Articles published on Intermediary Role
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- Research Article
1
- 10.1016/j.resglo.2025.100331
- Jun 1, 2026
- Research in Globalization
- Suhaib Al-Khazaleh + 5 more
This paper conducts a bibliometric and content analysis and offers a comprehensive overview of the research landscape on access to finance, revealing critical insights into the determinants of financial access, the role of financial intermediaries, and the impact of regulatory frameworks and providing potential future directions for FinTech innovations in the context of globalization. This study conducts a systematic literature review and bibliometric analysis spanning from 1950 to 2024, examining 2,657 relevant documents. The findings reveal three main clusters: access to finance, financial inclusion, and financial constraints. Financial access is essential for reducing poverty, fostering financial inclusion, and influencing environmental outcomes and digital integration. Financial constraints significantly impact investment behavior, innovation, and economic development, highlighting the importance of government policies and FinTech solutions. This review suggests several future research directions, including exploring FinTech innovations, sustainability criteria in financial inclusion, Artificial General Intelligence (AGI) applications in evaluating financial constraints, and understanding regional disparities in financial access and inclusion. These insights provide valuable guidance for policymakers and researchers to inform policy design, developing financial inclusion programs, and foster global economic growth and opportunities in globalization scope. This study contributes to the relevant literature by providing deeper insights into the themes and findings identified within each strand of this research field. The study highlights the importance of tangible assets and strong financial performance in improving access to finance. This study explores the important role of financial intermediaries in facilitating access to finance and the role of alternative financing options in enhancing financial inclusion and FinTech innovations. The study provides a deeper understanding of the impact of regulatory frameworks on access to finance by ensuring financial stability, enhancing transparency, and encouraging FinTech innovations in the globalization context.
- New
- Research Article
- 10.30574/wjarr.2026.30.2.1146
- May 31, 2026
- World Journal of Advanced Research and Reviews
- Nestor A Alquizalas Jr + 1 more
This study examines the development and implementation of agricultural marketing strategies in the Philippines, focusing on structural constraints, institutional dynamics, and emerging innovations within value chain systems. Utilizing a qualitative literature review of peer-reviewed journals, government reports, and institutional publications, the study synthesizes evidence on market access, digital transformation, collective marketing, intermediary roles, and policy interventions in the agricultural sector. Findings reveal that despite agriculture’s significant contribution to GDP and employment, the sector remains constrained by fragmented value chains, inadequate infrastructure, weak institutional coordination, and persistent marginalization of smallholder farmers from formal markets. Market inefficiencies are further intensified by dependence on intermediaries, limited access to credit and market information, and uneven integration into higher-value supply chains. While collective marketing arrangements and government-led initiatives such as the KADIWA program and the Philippine Rural Development Project demonstrate potential for improving market connectivity, their impacts remain uneven and limited in scale. Digital transformation has accelerated, particularly during the COVID-19 pandemic, yet adoption is hindered by low ICT literacy and infrastructure gaps. The study concludes that Philippine agricultural marketing requires a more integrated, inclusive, and climate-resilient framework that aligns production, marketing, and value chain development. Strengthened institutional coordination, digital capacity building, and scalable policy implementation are essential for long-term agricultural transformation and rural development.
