Search Results (133)

Urban waste-governance programs rely on household source segregation, yet often assume that discards can be classified through stable technical categories. In culturally governed settings, post-use materials may also be classified through ritual status, propriety, edibility, and social obligation. This focused ethnography examined why source-based management of post-ritual offering materials, locally referred to as sisa upakara, remains difficult to sustain in urban Denpasar, Bali. Data were collected between January and March 2026 through 18 semi-structured interviews, four focus group discussions with 30 participants, six directed observation episodes totalling approximately 21 h, and document review across four anonymized urban sites. A hybrid deductive–inductive thematic analysis produced 2183 selectively coded segments. Five interdependent mechanisms explained practice formation and breakdown: post-ritual classification and legitimacy, domestic routinization, material-infrastructure fit, local-to-downstream verification, and system absorptive capacity. Management weakened when households could not distinguish edible remnants, ritually sensitive materials, and ordinary discards; when ceremonial peaks overloaded domestic routines; when fibrous, wet, bulky, or contaminated materials exceeded available infrastructure; and when downstream systems failed to preserve separated materials. The findings show that sisa upakara constitutes a hidden ritual-urban material sub-stream embedded within household waste. Culturally responsive waste governance requires alignment between classification guidance, household routines, material design, collection reliability, downstream verification, and decentralized processing capacity. Full article

Background: Cognitive impairment is a common complication after ischemic stroke and affects patients’ quality of life. Elevated glial fibrillary acidic protein (GFAP) and low vitamin D levels may contribute to neuroinflammation and impaired neuroplasticity, but their association with post-stroke cognitive impairment remains unclear. This study aimed to determine whether high serum GFAP and low vitamin D levels are risk factors for cognitive impairment in ischemic stroke patients. Methods: A prospective cohort study was conducted in patients with acute ischemic stroke. Serum GFAP and vitamin D levels were measured on the third day after stroke onset using an enzyme-linked immunosorbent assay (ELISA). Cognitive function was assessed two weeks after stroke onset using the Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina). Data were analyzed using the chi-square test and multivariate logistic regression. Results: Seventy-six subjects were included in this study, of which 55 (72.4%) developed cognitive impairment. High serum GFAP (≥1.885 ng/mL) (RR = 1.755; 95% CI: 1.252–2.459; p = 0.001) and low vitamin D levels (<16.185 ng/mL) (RR = 1.773; 95% CI: 1.234–2.547; p = 0.001) were both associated with cognitive impairment. Multivariate analysis showed that high GFAP (AOR = 10.039; 95% CI: 2.484–40.569; p = 0.001) and low vitamin D levels (AOR = 6.640; 95% CI: 1.798–24.518; p = 0.005) were independent risk factors. Conclusions: Elevated serum GFAP and low vitamin D levels were independently associated with cognitive impairment after ischemic stroke and may serve as potential biomarkers for early risk stratification. Full article

Urban flooding in coastal megacities remains a critical challenge, with recurrent inundation driven by extreme rainfall, inadequate drainage, and topographic vulnerability. This study investigated the spatio-temporal dynamics of flooding in Mumbai between 2018 and 2025 using Sentinel-1 SAR data (VV and VH polarizations) along with automated thresholding and unsupervised classification techniques. The VV polarization consistently detected a larger flood extent than VH, with maximum inundation reaching 152 km² in 2024, compared to 67 km² with VH, highlighting VV’s superior sensitivity to surface water. Ward-wise analysis revealed that Chembur West (16.47 km²), Matunga (12.33 km²), and Ghatkopar (5.43 km²) were the most flood-prone areas, while Colaba and Marine Lines experienced lower exposure due to higher elevation and better drainage infrastructure. Annual flood variation corresponded with intense rainfall events, particularly those exceeding 300 mm/day in 2020, 2023, and 2024. Validation with Brihanmumbai Municipal Corporation (BMC) reported flood data confirmed a strong spatial agreement with SAR-derived flood zones, supporting the reliability of the geospatial model. The integration of remote sensing, rainfall data, and ward-level analysis offers a scalable framework for urban flood risk mapping. These findings emphasize the need for resilient drainage planning, green infrastructure, and real-time flood monitoring systems. Full article

