Search Results (613)

Against the backdrop of China’s fast-growing digital economy and its financial inclusion agenda, there is still little city-level evidence on whether the e-CNY pilot accelerates financial deepening at the grassroots. Using a balanced panel of 271 prefecture-and-above cities for 2016–2022, this study employs a staggered difference-in-differences (SDID) design augmented by the synthetic control method (SCM) to rigorously identify the policy effect of the e-CNY pilot. The results show that the pilot program significantly improves urban financial inclusion, contributing to more equitable access to financial services and supporting inclusive socio-economic development. Mechanism analysis suggests that the effect operates mainly through two channels, a merchant-coverage channel and a transaction-scale channel, with the former contributing the majority of the overall effect. Incorporating a migration-based mobility index shows that most studies’ focus on the merchant-coverage effect is amplified in cities under tight mobility restrictions but wanes where commercial networks are already saturated, whereas the transaction-scale channel is largely insensitive to mobility shocks. Heterogeneity tests further indicate stronger gains in non-provincial capital cities and in the eastern and central regions. Overall, the study uncovers a “penetration-inclusion” network logic and provides policy insights for advancing sustainable financial inclusion through optimized terminal deployment, merchant incentives, and diversified scenario design. Full article

Cancer disparities in low- and middle-income countries (LMICs) arise from multifaceted interactions between environmental exposures, infectious agents, and systemic inequities, such as limited access to care. The exposome, a framework encompassing the totality of non-genetic exposures throughout life, offers a powerful lens for understanding these disparities. In LMICs, populations are disproportionately affected by air and water pollution, occupational hazards, and oncogenic infections, including human papillomavirus (HPV), hepatitis B virus (HBV), Helicobacter pylori (H. pylori), human immunodeficiency virus (HIV), and neglected tropical diseases, such as schistosomiasis. These infectious agents contribute to increased cancer susceptibility and poor outcomes, particularly in immunocompromised individuals. Moreover, climate change, food insecurity, and barriers to healthcare access exacerbate these risks. This review adopts a population-level exposome approach to explore how environmental and infectious exposures intersect with genetic, epigenetic, and immune mechanisms to influence cancer incidence and progression in LMICs. We highlight the critical pathways linking chronic exposure and inflammation to tumor development and evaluate strategies such as HPV and HBV vaccination, antiretroviral therapy, and environmental regulation. Special attention is given to tools such as exposome-wide association studies (ExWASs), which offer promise for exposure surveillance, early detection, and public health policy. By integrating exposomic insights into national health systems, especially in regions such as sub-Saharan Africa (SSA) and South Asia, LMICs can advance equitable cancer prevention and control strategies. A holistic, exposome-informed strategy is essential for reducing global cancer disparities and improving outcomes in vulnerable populations. Full article

Introduction: Low medication adherence and low hypertension control are a public health challenge, particularly in low- and middle-income countries (LMICs). Healthcare system- and patient-related barriers hinder the successful management of hypertension. This study aimed to identify the perceptions of barriers and facilitators to hypertension management among health system stakeholders in Santander, Colombia. Materials and Methods: We conducted a qualitative, phenomenological, and interpretative study, comprising five focus groups, to explore the barriers and facilitators to managing people with hypertension. Each focus group was formed by stakeholders from territorial entities, healthcare insurers, or healthcare providers. Meetings were held between December 2022 and February 2023. The sessions were recorded and transcribed using NVivo Transcription and analyzed using NVivo version 1.6.1. Results: Seven categories of barriers and facilitators were identified: strategies, resources, access, risk assessment, cross-sector collaboration, articulation, and stewardship. Of these categories, articulation and stewardship emerged as the main barriers, as revealed through axial coding and cluster analysis, which highlighted deficiencies in stewardship practices, a lack of clear objectives, and misalignment with public policy frameworks. Conclusions: Multisectoral actions extending beyond healthcare providers and aimed at improving coordination and intersectoral collaboration are essential for enhancing hypertension control in LMICs, such as Colombia. Addressing social determinants and strengthening primary healthcare through community-based strategies are critical, making stewardship and improved access key priorities. Full article