- New
- Research Article
- 10.1108/ejim-05-2025-0557
- May 18, 2026
- European Journal of Innovation Management
- Marcella De Martino + 4 more
Purpose The study analyses the dynamics of collaboration between research infrastructures (RIs) and industry through the lens of Open Innovation in Science. It aims to identify collaboration typologies, barriers and enablers, as well as the knowledge and technology transfer mechanisms that contribute to innovation outcomes. Design/methodology/approach The study adopts a two-stage qualitative research design. First, a scoping literature review was conducted to map the existing body of knowledge on RI–industry collaboration. Second, a qualitative case study was carried out to explore the dynamics of collaboration within ACTRIS, a pan-European RI in the environmental domain. The analysis drew on extensive secondary data, including EU project deliverables, policy documents and strategic reports. Findings Multiple collaboration models emerge across the RI lifecycle, supporting both scientific advancement and innovation. The findings highlight the centrality of open and FAIR data, standardized methodologies, access to state-of-the-art instrumentation as key enablers of collaboration. Intellectual property management and limited SME access underscore the need for more flexible and adaptive governance frameworks. Research limitations/implications The focus on a single case study and the reliance on secondary data limit the generalizability of the findings. Longitudinal and multi-case approaches based on primary data would provide a more comprehensive understanding of RI–industry collaboration across different stages of the research and innovation process. Practical implications Flexible governance frameworks are crucial for addressing the diverse needs of industrial partners. Strengthening user support systems, enhancing visibility through innovation portfolios, and supporting the intermediary role of research performing organizations can reduce access barriers – particularly for SMEs – and foster regional innovation ecosystems. Social implications This study highlights how RIs in the environmental domani play a pivotal role in tackling pressing societal challenges, including climate change and air quality. By fostering collaboration with industry and providing open access to high-quality data and advanced facilities, RIs support technological innovation and contribute to broader societal well-being. Originality/value This study provides a new analytical approach for examining cross-sector innovation. It sheds light on collaboration models, governance challenges, and innovation outcomes, advancing current understanding of how RIs function as open, mission-oriented innovation platforms.
- Research Article
- 10.1016/j.eplepsyres.2026.107823
- May 13, 2026
- Epilepsy research
- Ercan Bakir + 2 more
The mediating role of self-management in the relationship between patient activation and rumination thoughts.
- Research Article
1
- 10.1097/md.0000000000045639
- May 12, 2026
- Medicine
- Yanping Zhu + 4 more
Diabetes mellitus (DM) significantly elevates cerebrovascular risk in stroke survivors, yet metabolic predictors specific to this population remain underexplored. The uric acid-to-high-density lipoprotein cholesterol ratio (UHR) encapsulates pro-oxidant and anti-atherogenic pathways relevant to DM pathogenesis, but its clinical utility in stroke cohorts is unestablished. This cross-sectional study analyzed 1999 to 2018 National Health and Nutrition Examination Survey data from 964 adults with stroke history (representing 3,481,079 U.S. adults). UHR was standardized into sex-stratified z-scores. DM was defined by American Diabetes Association criteria. Generalized variance inflation factors (GVIF) confirmed absence of multicollinearity (all GVIF(1/(2*Df)) < 5). Weighted multivariable logistic regression assessed UHR-DM associations across 3 models: unadjusted (model 1), sex/age-adjusted (model 2), and fully adjusted for clinical covariates (model 3). Restricted cubic splines evaluated nonlinearity, piecewise regression identified effect thresholds, and time-dependent receiver operating characteristic analysis assessed predictive performance with inverse probability weighting. Mediation analysis quantified body mass index (BMI)’s intermediary role. Elevated UHR z-scores demonstrated dose-dependent DM associations, with quartile 4 (Q4) exhibiting 3.12-fold higher odds (95% confidence interval [CI]: 1.86–5.25, P < .001) in model 3. Restricted cubic splines revealed significant nonlinearity (P < .05), identifying UHR z-score = −0.419 (raw value = 0.088) as an inflection point: below this threshold, each 1-unit increase conferred 3.39-fold higher DM risk (95% CI: 1.56–7.40, P = .002); above it, risk increased 1.20-fold (95% CI: 1.08–1.45, P = .041). BMI mediated 38% of the total effect (β = 0.04, 95% CI: 0.03–0.06; P < .001). A rea under the curve (AUC) for UHR z-scores predicting DM improved from 0.61 (unadjusted) to 0.68 (model 3-adjusted). Subgroup analyses showed effect modification by sex (P for interaction < .05). In stroke survivors, UHR elevation independently suggests DM risk through threshold-dependent mechanisms, with BMI mediating over one-third of this relationship. UHR assessment could enhance DM risk stratification in poststroke care.