African swine fever virus (ASFV) is an evolving threat to global swine health and food security, driven by its complex epidemiology, multi-host transmission cycles, and ongoing spread across countries. This review summarizes the global scenario and transmission pathways of ASFV, highlighting the outbreaks associated with evolving risk patterns to support effective disease prevention and control. ASF has been reported in pig-producing regions across Africa, Europe, and, more recently, Asia, largely driven by the spread of genotype II strains. The virus is transmitted through direct contact with infected pigs or pig-products, indirectly via contaminated materials, and through soft ticks of the genus Ornithodoros spp., with epidemiological patterns varying according to wildlife reservoirs and regional factors. Control measures mainly rely on early detection, movement control, strict quarantine, robust biosecurity measures, and international trade regulations. Despite significant advances, persistent challenges, including the absence of a widely available commercial vaccine, long-term stability of the virus, human activities, and inconsistencies in global response capacities, continue to hinder disease eradication efforts. This review underscores the need for transnational strategies and policies that integrate economically sustainable disease management systems and reduce the long-term impact of ASFV. Full article

Heart failure (HF) remains associated with high morbidity and mortality, with heart failure with preserved ejection fraction (HFpEF) becoming increasingly prevalent and therapeutically challenging despite advances in pharmacological and rehabilitative care. Beyond their glucose-lowering effects, glucagon-like peptide-1 receptor agonists (GLP-1RAs) confer cardiometabolic benefits and may serve as effective adjuncts to cardiac rehabilitation (CR), particularly in obese patients with HFpEF. Obesity plays a central role in the pathophysiology of HFpEF, and GLP-1RAs promote weight loss, reduce insulin resistance and leptin signaling, and improve hemodynamic and metabolic abnormalities associated with HFpEF. Accumulating evidence suggests that the benefits of GLP-1RAs are phenotype-specific and more pronounced in patients with HFpEF than in patients with HF with reduced ejection fraction. Current clinical guidelines recommend GLP-1RAs for patients who have type 2 diabetes mellitus and established cardiovascular (CV) disease or are at high CV risk, with recent updates recognizing their potential benefits in patients with HFpEF and obesity. Cardiac rehabilitation, delivered through multidisciplinary programs, remains a cornerstone of HF management. Although caloric restriction and aerobic exercise can be beneficial in patients with HFpEF and obesity, these interventions alone are often insufficient. Sarcopenia is common in older patients with HFpEF and contributes to adverse outcomes, underscoring the importance of incorporating resistance training into CR programs. The most frequent adverse effects of GLP-1RAs are gastrointestinal events, which are generally mild to moderate but may lead to treatment discontinuation in some patients. Future studies should investigate the potential synergistic effects of GLP-1RAs and CR, clarify their long-term safety and efficacy in HF populations, and define their role beyond obese HFpEF phenotypes. Full article

Background: Evidence comparing high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) for obesity remains inconsistent, particularly with respect to cycling-based protocols. Therefore, this meta-analysis aimed to evaluate randomized controlled trials comparing bicycle-ergometer HIIT with cycling-based MICT in adults with overweight or obesity. Methods: PubMed, Scopus, Cochrane Library, and Google Scholar were searched from January 2015 to September 2025; Google Scholar was used as a supplementary source. Eligible studies included adults aged 18–60 years and compared cycling-based HIIT with MICT interventions conducted over a minimum duration of 5 weeks. The primary outcomes were changes in body mass and fat mass. Between-group standardized mean differences (SMDs) were pooled using random-effects models. Results: Nine RCTs involving 394 enrolled participants were included, although analyzable samples varied by outcome. No significant between-group difference was observed for body mass (SMD: 0.04; 95% CI: −0.19 to 0.27; p = 0.710; I² = 0%; τ² = 0.00) or fat mass (SMD: 0.01; 95% CI: −0.23 to 0.26; p = 0.810; I² = 0%; τ² = 0.00). The pooled effects were close to zero and should be interpreted as short-term findings because interventions lasted 5–12 weeks. Conclusion: Current evidence from randomized controlled trials does not demonstrate the superiority of either cycling-based HIIT or MICT for reducing body mass or fat mass in adults with overweight or obesity. These findings do not establish equivalence and should therefore be interpreted with caution, given the small sample sizes, short follow-up, limited dietary control, and possible measurement error in body-composition outcomes. Full article

