Search Results (31)

Background/Objectives: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, with the Asia-Pacific (APAC) region bearing a disproportionate burden. This paper examines HCC challenges within seven APAC health systems, identifies key barriers at each stage of the patient journey, and proposes tailored, actionable solutions. To effectively address HCC challenges, a stepwise approach should prioritise high-impact solutions, focusing on prevention, early diagnosis, and expanding surveillance to maximise health outcomes and economic benefits, while tailoring strategies to each health system’s unique resources and constraints. Methods: A mixed-methods approach was used, including expert consultations from the 2024 HCC APAC Policy Forum, a literature review, and a review of Japan’s HCC management model. Data were collected through workshops and stakeholder feedback from healthcare professionals, policymakers, researchers and patient advocates across Australia, India, Malaysia, South Korea, Taiwan, Thailand, and Vietnam. Results: Key findings include significant disparities in HCC awareness, prevention, early detection, diagnosis, and access to treatment. Common challenges across APAC include limited public awareness, suboptimal surveillance infrastructure, and financial barriers to care. The integration of novel biomarkers and advanced surveillance modalities were identified as crucial priorities for improving early detection. Japan’s multi-faceted approach to HCC management serves as a successful model for the region. Conclusions: A customised and targeted approach is essential for reducing the HCC burden across APAC. The proposed recommendations, tailored to each health system’s needs, can significantly improve patient outcomes and reduce healthcare costs. Effective collaboration among stakeholders is necessary to drive these changes. Full article

The convergence of blockchain and metaverse technologies is poised to redefine how Global Value Chains (GVCs) create, capture, and distribute value, yet scholarly insight into their joint impact remains scattered. Addressing this gap, the present study aims to clarify where, how, and under what conditions blockchain-enabled transparency and metaverse-enabled immersion enhance GVC performance. A systematic literature review (SLR), conducted according to PRISMA 2020 guidelines, screened 300 articles from ABI Global, Business Source Premier, and Web of Science records, yielding 65 peer-reviewed articles for in-depth analysis. The corpus was coded thematically and mapped against three theoretical lenses: transaction cost theory, resource-based view, and network/ecosystem perspectives. Key findings reveal the following: 1. digital twins anchored in immersive platforms reduce planning cycles by up to 30% and enable real-time, cross-border supply chain reconfiguration; 2. tokenized assets, micro-transactions, and decentralized finance (DeFi) are spawning new revenue models but simultaneously shift tax triggers and compliance burdens; 3. cross-chain protocols are critical for scalable trust, yet regulatory fragmentation—exemplified by divergent EU, U.S., and APAC rules—creates non-trivial coordination costs; and 4. traditional IB theories require extension to account for digital-capability orchestration, emerging cost centers (licensing, reserve backing, data audits), and metaverse-driven network effects. Based on these insights, this study recommends that managers adopt phased licensing and geo-aware tax engines, embed region-specific compliance flags in smart-contract metadata, and pilot digital-twin initiatives in sandbox-friendly jurisdictions. Policymakers are urged to accelerate work on interoperability and reporting standards to prevent systemic bottlenecks. Finally, researchers should pursue multi-case and longitudinal studies measuring the financial and ESG outcomes of integrated blockchain–metaverse deployments. By synthesizing disparate streams and articulating a forward agenda, this review provides a conceptual bridge for international business scholarship and a practical roadmap for firms navigating the next wave of digital GVC transformation. Full article

The article seeks to read the contribution of religious practices in prison education within the broader framework of spirituality as a search for meaning in life. It argues that religious engagement can foster cognitive and emotional development, providing inmates with a sense of purpose, community, and resilience that supports their reintegration into society. In light of an exceptional and extremely significant experience with APAC in Brazil’s police-free prison model, the authors aim to highlight the nexus between spirituality and re-education in contexts of deprivation and restriction of personal liberty. Indeed, the APAC (Association for the Protection and Assistance of the Convicted) model, central to this study, emphasizes nonviolent coexistence, responsibility, and spiritual care as part of its rehabilitative framework, with a significant reduction in recidivism rates and costs compared to traditional prisons. The model’s approach, grounded in a collective sense of responsibility and spirituality, aligns with Viktor Frankl’s and Paulo Freire’s theories on meaning and liberation, illustrating how spirituality can transform prison environments and promote social justice. The study concludes that spirituality in prisons not only aids individual redemption but also calls for structural changes to support reintegration, marking a shift towards a more human-centered penitentiary system. Full article