- Research Article
- 10.1038/s41598-026-52962-1
- May 11, 2026
- Scientific reports
- Dhanya Pramod
The objective of this study is to evaluate the influence of human-AI co-creation on learning effectiveness and to assess the intermediary role of Engagement, Thinking Skills, and Knowledge Co-creation. A survey instrument was employed in this empirical study, designed by combining Self-Determination Theory, Connectivism, and Constructivism. The data was collected through a questionnaire from 415 Gen Z adults. PLS-SEM technique was used to carry out quantitative analysis. The results pointed out a significant association between students' psychological need satisfaction and Cognitive Engagement, with the effect of Perceived Autonomy and Perceived Competence evenly balanced, while Perceived Relatedness wielded a stronger influence on Cognitive Engagement. The findings also unveiled that AI interaction quality had a better influence on Cognitive engagement compared to Trust in AI and perceived agency of AI. Furthermore, the results demonstrated a significant positive impact of Cognitive Engagement on the development of thinking skills. This consequently influenced knowledge co-creation, ultimately leading to enhanced learning effectiveness. This study has implications for educational setups and training organizations to adopt Gen AI for co-creation, and guides policymakers in designing relevant policies to responsibly use Gen AI for co-creation.
- Research Article
- 10.1080/1755182x.2026.2668665
- May 7, 2026
- Journal of Tourism History
- I Kadek Dwi Noorwatha
ABSTRACT The early history of tourism in Bali is often narrated through the activities of colonial administrators, foreign artists, and cultural institutions that promoted the island as an exotic destination. Such narratives rarely consider the role of indigenous intermediaries who facilitated the circulation of Balinese cultural objects within emerging tourism markets. This article examines the activities of a Balinese woman known as Mak Patimah of Singaraja, whose presence in colonial newspapers, travel accounts, and exhibition reports between 1921 and 1937 reveals how local actors participated in the formation of Bali's early tourism economy. Mak Patimah occupied a strategic position linking local craft production, colonial exhibition networks, and international travellers. Drawing on the concepts of cultural brokerage and the commodification of cultural objects, this article argues that Mak Patimah functioned as an indigenous intermediary who mediated the early circulation of Balinese art and craft within emerging international tourism networks, highlighting the role of gendered entrepreneurship in Bali's early tourism economy.
- Research Article
- 10.70382/mejhlar.v12i6.0106
- May 3, 2026
- International Journal of Humanities, Literature and Art Research
- Paul Eshiozokhe Inanoremhe + 1 more
Ancestors in Africa are considered as an essential link in a hierarchical chain of powers stretching from this world to the spiritual world. However, there are theological problems created by the widespread negative and destructive Eurocentric approach to the issue of ancestral veneration in Africa. This emerged, perhaps, from the misconception of Ancestors’ place in African belief system by the Western missionaries. African ancestral Christian theology therefore, seeks to address some of the problems that misconceptions have caused the African Christian spirituality within the purview of the relationship between African Christians and their ancestors. This paper is an attempt to bring about a synthesis of the Christian belief in Christ as the sole mediator between God and humanity and ancestral veneration in Africa. It also examines the theology of ancestral veneration vis-à-vis the notion of the Church as Communio Sanctorum which is a relevant aspect of African Ecclesiology. It has a Christological as well as an Ecclesiological dimension which are contextualized within African ancestral theology. Its objective is to deconstruct the negative dispositions and reconstruct an African ancestral Christian theology that can be incarnated in the African cultural and religious milieu. The method of contextual theology is adopted in the research. Findings show that, the veneration of ancestors in Africa has a close affinity with the intermediary role of Christ and the Saints as well as the beatific vision (heaven) in Christianity. Thus, it serves as preparation for the gospel (Praeparatio Evangelica) which indicates the hidden presence of Christ and his gospel in African culture.
