Search Results (1,935)

Urban park areas mitigate urbanization’s negative impacts by integrating environmental, social and cultural benefits. Development strategies should enable participation and consider all user groups’ needs, following sustainability principles. However, ensuring multifunctionality often generates conflicting decisions. While the universal necessity for safety is widely acknowledged, its implementation frequently results in the diminution of a crucial sense of privacy. For example, the universally recognized need for safety may compromise the willingness sense of privacy or intimacy. This can discourage those for whom this need is important and prevent urban parks from fully utilizing their social potential. This study examines how spatial configurations of plant forms within urban parks shape personal experiences. We used an intra-group design to evaluate photographs of park spaces, manipulated using Photoshop AI algorithms to examine safety, privacy, preference, and willingness to spend time. Variables included space size and shape. The study used Computer-Assisted Web Interviewing (CAWI) with 300 participants. Regression and mediation analyses showed willingness to visit derives from space attractiveness, influenced by perceived safety and privacy. Analyses revealed the following: open areas were safest but the least private, corridor spaces were the least safe but the most private; curtain screens enhanced perception better than corridor screens; small spaces with corridor screens were least attractive; space size mattered less for open spaces than screened spaces; and spatial configuration was critical in assessing small spaces. The findings of this research enhance our comprehension of the perception of park spaces. They hold potential practical implications for sustainable design, facilitating the development of plant forms that are more socially effective, particularly those with substantial environmental value, such as dense vegetation that serves as visual screens. Neglecting these preferences may result in inappropriate design decisions that fail to accommodate users’ needs and behaviors, thereby not fully capitalizing on the potential of urban green spaces. Full article

Background: Fibromuscular dysplasia (FMD) is a non-inflammatory vascular disorder that affects medium and large arteries, with a notable association with intracranial aneurysms (IAs). This review aims to assess the prevalence, characteristics, and implications of IAs in patients with FMD, highlighting gaps in current knowledge and the need for further research. Methods: A comprehensive literature search was conducted on PubMed using keywords related to FMD and intracranial aneurysms. The search focused on studies published over the last 28 years, identifying relevant data on the prevalence and morphological features of IAs in FMD patients. Due to the limited quality and availability of information, a narrative review format was adopted to synthesize findings. Results: The review found that the prevalence of IAs in FMD patients is significantly higher than in the general population, with estimates varying widely (4.7–21.7%). The majority of patients identified with IAs were female, and the age range of affected individuals varied significantly. Key risk factors for aneurysm formation included hypertension, smoking, and the presence of multifocal or multisite FMD. Notably, the study indicated that routine screening for IAs in FMD patients has to be weighted with the relatively low prevalence of asymptomatic IAs and the risk-to-benefit ratio of treatment in older patients. Conclusions: The association between FMD and intracranial aneurysms is significant, and timely detection of these aneurysms may allow preventing subarachnoid hemorrhage, whose fatality rate is high. Identification of subgroups where the screening may be cost-effective, also considering the impact of the awareness to have an IA without treatment proposal, is warranted. Further research is essential to clarify the relationship between FMD and IAs, optimize screening protocols, and improve outcomes for affected patients. The findings underscore the importance of ongoing registries to enhance understanding of the natural history and treatment of IAs in the context of FMD. Full article

The prevalence of atrial fibrillation (AF) is increasing and often coexists with frailty. The management of anticoagulation therapy in frail older adults with AF is especially challenging due to the high risk of bleeding complications. The aim of this narrative review is to provide a comprehensive overview of current evidence about the management of anticoagulation in frail older adults with non-valvular AF. First, frailty itself should not be considered a contraindication. A comprehensive geriatric assessment is recommended to identify and potentially address conditions that may increase the risk of bleeding, such as inappropriately prescribed medications or malnutrition. Overall, the net clinical benefit remains in favour of oral anticoagulation in frail older adults, even if it decreases with increasing frailty severity. Direct Oral Anticoagulants (DOACs) show a better effectiveness and safety profile compared with Vitamin K antagonists (VKAs) in this population. Among DOACs, apixaban seems to be the safest. Also, edoxaban at a very low dosage (15 mg/day) could be an effective therapy in patients for whom the standard anticoagulation is contraindicated. Moreover, switching from VKAs to DOACs in frail older adults is a complex decision and should be personalized according to the stability of the ongoing anticoagulant therapy, the bleeding risk profile, and the severity of frailty. Finally, although further studies are required to confirm their effectiveness, factor XIa inhibitors are emerging as new promising alternative therapies because they have been associated with a lower bleeding risk compared with DOACs. Full article

