The integration of large language models (LLMs), commonly referred to as generative artificial intelligence (AI), into healthcare systems is increasingly common. The hope is that LLMs will reduce the workload on clinicians, streamline administrative tasks, and improve access to medical information. A new analysis of the output of LLMs published in the International Journal of Electronic Healthcare urges caution in their use, however. The work highlights the need for a nuanced understanding of what these tools actually do, and more importantly, what they do not.

LLMs, are statistical algorithms trained on large amounts of text and used to generate plausible sequences of words based on known patterns. They may appear to have what is commonly referred to as artificial intelligence (AI), but they do not understand the content of their training datasets nor their output. Indeed, the output is shaped not by reasoning but by mathematical correlations between words and phrases in the data on which it was trained and so, in a sense, LLMs are really just very sophisticated autocomplete systems.

The distinction between the received wisdom concerning AI and the workings of LLMs is critical, especially in the context of healthcare. The uncritical reliance on seemingly fluent and authoritative output from an LLM could be a matter of life or death when that output contains errors or worse, wholly incorrect 'hallucinations'.

There are also concerns regarding inherent bias in LLMs. Given that they are built on human-generated data, there is the possibility that said data contains embedded social, cultural, and institutional biases. These can manifest in outputs that inadvertently reinforce health disparities, particularly for patients from underrepresented or marginalised groups. For instance, if a model is trained primarily on data from Western clinical populations, its diagnostic suggestions or educational content may be less relevant, or even misleading, for patients with different backgrounds or needs.

Healthcare is not a static field; it is what scholars call a complex adaptive system, meaning that small changes can produce wide-reaching effects. The introduction of LLMs could subtly reshape how care is delivered, how records are kept, or even how professional expertise is perceived. Over time, increased reliance on AI-generated documentation or advice could deskill clinicians, shifting responsibility from trained professionals to automated systems. Meanwhile, patients may begin to see AI as a substitute for human attention, altering expectations around trust, empathy, and accountability in care.

In the light of these various risks, the research advocates for a model of reflexive governance, a flexible and responsive framework for monitoring and regulating AI in healthcare. This approach would replace rigid, one-time assessments with ongoing oversight that can adapt to new uses, emerging harms, and shifting ethical considerations. Crucially, such governance could and should go beyond technical safety to include values like equity, transparency, and patient autonomy.

Salzmann-Erikson, M., Göras, C., Lindberg, M., Arakelian, E. and Olsson, A. (2025) 'ChatGPT in complex adaptive healthcare systems: embrace with caution', Int. J. Electronic Healthcare, Vol. 14, No. 6, pp.1–17.
DOI: 10.1504/IJEH.2025.146764

As entrepreneurial firms expand into global markets, their success hinges not only on sound strategy or financial performance, but on a more elusive asset: legitimacy. A review in the International Journal of Entrepreneurship and Small Business has looked at a decade of academic research and reveals how boards of directors play a pivotal role in helping firms gain the acceptance and trust they need to operate and succeed in foreign environments.

Legitimacy, in this context, refers to the perception among local stakeholders, such as regulators, customers, business partners, and society in general, that any foreign firm is competent and fit to operate in the host nation. The concept goes beyond legal compliance or profitability. Without legitimacy, companies entering a host market will encounter the problem of what is referred to as the "liability of foreignness", a cluster of disadvantages noted by academics that arise from being perceived as outsiders. These include cultural missteps, limited networks, and suspicion from the local actors.

The review explores a little-studied dimension of internationalisation – the role of the Board in building legitimacy. The work draws on research from management studies, sociology, and political science. It then offers a cohesive framework that explains how Boards can help firms navigate and adapt to new institutional environments internationally.

Boards of directors are often comprised of seasoned professionals with governance duties and are traditionally viewed as vehicles for strategic oversight. But this review highlights a broader, dual function. Internally, boards influence legitimacy through their composition, ethical leadership, and adherence to good governance. Externally, they serve as conduits for reputational capital and local engagement, building connections with the political and economic hierarchy and aligning the company with the local societal norms.