- Research Article
- 10.1080/02666030.2026.2652691
- May 1, 2026
- South Asian Studies
- Edmond De Taillac
Today, sculptures of Śiva Naṭarāja are displayed at the centre of South Asian galleries in museums in Europe and North America. A significant number of these bronzes and some two hundred South Indian images entered major Western collections through a network of actors involving the French archaeologist Gabriel Jouveau-Dubreuil (1885-1945), the art dealer C.T. Loo (1880-1957), and the Musée Guimet in Paris. Jouveau-Dubreuil settled in the French colony of Pondicherry in 1909 and supplied artefacts to C.T. Loo from 1924 onwards, in close collaboration with the Musée Guimet. Combining archival research, fieldwork, and oral history, this paper explores the entangled histories of museums and art markets and highlights the role of Indian intermediaries in art collecting. Jouveau-Dubreuil relied on a small group of agents, who belonged to the French-speaking Indian elite and had previously been his pupils at the Collège Colonial in Pondicherry. These agents engaged with a wide range of actors and acquired artefacts through transactions shaped by informational, political, and economic asymmetries. The commodification of South Indian images resulted from collaborations, tensions within source communities, divergent claims to custodianship, imperial rivalries, and the contingent actions of local supply networks, ultimately shaping the art-historical canon of ‘Indian art’.
- Research Article
- 10.1016/j.erss.2026.104683
- May 1, 2026
- Energy Research & Social Science
- Aoife Brophy + 4 more
The strategic role of systemic transition intermediaries: A cross-sector perspective on voluntary standards for net zero
- Research Article
- 10.1108/ijmhsc-08-2025-0117
- Apr 29, 2026
- International Journal of Migration, Health and Social Care
- María Jiménez-Castro + 1 more
Purpose Migrants and refugees face barriers to accessing health information, including language, culture and administrative complexity, which limit their use of health-care services. This study aims to map and characterise the health information resources used by Spanish NGOs for migrants and refugees. Particular attention was given to languages, formats and topics to examine how these materials address linguistic and cultural barriers and facilitate access to care. Design/methodology/approach An exploratory descriptive study used the GuiaONGs directory to identify NGOs working with migrants in Spain. A total of 1,927 documents were collected, catalogued and analysed in terms of language, translation, format and thematic focus. Thematic analysis classified content into key health-related and administrative topics. Findings Most materials were multilingual. Aside from 131 Spanish-only documents and four image-only files, all others were available in Spanish plus at least one additional language, most commonly French, English and Arabic, with some African languages (Wolof, Bambara, Fulah). Formats were predominantly text-based, especially information sheets and leaflets, while audiovisual resources were rare. Eleven thematic areas were identified, including health system access, COVID-19, chronic and infectious diseases, mental health, sexual and reproductive health, gender-based violence and female genital mutilation. Many documents combined clinical information with administrative guidance. Research limitations/implications This study is limited to health information materials used by NGOs operating in the Spanish context and reflects specific institutional arrangements, funding frameworks and migration dynamics. Its exploratory and descriptive design does not assess the effectiveness, reception or impact of the materials on migrant populations. Nevertheless, the analytical categories and structural patterns identified offer a transferable framework for examining NGO-mediated health information provision in other settings, provided they are revalidated in relation to local health systems, migration regimes and organisational landscapes. Future research should build on this work through evaluative and comparative approaches. Practical implications The findings suggest that NGOs would benefit from greater institutional support to diversify formats, particularly through the development of audiovisual and low-literacy-friendly resources, and to strengthen cultural adaptation processes beyond translation. For public health institutions and policymakers, the results highlight the importance of recognising and supporting the work carried out by NGOs while avoiding an over-reliance on third-sector initiatives to address health communication needs. Ensuring equitable access to health information for migrant populations should be understood as a shared institutional responsibility embedded within public health systems. Social implications By documenting the scope, themes, languages, and formats of health information materials used with migrant populations, this study sheds light on persistent inequalities in access to health information. The predominance of text-based resources and the uneven thematic coverage risk excluding individuals with limited literacy or educational backgrounds. Improving culturally and linguistically adapted health communication can contribute to reducing barriers to healthcare access, enhancing health literacy and supporting more inclusive public health responses. Strengthening collaboration between NGOs and public institutions is essential to address structural inequalities affecting migrants’ access to health-related information and services. Originality/value This study offers the first systematic mapping of NGO health information resources for migrants in Spain. It highlights the scale of multilingual provision, the predominance of text-based formats and the frequent integration of health and administrative guidance, illustrating NGOs’ intermediary role in promoting equitable access to information.