Background: Obesity is a highly prevalent chronic disease characterized by excessive weight gain and fat accumulation. There is growing evidence that Lactiplantibacillus plantarum strains with bile salt hydrolase (BSH) activity are effective in preventing and alleviating obesity. Methods: Initially, we screened bacterial strains with high hydrolytic activity against glycochenodeoxycholic acid (GDCA), and constructed an isogenic bsh1 knockout mutant. Subsequently, male C57BL/6J mice fed a high-fat diet (HFD) were randomly assigned to receive daily gavage of either the wild-type Lp20 (Lp20-WT) or the bsh1-deficient mutant (Lp20-Δbsh1) for 8 weeks. Serum cholesterol levels and histopathological changes in liver sections were monitored. Hepatic gene expression was quantified by RT-qPCR, and fecal bacterial communities were analyzed via 16S rRNA gene sequencing. These comprehensive assessments aimed to evaluate metabolic improvements and uncover the potential mechanisms behind the observed effects. Results:L. plantarum Lp20 hydrolyzed 91.62% of GDCA, exhibiting the highest bile-salt hydrolase (BSH) activity among tested isolates. Whole-genome sequencing and in-silico analyses mapped this activity to bsh1; gene deletion of bsh1 confirmed the role of bsh1 in GDCA hydrolysis. Daily gavage of the wild-type strain (Lp20-WT) to diet-induced obese mice markedly attenuated weight gain, reduced inguinal white adipose tissue and mesenteric fat mass, and lowered serum TC and LDL-C by 20.8% and 33.3%, respectively, while decreasing ALT and AST levels and reversing hepatic steatosis. In contrast, the bsh1-null mutant (Lp20-Δbsh1) failed to elicit any measurable metabolic benefit. Mechanistically, Lp20-WT upregulated rate-limiting bile-acid synthetic enzymes CYP7A1 and CYP27A1, thereby accelerating the catabolism of cholesterol into bile acids. Concurrently, it activated hepatic TGR5 and FXR signaling axes to modulate hepatic metabolism. Moreover, Lp20-WT restructured the gut microbiota by notably enhancing the abundance of beneficial bacteria such as norank_f__Muribaculaceae, Akkermansia, and Alistipes, while reducing the abundance of potentially harmful taxa, including norank_f__Desulfovibrionaceae, Dubosiella, and Mucispirillum. Conclusions: This study provides direct evidence of BSH’s anti-obesity effects through gene deletion. Specifically, BSH lowers cholesterol by modulating hepatic bile-acid metabolism-related gene expression and altering the gut microbiota composition. However, the study is limited by a small sample size (n = 6), the use of male mice only, and its preclinical stage, indicating a need for further validation across diverse strains and human populations. Full article

Background: Aging populations make expanded workforce participation among older adults an economic and public health priority. The COVID-19 pandemic accelerated the growth of virtual work, providing new opportunities for healthy aging in the workplace through increased flexibility and less physical strain. However, digital exclusion, ergonomically challenging tasks, and social isolation can limit these opportunities for older populations. Objective: This scoping review aimed to synthesize interdisciplinary research on the relationship between remote work and labor force participation among adults aged 45 years and older, focusing on health-related outcomes, barriers, and facilitators. Methods: Following the JBI Manual for Evidence Synthesis and PRISMA-ScR guidelines, we conducted a comprehensive search across seven databases for peer-reviewed and gray literature published between 2000 and 2025. Of 2108 records screened, 33 studies met the inclusion criteria. Data were extracted using a standardized charting tool and analyzed thematically. Results: Most studies were published after 2020 and originated in North America (45%) and Europe (40%). Core barriers included digital exclusion, ageism, and adverse ergonomic environments. Facilitators involved flexible working hours, a supportive organizational environment, and digital skills. Health-related outcomes such as stress reduction and improved well-being were commonly reported. However, only 18% of studies assessed policy effects, and very few examined intersectionality (e.g., gender, socioeconomic status). Conclusions: Remote and flexible work options can improve the health and participation of older adults in the workforce, but technology, infrastructure, and social barriers remain. Age-inclusive policies, digital equity efforts, and inclusive workplace practices are necessary to maximize the benefits of remote arrangements for aging populations. Full article

