs in other regions seeking to expand mental health support for children and adolescents in primary care settings. Full article

Artificial Intelligence is reshaping social, political, economic, and cultural life, yet its developmental value in the Global South remains contingent on governance, participation, and design choices. This study develops and validates a data-driven framework that aligns Artificial Intelligence with inclusive development across four interdependent dimensions like access, agency, accountability, and adaptation using a mixed-method, sequential explanatory design that integrates large-sample surveys, qualitative interviews and observations, and participatory workshops across six urban, peri-urban, and rural sites (total $n=1920$). Measurement development followed best practices in item generation, content validity, cognitive interviewing, piloting, and psychometric evaluation; exploratory factor analysis and confirmatory factor analysis supported a four-factor structure with satisfactory reliability and convergent discriminant validity. Structural equation modeling indicated that access and adaptation are the strongest predictors of service reach and time efficiency, whereas agency and accountability are most closely associated with grievance resolution and reductions in reported harms; these relations were strong across subgroups and alternative specifications. Qualitative integration clarified mechanisms that map onto the quantitative signals, including infrastructural precarity that constrains reach, contestability gaps that limit remedy, and locally responsive design features that reduce transaction costs. The framework translates normative commitments into measurable levers for policy and practice: investments that prioritize access and adaptation expand reach and efficiency, while strengthening agency and accountability enhances remedy and safety. Embedding the four dimensions into diagnostics, procurement, audit, and performance management offers a practical pathway to make Artificial Intelligence inclusive by default in diverse low-resource settings. Full article

This article addresses the contemporary and highly relevant research area of business sustainability, which attracts the attention of both scholars and management practitioners.Although the social dimension of sustainability is gaining increasing importance, there remains a research gap regarding the extent to which social initiatives contribute to sustainable outcomes. This study specifically focuses on the social dimension of business sustainability. The primary objective of the study is to examine the relationship between activities within the social dimension and sustainable outcomes. Moreover the study extends earlier research by contributing new empirical evidence from the Polish context, thereby enriching the existing body of knowledge. The study encompasses 303 organizations operating in Poland and utilizes a questionnaire-based survey. The collected data were employed to construct a regression model. The results indicate statistically significant relationships between social outcomes and key variables, namely, societal values and employee-related outcomes. The results indicate that social value creation and value chain integration are the strongest predictors of sustainable outcomes The variables were measured using subjective indicators. In addition, the research was conducted only in companies operating in Poland, and the results may be typical of businesses operating in this country. Therefore, the research should be extended to other countries, and it would be particularly interesting to compare with companies operating in countries where sustainability-related indicators are highly rated. It would also be very interesting to expand the data gained through questionnaires through interviews and case studies, linking social-focused business activities to the benefits that businesses can achieve in the area of sustainable outcomes as a result. Full article

The rapidly expanding use of artificial intelligence (AI) technologies in recent years presents significant opportunities for achieving sustainable, clean, and safe environmental objectives. This study aims to comprehensively examine the potential use of AI technologies for clean and safe environmental goals in forest tourism areas in Turkey, Lithuania, and Morocco, and to conduct comparative analyses specific to each target country. The research was conducted using a qualitative methodology within a case study design. In line with purposive sampling principles, the sample was limited to a total of 72 participants from the three countries (24 from Turkey, 24 from Lithuania, and 24 from Morocco). To identify expert opinions relevant to the study objectives, semi-structured interviews were conducted across the three country samples, and the collected data were processed and analyzed using NVivo 14 software. The data were transformed into findings through descriptive analysis and content analysis. The results indicate that AI technologies are employed in forest tourism areas for diverse purposes and objectives related to clean and safe environmental management. In Turkey, AI applications are primarily directed toward proactive measures addressing pressing environmental issues, such as forest fires. In Lithuania, as an EU member state, AI technologies are utilized in a more strategic, institutional, and comprehensive manner across multiple areas and objectives. In contrast, Morocco appears to lag in AI adoption, focusing on international collaborations to enhance digital infrastructure and facilitate technology transfer. Full article

