Search Results (33,418)

Background/Objectives: The relationship between household tobacco expenditure and child health has attracted considerable attention from both academic and policy communities, as tobacco expenditure can influence children’s health, nutrition, and overall well-being in multiple ways, particularly in rural and low-income settings. This study examines the causal impact of household tobacco expenditure on child health outcomes in a transitional economy. Methods: Using nationally representative microdata from the most recent Household Living Standards Survey, the authors employ Ordinary Least Squares (OLS), Random Effects (RE), and Instrumental Variable (IV) estimations to identify the effects of tobacco spending on children’s healthcare utilization and health status. Results: The results consistently show that higher household tobacco expenditure significantly increases the likelihood of hospitalization among Vietnamese children, with the effects being most pronounced for those under six years of age. Moreover, the authors uncover substantial heterogeneity across gender, maternal age at childbirth, and regional contexts, highlighting persistent socioeconomic inequalities in health outcomes. Conclusions: This study provides compelling evidence of the adverse effects of household tobacco expenditure on children’s health in Vietnam. Theoretically, the study contributes to the literature on the economics of health and intra-household resource allocation by providing micro-level causal evidence from a transitional setting. From a policy perspective, the findings underscore the need for targeted fiscal and public health interventions to mitigate tobacco-related welfare losses and to promote equitable access to healthcare among vulnerable populations. Full article

Background/Objectives: Myotonic dystrophy type 1 (DM1) is a rare, multisystemic disorder caused by an expanded (CTG)n repeat in the DMPK gene. Although DM1 has been studied in several populations, access to molecular diagnosis and comprehensive care remains limited in many low- and middle-income countries. This study provides an updated overview of DM1 in Mexico, from diagnostic implementation to patient management, describing key clinical and genetic findings. Methods: We conducted a nationwide, 15-year prospective study at Mexico’s National Reference Center for neuromuscular diseases. A total of 853 individuals at risk were subjected to clinical and molecular evaluation using PCR, TP-PCR, and SP-PCR, encompassing symptomatic, pre-symptomatic, prenatal, and preimplantation genetic diagnosis. Socioeconomic, clinical, and molecular variables were analyzed. Results: A total of 488 individuals were confirmed as DM1 carriers, with the most prevalent phenotypes being classic (36.5%) and juvenile (28.5%). Genomic analysis revealed a correlation between CTG tract sizes and phenotypes. Intriguingly, interrupted CTG repeat tracts were identified in 2.8% of DM1 carriers, who exhibited milder clinical phenotypes and a reduced degree of somatic and intergenerational instability. Survival analysis revealed a reduction in symptom-free survival in patients with larger expansions, while interrupted CTG tracts were associated with delayed onset. Conclusions: The centralization of diagnostic services in Mexico resulted in regional disparities, impacting early diagnosis and family planning. This study highlights the clinical and molecular diversity of DM1 in a Latin American population and underscores the urgent need for decentralized diagnostic services, integrated care models, and tailored prognostic tools in underserved settings. Full article

This work establishes a large language model (LLM) specialized in the domain of thermoelectric generators (TEGs), for deployment on local hardware. Starting with the generalist JanV1-4B model and Qwen3-4B-Thinking-2507 models, an efficient fine-tuning (FT) methodology using quantized low-rank adaptation (QLoRA) was employed, modifying only 3.18% of the total parameters of thee base models. The key to the process is the use of a custom-designed dataset, which merges deep theoretical knowledge with rigorous instruction tuning to refine behavior and mitigate catastrophic forgetting. The dataset employed for FT contains 202 curated questions and answers (QAs), strategically balanced between domain-specific knowledge (48.5%) and instruction-tuning for response behavior (51.5%). Performance of the models was evaluated using two complementary benchmarks: a 16-question multilevel cognitive benchmark (94% accuracy) and a specialized 42-question TEG benchmark (81% accuracy), scoring responses as excellent, correct with difficulties, or incorrect, based on technical accuracy and reasoning quality. The model’s utility is demonstrated through experimental TEG design guidance, providing expert-level reasoning on thermal management strategies. This study validates the specialization of LLMs using QLoRA as an effective and accessible strategy for developing highly competent engineering support tools, eliminating dependence on large-scale computing infrastructures, achieving specialization on a consumer-grade NVIDIA RTX 2070 SUPER GPU (8 GB VRAM) in 263 s. Full article

