Search Results (677)

Many companies engage in earnings manipulation that obscures their actual financial condition and sustainability efforts, undermining the credibility of financial reports and eroding stakeholder trust. To address these concerns, the United Kingdom has strictly adhered to International Financial Reporting Standards (IFRS), enhancing financial transparency and reducing the risk of manipulation. This study applies agency theory to examine the effects of earnings management and IFRS adoption on corporate sustainability performance, while also assessing the moderating roles of institutional ownership and board independence. Data were drawn from 248 companies listed on the London Stock Exchange between 2002 and 2024, using purposive sampling and sourced from Thomson Reuters Eikon DataStream. Advanced estimation techniques, specifically the Augmented Mean Group (AMG) and fixed effects models with Driscoll-Kraay standard errors, were employed to address cross-sectional dependence and slope heterogeneity. The results indicate that earnings management, as measured by discretionary accruals, has a significant negative impact on sustainability performance. In contrast, the adoption of IFRS has a positive and significant influence on sustainability outcomes. Additionally, institutional ownership and board independence significantly moderate the adverse effects of earnings management, leading to improved sustainability performance. The findings suggest that managers should enhance the clarity and accountability of financial reporting by implementing robust internal systems aligned with IFRS, conducting regular compliance audits, and training finance staff on current disclosure standards. Full article

Background: As means of addressing ongoing challenges in accessing publicly funded specialist care, new models of care have been trialled. One such approach is using physiotherapists in advance practice roles, who in collaboration with other health professionals, act as an initial orthopedic point of contact and coordinate care. This research investigated the impact of a model of care, the Spinal Virtual Clinic Model, implemented for the first time in South Australia, using advanced practice physiotherapists in a large metropolitan hospital in South Australia. Although formally named the “Spinal Virtual Clinic” by the health service, this model does not involve direct patient contact and differs from traditional virtual or telehealth clinics. Instead, it is best understood as a physiotherapy-led referral triage and management service. Methods: This research was conducted in two stages. Stage 1 was a retrospective clinical audit of sequential patients triaged to the Spinal Virtual Clinic, as well as a follow up audit to capture any subsequent engagement with the Orthopaedic Spinal Service following the initial Spinal Virtual Clinic correspondence. Data were descriptively analysed. In Stage 2, semi-structured interviews were conducted with patients from the Spinal Virtual Clinic to explore their perspectives on this model of care. The interviews were transcribed verbatim and independently analysed using thematic analysis. The sequential use of quantitative and qualitative approaches enabled us to both describe engagement with this model of care and better understand the underlying perspectives. Results: Three hundred and nine referrals were triaged to the physiotherapy-led spinal virtual clinic over a six-month period from 1 January 2021 to 30 June 2021. Majority of referrals were triaged as low acuity did not need formal spinal specialist review and could be managed safely in primary care. Therapist-led active management strategies (80.8%), trial of neuropathic medication (35.6%) closely followed by advice regarding targeted spinal injections (foraminal and epidural), were the most common conservative management strategies recommended. Only a small proportion needed surgical review. Interviews with eleven patients revealed that while many valued the convenience, timely advice, and reassurance offered by the service, others expressed confusion about the referral process and disappointment at not seeing a specialist. A key recommendation identified was improved communication, including providing patients with direct feedback alongside general practitioner correspondence. Conclusions: This research, underpinned by quantitative and qualitative research, has showcased the potential of this model of care, the spinal virtual clinic, to have a positive impact on improving access and reducing the burden on the health system for low acuity patients. As historical models of care become unsustainable and obsolete, alternative models of care can be implemented in health care settings where outpatient demand significantly exceeds capacity. Full article

The integration of blockchain technology into healthcare offers a robust solution to challenges in secure data sharing, privacy protection, and operational efficiency. Effective exchange of sensitive patient information among hospitals, clinics, insurers, and researchers is essential for better outcomes and medical advancements. Traditional centralized systems often suffer from data breaches, inefficiency, and poor interoperability. This paper presents a blockchain-based secure data-sharing framework tailored for healthcare, addressing these limitations. The framework employs a hybrid blockchain model, combining private and public blockchains: the private chain ensures fast transactions and controlled access, while the public chain fosters transparency and trust. Advanced cryptographic methods—such as asymmetric encryption, hashing, and digital signatures—safeguard patient data and maintain integrity throughout the datalifecycle. Smart contracts automate processes like consent management, access control, and auditing, ensuring dynamic permission enforcement without intermediaries. Role-based access control (RBAC) further limits access to authorized entities, enhancing privacy. To tackle interoperability, standardized data formats and protocols enable smooth communication across diverse healthcare systems. Large files, such as medical images, are stored off-chain, with only essential metadata and logs on the blockchain. This approach optimizes performance, scalability, and suitability for large-scale healthcare deployments. Full article

