Search Results (1,449)

Optimizing tourist routes is a critical challenge in smart tourism, which aims to enhance the visitor experience while optimizing practical parameters. However, traditional routing algorithms often fail to provide personalized and efficient itineraries in complex real-world environments. This study aims to develop a hybrid framework that integrates Simulated Annealing for global route optimization with the A algorithm* for accurate local pathfinding, leveraging geographic data from OpenStreetMap. The proposed method computes the shortest paths between all Points of Interest using A*, constructing a comprehensive distance matrix, and applying Simulated Annealing to determine the most efficient visiting sequence. The framework was evaluated in the Old Medina of Fez, Morocco, demonstrating its effectiveness in generating realistic and efficient itineraries. Compared to alternative strategies such as Genetic Algorithms, the hybrid approach achieves superior computational efficiency and produces better routes in terms of travel distance. These findings highlight the practical applicability of the framework as a modular service for smart tourism applications, offering tourists and tourism platform developers a scalable solution for personalized and sustainable itinerary planning. Full article

The systemic delivery of oxytetracycline (OTC) by trunk injection has emerged as a viable strategy to manage huanglongbing (HLB, also known as citrus greening), a bacterial disease devastating citrus production around the world. This study examines the efficacy of delivering OTC systemically into the trunk of young, HLB-affected citrus trees using a drill-based or a drill-free system to improve tree health and productivity. Two field trials were conducted in two commercial production sites in Florida. Trees were four years old at the start of the study and composed of ‘Valencia’ or ‘OLL-8’ sweet orange (Citrus sinensis) scion grafted on X-639 (C. reticulata × Poncirus trifoliata) rootstock. Injections were performed in spring or late summer/early fall in 2022 and 2023. Using the drill-based system, 0.79 g of OTC was administered into each tree, whereas 0.15 g or 0.3 g was administered using the drill-free system. Delivering a higher dose of OTC by drill-based injection increased fruit yield and improved juice quality more than delivering lower doses by drill-free injection, though responses varied between cultivars. Injections in late summer/early fall increased the juice total soluble solids content considerably more than injections in spring. However, fall injections resulted in OTC fruit residues exceeding the maximum allowed level. Trunk injury was more extensive when OTC was applied with the drill-free system than when it was applied with the drill-based system. Full article

Background and Clinical Significance: Pituitary adenomas, also termed pituitary neuroendocrine tumors, pose a significant risk of hypogonadotropic hypogonadism (HH) after surgical resection, with profound consequences for fertility and sexual function in young patients. Case Presentation: We present the case of a 29-year-old man from rural Japan who developed severe HH and azoospermia following two transsphenoidal resections for a large pituitary adenoma. Despite early engagement with neurosurgery teams, fertility management was delayed by the absence of on-site endocrinology expertise and limited local oncofertility resources. After comprehensive endocrine evaluation and counseling, the patient began combined human chorionic gonadotropin and recombinant follicle-stimulating hormone therapy, resulting in full recovery of sexual function and normalization of semen parameters, ultimately leading to spontaneous conception and the birth of a healthy child. Building on this real-world case, we provide a narrative review of current practical management strategies for HH after pituitary surgery, including the utility of hormone-stimulation tests, Japanese guideline-based subsidy systems, and best-practice approaches to hormonal replacement. Conclusions: This case underscores not only the necessity for early, interdisciplinary collaboration and preoperative counseling but also highlights a rare instance in which a patient with a benign tumor received care that did not address his fertility-related needs, emphasizing that such considerations should be integrated into preoperative counseling even for non-malignant conditions. Strengthening regional oncofertility networks and improving healthcare providers’ awareness of fertility-preservation options remain essential for improving outcomes. Full article