Pragmatics is key to communicating effectively, and its assessment in vulnerable populations is of paramount importance. Although tools exist for this purpose, they are often effortful and time-consuming, with complex scoring procedures, which hampers their inclusion in clinical practice. To address these issues, we present the Brief Assessment of Pragmatic Abilities and Cognitive Substrates (APACS Brief), a rapid (10 min), easy-to-use and freely distributed tool for evaluating pragmatics in Italian, inspired by the existing APACS test and already validated in the remote version (APACS Brief Remote). The APACS Brief test measures–with a simplified scale–the domains of discourse production and figurative language understanding and is developed in two parallel forms, each including novel items differing from APACS. Psychometric properties, cut-off scores, and thresholds for change were computed on 287 adults. The analysis revealed satisfactory internal consistency, good test–retest reliability, and strong concurrent and construct validity. Moreover, APACS Brief showed excellent discriminant validity on a sample of 56 patients with schizophrenia, who were also cross-classified consistently by APACS Brief and APACS cut-off values. Overall, APACS Brief is a reliable tool for evaluating pragmatic skills and their breakdown, with brief administration time and simple scoring making it well-suited for screening in at-risk populations. Full article

Multi-population mean-field game is a critical subclass of mean-field games (MFGs). It is a theoretically feasible multi-agent model for simulating and analyzing the game between multiple heterogeneous populations of interacting massive agents. Due to the factors of game complexity, dimensionality disaster and disturbances should be taken into account simultaneously to solve the multi-population high-dimensional stochastic MFG problem, which is a great challenge. We present CA-Net, a coupled alternating neural network approach for tractably solving multi-population high-dimensional MFGs. First, we provide a universal modeling framework for large-scale heterogeneous multi-agent game systems, which is strictly expressed as a multi-population MFG problem. Next, we generalize the potential variational primal–dual structure that MFGs exhibit, then phrase the multi-population MFG problem as a convex–concave saddle-point problem. Last but not least, we design a generative adversarial network (GAN) with multiple generators and multiple discriminators—the solving network—which parameterizes the value functions and the density functions of multiple populations by two sets of neural networks, respectively. In multi-group quadcopter trajectory-planning numerical experiments, the convergence results of HJB residuals, control, and average speed show the effectiveness of the CA-Net algorithm, and the comparison with baseline methods—cluster game, HJB-NN, Lax–Friedrichs, ML, and APAC-Net—shows the progressiveness of our solution method. Full article

Backgroud: This prospective randomized trial evaluated the clinical efficacy of inhaled colistin administered through two distinct nebulizer types, a vibrating mesh nebulizer (VMN) and a jet nebulizer (JN), in the treatment of ventilator-associated pneumonia caused by multidrug-resistant bacteria. In addition, an in vitro model was used to determine the optimal delivery of colistin. Method: Thirty-two patients prescribed intravenous (IV) colistin inhalation were randomized to receive either a VMN (n = 17) or a JN (n = 15), then compared to the control group (IV alone) over a 7-to 10-day period. The primary endpoint was the clinical pulmonary infection score (CPIS), and the secondary endpoints were the Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACE) score, and duration of ventilator use. Results: Results from in vitro testing demonstrated that VMN delivered a significantly higher colistin dose than JN (35.68 ± 3.55% vs. 23.56 ± 3.31%; p < 0.001) when positioned at the humidifier inlet. Compared to the IV alone group, the IV with inhalation group yielded significant improvements in CPIS, SOFA score, and APACHE score on day 7; nevertheless, clinical outcomes between the two nebulizers were statistically indistinguishable. Conclusions: In conclusion, although VMN delivers a higher dose in vitro, both nebulizers yielded comparable clinical outcomes. This study was registered at US Clinical Trial Registration (NCT04633317). Full article