- Research Article
- 10.1287/msom.2024.1217
- Apr 27, 2026
- Manufacturing & Service Operations Management
- Olufunke Adebola + 2 more
Problem definition: In emerging markets, sharing economy platforms that connect customers with independent service providers often operate in environments with low digital literacy and small, fragmented demand. To address these challenges, such platforms often rely on human intermediaries, known as booking agents, to collect demand from individual customers and submit the aggregated demand on the platform. The presence of such agents requires the platform to set not only the customer price and provider wage but also the agent wage to coordinate supply and demand. This paper analyzes the platform’s pricing and wage decisions and examines how the presence of booking agents affects the surplus of providers, customers, and the platform. Methodology/results: We model a platform involving providers, customers, and booking agents and characterize the platform’s optimal price, wages, and equilibrium outcomes. Our analysis yields several actionable insights. First, a larger provider pool can make it optimal for the platform to raise agent wages while lowering customer prices, even if this combination may reduce the platform’s commission. Second, platforms may find it optimal to pair surge pricing with increased agent wages and decreased provider wages, departing from the conventional strategy of pairing surge pricing with increased provider wages. Finally, whereas the presence of booking agents increases provider earnings by enabling more demand to be served, it may not always benefit customers or the platform. Nevertheless, these agents lead to a “win-win-win” outcome when agents’ demand aggregation cost is moderate or when providers incur high fixed costs in serving colocated customers. Managerial implications: Our findings highlight how platforms should respond to different supply and demand conditions in the presence of booking agents and inform when the use of booking agents generates value for all stakeholders. Our insights have informed changes in the practice of our industry partner, Hello Tractor. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2024.1217 .
- Research Article
- 10.1142/s0219519426500144
- Apr 21, 2026
- Journal of Mechanics in Medicine and Biology
- Min Liao + 1 more
This study develops and validates an intervention system for college students’ tennis training. From the perspective of mindfulness meditation, it integrates virtual reality (VR) technology and artificial intelligence (AI) through a back propagation neural network (BPNN) model. The experiment divides respondents into three groups: VR mindfulness group, control group, and mindfulness group. It systematically evaluates changes in training performance, sleep quality, emotional states, fatigue perception, and mindfulness levels while constructing a BPNN model to predict training outcomes. Results demonstrate that the VR mindfulness group achieves the most remarkable performance improvement (average 9.53%), substantially exceeding the mindfulness group (8.13%) and control group (4.31%), with all p-values [Formula: see text] Psychological indicators, including mindfulness levels, fatigue perception, emotional states, and sleep quality, also exhibit marked improvement trends. The BPNN model shows strong predictive capability, with all three groups maintaining mean absolute percentage errors below 1%. Further analysis of the intermediary roles reveals that sleep quality, fatigue perception, mindfulness levels, and emotional states are all significant mediating paths. In contrast, the indirect path of mindfulness levels between training methods and performance is the most prominent, with a p-value [Formula: see text] The study indicates that AI-enhanced VR mindfulness training effectively boosts college students’ tennis training outcomes. Moreover, it achieves indirect promotion by optimizing the psychological state, which holds substantial and theoretical value and provides an empirical basis for intelligent sports training.
- Research Article
- 10.51659/josi.24.230
- Apr 20, 2026
- Journal of Organisational Studies and Innovation
- Edna Naa Amerley Okorley + 1 more
The purpose of the study is to investigate the nexus between co-worker support and employees’ innovative work behaviour (IWB) and the intermediary roles of employees’ wellbeing and employees’ competencies. Using the social exchange theory, a sample of 436 chop bars’ workers in Kumasi, Ghana, were used for the study. Data from the respondents was collected using a standardised interview schedule. Seven hypotheses were tested using PLS-SEM. The study found that co-worker support affected employees’ innovative work behaviour and employees’ wellbeing. Also, co-worker support had an indirect association with employees’ innovative work behaviour through employees’ wellbeing. Employees’ innovative work behaviour was influenced by emotional intelligence, employees’ wellbeing and employees’ competencies. The nexus between co-worker support and employees’ innovative work behaviour was strengthened by employees’ competencies. The findings highlight how policy makers and practitioners can increase employees’ innovative work behaviour in the hospitality industry.