This study aimed to describe the risk factors for locomotive syndrome (LS) in Brazilian oldest old individuals. Study subjects were older adults aged ≥80 years who were cognitively healthy, independent for activities of daily living and had been followed since 2011 by a Brazilian cohort study entitled the Longevos Project. A nested case–control study evaluating demographic and clinical characteristics was conducted. Physical tests including the 5 times sit-to-stand, hand-grip strength, 4-m gait speed and two-step test were performed. The World Health Organization Quality of Life Questionnaire short form (WHOQOL-BREF) and Numerical Rating Scale plus Verbal Rating Scale were applied to assess quality of life (QOL) and chronic pain (CP), respectively. LS was diagnosed using the Brazilian version of the 25-question Geriatric Locomotive Function Scale (GLFS-25-p), and sarcopenia by the SARC-F screening tool. The study sample included 52 participants, had a mean age of 89.3 years (±3.9 years) and was predominantly female (76.9%). Of this sample, 24 were diagnosed with LS and 28 were not. The prevalence of osteoporosis (20%), osteoarthritis (22%), depression (13%) and use of a walking device (14%) was higher in the LS group. Participants with LS had worse performance in physical tests. A multivariate logistic regression analysis identified the main risk factors for LS as osteoporosis (OR 10.80, 95%CI 1.08–108.48) and presence of moderate-to-severe chronic musculoskeletal pain (OR 8.92, 95%CI 1.25–63.89). Full article

The Yucatán Black Hairless Pig (YBHP) is a native Mexican breed with cultural and agricultural importance in the Yucatán Peninsula. This study explored the genetic diversity and population structure of YBHP using a genome-wide single-nucleotide polymorphism (SNP) from the porcine GGP 50K chip, comparing it with native and cosmopolitan breeds worldwide. Genetic diversity analyses revealed an observed heterozygosity (HO) of 0.3602 ± 0.032 and an inbreeding coefficient (F_IS) of 0.1517 ± 0.076, indicating moderate diversity and a relatively low level of inbreeding for an endangered native breed. ADMIXTURE analyses revealed a predominant and distinctive ancestry component exclusive to YBHP, along with shared ancestry with European breeds, particularly those of presumed Iberian origin. Principal Component Analysis (PCA) and phylogenetic network clustering supported its genomic singularity while confirming ancestral proximity to traditional European pigs. These findings highlight the dual nature of the YBHP: a genetically distinct native breed shaped by local adaptation yet retaining ancestral signals from Old World lineages. This genomic insight provides a scientific basis for conservation planning, supports the breed’s recognition as a unique genetic resource, and promotes its sustainable use in regional production systems. Full article

Background/Objectives: Although differences seem to exist by age in primary cardiovascular prevention with acetylsalicylic acid (ASA), direct comparisons are lacking, as are studies with real-world data. We sought to examine the effectiveness of ASA in reducing cardiovascular diseases and overall mortality in patients at high risk by age subgroups. Methods: We designed a retrospective cohort study using the database of the Catalan primary care system (SIDIAP), Spain, for the period 2006–2020. Included participants were high-cardiovascular-risk individuals without previous vascular disease. We considered people aged 40 to 59 and ≥60 years of age. We assessed the incidences of atherosclerotic cardiovascular disease (ASCVD), all-cause mortality, and ASA adverse effects using Cox proportional hazards modelling, adjusted by the propensity score of ASA treatment. Results: During the study period, 7576 and 30,282 people were aged 40 to 59 and ≥60 years, respectively. The median follow-up was 11.21 (10.71–11.54) years (40 to 59 year-olds) and 11.09 (10.55–11.54) years (≥60 year-olds). The hazard ratio of ASA use for ASCVD in the group aged 40–59 years was 0.64 (0.41–0.99). The number needed to treat in this group was 40 persons and the number that needed to harm for gastrointestinal bleeding (the only adverse effect with significant hazard ratio) was 75 individuals. Conclusions: This direct comparison of real-world age groups at high cardiovascular risk showed no benefit but increased risk in the older population (≥60 years). In the younger subgroup, our observations would support primary prevention with ASA with a consideration of the individual optimal risk–benefit. Full article

