Search Results (23,091)

Rapid urbanization and the urban-rural dualism are subjecting traditional villages to various slow-onset disturbances. The resilience of traditional villages (RTV) has become essential for their sustainable development. By measuring, classifying, and zoning RTV, this study aims to reveal its actual state and heterogeneous characteristics, thereby offering clear guidance for differentiated sustainable development strategies in traditional villages. From an integrated perspective of the tripartite attributes of traditional villages, this study develops an RTV assessment framework comprising three dimensions: structural persistability (SP) as vernacular heritage, functional adaptability (FA) as rural communities, and industrial transformability (IT) as tourism resources. Using hierarchical clustering, the obstacle degree model, the optimal parameters-based geographical detector, and spatially weighted hierarchical clustering, this study identifies distinct RTV types, along with their statistical distributions, key constraints, and spatial patterns. The main conclusions are as follows. (1) Most traditional villages in Jincheng exhibit low or medium-low levels of resilience. Moreover, the three dimensions of RTV are unevenly developed, with the IT dimension lagging markedly behind the others. (2) The key obstacles to enhancing RTV are the scarcity of high-value heritage resources, insufficient public services, low regional socioeconomic vitality, low public visibility, a scarcity of high-quality tourism assets, inadequate tourism support facilities, and a limited local tourism supply market. (3) Jincheng’s traditional villages cluster into four resilience-based zones, enabling a regional approach to their conservation. Full article

Background and Objectives: Diabetic kidney disease (DKD) is one of the leading causes of chronic kidney disease (CKD) worldwide. Individuals over 65 years of age with type 2 diabetes mellitus (T2DM) constitute a growing age group that is frequently underrepresented in randomized clinical trials. Finerenone has been shown to reduce renal progression and cardiovascular events in patients with albuminuric DKD. To evaluate the clinical and laboratory characteristics as well as the therapeutic response and safety profile of finerenone in patients over 65 years of age with DKD, based on data from the FINDKDLATAM observational study cohort. Materials and Methods: Subgroup analysis of a real-life, retrospective, multicenter observational study—the FINDKDLATAM cohort. For the present analysis, patients aged ≥ 65 years were stratified. Sociodemographic, clinical, paraclinical, and treatment variables and adverse events were evaluated. The descriptive analysis used medians with interquartile ranges (IQRs) for continuous variables of non-parametric distribution and absolute and relative frequencies for categorical variables. The comparison of baseline parameters and those at six months of follow-up was performed using non-parametric tests, with statistics. Results: Of the total of 347 patients included in the original study, 157 (45.2%) were ≥65 years of age. The median age was 72 years. The baseline profile showed a median glomerular filtration rate (eGFR) of 38.0 mL/min/1.73 m² (IQR: 30.0–50.75), as well as elevated albuminuria (ACR 327.0 mg/g; IQR: 186.5–805.5). In addition, the patients had a high burden of comorbidities. 58.0% of patients received finerenone at a dose of 10 mg and 42.0% at a dose of 20 mg. After six months of follow-up, a significant reduction in the median ACR was observed, decreasing from 327.0 mg/g (IQR: 186.5–805.5) to 78.0 mg/g (IQR: 27.5–143.0), corresponding to a decrease of 76% (p < 0.0001). Regarding safety, hyperkalemia occurred in 20.3% of patients, although, in all cases, it was mild hyperkalemia (potassium between 5.1 and 5.5 mEq/L), with no serious episodes or treatment suspensions attributable to this event. Conclusions: In this cohort of Latin American adults over 65 years of age with albuminuric DKD, finerenone demonstrated good efficiency given the clinically significant reduction of albuminuria with stable renal function at six months of treatment, also demonstrating a safety profile, with a low risk of hyperkalemia. Full article

To evaluate the clinical applicability of the 2023 ACR/EULAR serologic classification criteria for antiphospholipid syndrome (APS) in a cohort of pregnant women across the APS spectrum, and to assess the association between serologic burden and clinical manifestations, obstetric outcomes, and treatment response, a retrospective cohort study was conducted including 190 pregnant women with persistent antiphospholipid antibody (aPL) positivity. Patients were classified according to the ACR/EULAR serologic criteria into two groups: high serologic burden (≥3 points) and low serologic burden (≤2 points). Clinical, obstetric, therapeutic, and reproductive variables were compared between groups. Nearly one-third of women did not meet the 2023 ACR/EULAR serologic threshold. Although most patients with thrombotic or obstetric APS fulfilled the ACR/EULAR serologic threshold, 28% of women with obstetric APS and 35.3% of those with pregnancy-related morbidity had ≤2 serologic points. Baseline demographic characteristics were similar between groups. Obesity (23.9% vs. 10%; p = 0.04) and obstetric comorbidity (17.9% vs. 5.4%; p = 0.02) were more frequent among patients with higher serologic burden. Rates of obstetric complications were comparable between groups. The most commonly prescribed treatment was low-dose aspirin combined with low-molecular-weight heparin, with no differences according to serologic classification. Live birth rates and adverse pregnancy outcomes were comparable between groups, with favorable outcomes observed in treated pregnancies. Serologic burden as defined by the 2023 ACR/EULAR criteria does not reliably predict obstetric complications, nor identify a clinically more severe subgroup. These findings highlight that clinical judgment beyond formal classification frameworks remains essential when managing pregnant women with antiphospholipid antibodies. Full article