Cross-border data flows are critical to the operation of global supply chains, particularly for digital enterprises such as Alibaba and Infosys. However, these flows introduce substantial challenges related to digital supply chain risk and cybersecurity management. This study examines how blockchain technology addresses these challenges within the operational contexts of Alibaba and Infosys. Unlike earlier research that often focused on sector-specific implementations or conceptual models, this study positions its findings within broader empirical evidence on blockchain-enabled supply chain governance, offering a comparative perspective that has been largely absent in prior work. Using an explanatory mixed-methods approach, the research combines thematic analysis of 85 peer-reviewed studies with in-depth case evaluations of the two firms. NVivo-based qualitative coding was applied to supporting sources, including GDPR audit reports, blockchain transaction records, and company disclosures. The findings demonstrate that blockchain adoption reduces cybersecurity breaches, enhances data integrity, and improves supply chain resilience. The study further shows how blockchain integration strengthens digital collaboration and regulatory alignment, enabling secure and uninterrupted data flows that support operational continuity and innovation. Overall, the research offers practical insights for digital enterprises and contributes to a deeper understanding of blockchain’s strategic role in cross-border data risk management. Full article

Substance use during pregnancy is an increasingly important yet under-recognized threat to maternal and child health. This narrative review synthesizes the current evidence available on the epidemiology, pathophysiology, clinical management, and policy landscape of prenatal exposure to alcohol, tobacco, opioids, benzodiazepines, cocaine, cannabis, methamphetamines, and other synthetic drugs. All major psychoactive substances readily cross the placenta and can remain detectable in breast milk, leading to a shared cascade of obstetric complications (hypertensive disorders, placental abruption, pre-term labor), fetal consequences (growth restriction, structural malformations), and neonatal morbidities such as neonatal abstinence syndrome and sudden infant death. Mechanistically, trans-placental diffusion, oxidative stress, inflammatory signaling, and placental vascular dysfunction converge to disrupt critical neuro- and cardiovascular developmental windows. Early identification hinges on the combined use of validated screening questionnaires (4 P’s Plus, CRAFFT, T-ACE, AUDIT-C, TWEAK) and matrix-specific biomarkers (PEth, EtG, FAEE, CDT), while effective treatment requires integrated obstetric, addiction, and mental health services. Medication for opioid use disorders, particularly buprenorphine, alone or with naloxone, confers superior neonatal outcomes compared to methadone and underscores the value of harm-reducing non-punitive care models. Public-health strategies, such as Mexico’s “first 1 000 days” framework, wrap-around clinics, and home-visiting programs, demonstrate the potential of multisectoral interventions, but are hampered by structural inequities and punitive legislation that deter care-seeking. Research gaps persist in polysubstance exposure, culturally tailored therapies, and long-term neurodevelopmental trajectories. Multigenerational, omics-enabled cohorts, and digital longitudinal-care platforms represent promising avenues for closing these gaps and informing truly preventive perinatal health policies. Full article

In the ever-evolving world full of technologies, blockchain proves itself to be the most secure way of dealing with tampering of data. This paper proposes an innovative model for tracking employees within facilities using RFID, IoT devices and blockchain technology implemented on the Hyperledger Fabric platform. The blockchain system supports a secure and tamper-proof recording of employee movement because it keeps the data in a decentralized system. Smart contracts automate activities like control access, generate alerts and create audit trails without the need for centralized management. This implementation shows a high level of security and efficiency, making it a good approach to improve monitoring and compliance within organizations. Full article