The current global energy crisis is one of the most pressing challenges of the 21st century, it highlights the fragility of an old power system based on fossil fuels, geopolitical dependencies and often the precariousness and age of equipment and installations, affecting the economy, security and social stability on a national, regional and world scale. The risk of blackout thus becomes not only a technological threat, but a symbol of the need for a paradigm shift. The energy future must be sustainable, collaborative and adaptable—to guarantee not only the continuity of services with electricity, but also the stability of modern society. This paper provides an intrinsic interdisciplinary analysis on the causes, implications and possible solutions related to major imbalances in contemporary power systems, emphasizing the growing risk of blackout (large power outages). The main causes of crises are analyzed interdisciplinary, such as: insecurity in the functioning of the National Power System, terrorist attack on the National Power System, extreme weather condition, natural calamity, energy insecurity and political/military insecurity. The paper highlights the interdependence between energy infrastructure and energy security, as well as the vulnerability of power grids to cyberattacks, natural disasters and consumer pressures. In addition, socio-economic, technological and political issues are addressed, providing an integrated view of the phenomenon. Finally, national, regional and bilateral mitigation, limitation and restoration (resilience) procedures and measures are proposed in the event of an electricity crisis—blackout. Full article

Background/objectives: This was a post hoc analysis of safety data across the bivalent respiratory syncytial virus prefusion F (RSVpreF) vaccine clinical trial development program. Methods: Data from eight clinical trials in 46,913 immunocompetent adults who received RSVpreF or placebo were analyzed. Local reactions and systemic events were assessed among non-pregnant ≥18-year-olds (n = 9517); adverse events (AEs) among pregnant and non-pregnant 18–59-year-olds (n = 9238); and vaccine-related AEs among non-pregnant ≥18-year-olds (n = 39,314). Post-marketing data in non-pregnant adults were considered. Results: Local reactions and systemic events were reported more frequently in RSVpreF versus placebo recipients; injection site pain was the most common local reaction (RSVpreF, 18.9%; placebo, 7.4%), and fatigue (23.5%; 18.4%) and headache (19.5%; 15.0%) were the most common systemic events. Percentages of AEs within 1 month after vaccination were similar across groups (RSVpreF, 12.8%; placebo, 13.1%); severe AEs were reported in ≤1.5% of participants. Differences in percentages of individuals reporting vaccine-related AEs between the RSVpreF and placebo groups were <0.2% for all related AEs. Serious AEs throughout the study were reported in ≤14.0% (RSVpreF, 12.6%; placebo, 14.0%). No atrial fibrillation, Guillain-Barré syndrome, or acute polyneuropathy cases were reported. The AE data from post-marketing data sources were consistent with the safety profile from the clinical trial program, with no new safety concerns. Conclusions: Integrated data demonstrated that RSVpreF was well tolerated with a favorable safety profile in non-pregnant and pregnant adults. Ongoing surveillance through real-world use and clinical trial experience continue to support the safety profile of RSVpreF. ClinicalTrials.gov: NCT03529773/NCT04071158/NCT04785612/NCT05035212/NCT05096208/NCT05842967/NCT04032093/NCT04424316. Full article

In real-world applications, user demands for new functionalities and activities constantly evolve, requiring action recognition systems to incrementally incorporate new action classes without retraining from scratch. This class-incremental learning (CIL) paradigm is essential for enabling adaptive and scalable systems that can grow over time. However, Wi-Fi-based indoor action recognition under incremental learning faces two major challenges: catastrophic forgetting of previously learned knowledge and uncontrolled model expansion as new classes are added. To address these issues, we propose CAREC, a class-incremental framework that balances dynamic model expansion with efficient compression. CAREC adopts a multi-branch architecture to incorporate new classes without compromising previously learned features and leverages balanced knowledge distillation to compress the model by 80% while preserving performance. A data replay strategy retains representative samples of old classes, and a super-feature extractor enhances inter-class discrimination. Evaluated on the large-scale XRF55 dataset, CAREC reduces performance degradation by 51.82% over four incremental stages and achieves 67.84% accuracy with only 21.08 M parameters, 20% parameters compared to conventional approaches. Full article