PIWI-interacting RNAs (piRNAs) are small non-coding RNAs that interact with PIWI proteins and play essential roles in genome stability, gonadal development, and gametogenesis in animals. The Japanese flounder (Paralichthys olivaceus) is an important marine culture teleost in North Asia, showing pronounced sexual size dimorphism, where gynogenetic induction of all-female cohorts can markedly enhance production. However, the PIWI/piRNA pathway in gynogenetic diploid P. olivaceus, which often exhibit gonadal dysgenesis, poor gamete quality, and low fertilization rates, remains poorly understood. In this study, RNA-seq and small RNA-seq data from 11 tissues and 6 developmental stages of common P. olivaceus, as well as the gonads of gynogenetic P. olivaceus, were analyzed to characterize the PIWI/piRNA pathway and its roles in transposon and gene regulation within the germline. The results showed that PIWI/piRNA genes were predominantly expressed in gonads and early embryogenesis in common P. olivaceus, with the highest expression in testis. Clustered piRNAs were identified in the testis and early embryos of common P. olivaceus, which targeted multiple transposon and gene families. Intriguingly, gynogenetic P. olivaceus gonads harbored abundant clustered piRNAs not only in the testes but also in the ovaries, both targeting similar transposon families as that in common P. olivaceus. Notably, the DNA transposon Tc1/Mariner family and pim genes were the most heavily targeted by piRNAs in gynogenetic P. olivaceus, with testis-biased expression. Expanded pim genes were identified in P. olivaceus, overlapping with piRNA clusters, and the in vitro test in P. olivaceus testes revealed that the expanded pim genes may be pseudogenes as a piRNA cluster reference to generate piRNAs regulating the conventional pim members. These unique features of the PIWI/piRNA pathway in gynogenetic diploid P. olivaceus may underline their impaired reproductive ability, and have important theoretical and practical implications for teleost gynogenetic breeding. Full article

Against the backdrop of expanding off-farm employment, it is of great practical significance to examine how off-farm employment affects grain production and its underlying mechanisms, in order to build a more stable and sustainable national food security system. Drawing on micro-level data from wheat-producing households in the national Rural Fixed Observation Points survey from 2004 to 2021, this study systematically investigates the impact of off-farm employment on wheat planting decisions and the channels through which it operates. The findings reveal the following: (1) Off-farm employment encourages farmers to adjust their factor input structure and crop choices, leading to an increased proportion of wheat sown area. (2) Agricultural socialized services, especially mechanized operations, enhance the feasibility of factor substitution and effectively channel off-farm income into agricultural investment. Furthermore, the number of service providers at the village level plays a significant moderating role in this process; the more adequate the service supply, the stronger the positive effect of off-farm employment on wheat cultivation. (3) The influence of off-farm employment on wheat production is more pronounced in plain regions with favorable topographic conditions and among large-scale farming households. Based on these findings, the study recommends improving the agricultural service system, promoting better coordination between off-farm employment and agricultural development, and fostering a more stable and sustainable support system for grain production. Full article

Ecosystem services play a crucial role in sustaining human life, providing numerous benefits that are indispensable for our well-being. However, these vital functions are increasingly compromised by land use changes that have been instigated by human activities. This study aims to evaluate the spatiotemporal variability of ecosystem service value (ESV) within the urban agglomeration located on the northern slope of the Tianshan Mountains over a historical period stretching from 1990 to 2020, utilizing land use data to conduct a thorough analysis. Subsequently, the Future Land Use Simulation (FLUS) model was employed to forecast ESV in 2030 under three developmental pathways: Ecological Protection Scenario (EPS), Cultivated Land Protection Scenario (CLPS), and Natural Development Scenario (NDS). The evaluation incorporated six primary land classes: cultivated land, forest land, grassland, water bodies, construction land, and unused land. The FLUS model was validated with strong accuracy (overall accuracy = 0.97, Kappa = 0.94). ESV was estimated using the value coefficient method based on equivalent factors, adjusted with a local economic coefficient for crop production. All values are expressed in constant 2020 CNY without further price normalization. Our results show that between 1990 and 2020, cultivated land expanded by 27.18% (17,721 to 22,538 km²) and construction land increased by 75.91% (1926 to 3388 km²), while grassland decreased from 63,502 to 59,027 km² and unused land declined from 106,292 to 104,690 km². Minor changes occurred in forest land and water bodies. Total ESV decreased from 679.06 × 10⁸ CNY in 1990 to 657.67 × 10⁸ CNY in 2020, a decline of 3.15%. Regulating, supporting, and cultural services all decreased, while provisioning services increased. Spatially, vegetated areas functioned as ESV hot spots, whereas construction-degraded areas were identified as cold spots. Scenario projections for 2030 show that under the CLPS and NDS, ESV would further decline by 11.49 × 10⁸ CNY (−1.75%) and 10.18 × 10⁸ CNY (−1.55%), respectively. In contrast, the EPS is projected to increase ESV by 4.53 × 10⁸ CNY (+0.69%), reaching 662.20 × 10⁸ CNY. Full article

Emerging respiratory dimorphic fungi, including Coccidioides, pose a growing public health threat due to their ability to cause severe disease and the limited therapeutic options. A growing gap exists between rapidly expanding computational data and slower traditional experimental methods for virulence factor identification, limiting progress in fungal pathogenesis research and therapeutic development. This review presents a framework for integrating computational and experimental methodologies to accelerate virulence discovery in Coccidioides. We examine predictive tools for adhesins, transporters, secreted effectors, carbohydrate-active enzymes (CAZymes), and secondary metabolites, plus therapeutic target prioritization strategies based on druggability, selectivity, essentiality, and precedent. Examples from Coccidioides and other World Health Organization-designated emerging fungi highlight how computational pipelines clarify pathogenic mechanisms and guide experimental design. We also assess machine learning, structural prediction, and reverse vaccinology approaches for enhance target discovery. By applying computational advances to Coccidioides research with experimental validation, this integrated approach can guide future antifungal drug and vaccine development. Full article

