Search Results (2,822)

Background: Maternal mortality in Brazil remains a critical indicator of social and racial inequalities, reflecting structural failures in access to and quality of obstetric care. Black women, particularly those categorized as black or brown, are at a higher risk of dying during pregnancy, childbirth, or the postpartum period. This is the result of the intersection of institutional racism, poverty, and social vulnerabilities. This study aimed to analyze trends and associated factors of maternal mortality among black women in Brazil from 2000 to 2020. Methods: This is a retrospective cohort analytical study using data from the Brazilian Mortality Information System. The sample included women aged 10 to 49 years whose underlying cause of death was classified under ICD-10 codes O00–O99. Descriptive and bivariate analyses were conducted, as well as Poisson and multinomial logistic regressions to estimate adjusted risk ratios according to skin color, education, region, type, and place of death. Results: A total of 40,907 maternal deaths were identified, with 59.2% occurring among black women. The maternal mortality ratio was 39% higher among black women compared to white women and more than double among Indigenous women. Low education, residence in the North and Northeast regions, deaths outside hospital settings, and lack of formal investigation were independently associated with increased risk. Direct obstetric causes accounted for most deaths, with hypertensive disorders and puerperal complications being the leading conditions. Conclusions: Maternal mortality among black women in Brazil reveals deep structural inequalities. Urgent public policies that incorporate an intersectional perspective, addressing race, gender, and class, are necessary to reduce disparities and ensure equitable and dignified maternal healthcare. Full article

Background/Objectives: Gambling disorder (GD) is characterized by a high prevalence of co-occurring psychiatric disorders, including personality disorders (PDs), which may negatively influence clinical presentation, treatment outcomes, and relapse rates. The aim of this systematic review was to synthesize recent evidence regarding the association between GD and formally diagnosed PD and/or diagnostically anchored PD symptomatology, and to describe the main personality dimension most frequently reported in affected individuals. Methods: A systematic search was conducted in the PubMed and Dialnet databases for articles published between 30 November 2015 and 30 November 2025, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. PubMed was selected as the primary database because it is the most comprehensive source for peer-reviewed biomedical and psychiatric research, while Dialnet was included to complement PubMed by ensuring coverage of peer-reviewed psychiatric and psychological research published in other Romance-language journals, which are often underrepresented in international databases. The methodological quality and risk of bias of the included studies were evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for cross-sectional studies and the Newcastle–Ottawa Scale (NOS) for observational studies. Data extraction and synthesis were performed manually by two independent reviewers. Eight studies, predominantly cross-sectional in nature, assessing exclusively formally diagnosed personality disorders in adult individuals (≥18 years) diagnosed with GD were included. Results: Eight studies met the inclusion criteria, including a total of 4607 patients with GD. Across studies, personality pathology was highly prevalent among individuals with GD, with antisocial and borderline personality disorders most consistently reported. Elevated levels of impulsivity, emotional dysregulation, and narcissistic traits were frequently observed and were additionally associated with greater gambling severity, earlier onset, and poorer clinical outcomes. Antisocial personality symptoms were strongly linked to high-risk gambling subtypes, while obsessive–compulsive personality traits showed a more heterogeneous relationship with gambling severity. Conclusions: These results underscore the importance of personality assessment in individuals with GD and highlight the need for longitudinal studies using standardized diagnostic frameworks to inform tailored prevention and treatment strategies. Full article

This study examines the profiles of secondary special education teachers regarding their readiness for inclusive teaching, with technology-enhanced practices operationalized through participation in STEAM-related professional development. A total of 323 teachers from vocational high schools and integration classes participated. Four indicators of professional preparation were assessed: years of teaching experience, formal STEAM training, exposure to students with special educational needs (SEN), and perceived success in inclusive teaching, operationalized as self-reported competence in adaptive instruction, classroom management, positive attitudes toward inclusion, and collaborative engagement. Cluster analysis revealed three distinct teacher profiles: less experienced teachers with moderate perceived success and limited exposure to students with SEN; well-prepared teachers with high levels across all indicators; and highly experienced teachers with lower STEAM training and perceived success. These findings underscore the need for targeted professional development that integrates inclusive and technology-enhanced pedagogy through STEAM and is tailored to teachers’ experience levels. By integrating inclusive readiness, STEAM-related preparation, and technology-enhanced pedagogy within a person-centered profiling approach, this study offers actionable teacher profiles to inform differentiated professional development in secondary special education. Full article