Designing optimal heritage tourism routes in secondary cities involves complex trade-offs between cultural richness, travel time, carbon emissions, spatial coherence, and group satisfaction. This study addresses the Personalized Group Trip Design Problem (PGTDP) under real-world constraints by proposing DRL–IMVO–GAN—a hybrid multi-objective optimization framework that integrates Deep Reinforcement Learning (DRL) for policy-guided initialization, an Improved Multiverse Optimizer (IMVO) for global search, and a Generative Adversarial Network (GAN) for local refinement and solution diversity. The model operates within a digital twin of Warin Chamrap’s old town, leveraging 92 POIs, congestion heatmaps, and behaviorally clustered tourist profiles. The proposed method was benchmarked against seven state-of-the-art techniques, including PSO + DRL, Genetic Algorithm with Multi-Neighborhood Search (Genetic + MNS), Dual-ACO, ALNS-ASP, and others. Results demonstrate that DRL–IMVO–GAN consistently dominates across key metrics. Under equal-objective weighting, it attained the highest heritage score (74.2), shortest travel time (21.3 min), and top satisfaction score (17.5 out of 18), along with the highest hypervolume (0.85) and Pareto Coverage Ratio (0.95). Beyond performance, the framework exhibits strong generalization in zero- and few-shot scenarios, adapting to unseen POIs, modified constraints, and new user profiles without retraining. These findings underscore the method’s robustness, behavioral coherence, and interpretability—positioning it as a scalable, intelligent decision-support tool for sustainable and user-centered cultural tourism planning in secondary cities. Full article

Background and Clinical Significance: Breast reconstruction following mastectomy is a critical aspect of treatment for many patients, offering both physical and psychological benefits. Traditional methods include autologous tissue flaps and implants, with implant-based techniques being the most prevalent in the Western world. However, complications such as capsular contracture remain a concern. Acellular dermal matrices (ADM) have emerged as a valuable alternative, improving outcomes by reducing capsular contracture rates and enhancing tissue integration. Case Presentation: This case report presents the first use of a novel ADM, biocade^® (biotrics bioimplants AG, Berlin, Germany) in breast reconstruction following a mastectomy. A 55-year-old female patient underwent a left-sided nipple-sparing mastectomy, followed by prepectoral direct-to-implant reconstruction using an ADM-wrapped implant. The patient tolerated the procedure well, with no immediate complications observed. Postoperative monitoring focused on wound healing and assessing for signs of complications related to the implant. The use of the ADM resulted into satisfactory aesthetic and functional outcomes. Conclusions: The successful outcome of this case highlights the potential benefits of using collagen matrices in breast reconstruction, particularly in preserving mastectomy scenarios. The immediate results and improved aesthetics offered by prepectoral direct-to-implant reconstruction with ADM align well with patient expectations for a more natural appearance and faster recovery. However, this case report also highlights the need for ongoing research to fully explore the potential of these biomaterials and address associated challenges. Full article

When scholars view characters in King Lear through a Machiavellian lens, they read Edmund, Goneril, and Regan as stock Machiavels. In contrast, they often perceive Cordelia, Kent, and Edgar as selfless, apolitical characters. This essay argues that the latter characters are more complicated and politically adroit than they are often judged to be. They are Machiavellian as well, but Shakespeare conceives them within a more appreciative view of the concept of realpolitik. This essay explains the characters’ strategies by relating them to Machiavelli’s tenets of achieving and maintaining political power. The central quandary of the play is the lack of a male heir to the throne. Cordelia attempts to solve the problem by marrying the King of France for political reasons. She has an alliance with Kent, who helps her to justify her invasion of her homeland with French forces. Once the plans for a surprise attack go awry, Cordelia does not follow Machiavellian strategies and is consequently killed. Ironically, Edgar is as ambitious as Edmund, whom he lets plot against his father and bring about Gloucester’s slow decline so as to inherit his father’s fortune while Edmund incurs the blame for his father’s demise. Like Kent, he enlists a disguise for self-advancement. The most adroit Machiavellian characters—Edgar, Kent, and the King of France—all survive through chicanery and cunning. Shakespeare illustrates that secular methods of governorship defeat the old world of divine politics. Full article