This paper argues that despite two decades of reform, the European Union’s (EU) insolvency framework remains structurally and behaviourally inaccessible to micro-, small-, and medium-sized enterprises (MSMEs). While policy rhetoric has embraced the idea of a “rescue culture,” practical implementation has prioritised larger, well-resourced firms. Drawing on international guidance and case studies from Ireland, France, and the United States (US), the paper shows that legal reform alone is insufficient. Structural complexity, cultural stigma, and weak institutional outreach continue to block MSMEs’ access to rescue. The paper proposes a forward-looking agenda for EU reform centred on three pillars: legal simplification tailored to MSMEs, institutional scaffolding to enhance visibility and support, and cultural reframing to normalise restructuring as a second chance. It concludes that a functioning rescue culture must treat MSMEs not as scaled-down versions of large firms but as distinct users with unique constraints and capacities. Full article

Urban Green Spaces (UGSs) are essential for ecological sustainability and public health, offering benefits such as air pollution reduction, urban cooling, and recreational opportunities. However, existing evaluation tools remain inconsistent, often assessing isolated dimensions like accessibility or aesthetics without fully integrating health considerations. A systematic approach is needed to understand how these tools measure UGS quality and their relevance to health outcomes. This study employs a literature review (PRISMA framework) to analyze UGS evaluation tools with a focus on quality and health implications. A search in Scopus and Web of Science identified 14 relevant studies. Data extraction examined tool structure, assessed dimensions, data collection methods, geographic applications, and integration of health indicators. The review identified 13 distinct tools varying in complexity and methodology, from standardized checklists to GIS-based analyses. While key dimensions included accessibility, safety, aesthetics, and biodiversity, health-related factors were inconsistently integrated. Few tools explicitly assessed physical, mental, or social health outcomes. Technological innovations, such as Google Street View and AI-based analysis, emerged as enhancements for UGS evaluation. Despite methodological advances, gaps remain in linking UGS quality assessments to health outcomes. The lack of standardized health metrics limits applicability in urban planning. Future research should focus on interdisciplinary frameworks integrating environmental and health indicators to support the creation of sustainable and health-promoting UGS. Full article

Regarding the deep integration of China’s “dual carbon” strategy with high-quality development, the objectives of practicing ESG principles and fostering new quality productive forces are highly aligned, which constitute an endogenous driving force for corporate sustainability. Government subsidies, by providing directional incentives and guiding resource allocation, further facilitate the integration and agglomeration of factors that underpin new quality productive forces. Yet, existing research offers limited theoretical explanation and empirical evidence regarding the relationship among these three dimensions and the mechanisms through which their effects are transmitted. To fulfill the research, this study uses resources from A-share listed enterprises in China between 2015 and 2023. From the perspective of government subsidies and grounded in signaling theory and resource allocation theory, we construct an index system to measure new quality productive forces and employ a two-way fixed effects model alongside Bootstrap mediation test to investigate the mechanisms and transmission pathways linking ESG performance, government subsidies, and new quality productive forces. The results reveal that strong ESG performance substantially enhances the new quality productive forces, and the assertion stays steadfast after addressing endogeneity concerns and conducting multiple robustness checks. Moreover, ESG performance enhances firms’ access to government subsidies, which subsequently has a partial mediation effect. The analysis also uncovers heterogeneity: the beneficial impact of ESG performance is more salient among small and medium-sized firms as well as firms in eastern regions. This study contributes to the literature by extending the theoretical framework on the correlation between ESG performance and new quality productive forces, while also offering practical insights for advancing corporate ESG practices and refining government subsidy policies. Full article