Data governance for responsible AI systems remains challenged by the lack of automated tools that can apply robust privacy-preserving techniques without destroying analytical value. We propose AnonymAI, a novel methodological framework that integrates LLM-based intelligent agents, the mathematical guarantees of differential privacy, and an automated workflow to generate anonymized datasets for analytical applications. This framework produces data tables with formally verifiable privacy protection, dramatically reducing the need for manual classification and the risk of human error. Focusing on the protection of tabular data containing sensitive personal information, AnonymAI is designed as a generalized, replicable pipeline adaptable to different regulations (e.g., General Data Protection Regulation) and use-case scenarios. The novelty lies in combining the contextual classification capabilities of LLMs with the mathematical rigor of differential privacy, enabling an end-to-end pipeline from raw data to a protected, analysis-ready dataset. The efficiency and formal guarantees of this approach offer significant advantages over conventional anonymization methods, which are often manual, inconsistent, and lack the verifiable protections of differential privacy. Validation studies, covering both controlled experiments on four types of synthetic datasets and broader tests on 19 real-world public tables from various domains, confirmed the applicability of the framework, with the agent-based classifier achieving high overall accuracy in identifying confidential columns. The results demonstrate that the protected data maintains high value for statistical analysis and machine learning models, highlighting AnonymAI’s potential to advance responsible data sharing. This work paves the way for trustworthy and scalable data governance in AI through a rigorously engineered automated anonymization pipeline. Full article

Mega-event-led urban waterfront regeneration has played a key role in shaping public open spaces, particularly in newly developed areas within the Chinese context. However, public perceptions and their influence on the use of newly built open spaces created through mega-event-led regeneration have not been examined in existing research. To address this gap, this study establishes an integrated assessment framework to evaluate the quality of urban waterfront open spaces. A mixed methods approach was adopted, including direct observations and 770 online questionnaires collected between July and October 2024 at the South Bank of the Qiantang River (SBQR) in Hangzhou, China. Spatial analysis and Importance–Performance Analysis (IPA) were employed to determine priority improvement areas that should inform future waterfront regeneration strategies. The results indicate that inclusiveness emerged as the most important factor for enhancing waterfront open space quality, while spatial aesthetics ranked the lowest. Among the sub-sub factors, elements related to improving water accessibility, enhancing natural surveillance, providing artificial shelters and diverse seating options, introducing distinctive water features, and shaping collective memory through digital technologies are the key priorities for improvement in the future urban waterfront regeneration policies. Finally, the study highlights that the intangible legacies of the Asian Games and the adaptive reuse of informal built heritage have the potential to reshape a distinctive new city image and collective memory, even in the absence of tangible and formally recognised heritage buildings. Full article

This study investigates the configurational pathways enabling women in Oman to translate entrepreneurial intentions into technology venture creation. By integrating institutional theory and resource-based view, we develop a novel framework examining how formal institutional support (FIS), informal institutional support (IIS), and digital self-efficacy (DSE) interact in Oman’s conservative context. We emphasize the significant enabling role of work–life balance resources (WLBR) and the cultural legitimacy of spousal endorsement. Our mixed-methods design utilizes survey data from 418 female IT graduates and 20 semi-structured interviews, analyzed through fuzzy-set Qualitative Comparative Analysis (fsQCA). The findings indicate that FIS predicts entrepreneurial intention (β = 0.34, p < 0.001) but not venture creation (OR = 0.85, p = 0.298), revealing a visibility gap in policy implementation. IIS predicts venture creation (OR = 1.43, p = 0.033), with spousal endorsement acting as a cultural legitimacy signal. DSE alone fails to predict venture creation but is vital when combined with WLBR. FsQCA identifies a sufficient configuration pathway characterized by the combination of spousal endorsement, domestic support, DSE, and WLBR with solution consistency of 0.93 and coverage of 0.78. WLBR is a necessary condition with necessity consistency of 0.96, demonstrating that venture creation is improbable without it. Qualitative evidence shows founders reposition conservative norms as legitimacy signals, while non-founders emphasize funding barriers despite policy awareness. We recommend that policymakers subsidize care infrastructure, leverage women-led community networks for targeted outreach, and formalize state-backed legitimacy programs that reduce kinship dependency while building autonomy-focused alternatives. Full article