The global elimination of hepatitis C virus (HCV) has been prioritized by the World Health Organization (WHO) as a key public health target, with a deadline set for 2030. This initiative aims to significantly reduce both new infection rates and HCV-associated mortality. A major breakthrough in achieving this goal has been the development of direct-acting antiviral agents (DAAs), which offer cure rates exceeding 95%, along with excellent safety and tolerability. Nevertheless, transmission via parenteral routes continues to be the dominant pathway, particularly among high-risk groups, such as individuals who inject drugs, incarcerated populations, those exposed to unsafe medical practices, and healthcare professionals. Identifying, monitoring, and delivering tailored interventions to these groups is crucial to interrupt ongoing transmission and to reduce the burden of chronic liver disease. On a global scale, several nations have demonstrated measurable progress toward HCV elimination, with some nearing the targets set by WHO. These achievements have largely resulted from context-adapted policies that enhanced diagnostic and therapeutic access while emphasizing outreach to vulnerable communities. This review synthesizes current advancements in HCV prevention and control and proposes strategic frameworks to expedite global elimination efforts. Full article

Endometrial cancer (EC) is the most common gynecological malignancy in developed countries. Risk factors for EC include metabolic alterations (obesity, metabolic syndrome, insulin resistance), hormonal imbalance, age at menopause, reproductive factors, and inherited conditions, such as Lynch syndrome. For the inherited forms, several genes had been implicated in EC occurrence and development, such as POLE, MLH1, TP53, PTEN, PIK3CA, PIK3R1, CTNNB1, ARID1A, PPP2R1A, and FBXW7, all mutated at high frequency in EC patients. However, gene function impairment is not necessarily caused by mutations in the coding sequence of these and other genes. Gene function alteration may also occur through post-transcriptional control of messenger RNA translation, frequently caused by microRNA action, but transcriptional impairment also has a profound impact. Here, we review how chromatin modifications change the expression of genes whose impaired function is directly related to EC etiopathogenesis. Chromatin modification plays a central role in EC. The modification of chromatin structure alters the accessibility of genes to transcription factors and other regulatory proteins, thus altering the intracellular protein amount. Thus, DNA structural alterations may impair gene function as profoundly as mutations in the coding sequences. Hence, its central importance is in the diagnostic and prognostic evaluation of EC patients, with the caveat that chromatin alteration is often difficult to identify and needs investigations that are specific and not broadly used in common clinical practice. The different phases of the healthy endometrium menstrual cycle are characterized by differential gene expression, which, in turn, is also regulated through epigenetic mechanisms involving DNA methylation, histone post-translational modifications, and non-coding RNA action. From a medicolegal and policy-making perspective, the implications of using epigenetics in cancer care are briefly explored as well. Epigenetics in endometrial cancer is not only a topic of biomedical interest but also a crossroads between science, ethics, law, and public health, requiring integrated approaches and careful regulation. Full article

Highway accessibility plays a vital role in supporting local economic development, particularly in regions lacking access to sea or river ports. Recognizing the functional transformation of road infrastructure, the Chinese government has made substantial investments in its expansion. Nevertheless, a theoretical gap remains in justifying whether such investments yield significant economic returns. Drawing on the theory of economic externalities, this study investigates the causal relationship between highway development and regional economic growth, and assesses whether highway construction leads to an acceleration in growth rates. Utilizing panel data from 14 Chinese cities spanning 2000 to 2014, the synthetic control method (SCM) is employed to evaluate the economic externalities of highway investment. The results indicate a positive impact on surrounding industries. Furthermore, a growth rate forecasting analysis based on Back-Propagation Neural Networks (BPNNs) is conducted using industrial enterprise data from 2005 to 2014. The growth rate in the treated city is 1.144%, which is close to the real number 1.117%, higher than the number for the weighted control group, which is 1.000%. The findings suggest that the growth rate of total industrial output improved significantly, confirming the existence of positive spillover effects. This not only enriches the empirical literature on transport infrastructure but also provides targeted enlightenment for the sustainable development of urban economy in terms of policy guidance. Full article

In the deep integration process between digital infrastructure and new economic forms, structural imbalance between the evolution rate of cloud storage technology and the growth rate of data-sharing demands has caused systemic security vulnerabilities such as blurred data sovereignty boundaries and nonlinear surges in privacy leakage risks. Existing academic research indicates current proxy re-encryption schemes remain insufficient for cloud access control scenarios characterized by diversified user requirements and personalized permission management, thus failing to fulfill the security needs of emerging computing paradigms. To resolve these issues, a revocable attribute-based proxy re-encryption scheme supporting policy-hiding is proposed. Data owners encrypt data and upload it to the blockchain while concealing attribute values within attribute-based encryption access policies, effectively preventing sensitive information leaks and achieving fine-grained secure data sharing. Simultaneously, proxy re-encryption technology enables verifiable outsourcing of complex computations. Furthermore, the SM3 (SM3 Cryptographic Hash Algorithm) hash function is embedded in user private key generation, and key updates are executed using fresh random factors to revoke malicious users. Ultimately, the scheme proves indistinguishability under chosen-plaintext attacks for specific access structures in the standard model. Experimental simulations confirm that compared with existing schemes, this solution delivers higher execution efficiency in both encryption/decryption and revocation phases. Full article