Access to nature is fundamental to human health and wellbeing, yet opportunities for direct and frequent engagement with natural environments are often restricted for individuals in the 80+ age category, particularly those in care settings or living in remote locations. There is therefore an urgent need to enhance nature connections in care settings and provide personalised, restorative experiences that reflect individuals preferred natural features. This prefeasibility pilot study developed a framework to inform the design of therapeutic care settings, grounded in the principles of biophilic neuroarchitecture and designed to support ageing well. Conducted over six months in two care environments, the study applied the biophilic pattern of Complexity and Order to simulate Natural Analogues within immersive virtual settings. Mixed methods combining wearable sensor data and self-reported wellbeing measures were used to assess psychophysiological, emotional, and cognitive responses among participants aged 80 and above. Findings revealed that VR content aligned with individual nature preferences elicited higher levels of engagement, relaxation, and positive affect. This study demonstrates the potential for implementing biophilic design applications to develop therapeutic care settings which promote wellbeing and healthy ageing, particularly where access to real nature is infrequent or limited. Full article

The importance of Early Childhood Education and Care (ECEC) is recognised by Australian governments and significant reforms are being implemented to increase access to high-quality ECEC. Whilst increased recognition and access are vital, so are strategies to support a high-quality and sustainable workforce. One strategy is for governments to partner with universities to support Diploma-qualified educators to upskill to become teachers. Providing support for Diploma pathway students to be successful in their studies and motivated and to stay in the profession post-graduation is vital. The aim of this study was to investigate a specific design element within one innovative initial teacher education programme for Diploma pathway students—the role of the teaching coach. The teaching coach role was designed to support Diploma pathway students to complete their degree and help create the professional networks needed to sustain them in the profession long term. Using a single site case study approach, qualitative data were collected via semi-structured interviews with teaching coaches. Using the theory of practice architectures to the analyse data, we interrogated the practices of the teaching coaches, how teaching coaches perceived they supported student success and the arrangements that enabled and constrained these practices. From the perspective of the teaching coaches, their role supported student learning and professional networks. The role also provided unanticipated benefits for the teaching coaches themselves. The study highlights the importance of universities going beyond traditional practices to contribute to professional learning and networks for ECEC professionals throughout their careers. Full article

The last kilometer connection problem of metro transit stations is the core factor to measure the connection efficiency and service quality. Establishing the spatiotemporal distribution pattern of the connection distance is conducive to clarifying the interaction mechanism between bike-sharing connections and urban space. This study focuses on the travel behavior of shared bicycle users accessing metro stations, aiming to reveal the access distance decay patterns and their relationship with influence factors. Finally, the random forest algorithm was used to explore the nonlinear relationship between the influencing factors and the connection decay distance, and to clarify the importance of the factors. Multiple linear regression was applied to examine the linear correlation between the distance decay coefficient and the factors influence. The geographically weighted regression was further employed to explore spatial variations in their effects. Finally, the random forest algorithm was used to rank the importance of the impact factors. The results indicate that proximity distance to metro stations, proximity distance to bus stops, and the number of bus routes serving the station area have significant negative correlations with the distance decay coefficient. Significant spatial heterogeneity was observed in the influence of each factor on the distance decay coefficient, based on the geographically weighted regression analysis. With a high goodness-of-fit (R² = 0.8032), the Random Forest regression model furthermore quantified the relative importance of each factor influencing the distance decay coefficient. The findings can be directly applied to optimize the layout of shared bicycle parking, metro access facilities planning, and multi-modal transportation system design. Full article

In this paper, we present a conceptual design framework for developing immersive learning experiences at scale with generative AI and extended reality (XR) for primary and secondary education. Based on the synthesis of current literature, our framework asserts a practical five-step pipeline: curriculum ingestion, AI-powered blueprinting, asset assembly, educator review, and classroom deployment with formative assessment. The model is designed to be flexible, focusing on narrative and gamification for primary students, moving on to sophisticated simulations and analytical activities for secondary students. We place this framework into the context of recent developments in generative 3D models, bridging fundamental technical and ethical gaps between concept and classroom practice. Finally, we summarize a prioritized research agenda around evaluation, access, and teacher workflows to enable near-term pilot studies. This work is intended to inform educators, researchers, and stakeholders who are interested in implementing effective AI-XR solutions in schools in a pedagogically sound way. Full article