- Research Article
- 10.1097/md.0000000000048404
- Apr 17, 2026
- Medicine
- Kang Xu + 4 more
Clinical investigations have demonstrated that blood and immune cells are involved in the pathophysiological processes of dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM). However, the causal relationships between these cellular components and the development of DCM and HCM remain uncertain. A two-sample Mendelian randomization analysis was performed to evaluate the causal effects of blood cells and immune cells on DCM and HCM. The primary analytical method was inverse variance weighting, supplemented by Mendelian randomization-Egger, weighted median, and MR-PRESSO approaches. Furthermore, immune cells were examined as mediators to assess their intermediary roles in the causal pathways linking blood cells with DCM and HCM. Significant causal associations were observed between red blood cells, monocytes, eosinophils, and platelets and DCM and HCM (P < .05). CD127 on CD8br, naive CD8br %CD8br, CD16- CD56 on natural killer cell, CD45 on T cell, and lymphocyte AC were identified as mediators in the causal pathways connecting various blood cell types to DCM and HCM. This study provides robust evidence for the causal roles of specific blood cell and immune cell phenotypes in the development of DCM and HCM. These findings open new avenues for investigating the hematological immune system in cardiomyopathy and present novel opportunities for therapeutic interventions targeting DCM and HCM.
- Research Article
- 10.1080/01900692.2026.2643676
- Apr 13, 2026
- International Journal of Public Administration
- Pawinee Chuayprakong + 2 more
ABSTRACT Administrative burden in social welfare inequitably costs the disadvantaged their time, financial resources, and emotions. This exploratory qualitative study investigates Thailand’s Section 40 social insurance, in which informal workers seek assistance from welfare intermediaries to alleviate these burdens. Thirty-three in-depth interviews with these intermediaries and informal workers were conducted, and constant comparative analysis and in-vivo technique were carried out. Findings reveal that the scheme incurred learning, compliance, and psychological costs on the informal workers with limited education and lower incomes. However, community-based welfare intermediaries significantly alleviate these costs by leveraging spatial and cultural advantages, such as using local dialects to mitigate the psychological cost of “Kreng-Jai.” While these intermediaries are irreplaceable for program accessibility, their non-institutionalized nature poses sustainability risks. The study recommends formal reward systems and capacity-building to ensure long-term, equitable policy implementation.
- Research Article
- 10.1177/13675494261433791
- Apr 6, 2026
- European Journal of Cultural Studies
- Matina Magkou + 1 more
This article examines the role of European cultural networks as cultural intermediaries in the green transition within European Union context, where climate action is being mainstreamed in all policy fields, including culture. It contributes to discussions on environmental sustainability in the cultural and creative sectors, the contemporary cultural politics of the environment and the expanded social and political roles of cultural intermediaries. Methodologically, the study combines a review of materials produced by the networks with interviews with 16 network representatives. The article expands the concept of cultural intermediation by identifying three modalities in relation to the green transition – proactive, reactive and passive – and the parameters that shape them. It shows that these modalities should not be understood merely as varying degrees of enthusiasm in relaying policy priorities but also as political stances towards a highly contested agenda and the evolving social roles expected of cultural intermediaries. The analysis argues that intermediation is fundamentally a balancing act – between policy imperatives, funding dependencies, constrained resources and expertise, competitive peer dynamics and individual agency – and provides insights into the negotiated social roles of cultural intermediaries.