This study assesses energy management practices in the automotive sector of Poland’s Silesian Voivodeship, a highly industrialized region. Using structured interviews with 40 manufacturing firms, it examines the adoption of energy monitoring, submetering, Energy Performance Indicators (EnPIs), audits, and energy efficiency investments. The research addresses the problem of persistent energy waste and the difficulties many firms face in integrating ISO 50001-aligned energy management into daily operations, where declared policies often outpace actual practices. Results show that 92.5% of firms monitor total energy consumption, but only 40% implement submetering, and 45% use EnPIs. Half have conducted energy audits, and 85% report taking energy-saving actions such as lighting upgrades, equipment modernization, and thermal improvements. However, no companies reported measurable energy or cost savings, and few track investment outcomes quantitatively. While energy awareness is widespread, many practices appear to be implemented in a tactical manner, potentially lacking strategic integration or consistent performance tracking. Larger firms are more likely to use audits and EnPIs, while smaller firms face barriers such as limited resources or technical expertise. The findings highlight a need for formalized EMS adoption, standardized energy governance, and greater use of performance-based tools such as EnPIs. By exploring EMS-aligned behavior without referencing management systems directly, the study provides a unique lens on the operational maturity of industrial firms. Full article

Wildlife rescue centres face considerable challenges in promoting animal welfare and enhancing the care and housing conditions of animals under professional supervision. These challenges are further compounded by the diversity of species admitted, each with distinct specific needs. In Colombia and other Latin American countries, primates are among the most frequently rescued and behaviourally complex mammalian taxa, requiring particular attention. In response, this study aimed to assess the content validity of proposed animal welfare indicators for Cebus albifrons through a Delphi consultation process and to develop two species-specific assessment protocols: a daily-use tool for keepers and a comprehensive protocol for professional audits. A panel of 23 experts in primate care and rehabilitation participated in two consultation rounds to evaluate and prioritise the indicators based on their content validity, perceived reliability, and practicality. Indicators were classified as either animal-based (direct measures) or resource- and management-based (indirect measures). After each round, experts received summarised feedback to refine their responses and facilitate consensus building. Of the 39 initially proposed indicators, 28 were validated for inclusion in the extended protocol and 10 selected for the daily-use checklist. Among these, 20 indicators in the extended protocol and 6 in the daily protocol were resource- or management-based—such as adequate food provision, physical enrichment, and habitat dimensions—highlighting their practical applicability and relevance in identifying welfare issues and risk factors. Although these indirect indicators were more numerous, the top-ranked indicators in both protocols were animal-based, including signs of pain, affiliative behaviours, and abnormal repetitive behaviours. These are essential for accurately reflecting the animals’ welfare state and are therefore critical components of welfare assessment in captive non-human primates. This study demonstrates that welfare assessment tools can be effectively tailored to the specific needs of wildlife rescue centres, providing a robust foundation for enhancing welfare practices. These protocols not only offer practical approaches for assessing welfare but also underscore the importance of embedding animal welfare as a priority alongside conservation efforts. Future research should aim to refine these tools further, assess their implementation, and evaluate inter- and intra-observer reliability to ensure consistency across different settings. Full article

The EU Artificial Intelligence Act (Regulation (EU) 2024/1689) designates AI systems used in life and health insurance underwriting as high-risk systems, imposing rigorous requirements for bias testing, technical documentation, and post-deployment monitoring. Leveraging 12.4 million quote–bind–claim observations from four pan-European insurers (2019 Q1–2024 Q4), we evaluate how compliance affects premium schedules, loss ratios, and solvency positions. We estimate gradient-boosted decision tree (Extreme Gradient Boosting (XGBoost)) models alongside benchmark GLMs for mortality, morbidity, and lapse risk, using Shapley Additive Explanations (SHAP) values for explainability. Protected attributes (gender, ethnicity proxy, disability, and postcode deprivation) are excluded from training but retained for audit. We measure bias via statistical parity difference, disparate impact ratio, and equalized odds gap against the 10 percent tolerance in regulatory guidance, and then apply counterfactual mitigation strategies—re-weighing, reject option classification, and adversarial debiasing. We simulate impacts on expected loss ratios, the Solvency II Standard Formula Solvency Capital Requirement (SCR), and internal model economic capital. To translate fairness breaches into compliance risk, we compute expected penalties under the Act’s two-tier fine structure and supervisory detection probabilities inferred from GDPR enforcement. Under stress scenarios—full retraining, feature excision, and proxy disclosure—preliminary results show that bottom-income quintile premiums exceed fair benchmarks by 5.8 percent (life) and 7.2 percent (health). Mitigation closes 65–82 percent of these gaps but raises capital requirements by up to 4.1 percent of own funds; expected fines exceed rectification costs once detection probability surpasses 9 percent. We conclude that proactive adversarial debiasing offers insurers a capital-efficient compliance pathway and outline implications for enterprise risk management and future monitoring. Full article