Godley, A., Bolade-Ogunfodun, Y., Lodorfos, G., Nasr, R., Konstantopoulou, A., Soga, L.R. and Amankwah-Amoah, J. (2025) 'The role of governing boards in building legitimacy for new entrepreneurial ventures in host markets: a systematic literature review', Int. J. Entrepreneurship and Small Business, Vol. 55, No. 7, pp.1–36.
DOI: 10.1504/IJESB.2025.146677

As e-commerce platforms grow ever more reliant on cloud computing, efficiency and sustainability have come to the fore as urgent pressures on development. A study in the International Journal of Reasoning-based Intelligent Systems, has introduced an innovative approach to the problem based on a slime mould algorithm (SMA). The work could improve both performance and energy efficiency for e-commerce systems.

At the core of the work is the development of BOSMA – the Balanced Optimisation Slime Mould Algorithm. The SMA is a heuristic optimisation technique inspired by the natural behaviour of slime moulds.

Slime moulds are useful models for algorithms because they excel at finding efficient paths through complex environments and adapting to changing conditions. Moreover, they do so without any central control system. They can explore their surroundings by sending out multiple tendrils, pseudopodia, in different directions, adjusting their shape and connections in response to feedback such as nutrient availability or obstacles.

This decentralised, probabilistic behaviour helps maintain a balance between exploring new possibilities and refining promising ones. By translating these adaptive behaviours into mathematical rules, researchers have designed algorithms that solve complex computational problems, such as network routing, task scheduling, and data migration, where the goal is to find efficient solutions in large, dynamic, and uncertain search spaces.

BOSMA addresses the issues that have become apparent with the simple SMAs by integrating two key enhancements. First, the researchers have added a balanced optimisation operator, which fine-tunes the algorithm's balance between exploration (seeking out new possible solutions) and exploitation (refining known good ones). The second enhancement is the addition of a stochastic difference variance operator, which injects some randomness into the search process and so helps avoid the kind of early convergence on an inferior solution to which simpler SMAs are prone. Together, these modifications make BOSMA more agile and more efficient in solving problems.

In this latest research, the team uses BOSMA to tackle the data migration problem. The transfer of data between different cloud systems or storage environments is complex especially in high-volume e-commerce operations. If data migration is not optimised then energy costs and so economic costs rise. BOSMA recruits mobile devices and edge computing terminals to reduce the load on the cloud systems. By dynamically adjusting for communication delays and other operational constraints, BOSMA thus reassigns tasks to whichever processing environment delivers the greatest energy saving.

Li, Y., Liu, N., Dang, L. and Huang, Y. (2025) 'E-commerce cloud computing data migration method based on improved slime mould algorithm', Int. J. Reasoning-based Intelligent Systems, Vol. 17, No. 7, pp.1–10.
DOI: 10.1504/IJRIS.2025.146670

An innovative design for electric torque motors that could reshape how heavy-duty machinery, industrial automation, and electric vehicles are built is reported in the International Journal of Hydromechatronics. By rethinking how permanent magnets are embedded within the rotating component responsible for generating motion, the researchers have developed a method that increases torque without compromising durability or thermal stability.

Torque motors are a category of electric motor engineered specifically to generate high levels of torque, or rotational force, particularly at low speeds. This makes them ideal for applications such as hydraulic pumps, industrial robotics, and aerospace actuators. Unlike conventional motors that require gearboxes to achieve sufficient torque, torque motors often use a direct-drive approach, eliminating mechanical complexity and potential points of failure. However, enhancing torque output without risking overheating or structural failure remains a central engineering challenge.

Traditional torque motor designs commonly mount permanent magnets directly on the surface of the rotor. While this arrangement can strengthen the motor's magnetic field and thereby improve torque, it introduces a serious vulnerability: magnets can detach under stress, particularly at high rotational speeds or under heavy loads. To mitigate against this, engineers commonly use carbon fibre sleeves to encase the magnets. But these protective layers increase the electromagnetic air gap, i.e. the space between rotor and stator where magnetic interaction occurs, and this reduces magnetic efficiency and so the torque.

This research focuses on a novel semi-inset permanent magnet pole rotor structure. Such a design offers a more integrated solution by partially embedding the magnets into notched sections of the rotor itself, the new structure locks the magnets securely in place reducing the risk of detachment without the need for bulky external reinforcement. The approach allows the electromagnetic air gap to remain tight. In turn, this supports a stronger magnetic flux for greater torque generation.