Background: Human cysticercosis, caused by the larval stage (cysticerci) of the pork tapeworm Taenia solium, is an important zoonotic disease. The disease is prevalent in developing countries where porcine cysticercosis is common and undercooked pork is habitually consumed. Objective: This study aimed to develop an immunochromatography-based test kit for the rapid diagnosis of human cysticercosis using low-molecular-weight antigens purified from cyst fluid of the T. solium Asian genotype to detect specific IgG antibodies in whole blood. The kit was designated as “the cysticercosis whole-blood test kit (iCys WB kit).” Methods: It was evaluated under laboratory conditions using 164 whole-blood samples, of which 21 were from confirmed cysticercosis cases. The results of the iCys WB kit, which detects anti-T. solium (cysticercus) antibodies in simulated whole blood samples, were compared with results from corresponding human serum samples. Results: When using both sample types, iCys WB kit demonstrated an accuracy of 98.8%, a sensitivity of 91.7%, a specificity of 100%, a positive likelihood ratio of 0, a negative likelihood ratio of 0.083, and an ROC area of 0.96. The agreement between results obtained from simulated whole-blood and serum samples showed perfect concordance. Conclusions: The iCys WB kit is a valuable easy-to-handle diagnostic tool and may be applicable for supporting clinical diagnosis at the point of care. Full article

Background/Objectives: The excessive use of antibiotics in the intensive care unit (ICU) is driving antimicrobial resistance and poor clinical results. Therefore, the aim of this study was to assess antibiotic exposure and clinical results stratified by baseline procalcitonin (PCT) levels in critically ill ICU patients with suspected bacterial infections. Methods: A retrospective observational cohort study was conducted at a tertiary referral center in Bali, Indonesia. This study included adult ICU patients with suspected bacterial infections and documented baseline PCT levels. Participants were stratified into two cohorts based on a baseline PCT threshold, namely <0.5 ng/mL and ≥0.5 ng/mL. Comprehensive clinical data, antibiotic utilization, and patient results were extracted from electronic medical records. Comparative statistics and multivariable logistic regression were used to identify independent association after adjustment for relevant clinical confounders. Results: In this study, a total of 84 patients were analyzed. Patients in the elevated PCT group (≥0.5 ng/mL) were significantly older and had higher APACHE II scores, suggesting greater baseline illness severity at ICU admission. The median duration of antibiotic therapy was significantly longer in the elevated PCT than the normal group (8 vs. 5 days; p < 0.001). After adjustment for age, APACHE II score, and other relevant clinical variables, elevated baseline PCT levels remained independently associated with prolonged antibiotic exposure and in-hospital mortality. Incremental increases in PCT levels were associated with higher odds of mortality, along with advanced age and higher SOFA scores. Furthermore, the presence of multidrug-resistant (MDR) pathogens was independently associated with prolonged antibiotic use. Conclusions: Elevated baseline PCT levels upon ICU admission were associated with prolonged antibiotic exposure and increased in-hospital mortality. Baseline PCT levels likely reflect underlying illness severity and the magnitude of the host inflammatory response. Within antimicrobial stewardship frameworks, they should be interpreted alongside clinical assessment and severity scores rather than as a standalone determinant of antibiotic duration. Full article