The Sharia Supervisory Board (SSB) and the Audit Committee (AC) are crucial components of Good Corporate Governance (GCG) in Islamic banks. This study investigates the moderating role of SSB conflicts of interest arising from cross-membership in various Islamic Financial Institutions (IFIs) and AC members’ independence in the relationship between GCG and Islamic bank performance in Indonesia. Using a sample of ten full-fledged Islamic banks from 2014 to 2023, a Moderated Regression Analysis (MRA) was employed to test three hypotheses. The key findings indicate a significant positive relationship between GCG and Islamic bank financial performance. However, no significant moderating effects of SSB conflicts of interest on the GCG–performance relationship were found. Conversely, a significant positive moderating effect of AC independence was identified. These results have important implications for practitioners, regulators, and stakeholders of the Islamic banking industry. Islamic banks should prioritize the establishment of independent audit committees to strengthen their governance framework. While SSB cross-membership may not necessarily harm performance, banks should implement appropriate oversight mechanisms to manage potential conflicts of interest. The Indonesian Financial Services Authority (OJK) and similar regulatory bodies should continue to emphasize the importance of audit committee independence in their governance guidelines. Full article

Artificial intelligence (AI) is playing an increasingly important role in driving sustainable change across coastal and marine environments. Artificial intelligence offers strong support for environmental decision-making by helping to process complex data, anticipate outcomes, and fine-tune day-to-day operations. In busy coastal zones such as the Mediterranean where tourism and boating place significant strain on marine ecosystems, AI can be an effective means for marinas to reduce their ecological impact without sacrificing economic viability. This research examines the contribution of artificial intelligence toward the development of environmental sustainability in marina management. It investigates how AI can potentially reconcile economic imperatives with ecological conservation, especially in high-traffic coastal areas. Through a focus on the impact of social and technological context, this study emphasizes the way in which local conditions constrain the design, deployment, and reach of AI systems. The marinas of Ibiza and Monaco are used as a comparative backdrop to depict these dynamics. In Monaco, efforts like the SEA Index^® and predictive maintenance for superyachts contributed to a 28% drop in CO₂ emissions between 2020 and 2025. In contrast, Ibiza focused on circular economy practices, reaching an 85% landfill diversion rate using solar power, AI-assisted waste systems, and targeted biodiversity conservation initiatives. This research organizes AI tools into three main categories: supervised learning, anomaly detection, and rule-based systems. Their effectiveness is assessed using statistical techniques, including t-test results contextualized with Cohen’s d to convey practical effect sizes. Regression R² values are interpreted in light of real-world policy relevance, such as thresholds for energy audits or emissions certification. In addition to measuring technical outcomes, this study considers the ethical concerns, the role of local communities, and comparisons to global best practices. The findings highlight how artificial intelligence can meaningfully contribute to environmental conservation while also supporting sustainable economic development in maritime contexts. However, the analysis also reveals ongoing difficulties, particularly in areas such as ethical oversight, regulatory coherence, and the practical replication of successful initiatives across diverse regions. In response, this study outlines several practical steps forward: promoting AI-as-a-Service models to lower adoption barriers, piloting regulatory sandboxes within the EU to test innovative solutions safely, improving access to open-source platforms, and working toward common standards for the stewardship of marine environmental data. Full article

This paper proposes and evaluates a novel real-time cybersecurity framework integrating artificial intelligence (AI) and blockchain technology to enhance the detection and auditability of cyber threats. Traditional cybersecurity approaches often lack transparency and robustness in logging and verifying AI-generated decisions, hindering forensic investigations and regulatory compliance. To address these challenges, we developed an integrated solution combining a convolutional neural network (CNN)-based anomaly detection module with a permissioned Ethereum blockchain to securely log and immutably store AI-generated alerts and relevant metadata. The proposed system employs smart contracts to automatically validate AI alerts and ensure data integrity and transparency, significantly enhancing auditability and forensic analysis capabilities. To rigorously test and validate our solution, we conducted comprehensive experiments using the CICIDS2017 dataset and evaluated the system’s detection accuracy, precision, recall, and real-time responsiveness. Additionally, we performed penetration testing and security assessments to verify system resilience against common cybersecurity threats. Results demonstrate that our AI-blockchain integrated solution achieves superior detection performance while ensuring real-time logging, transparency, and auditability. The integration significantly strengthens system robustness, reduces false positives, and provides clear benefits for cybersecurity management, especially in regulated environments. This paper concludes by outlining potential avenues for future research, particularly extending blockchain scalability, privacy enhancements, and optimizing performance for high-throughput cybersecurity applications. Full article