The team has simulated their design using Finite Element Analysis (FEA), a computational modelling technique that factors in physical forces, stress, and heat. Such simulations allow for the fine-tuning of the magnet shape and position to optimize magnetic flux density and structural integrity. Particular attention was paid to the thermal characteristics of the motor, since greater torque typically demands more current, and thus produces more heat. Heat dissipation features were integrated to prevent overheating, and mechanical tests showed the structure could endure operational stress without magnet failure or demagnetization.

He, X., Xiang, P., Xu, Z., Wei, X. and Li, Y. (2025) 'Development of a torque motor with enhanced performance employing novel semi-inset PM pole', Int. J. Hydromechatronics, Vol. 8, No. 5, pp.40–54.
DOI: 10.1504/IJHM.2025.144973

The indirect, long-term effects of armed conflict, particularly worsening food insecurity and reduced access to education, are discussed in the International Journal of Economic Policy in Emerging Economies. The study reveals that conflicts are more economically damaging than the immediate physical destruction of war. The conclusion is drawn from data covering 169 countries over an almost three-decade period beginning in 1990. The work could give pause for thought for rethinking how we design humanitarian aid and post-conflict recovery strategies.

By using a path-analytical approach, the study maps out the interconnected ways conflict influences national outcomes, tracing how disruptions to food systems and education ultimately reduce future income. This approach stands in contrast to standard analyses that examine the direct effects of conflict in isolation, such as infrastructure damage or population displacement. As such, it explores how war erodes a nation's human capital, the health of its citizens, the national knowledge and skills base, and how this occurs long before those detrimental effects become visible in the simplistic economic accounting of gross domestic product.

The findings are overwhelming. The work shows that over time, the economic harm caused by deteriorated nutrition and lost schooling is about 1.5 times greater than the damage wrought by bombed buildings or burned-out factories. In other words, while war's immediate effects grab headlines, its most enduring costs are often borne quietly by the young and vulnerable.

Central to this argument are the three D's of conflict: destruction, diversion, and disruption. "Destruction" refers not just to physical infrastructure loss but also to public health degradation, a phenomenon sometimes described as the third army of war. Diversion involves the redirection of public resources away from essential services like schools and hospitals toward military spending. Disruption captures the systemic breakdowns, such as severed supply chains or institutional collapse, which make it difficult to sustain basic services even where they still exist.

By interfering with food security and access to education, these mechanisms have compounding effects on a population's long-term productivity. Children who are malnourished or out of school during conflict are less likely to contribute effectively to the economy years later, weakening the foundation for recovery. The findings thus challenge the emphasis in humanitarian response, which prioritizes short-term survival for obvious reasons. However, a broader approach is need to safeguard education and nutrition, particularly for children, and so the national future.

Marktanner, M. and Merkel, A. (2025) 'From conflict to empty stomachs, empty classrooms, and empty wallets', Int. J. Economic Policy in Emerging Economies, Vol. 21, No. 3, pp.244–264.
DOI: 10.1504/IJEPEE.2025.146573

A study in the International Journal of Environment and Waste Management found a direct link between Ghana's mounting urban flooding challenges and unregulated waste disposal practices. The findings have significant consequences for public health, the real estate market, and broader urban development. The researchers focused on the cities of Kumasi and Tamale and found that open dumping, fly-tipping as it is known in some parts of the world, where households discard waste indiscriminately in streets, drains, and vacant lots, has become a serious problem associated with urban vulnerability. Four out of five households surveyed admitted to open dumping.

The research used waste management theory alongside statistical regression modelling to look at the prevalence of waste mismanagement and showed that it is a central factor in recurring flood events. The number of households engaging in open dumping is surprising, as the infrastructure for waste management does exist in many of the areas where this occurs. The behaviour is perhaps rooted more in public attitudes and a lack of civic awareness than problems with the waste management systems.

Increased flood risk associated with waste mismanagement has led to a reduction in residential property values. Moreover, the researchers found that tenants are reluctant to pay higher rents in areas that are vulnerable to floods, even when the architectural standards of the buildings are high. The team quantified this market reaction using statistical analysis and found a consistent downward pressure on rental prices in flood-prone zones.

Falling property values is important economically to landlords and developers, but also to the financial viability of investing in urban housing, particularly in lower-income neighbourhoods. The researchers warn that this downward pressure on prices might threaten the health of mortgage markets and reduce local government revenues that depend on property-related taxes—creating a cycle of underinvestment and further degradation.