As green building concepts continue to expand into public cultural spaces, green concert halls not only serve functions of cultural communication and artistic services, but also play an important role in shaping urban residents’ psychological experiences and well-being. However, existing studies on green buildings have mainly focused on energy performance and technical indicators, while limited attention has been paid to how green cultural buildings are associated with residents’ well-being through environmental perception. In the Chinese context, research specifically examining green concert halls remains scarce. Based on environmental psychology and restorative environment theory, this study takes the Chengdu City Concert Hall, which has received China’s Three-Star Green Building certification, as the research object. A conceptual model of “green concert hall design perception–perceived nature connectedness–perceived restorativeness–residents’ well-being” was constructed to explore the underlying mechanisms linking green concert hall design perception and residents’ well-being. Green concert hall design perception was conceptualized as a second-order construct consisting of four dimensions: green design legibility, eco-environmental comfort, green aesthetic integration, and green cultural symbolism. Perceived nature connectedness and perceived restorativeness were introduced as mediating variables. A survey was conducted among 879 Chengdu residents with concert-hall attendance experience, and structural equation modeling (SEM) was employed for empirical analysis. The results indicate that (1) green concert hall design perception is significantly and positively associated with residents’ well-being; and (2) perceived nature connectedness and perceived restorativeness both play significant mediating roles in the relationship between green concert hall design perception and residents’ well-being, while also forming a significant sequential mediating effect. The findings suggest that green concert halls are associated with more positive environmental experiences through ecological and aesthetic characteristics, and that residents’ well-being may be further linked to strengthened nature connectedness and restorative perceptions. This study extends research on green public cultural buildings from the perspective of residents’ psychological perception, and provides theoretical support and practical implications for human-centered green concert hall design and the development of urban green cultural spaces. Full article

Recent studies have shown that building-envelope characteristics, including thermal mass and window-related solar gains, can significantly influence heating load behavior. However, their implications for the applicability and accuracy of simplified volumetric heating load methods remain insufficiently understood. Therefore, this study evaluates the applicability and accuracy of steady-state volumetric heating load methods under varying envelope conditions. Representative residential building models with different envelope types and window-to-wall ratios (WWRs) were analyzed. Heating loads were calculated using a normative volumetric approach based on tabulated specific heat-loss coefficients (Method 1) and a recalculated approach incorporating envelope characteristics and solar gains (Method 2). A comparison at hourly, peak-load, seasonal, and load-duration-curve (LDC) levels revealed that the performance of steady-state volumetric methods is strongly dependent on both envelope characteristics and the level of heating load assessment. Method 1 consistently overestimated seasonal heating demand by 41–218%, whereas Method 2 substantially reduced the error. However, Method 2 still underestimated annual heating demand in highly insulated buildings (up to 39%) and peak heating load (up to 63%). These findings indicate that the applicability of volumetric methods depends on both envelope characteristics and the level of heating load assessment. The results highlight the importance of accounting for envelope-dependent thermal-mass effects when applying volumetric methods to hourly, peak-load, seasonal, and LDC-based analyses. Full article

In this paper, we propose a novel generative adversarial network (GAN)-based joint localization and mapping (JLAM) method using angle difference of arrival (ADOA) measurements for millimeter-wave (mmWave) communication systems. The proposed method adopts a deep auto-encoder neural network as the discriminator of the GAN and models the generator as an explicit geometric ADOA function of the access point (AP) positions and the mobile terminal (MT) position, rather than as a conventional black-box neural network. By exploiting the two-dimensional distribution characteristics of high-dimensional ADOA vectors collected at a large number of random and unknown MT positions, the proposed method learns the ADOA data distribution and transforms it into the AP geometric topology. Then, the MT positions and the indoor map are estimated based on the recovered physical and virtual AP topology. The simulation results show that, under the representative setting with $N=2000$ measured ADOA vectors and $\sigma =2^{\circ }$ AOA measurement noise, the proposed method achieves an average localization error of about 0.25 m, compared with about 0.60 m for the JADE algorithm, corresponding to an error reduction of approximately $58\%$. The proposed method also provides more accurate room boundary estimation than JADE, confirming its effectiveness for mmWave JLAM. Full article