Background/Objectives: An evidence-based list of key variables regarding jejunoileal atresia (JIA) care needs to be established to enable quality evaluation and optimization of its care. The aim of this study is to provide an overview of reported patient, treatment, and outcome variables for JIA as documented in recent literature. This list has not been developed previously and will be the foundation for a JIA quality indicator set of the European Pediatric Surgery Audit (EPSA). Methods: A systematic review of the literature on the primary care path of JIA, published between 2013 and 2023, was conducted following the PRISMA guidelines. All relevant patient characteristics, parameters regarding JIA treatment, and outcomes were extracted from the included publications. Results: A total of 844 variables were extracted from 94 included articles. One hundred fifty-seven parameters were mentioned in more than 5% of publications. The most mentioned patient characteristics were sex (86%), gestational age (71%), and associated anomalies (66%). The most mentioned treatment parameters were stoma placement (34%), primary anastomosis (41%), and time to full enteral nutrition (24%). Most mentioned outcomes were mortality (70%), length of hospital stay (55%), and complications (60%). Conclusions: This study created an overview of reported patient characteristics, treatment, and outcome variables regarding the treatment of JIA. A focus on the short-term management and outcomes of JIA was observed; frequently discussed topics were perioperative management, surgical techniques, and feeding management. Our results will serve as the foundation for a Delphi study to develop a core indicator set for JIA, enabling benchmarking and measurement of quality of care. Full article

Background/Objectives: Green light laser photosensitive vaporisation of the prostate (GLL-PVP) is a common procedure for bladder outlet obstruction, with a low incidence of post-operative bleeding. At Northern Health, postoperative management involved limited bladder washout with two bags of 2 L saline, spigotting, and undergoing a trial of void (TOV) the next morning. A new model of care was commenced in which patients were discharged after the two bags of washout, and the TOV occurred at home through the Hospital in the Home service. The aim of this study was to audit patient outcomes, patient satisfaction, and health service benefits of this novel program. Methods: Patients assigned to the program between March 2023 and June 2024 were analysed. Catheter removal occurred the morning after surgery, and the decision on the success of the TOV was made following an afternoon review. Results: A total of 93.3% (28/30) patients passed their TOV at home. There were no readmissions in the first 48 h postoperation, with only three emergency department (ED) presentations in this time. On a five-point rating scale, 25/25 questionnaire respondents were happy with their care, 20/25 rated the service as very good, and 5/25 rated the service as good. An extra AUD 3377.56 in revenue was generated per patient from the freed inpatient beds, which correlated to a net revenue of AUD 83,016.83 generated over the study period. Conclusions: At-home TOV after GLL-PVP is safe and feasible. There is high patient satisfaction and significant benefits to the healthcare system. This framework can additionally be adopted after other urological surgeries. Full article

The shift towards renewable energy has highlighted the importance of sustainable practices in wind power development, particularly concerning the end-of-life (EoL) management of wind turbine blades. Conventional blades made from thermoset resins present significant recycling challenges due to their cross-linked structure, which often leads to landfill disposal or energy-intensive recycling processes. This study evaluates the environmental impacts of 45 m wind turbine blades using the Eco Audit approach across four primary life cycle stages: material production, manufacturing, transportation, and operation and maintenance. Six blade models with different fiber and resin configurations are assessed, focusing on a comparison between conventional thermoset resins and Elium, a newly developed liquid thermoplastic resin by Arkema. Elium offers promising recyclability options, including mechanical and chemical processes, which could substantially lower the environmental burden. Compared to composites made with thermoset resins, Elium-based blades demonstrate up to a 22.5% reduction in embodied energy and a 16% decrease in carbon footprint. Additionally, Elium’s compatibility with existing manufacturing processes, room-temperature curing capability, and lower processing energy contribute to its industrial feasibility. Notably, the analysis reveals that the material production phase significantly contributes to the total environmental impact, accounting for up to 98% of the embodied energy and carbon footprint in certain blade models, underscoring the importance of selecting a more sustainable resin, such as Elium, from the outset to reduce the overall environmental load. Full article