Lentil (Lens culinaris Medik. subsp. culinaris) is a Mediterranean legume crop of high value due to nutritional quality and adaptability; however, its cultivation is increasingly threatened due to climate uncertainty and reduction in genetic diversity in modern cultivars. The present research study evaluated 31 Greek lentil accessions (twenty-two landraces and nine commercial cultivars of both small and large seed types) in a semi-arid environment of Central Greece, over two cropping seasons, focusing on phenological, morphological, yield, and quality traits. The great diversity observed at the morpho-phenological and qualitative levels implies the high genotypic diversity of these genetic resources. Small-seeded landraces performed better in seed and biological yield, harvest index, and protein content, having greater phenological stability and tolerance to the Mediterranean environments. In particular, the highest seed yield was observed in LAX small-seeded landrace (1930 kg ha⁻¹), followed by TSO (1559 kg ha⁻¹), DIG (1449 kg ha⁻¹), and EGL (1437 kg ha⁻¹) small-seeded landraces. As for the regression analysis, seed yield was positively correlated with days to flowering (TF: r = 0.076, p < 0.01), plant height (PH: r = 0.143, p < 0.05), number of pods per plant (NPP: r = 0.941, p < 0.001), number of seeds per pod (NPP: r = 0.432, p < 0.001), number of branches (NPB: r = 0.234, p < 0.01), biological yield (BY: r = 0.683, p < 0.001), and harvest index (HI: r = 0.650, p < 0.001). Principal component analysis (PCA) distinguished small-seeded landraces associated with adaptive and yield traits from large-seeded cultivars associated with seed size. Greek lentil landraces, especially the small-seeded genotypes (e.g., LAX and DIG), have great potential for use in the development of climate-tolerant and high-yielding lentil varieties adapted for sustainable Mediterranean production. Breeding programs can target the crossing of landraces with large-seeded cultivars (e.g., IKAm and THEm) to develop varieties that combine stress tolerance, adaptation, and high productivity with adaptation to different seed sizes. Subsequent studies on drought tolerance and heat resistance are still important for continued improvement in lentil productivity in a changing climate. Full article

Background: Street running has seen rapid growth due to its health benefits and accessibility, leading to a simultaneous rise in running-related injuries, particularly among recreational and professional street runners. Medial Tibial Stress Syndrome (MTSS) is a common injury affecting up to 15% of athletes and posing significant risks to runners of all levels of participation. Objective: This study aimed to investigate the strength and kinematic differences in the lower limbs of runners diagnosed with MTSS compared to asymptomatic runners. Methods: A total of 56 participants were divided into an MTSS group (27 runners) and a healthy control group (29 runners). Participants were evaluated for demographics, physical activity level, pain threshold using algometry, and running kinematics obtained through high-resolution 2D video analysis with Kinovea software. Lower-limb muscle strength was measured using an isometric Lafayette^® digital dynamometer. Results: Although there were no significant differences in age or anthropometric measures, MTSS runners exhibited lower initial (∆% = 10.6%, p = 0.002) and intermediate (∆% = 8.7%, p = 0.026) running speeds. Pain assessment revealed significant lower pain thresholds in the MTSS group. Kinematic analysis identified greater foot-strike angles (left foot: ∆% = 31.9%, p = 0.004; right foot: ∆% = 25.9%, p = 0.0049) at initial speeds in MTSS runners, while other parameters like medial calcaneus rotation, push-off angles, and support time did not differ significantly. Additionally, MTSS runners demonstrated reduced strength in the quadriceps femoris (QF—Left QF: ∆% = −28.5%, p = 0.0049; Right QF: ∆% = −28.2%, p = 0.003). Conclusions: MTSS appears to affect female and male runners. MTSS may be attributed to a weaker quadriceps strength, higher heel contact angles during foot strike, or both, suggesting that interventions focusing on the improvement of these factors may be beneficial in preventing and treating MTSS. Full article