Background: Depression and diabetic neuropathy (DN) commonly complicate diabetes and impair glycemic control and quality of life. Ketamine and its S-enantiomer, esketamine, provide rapid antidepressant and analgesic effects, yet diabetes-related pathophysiology and co-therapies may modify exposure, response, and safety. Methods: We conducted a scoping review following PRISMA-ScR. MEDLINE/PubMed, CINAHL, and APA PsycInfo were searched (January 2020–31 May 2025). Eligible human and animal studies evaluated ketamine, esketamine, or norketamine in the context of diabetes (type 1 [T1DM], type 2 [T2DM], gestational [GDM]), or DN, and reported psychiatric, analgesic, metabolic, or mechanistic outcomes. Two reviewers independently screened and charted data; no formal risk-of-bias assessment was performed. Results: Eleven studies met inclusion criteria: four human case reports/series (three T1DM, one T2DM), one randomized trial in GDM, two narrative reviews of topical ketamine for DN, and four preclinical rodent studies using streptozotocin- or diet-induced diabetes models. Short-term improvements were reported for treatment-resistant depression and neuropathic pain, including opioid-sparing postoperative analgesia in GDM. Glycemic effects varied across settings, with both hyperglycemia and hypoglycemia reported. Mechanistic and clinical drug–drug and drug-disease interactions (particularly involving metformin, GLP-1 receptor agonists, SGLT2 inhibitors, and CYP3A4/CYP2B6 modulators) remain insufficiently studied. We outline a forward-looking population pharmacokinetic (popPK) and pharmacokinetic-pharmacodynamic (PK-PD) research agenda, including priority covariates (eGFR, hepatic function, inflammatory status, HbA1c, genotype, co-medications) and sparse-sampling windows for future model-informed precision dosing. Conclusions: Current evidence supports cautious, selective use of ketamine for refractory depression and DN within multidisciplinary diabetes care. Purpose-built popPK/PK-PD studies in both human and preclinical diabetic models cohorts are needed to quantify variability, define drug–disease–drug interactions and glycemic risk, and inform individualized dosing strategies. Full article

Violence against women remains prevalent, yet many survivors do not engage with services even where health infrastructure exists. This study investigated the role of institution-facing resources, Institutional Trust (ITR) and Procedural Justice (PJ), and the role of interpersonal resources, Social Support Provided (SSP), in women’s formal care-seeking intentions, as mediated by Psychological Distress (PSS) and General Self-Efficacy (GSE). An online survey was administered to women in Greece (n = 392) and the United Kingdom (n = 328), yielding a sample of 718. To compare the structural paths in the model across the two countries, measurement invariance was first explored, while the model was estimated through multi-group structural equation modeling. Across the pooled sample, PJ and GSE predicted HSB firmly, while ITR had no direct link to the construct. SSP did not directly predict HSB, but was linked to GSE in all models. The results of the interaction and group-difference models showed PJ and SSP had a slight indirect effect through GSE, while distress-based pathways were weaker and context-dependent. Multi-group models revealed significant cross-national differences: the direct effect of ITR and PSS on GSE was stronger in the United Kingdom than in Greece. The direct effect of PJ/GSE and SSP/GSE also had a stronger impact in Greece than in the United Kingdom. Overall, the results indicate that the willingness of women to seek help is less driven by their trust in institutions and more driven by their expectations of fairness in provider interaction and their perceived personal capability, where social support plays a role as the antecedent increasing women’s Perceived Self-Efficacy. The implications include prioritizing procedurally just practices, designing interventions that enhance self-efficacy for system navigation, and mobilizing informal networks as partners in the help-seeking process. Full article