Ofori, P. (2025) 'Indiscriminate disposal of waste challenges and implication for urban flooding and property values in emerging cities', Int. J. Environment and Waste Management, Vol. 37, No. 1, pp.88–133.
DOI: 10.1504/IJEWM.2025.146388

Research in the International Journal of Shipping and Transport Logistics has looked at one of the less obvious, but crucial, parts of global trade: how goods move between seaports and their inland destinations. This aspect of logistics is known as hinterland connections. The team have looked at how a digital scheduling system called the Truck Appointment System (TAS) might be used. They suggest that this technology has the potential to reduce congestion and improve efficiency, but its ultimate success will depend less on the tool itself and more on the corporate business models in which it is embedded.

TAS is a platform that allows haulage companies to book specific time slots for container pickups and drop-offs at ports. It aims to streamline operations by spreading truck arrivals more evenly throughout the day, cutting down queues, and helping ports manage capacity. But despite these obvious advantages, the system has had mixed results. Some ports see tangible benefits, others find it adds complexity without obvious improvements in efficiency.

The new work, based on interviews and field observations at five European container ports, investigates why TAS is effective in some contexts but falters in others. The research moves beyond technical analysis to examine how the system interacts with the commercial and operational priorities of ports and their logistics partners.

The team used a business model canvas, as a framework to break down the different components of a business, such as cost structures, revenue streams, and customer relationships. By approaching their analysis in this way, they could show how TAS could lead to improvements in efficiency but also change the way in which ports operate and engage with stakeholders to their advantage. For example, the findings show that ports with more flexible TAS policies, where truckers can cancel or change appointments without penalty, for instance, tend to have higher user participation.

Unfortunately, this flexibility undermines the reliability of scheduling data, making it harder for terminal operators to plan and allocate resources. Conversely, stricter regimes that penalise missed appointments deliver better data but deter some hauliers, especially smaller firms sensitive to cost and time constraints. There are thus deeper tensions between operational efficiency, service quality, and business relationships that TAS implementation can expose.

Ports with better hinterland connections can offer faster and more predictable service and so become more attractive to international shippers, potentially enhancing their economic competitiveness. By integrating TAS with real-time tracking and predictive systems, appointment scheduling could evolve into a broader coordination mechanism. This approach could link ships, terminals, hauliers, and even rail operators in a more dynamic and responsive logistics network. But, TAS needs to be aligned with business aims otherwise it simply becomes an additional layer of complexity in an already complex logistical world.

Wide, P., Rogerson, S. and Williamsson, J. (2025) ‘A business model perspective to enhance efficiency of port hinterland connection with truck appointment system – a multiple case study of ports in northern Europe‘, Int. J. Shipping and Transport Logistics, Vol. 20, No. 2, pp.271-289.
DOI: 10.1504/IJSTL.2025.146589

Research in the International Journal of Applied Decision Sciences describes how artificial intelligence could be used to root out internal threats in the US Army. The research centres on the Army's Insider Threat Hub, a facility that assesses the danger posed by individuals flagged for potentially harmful behaviour. It then introduces a deep learning tool capable of significantly improving how such cases are prioritised and processed.

Insider threats are very different from external threats. That much is obvious, by definition. Individuals with legitimate access to sensitive systems or information can wreak havoc if they have a mind to or even unintentionally. Such individuals might be current or former staff or contractors. In a military context, data disruption can be a matter of life or death.

The US Army has hundreds of thousands of personnel and endless incoming threat reports. According to the researchers, there is an absence of a standardised system to triage threat reports, which complicates efforts to identify risks and so the backlog of unresolved cases continues to accrue.

The research offers a novel response to the problems facing the US Army: a classification model trained on historical data from previously reviewed cases that can determine whether a given individual is a negligible threat or high risk. The output from the system then allows staff to prioritise their efforts in handling the high risk cases first. The system uses known personality traits, such as impulsiveness or aggression, and situational indicators such as external financial pressures or personal trauma to judge the threat an individual might pose. The interplay of these elements gives the most predictive insight.

Tests with the trained model on a second set of historical data gave a detection accuracy rate of 96%. The system assessed the severity of most threats accurately or if it didn't it slightly overestimated the risk, which is a better result than overlooking dangerous individuals.