The blockchain technology is transforming the mining industry by enabling mineral reserve tokenization, improving security, transparency, and traceability. However, controlling access to sensitive mining data remains a challenge. Existing access control models, such as role-based access control, are too rigid because they assign permissions based on predefined roles rather than real-world conditions like mining licenses, regulatory approvals, or investment status. To address this, this paper explores an attribute-based access control model for blockchain-based mineral tokenization systems. ABAC allows access permissions to be granted dynamically based on multiple attributes rather than fixed roles, making it more adaptable to the mining industry. This paper presents a high-level system design that integrates ABAC with the blockchain using smart contracts to manage access policies and ensure compliance. The proposed model is designed for permissioned blockchain platforms, where access control decisions can be automated and securely recorded. A comparative analysis between ABAC and RBAC highlights how ABAC provides greater flexibility, security, and privacy for mining operations. By introducing ABAC in blockchain-based mineral reserve tokenization, this paper contributes to a more efficient and secure way of managing data access in the mining industry, ensuring that only authorized stakeholders can interact with tokenized mineral assets. Full article

This paper reviews the variability of passenger service time (PST) at the platform–train interface (PTI), a critical performance indicator in metro systems shaped by the infrastructure design, affecting passenger behavior and accessibility. Despite its operational importance, PST remains underexplored in relation to crowd management strategies. This review synthesizes findings from empirical and experimental research to clarify the main factors influencing PST and their implications for platform-level interventions. Key contributors to PST variability include door width, gap dimensions, crowd density, and user characteristics such as mobility impairments. Design elements—such as platform edge doors, yellow safety lines, and vertical handrails—affect flow efficiency and spatial dynamics during boarding and alighting. Advanced tracking and simulation tools (e.g., PeTrack and YOLO-based systems) are identified as essential for evaluating pedestrian behavior and supporting Level of Service (LOS) analysis. To complement traditional LOS metrics, the paper introduces Level of Interaction (LOI) and a multidimensional LOS framework that captures spatial conflicts and user interaction zones. Control strategies such as platform signage, seating arrangements, and visual cues are also reviewed, with experimental evidence showing that targeted design interventions can reduce PST by up to 35%. The review highlights a persistent gap between academic knowledge and practical implementation. It calls for greater integration of empirical evidence into policy, infrastructure standards, and operational contracts. Ultimately, it advocates for human-centered, data-informed approaches to PTI planning that enhance efficiency, inclusivity, and resilience in high-demand transit environments. Full article

Youth unemployment remains a pressing issue in many emerging economies, where educational disparities and demographic pressures interact in complex ways. This study investigates the links between higher-education enrolment, demographic structure and youth unemployment in eight developing countries from 2009 to 2023. Panel cointegration techniques—Fully Modified Ordinary Least Squares (FMOLS) and Dynamic Ordinary Least Squares (DOLS)—are applied to estimate the long-run effects of gross tertiary-school enrolment on youth unemployment while controlling for GDP growth and youth-cohort size. Robustness is confirmed through complementary estimations with pooled-mean-group ARDL and system-GMM panels, which deliver consistent coefficient signs and significance levels. Results show a significant negative elasticity between enrolment and youth unemployment, indicating that wider access to higher education helps lower joblessness among young people. Youth-population growth exerts an opposite, positive effect, while GDP growth reduces unemployment but less uniformly across regions. The evidence points to an integrated policy mix—expanding tertiary (especially vocational and technical) education, managing demographic pressure and maintaining macro-economic stability—to improve youth-employment outcomes in emerging economies. Full article

This article focuses on how rising nativism, manifested through immigrants’ experiences of everyday discrimination, and Florida’s legal context (ascertained through immigrants’ fears of deportation), are related to immigrants’ hesitation when seeking healthcare services. Hesitation to seek healthcare, or healthcare hesitancy, is examined in the context of Florida’s SB1718, a law passed in 2023 that criminalized many aspects of being an immigrant. Based on a survey of 466 Florida immigrants and U.S. citizen adult children of immigrants, logistic regression analysis reveals that everyday experiences with discrimination are associated with a reluctance to seek healthcare services among this population. In particular, those with insecure legal immigrant status (i.e., undocumented and temporary statuses), those with financial hardship, and women demonstrate reluctance to engage with healthcare systems when controlling for other sociodemographic factors. Findings from this study exemplify how immigration policies that restrict access to healthcare and social services not only create logistical barriers to seeking care but also foster a climate of fear and exclusion that deters even those with legal status from seeking medical attention. Full article