Under low-temperature and high-humidity conditions, stable ice layers readily form on asphalt pavements in cold regions, and the enhanced ice–asphalt interfacial adhesion significantly increases deicing difficulty and traffic safety risks. To clarify the factors governing ice–asphalt interfacial adhesion strength, this study combines macroscopic pull-off tests and molecular dynamics simulations to systematically investigate the effects of interfacial contact area, temperature, pull-off rate, and molecular characteristics of representative asphalt components. The pull-off results show that adhesion strength increases markedly with decreasing temperature, rising from approximately 163 kPa at −2 °C to 242 kPa at −10 °C. In contrast, the nominal adhesion strength decreases with increasing ice specimen size, suggesting that size-related interfacial heterogeneity and nonuniform stress transfer may contribute to the pull-off response. The adhesion strength also generally decreases as the pull-off rate increases. Molecular dynamics simulations show that smaller asphalt–ice interfacial models exhibit higher molecular-scale nominal adhesion responses, while temperature-dependent simulations provide short-range asphalt–ice interaction descriptors for interpreting the experimental temperature trend. The calculated short-range asphalt–ice interaction energy becomes less negative from −531.4 to −352.5 kJ mol⁻¹ with increasing temperature, supporting the experimentally observed strengthening of adhesion at lower temperatures. Single-molecule pull-off simulations of 12 representative asphalt molecules reveal pronounced molecular differences, with molecular-scale nominal adhesion strengths ranging from 303.7 to 734.6 MPa. Asphaltene and polar aromatic molecules generally show stronger adhesion, which is associated with larger projected contact area, flatter molecular configurations, and heteroatom-induced polar sites. The molecular polarity index shows a moderate positive association with molecular-scale nominal adhesion strength. These results establish a scale-aware mechanistic correspondence between macroscopic pull-off behavior and molecular interaction descriptors at the ice–asphalt interface, providing insights for interfacial adhesion regulation and anti-icing design of asphalt pavement materials in cold regions. Full article

Background: Sodium–glucose cotransporter 2 (SGLT2) inhibitors have demonstrated significant renoprotective effects in patients with chronic kidney disease. However, kidney transplant recipients have been excluded from major randomized trials, and evidence in non-diabetic transplant patients remains limited. This study aimed to investigate the potential effects of SGLT2 inhibitors in non-diabetic kidney transplant recipients. Methods: Kidney transplant recipients were screened retrospectively and divided into two groups based on SGLT2 inhibitor use. A total of 18 non-diabetic patients receiving SGLT2 inhibitors (Group 1) were compared with 30 matched controls (Group 2). Patients were followed at baseline, 3, 6, and 12 months. Proteinuria, serum creatinine, eGFR, uric acid, and tacrolimus levels were analyzed. Results: Baseline demographic and biochemical characteristics were similar between groups. In Group 1, proteinuria decreased by 20% at 6 months and 26% at 12 months compared with baseline. The reduction in proteinuria from baseline to 6 months was significantly greater in Group 1 than in controls (p = 0.037). No significant changes were observed in serum creatinine, eGFR, tacrolimus levels, or infection-related adverse events between groups. Conclusions: SGLT2 inhibitors may confer an early antiproteinuric benefit in non-diabetic kidney transplant recipients without apparent adverse effects on renal function or safety. Larger prospective studies are needed to confirm long-term effects. Full article

Treatment of cleft lip alveolus and/or palate includes surgical repair to treat communication-related outcomes such as velopharyngeal insufficiency and otological dysfunction. Robot-assisted surgery has recently evolved into a promising adjunct to conventional surgery, particularly for complex procedures such as transoral (reconstructive) surgery. This structured literature review aims to investigate whether robot-assisted transoral cleft palate repair enhances communication (i.e., speech and otological) outcomes compared to conventional manual cleft palate surgery. A literature search was performed using PubMed, Embase, the Cochrane Library and Google Scholar. Primary outcomes were the change in cleft speech characteristics and otological disease after robot-assisted cleft palate surgery versus manual cleft palate surgery. The available evidence on communication-related outcomes remains sparse. Six relevant articles were included. In only one study, transoral robotic cleft surgery (TORCS) significantly reduced otitis media with effusion (OME), need for ventilation tubes and hearing threshold within 2 years post-surgery. No postoperative speech or velopharyngeal outcomes were reported. In conclusion, transoral robotic cleft surgery (TORCS) appears safe and feasible for repair of a cleft palate. It provides superior intraoral view and improved surgeon ergonomics. Current drawbacks are the costs and the available tools, the extended surgical duration and the lack of haptic feedback, which limit the current clinical applicability of TORCS. Based on limited clinical evidence, TORCS may support faster recovery of Eustachian tube function and hearing, but no conclusions on speech outcomes can yet be drawn. Full article