Global climate change and persistent droughts lead to soil desertification, posing significant challenges to food security. Desertified lands, characterized by high permeability, struggle to retain water, thereby hindering ecological restoration. Sand, a natural resource abundant in deserts, inspired our proposal to design hydrophobic sand and construct Air-permeable Aquicludes (APAC) using this material. This approach aims to address issues related to the ecological restoration of desertified lands, food security, and the utilization of sand resources. Reclamation of desertified land and sandy areas can simultaneously address ecological restoration and ensure food security, with soil reconstruction being a critical step. This study investigated the effects of constructing an Air-permeable Aquiclude (APAC) using hydrophobic sand on rice yield and lodging resistance, using clay aquitard (CAT) and plastic aquiclude (PAC) as control groups. The APAC enhanced soil oxygen content, increased internode strength, and improved vascular bundle density, substantially reducing the lodging index and increasing yield. This research finds that the APAC (a) increased internode outer diameter, wall thickness, fresh weight, and filling degree; (b) enhanced the vascular bundle area by 11.11% to 27.66% and increased density; (c) reduced the lodging index by 37.54% to 36.93% (p < 0.01); and (d) increased yield to 8.09 t·hm⁻², a rise of 12.05% to 14.59% (p < 0.05), showing a negative correlation with lodging index. These findings suggest that APAC has very good potential for desertified land reclamation and food security. In conclusion, the incorporation of hydrophobic sand in APAC construction considerably strengthens rice stem lodging resistance and increases yield, demonstrating considerable application potential for the reclamation of desertified and sandy land and ensuring food security. Full article

(1) Background: The aim of this study was to compare the cytotoxicity of selected resin-modified materials used in direct contact with the dental pulp (TheraCal LC, TheraCal PT, and ApaCal ART) with calcium silicate cement (Biodentine). (2) Methods: The mouse fibroblast Balb/3T3 cell line and the extracts of tested materials in four concentrations were used for the testing. An MTT assay was performed in three independent experiments with six replicates for each concentration of tested material. The cell viability (%) and cytotoxicity were expressed (cytotoxic effect is considered in cases where the cell viability is lower than 70%). The mean of the cell viability and the standard deviation were expressed for each material at all concentrations. ANOVA and Dunnet’s post hoc tests were used for the statistical analysis. All of these tests were performed at the 0.05 significance level. (3) Results: At all concentrations, the cell viability was statistically significantly lower (p ≤ 0.002) for all tested materials compared to Biodentine. ApaCal ART showed a high level of cytotoxicity at all concentrations (cell viability lower than 47.71%, p < 0.0001). The same result was found for TheraCal LC at concentrations of 100%, 50% and 25% and TheraCal PT at concentrations of 100% and 50%. TheraCal LC at a 10% concentration (cell viability 68.18%) and TheraCal PT at a 25% concentration (cell viability 60.63%) indicated potential cytotoxicity. TheraCal PT at a 10% concentration was not found to be cytotoxic (cell viability 79.18%, p = 0.095). (4) Conclusion: The resin-modified calcium silicate and calcium phosphate materials showed higher cytotoxic potential, so they should be used with caution when in direct contact with the dental pulp. Full article