Utilizing the InVEST coastal exposure model and multi-source geospatial data, this study evaluates coastal vulnerability to sea-level rise along a critical stretch of the North Coast of Central Java, Indonesia, specifically focusing on the Semarang, Demak, and Jepara regions. A Coastal Exposure Index (CEI) was constructed for 256.63 km of shoreline by integrating key environmental variables, including wave climate, high-resolution coastal topography, shoreline geomorphology, bathymetry, coastal habitat distribution, and observed sea-level rise trends-based satellite altimetry from AVISO. The CEI classified coastal segments into five risk categories from Very Low to Very High exposure. A comparative analysis was performed between a scenario incorporating coastal habitats and a scenario without habitats to determine the protective role of natural ecosystems. The results of the analysis show that the average sea-level rise in the study area is 4.3 mm/year. Moreover, the findings also show that the inclusion of coastal habitats significantly reduces extreme exposure levels. Without accounting for habitats, 22.8% of the coastline was classified as Very High exposure, whereas with habitats included this portion dropped to 1.8%. For example, in Jepara Regency the length of shoreline in Very High exposure class decreased from 53.7% (no habitat scenario) to 5.5% when habitats were considered. Overall, the presence of coastal ecosystems shifted large stretches of the coast to lower exposure classes. This study demonstrates that natural habitats have a critical influence on coastal exposure, substantially mitigating the vulnerability of North Java’s coastline to sea-level rise. Full article

Hazard risk monitoring of groundwater depletion and land subsidence due to excessive groundwater extraction is crucial for groundwater resource development, especially in densely populated, small-island developing sites. The island of Bali, Indonesia, represents such an urban environment at risk of land subsidence arising from groundwater depletion. The total percentage of groundwater depletion was calculated and interpolated spatially using measurements of groundwater level from 2008 to 2017 at 18 monitoring well sites available in the area. Furthermore, time-series synthetic-aperture radar (SAR) interferometry processing was applied to estimate the temporal change in land displacement using the Phased Array type L-band SAR (PALSAR) data from 2007 to 2010. The result of downward displacement, signifying subsidence, corresponded with the Global Navigation Satellite System (GNSS) data measurements at stations distributed in the observed subsided areas, i.e., CDNP and CPBI. The displacement varied consistently with changes in groundwater level. In regard to maintaining groundwater utilization, the hazard–risk relation of the groundwater depletion, i.e., low (<10%), moderate (10–25%), and high (>25%), and the presence/absence of subsidence were utilized to classify groundwater conservation into safe, vulnerable, critical, and damaged zones. This application can be considered effective in providing spatial information for sustainable groundwater management. Full article

This study examines risky decision-making in a free-ranging population of Balinese long-tailed macaques (Macaca fascicularis fascicularis), addressing gaps in research that have largely focused on captive primates and have rarely considered individual differences by age and sex. Thirty-three macaques of different age–sex classes were tested using a choice task contrasting a guaranteed small reward with a probabilistic larger reward. At the group level, macaques showed no preference for safe or risky options. However, substantial individual variation emerged: some individuals were risk-prone, others risk-averse, and many indifferent. Notably, age and sex interacted in shaping risk preferences. Among males, adults and juveniles were more risk-prone than younger adults, whereas among females, adults were more risk-prone than juveniles. Juveniles also displayed outcome-dependent flexibility, choosing the risky option more often after a previous successful risky choice, consistent with a win–stay strategy. Like in rodents, this pattern may reflect adaptive learning during developmental transitions. Importantly, the observed behavioral differences were not due to misunderstanding of the task, as macaques reliably chose the larger option when outcomes were visible. This pronounced individual variability in primate risk preferences underscore the importance of considering demographic factors when characterizing species-typical risk preferences. Full article