Network development level and inequality level within urban agglomerations profoundly shape regional sustainability and global competitiveness. Existing studies predominantly focus on economic scale, geographic proximity, and static cross-sectional data analysis, often lacking systematic consideration of people’s wellbeing, network connectivity, and dynamic evolutionary processes. Furthermore, insufficient attention has been paid to the intrinsic connection between network development and inequality levels. Addressing this gap, this study systematically investigates the network development level, inequality level, and the correlation mechanisms between them, focusing on six national-level urban agglomerations located in China’s Yangtze River and Yellow River basins. Key findings include the following: (1) The overall connectivity efficiency of development networks within urban agglomerations continues to improve, yet the disparity in network status among node cities has gradually widened. The network centrality of core cities initially strengthens and then weakens. (2) Urban agglomerations with relatively lagging economic development often exhibit greater internal disparities in development momentum. Wealth distribution inequality within agglomerations has gradually eased, while the urban–rural development gap shows a trend of first increasing and then decreasing. Conversely, social welfare distribution inequality has intensified overall. (3) Network indicators centering on centrality significantly contribute to the imbalance in regional wealth distribution. As social welfare distribution inequality increases, the influence of network centrality characteristics on it strengthens. (4) The impact of regional network development level on inequality level is hierarchical and directional. Increasing network density, average distance, and degree of association helps mitigate wealth distribution imbalance, whereas increasing network density and centrality may exacerbate regional development inequality. Overall, this study provides empirical evidence and theoretical support for policy-making of sustainable development in urban agglomerations, and enriches the theoretical connotation of regional balanced development. Full article

This study presents a computational analysis of degradation caused by cavitation and hydro-abrasive erosion in a low-head axial microturbine ($H=4\mathrm{m}$), incorporating strategic air injection as a passive mitigation technique. Using Computational Fluid Dynamics (CFD) within ANSYS CFX 2025 R2, the study investigates hydrodynamic performance and the spatial distribution of surface wear across the runner blades. The turbine geometry was developed from aerofoil profiles mapped onto cylindrical coordinates, using a structured three-dimensional mesh with localized refinement to ensure grid independence. Physical modeling employed the Shear Stress Transport (SST) turbulence model, with cavitation dynamics governed by the Rayleigh–Plesset equation and sediment transport modeled using a Lagrangian framework incorporating the Finnie erosion model. The numerical framework showed good agreement with reference characteristic curves, confirming its predictive accuracy. The results indicate that vapor cavities form predominantly on the suction side, whereas solid particle erosion highly concentrated on the pressure side of the blades, where the outer $20\%$ of the span accounts for over $91\%$ of the total erosion intensity. Parametric assessments of controlled air injection revealed a highly non-linear mitigation response, identifying IAVF 2 as the optimal air-injection case. This configuration reduced integrated erosion by $0.95\%$ and maximum localized erosion by $6.17\%$. In contrast, excessive air volumes accelerated material removal due to localized flow distortion. The findings indicate that carefully controlled air injection is a viable strategy for extending the operational lifespan of small-scale hydropower assets. Full article

The rapid expansion of online health information channels, particularly emerging artificial intelligence (AI) platforms, is transforming how individuals access and evaluate health information. Drawing on an extended Comprehensive Model of Information Seeking (CMIS), this research examined how different channel types (AI-based, short-video, and text-based) influence online health information-seeking behavior (OHISB) through a pilot validation (N = 258), a cross-sectional survey (Study 1; N = 300), and a between-subjects experiment (Study 2; N = 300). Study 1 tested an extended CMIS model incorporating channel type, source credibility, information credibility, and perceived usefulness, while Study 2 examined the causal effects of channel exposure. Structural equation modeling in Studies 1 and 2 consistently showed that source and information credibility predicted OHISB indirectly through perceived usefulness. AI channels showed no advantage in Study 1, whereas Study 2 found that participants perceived AI sources as more credible and useful, which indirectly predicted stronger intentions for SAMC and information seeking through the credibility–usefulness pathway. This change may reflect methodological differences between self-report recall-based and direct exposure designs, and the public’s growing familiarity with AI technologies. By integrating channel characteristics and credibility perceptions, this study extends the CMIS framework and provides evidence for AI’s enhanced perceived credibility in health information contexts, offering insights for improving AI-driven health communication. Full article