Ali, S., Deverill, H., Lindquist, J. and Roginski, J. (2025) 'Human and machine partnership: natural language processing of army insider threat hub data', Int. J. Applied Decision Sciences, Vol. 18, No. 7, pp.1–22.
DOI: 10.1504/IJADS.2025.146569

Migrant-serving organisations (MSOs) along the border between Mexico and the USA are an important, yet underappreciated, component of the global humanitarian infrastructure, according to research in the International Journal of Migration and Border Studies.

The research has looked at how these frontline groups persist despite unrelenting challenges. Operating in a region shaped by shifting immigration policies, recurrent humanitarian emergencies, and increasing flows of displaced people, these organisations have developed a form of resilience based on day-to-day adaptability rather than formal plans.

The study assessed 40 MSOs through surveys and interviews to examine how these organisations maintain services such as healthcare, legal aid, and shelter under constant pressure. Rather than relying on long-term strategic planning or physical infrastructure, MSOs were found to survive largely thanks to their capacity for bricolage. Bricolage is a term borrowed from art where diverse materials that just happen to be available are used creatively to assemble a solution.

This improvisational approach, the research suggests, is largely driven by staff commitment, trust among partners, and participatory leadership rather than financial resources or facilities. Such a human approach allows organisations to adapt quickly in the face of crises, such as pandemics, conflicts, or sudden increases in migration.

These traits have allowed MSOs to sustain their response capabilities, but the research also shows that there is a lack of long-term strategic development. Few MSOs have mechanisms in place to systematically learn from past crises or plan for future disruptions. Many simply operate under the working assumption that crisis is not a temporary disruption, but a constant condition. As such, conventional approaches to organisational resilience, that are built around discrete shocks and have recovery phases, are inadequate.

The research could help guide policymakers and stakeholders along the Mexico-US border and elsewhere in the world. This will be increasingly important as the effects of climate change, political instability, and conflict displace even more people. The demand for grassroots humanitarian work is thus growing, a broader understanding of what organisational resilience entails is needed to allow MSOs to do their work.

Burrowes, S., Sullivan, S., Cazares, R., Hunt, J. and Hwang, G. (2025) 'The border is always changing: a mixed-methods study of resilience among migrant serving organisations in the USA and Mexico', Int. J. Migration and Border Studies, Vol. 9, No. 5, pp.1–28.
DOI: 10.1504/IJMBS.2025.146567

Research from India published in the International Journal of Business Excellence suggests that personality traits, rather than simply income or family size, has a role to play in whether a person takes out life insurance. The finding has implications for insurers, policymakers, and financial planners alike.

The researchers surveyed 580 individuals across India and found that specific personality characteristics are closely tied to a person's view of financial risk. Risk aversion, they found, significantly influences the intention to buy life insurance. They add that three traits from the psychological Big Five model (conscientiousness, being responsible and organized, neuroticism, the tendency to emotional instability, and openness to experience, curiosity and broad-mindedness) were found to affect risk aversion. Risk aversion itself then mediated a person's life insurance intentions.

Risk aversion, in this context, refers to an individual's tendency to avoid uncertain outcomes, especially those with potentially negative financial consequences. It has long been assumed that buying life insurance is broadly a rational decision based on life stage or income. However, this research shows that a person's character and dispositions affect their perception of risk and security and so their intention to take out life insurance.

The researchers suggest that the finding is particularly relevant across India's emerging economy, where changes in social structure and increasing urbanization are changing the way in which families manage their financial responsibilities. As extended families give way to nuclear households and more younger people enter the workforce, the role of life insurance has expanded beyond income replacement. It now encompasses wealth preservation, estate planning, and long-term financial independence.

The work could help insurers better predict customer needs and tailor their products accordingly. By taking this behavioural approach, it might be possible to close the protection gap, the difference between the amount of insurance coverage a person has and what they actually need. This gap is alarmingly wide in developing countries.

Elangovan, J., Premkumar, M.D. and Yoganandan, G. (2025) 'Exploring the mediating role of risk aversion in the relationship between personality traits and life insurance purchase intention', Int. J. Business Excellence, Vol. 36, No. 5, pp.1–26.
DOI: 10.1504/IJBEX.2025.146552