In response to the challenges of urbanization, digitalization, and the e-commerce surge intensified by the COVID-19 pandemic, Smart Urban Logistics (SUL) has become a key framework for addressing last-mile delivery issues, congestion, and environmental impacts. This study introduces a System Dynamics (SD)-based approach to investigate how urban logistics and access management policies may interact. At the center, there is a Causal Loop Diagram (CLD) that illustrates dynamic interdependencies among fleet composition, access regulations, logistics productivity, and environmental externalities. The CLD is a conceptual basis for future stock-and-flow simulations to support data-driven decision-making. The approach highlights the importance of route optimization, dynamic access control, and smart parking management systems as strategic tools, increasingly enabled by Industry 4.0 technologies, such as IoT, big data analytics, AI, and cyber-physical systems, which support real-time monitoring and adaptive planning. In alignment with the Industry 5.0 paradigm, this technological integration is paired with social and environmental sustainability goals. The study also emphasizes public–private collaboration in designing access policies and promoting alternative fuel vehicle adoption, supported by specific incentives. These coordinated efforts contribute to achieving the objectives of the 2030 Agenda, fostering a cleaner, more efficient, and inclusive urban logistics ecosystem. Full article

The rapid expansion of blockchain-based digital asset trading raises new challenges in security, privacy, and efficiency. Although traditional attribute-based encryption (ABE) provides fine-grained access control, it imposes considerable computational overhead and introduces additional vulnerabilities when decryption is outsourced. To address these limitations, we present EBODS, an efficient outsourced decryption framework that combines an optimized ABE scheme with a decentralized blockchain layer. By applying policy matrix optimization and leveraging edge decryption servers, EBODS reduces the public key size by 8% and markedly accelerates computation. Security analysis confirms the strong resistance of EBODS to collusion attacks, making it suitable for resource-constrained digital asset platforms. Full article

This study presents an analysis of England’s 2023 national assessment of assistive technology (AT) access and use, with a particular focus on the qualitative impact of AT as described by users. It aims to address limitations in conventional AT impact assessments, which often prioritize clinical outcomes or user satisfaction, by offering a deeper account of how impact is experienced in everyday life. Drawing on data from a nationally representative survey of 7000 disabled adults and children, as well as six focus group discussions and 28 semi-structured interviews with stakeholders across the WHO 5Ps framework (People, Providers, Personnel, Policy, and Products), the study applies Amartya Sen and Martha Nussbaum’s Capability Approach to explore these experiences. Using inductive thematic analysis, we identify three main domains of user-reported impact: Functions and Activities (e.g., mobility, communication, vision, leisure, daily routines, and cognitive support), Outcomes (e.g., autonomy, quality of life, safety, social participation, wellbeing, and work and learning), and Lived Experience (e.g., access barriers, essentiality, identity and emotional connection, peace of mind, and sense of control and confidence). These findings offer a more user-centered understanding of AT impact and can inform the development of future measurement tools, research design, and government-led interventions to improve AT provision. Full article

A scheme of load frequency control (LFC) is proposed based on the deep deterministic policy gradient (DDPG) and active disturbance rejection control (ADRC) for multi-region interconnected power systems considering the renewable energy sources (RESs) and energy storage (ES). The dynamic models of multi-region interconnected power systems are analyzed, which provides a basis for the subsequent RES access. Superconducting magnetic energy storage (SMES) and capacitor energy storage (CES) are adopted due to their rapid response capabilities and fast charge–discharge characteristics. To stabilize the frequency fluctuation, a first-order ADRC is designed, utilizing the anti-perturbation estimation capability of the first-order ADRC to achieve effective control. In addition, the system states are estimated using a linear expansion state observer. Based on the output of the observer, the appropriate feedback control law is selected. The DDPG-ADRC parameter optimization model is constructed to adaptively adjust the control parameters of ADRC based on the target frequency deviation and power deviation. The actor and critic networks are continuously updated according to the actual system response to ensure stable system operation. Finally, the experiment demonstrated that the proposed method outperforms traditional methods across all performance indicators, particularly excelling in reducing adjustment time (45.8% decrease) and overshoot (60% reduction). Full article