Background/Objectives: A recent Delphi survey of endocrinologists revealed low consensus regarding the diagnosis of pediatric growth hormone deficiency (GHD). Thus, we sought to describe the various trajectories undertaken by healthy 8–14-year-old youth in the 2 years following testing for GHD at a single major pediatric academic institution. Methods: Electronic health records were reviewed for the current analysis from healthy 8–14-year-old participants enrolled in a prospective longitudinal observational study of parent and youth characteristics associated with youth quality of life and self-esteem over a two-year period following growth hormone (GH) stimulation testing. Participants were grouped according to their peak GH concentration on testing (<7, 7–10, and ≥10 ng/mL), and outcomes included treatment (or not) with GH or other growth-altering hormonal treatments. Results: Of the 115 participants, 27 (23%) had peak GH < 7 ng/mL, 27 (23%) 7–10 ng/mL, and 61 (53%) peaked ≥ 10 ng/mL. Across the three groups, some patients were not offered GH treatment, some were offered yet did not pursue treatment, and some were offered and treated—with further variance provided by GH treatment interruptions, early cessation vs. continued GH treatment, delayed GH treatment start, and treatment with other agents (testosterone, gonadotropin-releasing hormone agonist, or aromatase inhibitor) either in lieu of or in addition to GH. Conclusions: Even within the network of a single academic institution, variability is evident in the management of healthy 8–14-year-old short youth following GH stimulation testing. Full article

Morphostructural characterization of Creole cattle is essential for assessing the diversity and productive potential in the highland livestock systems. The study was conducted in Chuschi and Chipao districts, at 3800 m above sea level, with the objective of morphostructurally characterizing 154 Creole cows. Seventeen phaneroptic variables and twenty-one morphometric variables were recorded. The multivariate analysis identified three cattle biotypes. Based on proportionality, compactness, and cannon bone load indices, Biotype 1 (16.9%) comprised more compact, robust, and heavier animals with a greater tendency toward meat production aptitude, followed by Biotype 2 (48.1%) and Biotype 3 (35.1%), which were more slender but with a stronger bone structure. No association was found between biotypes and phaneroptic characteristics, except for teat type (p < 0.05). The proportions of red, black, dull black, qosca, and roan coat colors were common across all biotypes; however, Biotype 1 predominated in callejón (15.38%), Biotype 2 in qosne (8.11%) and in other less frequent coat colors (10.81%), while Biotype 3 predominated in dark roan (16.67%) and jet black (11.11%). In the high-Andean region of Ayacucho, three subpopulations of Creole cattle were identified with potential for beef production, dual-purpose use, and adaptation to rugged terrain, highlighting the need to investigate their genetic diversity. Full article

The preparation of platelet-rich plasma (PRP) requires precise density-based centrifugation of anticoagulated whole blood to achieve an optimal hematologic bioformulation while enhancing platelet recovery efficiency. Commercial PRP systems exhibit substantial heterogeneity in processing architecture, with variable platelet yields and inconsistent cellular composition profiles. In this clinical PRP device evaluation, 70 sequential samples sourced from two independent clinical facilities were used to evaluate the performance characteristics of the XCELL 60 mL single-spin centrifugation platform. Two different PRP preparations were consistently prepared as per physician preferences: PRP-1 and PRP-2. The main differences between these two preparations were the concentration of leukocytes and reduction in red blood cells. The system was evaluated based on critical PRP performance metrics. The results demonstrated the following: (1) A consistent 8-fold increase in platelet concentration relative to baseline whole blood was achieved. (2) The average platelet capture rate (PCR) was 83%. (3) The total available platelets (TAPs) in the PRP specimen produced from both groups combined were 10.8 ± 2595 billion platelets within a final product volume of 6 mL. (4) Hematocrit values were reduced to <2–6% across sites (reduction of 94% and 84% in RBCs, respectively). Finally, (5) a customizable leukocyte content (20.9–25.4 × 10⁹/L) was achieved without comprising platelet yield. This single-spin centrifugation architecture achieved performance parity with historically preferred double-spin systems while reducing the processing time and number of preparation steps. Engineering analysis established that high-precision platelet recovery and bioformulation control are achievable through optimized single-spin centrifugal design, enabling standardized therapeutic dosing for autologous regenerative medicine applications. Full article