- Research Article
- 10.1111/ejed.70612
- Apr 4, 2026
- European Journal of Education
- Yonghua (Yoka) Wang + 3 more
ABSTRACT This study explores how international and interdisciplinary research collaboration is experienced and sustained in practice, with particular attention to the roles of early‐career researchers (ECRs). Drawing on a collaborative autoethnographic approach, we analyse four collaboratively constructed narrative vignettes from a three‐year UK–China research project. The vignettes capture researchers' lived experiences of working across epistemic, cultural and institutional boundaries. The findings show that collaboration is sustained not primarily through formal coordination or technical alignment but through ongoing negotiation of epistemic boundaries, power asymmetries and care practices in collaborative work. ECRs frequently encounter epistemic boundaries as sites of uncertainty, legitimacy negotiation, and vulnerability, shaped by career stage, institutional location and governance contexts. Meanwhile, they occupy intermediary roles as linguistic, disciplinary and cultural mediators, making them indispensable while exposing them to disproportionate epistemic and relational labour. The analysis further shows that care practices, such as attentiveness, reflexivity, emotional support and coordination across differences, are central to sustaining collaboration. When care labour is privately absorbed by ECRs, collaboration risks exhaustion; when recognised and embedded in collective and leadership practices, it supports sustainable collaboration. Methodologically, the study demonstrates the value of CAE for revealing the micro‐dynamics of collaborative research.
- Research Article
- 10.3389/fendo.2026.1814718
- Mar 31, 2026
- Frontiers in endocrinology
- Zheping Zhou + 6 more
Diabetes-related gait disorders are important drivers of falls and functional decline in older adults. Gait variability, as an indicator highly sensitive to fluctuations between steps, remains underexplored in diabetic populations. Compared with the average gait parameters, gait variability may better reflect impaired neuromuscular control and the risk of falling. This study aimed to evaluate the diagnostic accuracy of gait variability parameters, and test whether cognitive function plays an intermediary role between type 2 diabetes mellitus (T2DM) and gait variability. A total of 56 non-diabetic older participants and 37 T2DM patients (aged 60 years or older) were enrolled in this study. We used wearable inertial sensors to evaluate the gait parameters (including the variability in stance time, gait speed, stride length and turn duration) during straight walking and turning tasks. Standardized tools were used to evaluate cognitive functions, including the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) and other verified measures. Our results showed that T2DM patients exhibited significantly higher gait variability across all indicators. All gait variability indices were significantly negatively correlated with cognitive function (r = -0.20 to -0.53, P < 0.05). After adjusting for demographic characteristics and cognitive functions, the T2DM status was still an independent predictor of gait variability. The receiver operating characteristic (ROC) curve analysis showed that the stance time variability had good diagnostic accuracy (area under the curve [AUC] = 0.813, 95% CI 0.727-0.898, p < 0.001, sensitivity 94.6%), and gait speed variability also demonstrated good diagnostic performance (AUC=0.801, 95% CI 0.705-0.897, p < 0.001). Mediation analysis showed that cognitive function mediated the effect of T2DM on stance time variability, and the mediated effect accounted for 31.9% of the total effect. This study showed that T2DM patients demonstrated a significant increase in gait variability. This variation was closely associated with cognitive decline. Stance time and gait speed variability could be used as a sensitive and non-invasive screening method to identify gait dysfunction related to diabetes. T2DM may affect gait stability through dual pathways, involving both cognitive decline and non-cognitive mechanisms. Comprehensive intervention strategies (including blood sugar control, neuropathy management and cognitive training) could improve the gait stability of T2DM elderly people and mitigate the risk of falling.
- Research Article
- 10.14453/aabfj.v20i1.06
- Mar 30, 2026
- Australasian Accounting, Business and Finance Journal
- Ellen Rusliati + 3 more
Intermediaries have an important role in the value chain of agricultural products, especially Indramayu mango (magnivera indica L.). The use of marketing 4.0 integrates both offline and online activities and can help carry out intermediary functions efficiently and effectively. This research aims to increase the market share of Indramayu mangoes by utilizing marketing 4.0 by intermediaries. This field research with a qualitative approach and data were retrieved through observation and deep interviews with farmers, intermediaries, derivative product entrepreneurs, and government agencies related to mango trading in Indramayu. Data validation is carried out by confirming the results of obtaining primary data with secondary data. Intermediaries play a core role in connecting consumers with producers. Intermediaries who implement marketing 4.0 will foster trust in the mango value chain to increase market share. A mango business that is run fairly will increase the confidence of producers and consumers so that market share increases.