This study investigates parents’ experiences of partnerships with their children’s preschool teachers in Sweden, focusing on two questions: (1) How do parents describe communication with preschool teachers, and what information about their child is valued? (2) How do parents position preschool in their child’s life? Framed through Bourdieu’s concept of habitus, the analysis examines how parents’ dispositions, values, and prior experiences shape engagement with early childhood education. Data were collected via interviews with 25 parents across three counties in western Sweden and analysed using narrative methods. Findings show that parents prioritise communication about children’s well-being and social development as central to partnership, while instructional information is largely viewed as the teacher’s domain. Preschool is primarily seen as a context for socialisation, developing norms, values, and behaviours, rather than formal academic preparation. By exploring consistencies and contradictions in parental accounts, the study offers a nuanced understanding of how habitus informs parental expectations and communication practices, highlighting the complex interplay between family dispositions and preschool engagement. Full article

This paper empirically analyses variation in use of formally, semi-formally, and informally regulated finance using the South African National Income Dynamics Study longitudinal data. The logistic regressions indicate that many individuals use a combination of services across all levels of regulation depending on age, gender, education, population group, religiosity, and social trust. Widespread use of informally regulated finance in South Africa is particularly evident on the savings side through savings groups/stokvels. The originality of the paper lies in its use of nationally representative longitudinal data to disentangle and analyze the variations in the use of different financial mechanisms, moving beyond the conventional formal–informal dichotomy. In doing so, it contributes to ongoing debates on financial inclusion by demonstrating that informally regulated finance represents a rational, adaptive response to the limitations of formally regulated services rather than a residual or inferior alternative. Depicting the market as dualistic is therefore misleading, ignoring the need for a more nuanced understanding and official recognition of the drivers of financial services’ use. Full article

Kolmogorov complexity asks whether a string can be outputted by a Turing Machine (TM) whose description is shorter. Analogously, a real number is considered computable if a Turing machine can generate its decimal expansion. The modern $ϵ$-approximation definition of computability, widely used in practical computation, ensures that computable reals are constructively closed under addition. However, Turing’s original 1936 digit-by-digit notion, which demands the direct output of the $n\text{-th}$ digit, presents a stark divergence. Though the set of Turing-computable reals is not constructively closed under addition, we prove that a Turing machine capable of computing $x+y$ non-constructively exists. The core constructive computational barrier arises from determining the ones digit of a sum like $0.33\overline{3}+0.66\overline{6}=0.99\overline{9}=1.00\overline{0}$. This particular example is ambiguous because both $0.99\overline{9}$ and $1.00\overline{0}$ are legitimate decimal representations of the same number. However, if any of the infinite number of 3s in the first term is changed to a 2 (e.g., $0.33\dots 32\dots +0.66\overline{6}$), the sum’s leading digit is definitely zero. Conversely, if it is changed to a 4 (e.g., $0.33\dots 34\dots +0.66\overline{6}$), the leading digit is definitely one. This implies an inherent undecidability in determining these digits. Recent papers and our work address this issue. Hamkins provides an informal argument, while Berthelette et al. present more complicated formal proof, and our contribution offers a simple reduction to the Halting Problem. We demonstrate that determining when carry propagation stops can be resolved with a single query to an oracle that tells if and when a given TM halts. Because a concrete answer to this query exists, so does a TM computing the digits of $x+y$, though the proof is non-constructive. As far as we know, the analogous question for multiplication remains open. This, we feel, is an interesting addition to the story. This reveals a subtle but significant difference between the modern $ϵ$-approximation definition and Turing’s original 1936 digit-by-digit notion of a computable number, as well as between constructive and non-constructive proof. This issue of computability and numerical precision ties into algorithmic information and Kolmogorov complexity. Full article

As genomic technologies continue to evolve, understanding the scope and limitations of available prenatal testing methods is essential for accurate diagnosis and counseling. Chromosomal microarray analysis (CMA) and exome sequencing (ES) have emerged as key complementary tools in this setting. This review aims to outline the technical principles underlying CMA and ES and to compare their diagnostic capabilities and limitations in the prenatal context. This narrative review includes a literature search, with additional relevant articles identified through manual screening of reference lists from key publications and review articles. Due to the narrative nature of this review, no formal inclusion or exclusion criteria or quantitative synthesis were applied. Special focus was placed on clinical indications, variant interpretation challenges—particularly uncertain and incidental findings—gene selection strategies, and implications for prenatal counseling. Indications for both tests have increased over time but differ substantially. CMA is becoming the standard prenatal genetic test, particularly in the evaluation of fetal structural anomalies, whereas ES remains restricted to selected fetal structural anomalies. Interpretation of molecular results remains a major challenge, especially for variants of uncertain significance and incidental findings with unclear or unexpected implications for pregnancy management. For ES, agnostic gene selection strategies showed superior diagnostic yield compared with phenotype-driven approaches, likely reflecting the limited characterization of prenatal phenotypes. Continuous refinement of clinical indications, bioinformatic pipelines, variant classification criteria, and gene curation strategies is critical to ensure that prenatal results are accurate and clinically meaningful. Together, ongoing improvements in technology, interpretation, and clinical integration have the potential to transform prenatal genomics into a more precise, informed, and ethically responsible field. Full article