Highway construction in China has bolstered Chinese claims of having the longest highways in the world, yet it has led to the involuntary relocation and resettlement of millions of people all over China. This study examines the interplay of power relationships in modernity and ethnic cultures. Using interviews with 201 Zhuang ethnic minority people and participant observations from two years in the Southwest of China, this paper presents findings that show both the positive and negative effects of urbanization and modernization as the consequence of highway expansion. By discussing the removal of a religious Sacred Rock which was in the way of the highway construction, the authors reveal the subtleties of the power interplay of majority–minority relations and the meanings of cultures and rituals in the face of modernity. In the process of modernization, highway construction reconstructs new communities while deconstructing the old one. The authors argue that recognizing the meanings of ethnic cultures as defined by ethnic people themselves is the first step to the reconciliation of social relationships between the majority and minority people in created new communities. To enhance social integration, religion has an important role to play in Chinese society. Full article

The climate crisis poses profound risks to present and future generations. Nonetheless, the perspectives of children and young people internationally, and more specifically in Brazil, remain underexplored. Based on a multi-discipline literature review on climate anxiety and nature (dis)connectedness, the hypothesis is that the effects and symptoms of increasing (dis)connection with natural environments have short-, medium-, and long-term consequences. Access to natural spaces is a vital response to counteract the negative impacts of climate change. This article discusses findings from a study conducted in urban Brazil with 200 young people aged 12 to 18 years old, with the aim of addressing three research questions from ten questions that comprised the complete survey. The major research questions were as follows: 1. ‘Climate change worries me’: How do you relate to this statement? 2. How does climate change affect you?, and 3. Do you think some young people are more affected by climate change than others? The results show that young people care about and are preoccupied with climate change, especially when they reflect on their futures and the future generations. Although young participants are deeply concerned about climate change and feel its effects personally in the form of anxiety, fear, and insecurity, they often lack clear pathways for contributing to broader environmental efforts beyond individual actions. These findings highlight an urgent need to foster community-based approaches and enhance education and resources for enlarging and improving youth engagement, especially to rethink the everyday strategies addressing these challenges, and to foster new paradigms of interaction with the natural world based on (re)connection with natural spaces. The correlation between climate anxiety and nature (dis)connection offers an approach that is still little explored, especially concerning children and young people. Full article

Aside from a few passages addressing animals or the environment, Confucian philosophy appears to lack an environmental ethics perspective. Li Zhehou’s (李澤厚) contemporary work in Confucian philosophy continues this lacuna by limiting his understanding of community to the human realm. Using the common liberal humanism that limits moral actions to the interpersonal human realm misses the importance of inclusive moralities such as animal rights and environmental ethics. I propose that if we return to the original shared common cultural roots of Confucian and Daoist philosophy that a Confucian understanding of the natural world can embrace the non-human environment within the scope of Confucian morality. Extricating ideas from the Yijing, the Shijing, Xunzi, Dong Zhongshu, Wang Chong, and later scholars, the concept of the mutual resonance and response (ganying 感應) between the natural world and humans developed into the unity of heaven and humanity (tianren heyi 天人合一). An inclusive Confucian depth ecology opens new ways of thinking that can be deployed to envision deeper dimensions for understanding the self’s inner life, its connections to the outer life of the self–other relationship, and its extension to a kin relationship with the environment. This paper explores how these old and new ways of thinking can change our behavior and change our moral interactions with others including the environment and thereby enhancing freedom as an achievement concept derived from graceful moral action. Full article