Violent social and political conflicts have caused several challenges to internally displaced persons (IDPs), especially girls and young women, among which is sexual violence (SV). Despite extensive records on SV in humanitarian contexts, studies to assess the level, examine the disclosure pattern (DP) and evaluate the availability of abortion care in these settings have received inadequate attention. This scoping review sought to synthesise the current African-based research on SV, DP, and abortion and post-abortion care (APAC) in humanitarian contexts. We conducted a systematic search of five databases: MEDLINE, PubMed, Scopus, Embase and Google Scholar, where the articles retrieved met the criteria for inclusion. The review adhered to PRISMA guidelines and the Critical Appraisal Skills Programme (CASP), containing ten questions to help confirm the validity of the research design and the originality of the results in comparison with similar studies. A series of inclusion and exclusion criteria were applied after the search, and 35 eligible articles from ten African countries with evidence of sexual violence, disclosure patterns, and APAC in camp settings were included in the study. Results described situations of SV in humanitarian settings in Africa as “terrible”, “bad”, “an epidemic”, and “severe” as girls were used as sex objects, for profile enhancement and as a weapon of war. We also found that the illegality of APAC in Africa is causing a high occurrence of clandestine abortions in conflict contexts. Disclosing SV among IDPs in Africa did not follow a clear-cut pattern but was generally determined by socio-demographic characteristics. Sexual health is a fundamental right of all, as enshrined in SDG 3, which makes this topic a major public health issue. We therefore conclude that although disclosure may aggravate stigmatisation in some instances due to adverse reactions, it is still crucial to the healing processes. Full article

The GEMKAP study (2023) unveiled consistent knowledge, attitude, and practice (KAP) levels across Asia-Pacific (APAC) and Latin America (LATAM) countries regarding dengue, with variations in the willingness to vaccinate. Despite an overall KAP parity, the disparities within and between the countries indicated the need for both overarching and tailored strategies. Population-wide gaps in dengue awareness result in suboptimal vaccination priorities and preventive measures. This commentary delves into identifying the drivers and barriers for implementing a multi-pronged dengue prevention and management program, emphasizing the pivotal role of vaccination alongside education and vector control. Drawing on expert interviews in APAC and LATAM, informed by the Consolidated Framework for Implementation Research (CFIR), four key themes emerged: prioritizing and continuously advocating for dengue on national health agendas, fostering stakeholder collaboration, incorporating population perspectives for behavioral change, and designing sustainable dengue prevention and management programs. Successful implementation requires evidence-based decision making and a comprehensive understanding of population dynamics to design adaptive education tailored to diverse population views. This commentary provides actionable strategies for enhancing dengue prevention and management, with a pronounced emphasis on dengue vaccination, advocating for a holistic, population-centric approach for sustained effectiveness. Full article

Free route airspace allows airspace users to freely plan a route in en-route airspaces within certain restrictions. It is anticipated to offer the benefit of fuel saving and operational flexibility. Regarding its efficient implementation into the ASEAN airspace, the key challenge would be reducing hotspots with clusters of potential conflicts. This paper designed a time-varying queuing network model, which contributed to untangle trajectory complexity in the most congested hotspot area. A series of fast-time simulation experiments were conducted to identify hotspots in en-route airspace in Singapore FIR. The application of departure time control using time-varying queuing networks successfully reduced up to 45% of potential conflicts. This was achieved within an average delay of 30 min by controlling time of less than 60% of candidate flights. The original contribution of this paper is to develop a novel modeling and simulation framework for composing ideal air traffic patterns. Lastly, we discussed the extension of this study toward a generalized application of the proposed approach in future air traffic management. Full article

The construction of new renewable energy infrastructures and the development of new ocean resources continues to proceed apace. In this regard, the increasing size and capacity of offshore wind turbines demands that the size of their accompanying supporting marine structures likewise increase. The types of marine structures utilized for these offshore applications include gravity base, monopile, jacket, and tripod structures. Of these four types, monopile structures are widely used, given that they are comparatively easy to construct and more economical than other structures. However, constant exposure to harsh cyclic environmental loads can cause material deterioration or the initiation of fatigue cracks, which can then lead to catastrophic failures. In this paper, a 3D fatigue finite element analysis was performed to predict both the fatigue life and the crack initiation of a welded monopile substructure. The whole analysis was undertaken in three steps. First, a 3D non-steady heat conduction analysis was used to calculate the thermal history. Second, a thermal load was induced, as an input in 3D elastoplastic analysis, in order to determine welding residual stresses and welding deformation. Finally, the plastic strain and residual stress were used as inputs in a 3D fatigue FE analysis in order to calculate fatigue crack initiation and fatigue life. The 3D fatigue finite element analysis was based on continuum damage mechanics (CDM) and elastoplastic constitutive equations. The results obtained from the 3D fatigue finite element analysis were compared with hot spot stresses and Det Norske Veritas (DNV-GL) standards. Full article