Hot springs represent unique geothermal ecosystems where extreme physicochemical conditions intersect with remarkable microbial diversity and metabolic innovation. These natural laboratories harbor specialized communities of thermophilic and hyperthermophilic microorganisms that have evolved exceptional adaptations to elevated temperatures, extreme pH, and high salinity. This review synthesizes current understanding of hot spring systems as multifunctional natural resources, examining their roles in fundamental microbiology, biotechnology, and sustainable development. We explore the ecological principles governing microbial community assembly, the taxonomic and functional diversity of prokaryotic and eukaryotic microorganisms, and the genomic mechanisms underlying thermophilic adaptation. Hot springs yield enzymes revolutionizing molecular biology and industrial catalysis, bioactive metabolites with pharmaceutical potential, and novel bioremediation capabilities including plastic degradation. Beyond biological significance, these systems contain valuable minerals and rare earth elements, supporting an emerging bioeconomy integrating wellness tourism, bioprospecting, and sustainable resource extraction. However, critical knowledge gaps remain regarding viral ecology, horizontal gene transfer, eukaryotic diversity, and climate change impacts. We emphasize that hot springs merit renewed interdisciplinary attention as model systems for understanding extremophile physiology, early life evolution, and the development of nature-based biotechnological solutions. Realizing their full potential requires balanced management strategies that preserve ecosystem integrity while enabling responsible utilization of these irreplaceable geobiological resources. Full article

Road transport across Asia is undergoing rapid motorisation and exemplifies growing road safety challenges, with rising accident rates closely linked to driver behaviour. Recent reports indicate that Vietnamese drivers often perceive risk as manageable and enforcement as inconsistent, contributing to habitual violations such as speeding, signal ignoring, and risky manoeuvres, particularly when traffic is light. Evidence shows that riders, especially young adults, feel confident controlling their vehicles and frequently disregard safety warnings. This study investigates traffic safety awareness among motorcyclists and car drivers in Hanoi, based on a questionnaire survey of 393 respondents. Principal Component Analysis (PCA) was used to group 11 attitudinal statements into key components influencing road safety perceptions, identifying five: non-compliance with traffic regulations (Component 1), aggressive driving behaviour (Component 2), traffic signal issues (Component 3), road quality and infrastructure (Component 4), and preventive measures (Component 5). Multiple Correspondence Analysis (MCA) and two-step cluster analysis (TCA) were then applied to determine user clusters by socio-demographic characteristics, producing three groups: young adults in employment riding motorcycles (Cluster 1), young adults in education riding motorcycles (Cluster 2), and mature adults in employment driving cars (Cluster 3). Finally, Multinomial Logistic Regression (MLR) was applied to assess variations in road safety perceptions across the different groups (clusters). Mature adults driving cars (Cluster 3) identified the first four components as significant, with Components 1 and 2 showing negative associations and Components 3 and 4 positive associations. Full article

The urgency of research into innovation and digital marketing is driven by growing competition within the tourism industry, which demands greater destination visibility (DV) and tourist engagement (TE). At the same time, Areia Branca Beach, a prominent destination in Timor-Leste, has not been managed optimally to support sustainable tourism. Furthermore, the utilisation of governance innovation and digital marketing—particularly the integration of content marketing (CM), immersive technology (IT), and digital data analytics (DDA)—remains limited and has yet to be substantiated by robust empirical evidence at the scale of a developing destination. This study aims to investigate the role of DDA in the causality between CM and IT in influencing DV and TE. A quantitative approach was employed, using moderated regression analysis (MRA) to test the empirical relationships between the variables. Primary data were collected through face-to-face field surveys of tourists who had visited Areia Branca Beach, located northeast of Dili, Timor-Leste, on at least two occasions. The study adopted simple random sampling (SRS) with a finite population correction (FPC). A total of 364 tourists were selected to assess their perceptions using a structured questionnaire. The study reveals four main findings. First, CM significantly affects DDA and DV. Second, IT influences DDA, but not TE. Third, DDA significantly affects both DV and TE. Fourth, DDA moderates the effect of CM on DV and the effect of IT on TE. The findings underscore that the collaborative governance concept, through governance and marketing innovations, is not yet optimal for shaping sustainable tourism. Finally, future academic and practical policy implications require more in-depth exploration to emphasise the enhancement of resource management capacity genuinely needed in the subjects studied, beyond governance and digital marketing innovations within the sustainable tourism framework. Full article