Background/Objectives: As the aging population is growing globally, oral health has become integral to ensuring healthy aging and quality of life. This study assessed the oral health status of older adults in a Malaysian long-term care facility and explored caregiver-reported challenges in providing oral care. Methods: A convergent mixed-methods design was applied, involving 115 residents aged ≥60 years and 16 caregivers in a public facility. The residents’ oral health was assessed using interviewer-assisted questionnaires (demography, dependency level, Oral Frailty Five-item Checklist), clinical examinations (dental caries status, number of remaining teeth, oral and denture hygiene), and the Decayed, Missing, and Filled Teeth (DMFT) index. Focus group discussions with caregivers were conducted, transcribed, and thematically analyzed. Quantitative data were descriptively analyzed using SPSS version 29.0. Results: Over one-third of the residents (39%) were moderately to highly dependent on caregivers. All had experienced dental caries, with most having fewer than 20 teeth (92.9%) and requiring dentures (81.7%). Overall, both oral and denture hygiene were poor. Assessment of oral frailty indicated that the majority of residents (94.8%) were at risk of impaired oral function. A thematic analysis identified four key themes influencing oral health: (1) health and oral health conditions of residents; (2) variety in oral care practices; (3) older adults’ attitudes and behaviors; and (4) system factors. These themes were mapped in a conceptual framework demonstrating multilevel influences on oral care. Conclusions: Despite the single-center design, these findings provide actionable insights for improving geriatric oral health policies in Malaysia. Practical recommendations include integrating oral health into aged-care standards, expanding mobile dental services, and establishing oral care champions within facilities. Addressing these challenges is critical to improving quality of life and aligning long-term care practices with the WHO’s healthy aging priorities. Full article

Background: Schedule reliability in container liner services is essential for the efficiency of maritime and inland transport, terminal operations, and the overall supply chain. Disruptions to vessel schedules can trigger a series of disruptions at other points, generating additional operational costs for carriers, terminal operators, inland transport providers, and ultimately, for importers, exporters, and end consumers. Methods: The research paper combines literature reviews and shipping company data. A qualitative analysis contains specific causes of vessel delays and corrective actions used to realign schedules with the pro forma plan. The analysis was expanded to include transport of cargo in containers from origin to the final inland destination. Results: Disruption factors are identified and classified by their place of occurrence: (1) inland transport, (2) anchorage, (3) ports, and (4) navigation between ports. The research produced several new disruptive factors previously not identified and published. It has been confirmed that port congestion acts as the principal cause of delay in liner service. Conclusions: The findings indicate that while the number and complexity of disruptive factors are increasing due to global and regional dynamics, the range of recovery measures remains narrow. A deeper understanding of these causes enables more effective prevention, aiming to minimize supply chain disruptions and costs and increase the reliability of door-to-door container transport. Full article

Background: In recent years, indications for liver transplantation have expanded, while the age of transplant recipients has significantly increased due to improvements in perioperative management. As clinical manifestations of posttransplant complications vary and are often nonspecific, the identification of appropriate biomarkers is important for the assessment of graft quality and early recognition of potential complications following liver transplantation. Liver-type FABP (L-FABP) is a small cytoplasmic protein found abundantly in hepatocytes and is involved in the intracellular transport of long-chain fatty acids. Elevated serum levels have been detected in acute and chronic liver failure, kidney failure, and some malignancies. Materials and Methods: We conducted a prospective, single-center study from July 2023 to January 2025, including 29 adult patients who underwent deceased-donor transplantation. Three patients were excluded due to inadequate sample withdrawals. Serum L-FABP was measured preoperatively and on postoperative days 1, 3, 5, 7, and 14. Clinical, surgical, and biochemical data were collected and analyzed using non-parametric statistical tests. Results: L-FABP levels were significantly higher on POD 7 in recipients of grafts from donors ≥ 65 years (p = 0.035), with no corresponding changes in standard liver function markers. While no significant differences in L-FABP levels were found between patients with and without infectious biliary or vascular complications (all p > 0.05), we proved a strong negative correlation between intraoperative blood transfusion volume and L-FABP levels on POD 5 (ρ = −0.677, p < 0.001) and POD 7 (ρ = −0.455, p = 0.025). Conclusions: Our findings suggest that L-FABP holds promise as a biomarker for the early detection of subclinical hepatic graft cellular injury, which is not detected by means of conventional biomarkers for liver function. Full article