Under the pressures of neoliberalism, in Australia, the Victorian senior Music curriculum has been diminished. Neoliberal reforms have prioritised accountability, employability, and standardised outcomes, leading to a re-prioritisation of musical content and knowledge. This has led to reductions in musically specific content and increased focus on non-musical transferable skills. Concomitant has been an emphasis on informal processes within formal curricula. Highlighting implications for creativity, cultural diversity, and pedagogical practice, we contextualise changes to the Victorian example with curricula in the UK and US. Findings reveal a global trend toward more balanced, hybrid models integrating formal and informal learning. The findings inform debates on curriculum design, pedagogical practice, and policy development, highlighting the need for balanced approaches that preserve musical depth while accommodating broader educational goals. Full article

This research has successfully addressed the challenges attributed with SMS, including the fragmented data, heavy reliance on experience, and lack of life cycle integration. This study presents the development and validation of a novel sustainable material selection (SMS) model using Artificial Intelligence (AI). The proposed model structures the process around four core life cycle phases—design, construction, operation and maintenance, and end of life—and incorporates a dual-interface system. This includes a main credits interface for high-level tracking of 100 total credits to trace the dynamics of SMS in relation to energy efficiency, indoor air quality, site selection, and efficient use of water. Further, it includes a detailed credit interface for granular assessment of specific material properties. A key innovation is the formalization of closed-loop feedback mechanisms between phases, ensuring that practical insights from construction and operation inform earlier design choices. The model’s functionality is demonstrated through a proof of concept for SMS considering thermal properties, showcasing its ability to contextualize benchmarks by climate, map properties to building components via a weighted networking system, and rank materials using a comprehensive database sourced from the academic literature. Automated scoring aligns with green building certification tiers, with an integrated alert system flagging suboptimal performance. The proposed model was validated through a structured practitioner survey, and the collected responses were analysed using descriptive and inferential statistical analysis. The result presents a scalable quantitative AI-assisted decision-making support model for optimizing material selection across different project phases. This work paves the way for further research with additional assessment criteria and better integration of AI and Machine Learning for SMS. Full article

Objectives: Against common belief, mandibular condyle fractures are not that rare, with morbidity rates ranging from 19 to 52%, depending on actual literature sources. Practitioners try to improve the surgical techniques applied to obtain the most satisfactory anatomical and functional effect. The purpose of this study is to identify the relationships that affect bone loss around screws and plates in mandibular condylar process fractures treated surgically using the Open Reduction and Internal Fixation (ORIF) technique. Materials and Methods: Our research covered 276 fractures of the base, low and high neck of the condylar process. No formal sample size calculation was performed; the study enrolled patients treated at the Department during the last 4 years, based on informed consent granted both prospectively and retrospectively compares to the actual treatment time. The study group was selected based on injury type and the ability to implement surgical treatment. The imaging modality selected for the study was computed tomography (CT), which was assessed in each case by the same operator. Therefore, there was no need to account for inter-rater variability in the results. Based on CT scans, we studied various parameters, including bone healing in the fracture area, bone loss in the screws and plates area, change in the length of the mandibular ramus following osteosynthesis and on the opposite side after 12 months, as well as deformities of the mandibular head. Results: Using screws and plates is the gold standard for treating mandibular condylar process fractures. The number of screws used affects the bone loss ratio around head of the screw. Another factor that impacts the results achieved is the distance from the plate edge to the lateral pole of the mandibular head. Statistical evaluation indicated that proximity to the lateral pole is a risk factor for bone resorption at the plate edge. Conclusions: Based on the collected data, it is possible to predict bone loss, determine the location and selection of plates and screws, as well as to plan the procedure, achieving the lowest possible loss rates. Full article