This study aimed to investigate the safety and efficacy of rapid primary phacoemulsification in patients with acute primary angle closure (APAC) (n = 41), with or without preoperative IOP-lowering medication. The best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of corneal endothelial cells (CECs), and number of IOP-lowering medications at the preoperative examination (Pre), postoperative day 1 (1d), week 1 (1w), and month 1 (1m) were used as indicators and compared. BCVA significantly improved at 1d, 1w, and 1m compared with Pre (p < 0.05) and significantly improved at 1m compared to 1d (p < 0.05) for all eyes. IOP significantly decreased at 1d, 1w, and 1m compared with Pre (p < 0.05). CECs were not significantly different between Pre and 1m; the number of IOP-lowering medications decreased significantly from Pre to 1m (p < 0.05). BCVA and IOP were not significantly different between the two groups for all periods. CECs were not significantly different between the two groups at Pre and 1m. Rapid primary phacoemulsification improved visual acuity due to improvement of corneal edema without central visual field defects and good IOP control without reoperation or IOP-lowering medication and maintained the number of corneal endothelial cells with or without preoperative IOP-lowering medication in patients with APAC. Full article

Understanding how neuronal activity changes and detecting such changes in both normal and disease conditions is of fundamental importance to the field of neuroscience. Neuronal activity plays important roles in the formation and function of both synapses and circuits, and dysregulation of these processes has been linked to a number of debilitating diseases such as autism, schizophrenia, and epilepsy. Despite advances in our understanding of synapse biology and in how it is altered in disease, the development of therapeutics for these diseases has not advanced apace. Many neuronal activity assays have been developed over the years using a variety of platforms and approaches, but major limitations persist. Current assays, such as fluorescence indicators are not designed to monitor neuronal activity over a long time, they are typically low-throughput or lack sensitivity. These are major barriers to the development of new therapies, as drug screening needs to be both high-throughput to screen through libraries of compounds, and longitudinal to detect any effects that may emerge after continued application of the drug. This review will cover existing assays for measuring neuronal activity and highlight a live-cell assay recently developed. This assay can be performed with easily accessible lab equipment, is both scalable and longitudinal, and can be combined with most other established methods. Full article

(1) Purpose: To measure the change in vessel density (VD) and the flow area (FA) on the retina of eyes with primary angle-closure diseases (PACD), including primary angle-closure suspect (PACS), primary angle-closure (PAC), acute primary angle-closure (APAC) and primary angle-closure glaucoma (PACG). (2) Methods: Patients with PACD were prospectively enrolled in this study. All participants underwent thorough ophthalmic examinations. The mean defect (MD), retinal nerve fiber layer (RNFL), ganglion cell complex (GCC) thickness, VD measurement, and blood FA were measured. (3) Results: A total of 147 eyes from 121 subjects were included in this study. The VD of the nerve head layer was significantly lower in PACG and APAC (all p < 0.001). APAC and PACG had lower FA of all layers, except for the choroid layer (p < 0.05). The macular VD of the whole image and blood FA in the superficial layer was significantly lower in PACG (all p < 0.001). The MD, RNFL, and GCC thickness demonstrated a strong correlation with whole image VD in the superficial layer (p < 0.001), while the inside disc VD did not show a significant correlation with MD, RNFL, and GCC thickness (p > 0.05). (4) Conclusions: There was a significant decrease in the VD and FA on the optic disc as well as the VD and FA of the superficial layer in the macular area in APAC and PACG. The changes in VD and FA are correlated with the severity of the glaucomatous structural damage and functional impairment. Full article