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Background & aimsIn the United States, Non-Hispanic Black (Black) people are 2–threefold more likely than Non-Hispanic White (White) people to have pregnancy complications, such as a baby with low birthweight. Multi-level, community-based interventions aimed at mitigating the impacts of interpersonal and structural racism may decrease bias, improve the quality of care, and improve pregnancy outcomes. The Accountability for Cancer Care through Undoing Racism and Equity and the Heart Health Now studies reduced disparities in cancer treatment and cardiovascular risk, respectively. The Accountability for Care through Undoing Racism and Equity for Moms Study (ACURE4Moms) was modified from these successful interventions and designed to test the impact of multi-level, community-engaged antiracism interventions delivered on disparities in low birth weight (LBW) (Aim 1), experiences with perinatal depression and experiences with discrimination in medical settings (Aim 2) and other patient-centered outcomes. We will also measure implementation barriers and facilitators (Aim 3).MethodsACURE4Moms is a 4-arm, cluster-randomized trial which has enrolled 39 prenatal practices randomized to implement the following interventions for 2 years: Arm 1–Standard Care; Arm 2—Data Accountability and Transparency; Arm 3—Community-Based Doula linkages; and Arm 4—Data and Doula interventions combined. Practice staff in Arms 2–4 will also receive quarterly Maternal Healthcare Equity Education and Training. A subgroup of 100 Black patients from each practice will participate in a longitudinal survey that measures mental health symptoms and experiences with discrimination during pregnancy and postpartum. A stakeholder advisory board including doulas, community members, and policymakers helps to make decisions regarding study design, implementation, and dissemination.Multi-level mixed models will be used to evaluate outcomes using administrative, vital records and survey data. The primary outcome is a reduction in low birth weight for Black infants. Secondary outcomes include reductions in hospitalizations and emergency department use, mental health symptoms, and experiences with discrimination during pregnancy and postpartum. Intermediate outcomes include implementation barriers and facilitators.DiscussionThe findings of the ACURE4Moms study will inform policy makers, health systems, clinicians and communities about the effectiveness of multi-level, practice-based interventions to reduce maternal health disparities and provide information regarding scalability.Trial RegistrationThis trial has been prospectively registered as (7/29/2022) with clinicaltrials.gov under the name Accountability for Care Through Undoing Racism & Equity for Moms (ACURE4Moms), Identifier: NCT05484804. URL: https://clinicaltrials.gov/ct2/show/NCT05484804.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13063-026-09514-9.

Information systems play a critical role in enhancing service quality and operational efficiency in healthcare institutions. However, personnel and activity management in many hospitals is still conducted through manual or fragmented processes, leading to data duplication, administrative delays, limited transparency, and difficulties in generating accurate reports. RSKM Regina Eye Center faces similar challenges, particularly in recording daily employee activities, managing leave and overtime submissions, and organizing doctor schedules, which are not yet integrated into a unified system. This study aims to design and develop a web-based Hospital Personnel and Activity Management Information System (SIM-KARS) to address these issues. The system was developed using the Waterfall method for software development and implemented with the Laravel framework, supported by PHP, JavaScript, and MySQL. System evaluation was conducted through black-box testing and a user satisfaction assessment. The results indicate that SIM-KARS improves administrative efficiency, data accuracy, transparency, and ease of access to personnel information. User evaluation results show a satisfaction level of 90%, reflecting positive user acceptance and perceived usefulness. This study contributes a practical, integrated model for digitalising personnel and operational activity management in specialised hospitals to support data-driven decision-making and sustainable healthcare administration. Contribution to Sustainable Development Goals (SDGs):SDG 3: Good Health and Well-BeingSDG 9: Industry, Innovation, and InfrastructureSDG 16: Peace, Justice, and Strong Institutions

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This dissertation aims to gain insights into achieving sustainable human use of the oceans through investigating human attitudes towards utilizing marine resources in coastal Chinese society. An online survey and a grounded-theory approach were utilized to collect data and carry out the multifaceted analysis. It is discovered the majority of coastal Chinese citizens have favorable attitudes towards marine environment and marine life protection. How Chinese people perceive the use of marine life is correlated with their moral orientations and core environmental values. In terms of offshore oil and gas resources, Chinese people hold a low support, high risk-perception, and moderate trust over offshore oil and gas drilling. Such attitudes find their origin on the one hand in the millennia old Chinese history and agrarian society, on the other hand in the Confucianism-based traditional Chinese culture. Findings from this research draw attention to the concepts of morality, anthropocentrism, and cultural and social context in sustainable human use of the oceans.

Abstract Does the reader comprehend the text because the reader is able or because the text is easy? Localizing the cause of comprehension in either the reader or the text is fraught with contradictions. A proposed solution uses a Rasch equation to models comprehension as the difference between a reader measure and text measure. Computing such a difference requires that reader and text are measured on a common scale. Thus, the puzzle is solved by positing a single continuum along which texts and readers can be conjointly ordered. A reader’s comprehension of a text is a function of the difference between reader ability and text readability. This solution forces recognition that generalizations about reader performance can be text independent (reader ability) or text dependent (comprehension). The article explores how reader ability and text readability can be measured on a single continuum, and the implications that this formulation holds for reading theory, the teaching of reading, and the testing of reading.

Abstract In his classic paper entitled “The Unreasonable Effectiveness of Mathematics in the Natural Sciences,” Eugene Wigner addresses the question of why the language of Mathematics should prove so remarkably effective in the physical [natural] sciences. He marvels that “the enormous usefulness of mathematics in the natural sciences is something bordering on the mysterious and that there is no rational explanation for it.” We have been similarly struck by the outsized benefits that theory based instrument calibrations convey on the natural sciences, in contrast with the almost universal practice in the social sciences of using data to calibrate instrumentation.

The increase in life expectancy, leading to a rise in the proportion of older people, is accompanied by a prevalence of age-related disorders among the world population, the fight against which today is one of the leading biomedical challenges. Exploring the biological insights concerning the lifespan is one of the ways to provide a background for designing an effective treatment for the increase in healthy years of life. Untargeted direct injection mass spectrometry-based metabolite profiling of 12 species of Drosophila with significant variations in natural lifespans was conducted in this research. A cross-comparison study of metabolomic profiles revealed lifespan signatures of flies. These signatures indicate that lifespan extension is associated with the upregulation of amino acids, phospholipids, and carbohydrate metabolism. Such information provides a metabolome-level view on longevity and may provide a molecular measure of organism age in age-related studies.

Over the last few decades, global health workforce inequalities have increased. The covid-19 pandemic indicates how essential health care workers are to protect societal health and economies. This thesis takes a cosmopolitan outlook, to study what is required to develop the global health workforce in an equitable manner. It looks into principles and policies of global health governance to assess what has been done to strengthen the health workforce and how to govern health labour migration while respecting human rights. It shows that there is a paradox in economic globalization, which leads to a structural problem to invest in the health workforce at the national level. Overcoming this ‘gridlock’ requires that countries take a shared sovereignty approach and find ways to regulate economic globalization so that it benefits the public good rather than the wealth of a few.