This study explores the effect of Energy Inequality (EINQ) on environmental sustainability within the frameworks of the Environmental Kuznets Curve (EKC) and the Load Capacity Curve (LCC), while accounting for technological progress (TECH), financial development (FD), and foreign direct investment (FDI). Using annual data for six Gulf Cooperation Council (GCC) countries from 2005 to 2024, the analysis applies the Method of Moments Quantile Regression (MMQR) to capture heterogeneous effects across the distribution of the Load Capacity Factor (LCF). The results show that energy inequality consistently reduces environmental sustainability, indicating that unequal access to efficient and clean energy services heightens ecological pressure. In contrast, technological innovation and financial development enhance sustainability by improving energy efficiency and supporting green investments. Economic growth exhibits an inverted U-shape, validating the EKC and LCC hypotheses. These findings are especially important for the GCC, where hydrocarbon dependence, uneven access to clean energy, and rapid structural change intensify the environmental consequences of inequality. The study underscores the need for policies that promote equitable energy access, innovation-led diversification, and sustainable financial mechanisms. Full article

Refugees often face significant barriers to healthcare access and integration, contributing to poor health outcomes. Although perceptions of health are known predictors of self-reported health status, little is known about how refugees themselves conceptualize health. This study employed a community-engaged, transformative mixed-methods design to explore refugee health perceptions in the Denver-metro area. Data collection included 149 surveys and 27 interviews with refugees and asylum seekers conducted between November 2018 and March 2019. Hierarchical linear regression was used to assess associations between social determinants of health (SDoH) and self-reported health, while qualitative data were analyzed using a constant comparative approach. The final regression model explained 75.8% of the variance in self-reported health (R² = 0.758, p < 0.001). Significant predictors included country of origin (Burma: −3.419, p = 0.030; Somalia: −9.155, p < 0.001), age (1.901, p < 0.001), sex (male: −3.252, p < 0.001), and education level (−0.999, p < 0.001). Qualitative findings revealed themes such as health as the ability to live life and health as happiness, each shaped by cultural context, community connectedness, and perceptions of safety. Integrating these findings highlights how structural conditions and culturally rooted understandings of well-being intersect to shape refugee health after resettlement. This study underscores the need for public health and clinical interventions that center refugee-defined priorities and suggests future research should incorporate constructs, such as happiness and culturally grounded notions of safety, that emerged as central to health in this study. Full article

Supply chain disruptions and climate shocks have exposed the fragility of food systems, highlighting the urgency of reconnecting urban areas with local food production through spatial planning. This study develops a regional-scale ecosystem service (ES)-based foodshed assessment framework, integrating agricultural capacity, ecological functionality, and infrastructure, specifically roads, food industries, and markets. The framework combines the Metropolitan Foodshed and Self-Sufficiency Scenario (MFSS) model with stakeholder-prioritized integrated ES mapping and Geographic Information System (GIS)-based multi-criteria suitability analysis. Applied to Istanbul and the Marmara Region, the assessment focuses on cereals/legumes, vegetables, and fruits/spices under four scenarios projected to 2033. Results show that integrating ESs increases the area classified as suitable by 26%, while infrastructure constraints reduce it to 9%, reflecting the spatial trade-offs between ecological potential and accessibility. Istanbul, with limited agricultural land, achieves self-sufficiency levels below 10% in all scenarios, highlighting its structural dependency. Eliminating food loss and waste reduces regional land demand by 23%. The framework offers policy-relevant insights for conservation, ecological restoration, and decentralized food system development. It remains open to further enhancement through the inclusion of livestock-based systems, updated land cover data, and climate projections, factors essential for assessing long-term resilience. Overall, the ES-based assessment can support food- and ecosystem-sensitive spatial planning in metropolitan regions. Full article