Currently, an active debate is underway among the academic community, urban planners, and policymakers regarding optimal models of urban development, given that the majority of the population now resides in cities. One concept under discussion is the 15 min city, which posits that all urban residents should be able to reach key, frequently used services within a 15 min walk or cycle. Although the literature suggests numerous potential benefits, debate persists about whether such cities would be optimal from the standpoint of sustainable development objectives and residents’ quality of life. The ongoing discussion also concerns the extent to which existing cities are capable of aligning with this concept. This is directly linked to the actual spatial distribution of individual services within the city. The literature indicates a research gap arising from a shortage of robust case studies that would enable a credible assessment of the practical implementation of this idea across diverse cities, countries, and regions. This issue pertains to Poland as well as to other countries. A desirable future scenario would involve comprehensive mapping of all cities, with respect to both the spatial distribution of specific services and related domains such as the quality and coherence of linear infrastructure. This article presents an analysis of the spatial accessibility of basic urban services in the context of implementing the 15 min city concept, using the city of Koszalin (Poland) as a case study. This city was selected due to its representative character as a medium-sized urban centre, both in terms of population and area, as well as its subregional functions within Poland’s settlement structure. Koszalin also exhibits a typical spatial and functional layout characteristic of many Polish cities. In light of growing challenges related to urbanisation, climate change, and the need to promote sustainable mobility, this study focuses on evaluating access to services such as education, healthcare, retail, public transport, and green spaces. The use of Geographic Information System (GIS) tools enabled the identification of spatial variations in service accessibility across the city. The results indicate that only 11% of Koszalin’s area fully meets the assumptions of the 15 min city concept, providing pedestrians with convenient access to all key services. At the same time, 92% of the city’s area offers access to at least one essential service within a 15 min walk. Excluding forested areas not intended for development increases these values to 14% and 100%, respectively. This highlights the extent to which methodological choices in assessing pedestrian accessibility can shape analytical outcomes and the interpretations drawn from them. Moreover, given this article’s objective and the adopted analytical procedure, the assumed pedestrian walking speed is the key parameter. Accordingly, a sensitivity analysis was conducted, comparing the reference scenario (4 km/h) with alternative variants (3 and 5 km/h). This approach demonstrates the extent to which a change in a single parameter affects estimates of urban-area coverage by access to individual services reachable on foot within 15 min. The analysis reveals limited integration of urban functions at the local scale, highlighting areas in need of planning intervention. This article proposes directions for action to improve pedestrian accessibility within the city. Full article

This research pioneers the incorporation of grape pomace (GP) as a sustainable additive in unfired adobe construction materials, establishing a novel circular pathway that valorises agro-waste in zero-emission, low-energy building components. Five mix designs were developed with GP contents of 0%, 2.5%, 5%, 7.5%, and 10% by weight, using a soil matrix composed of 15% clay, 25% silt, and 60% sand with a 20% water content. Comprehensive characterization included physical properties, mechanical performance, thermal behavior, acoustic properties, and durability assessment. The incorporation of GP demonstrated dose-dependent effects on all measured properties. Bulk density decreased linearly from 1951 kg/m³ (0%GP) to 1595 kg/m³ (10%GP), representing an 18.3% reduction. Optimal mechanical performance was achieved at a 2.5–5% GP content, with compressive strength ranging from 1.51–1.64 MPa and flexural strength of 0.56–0.80 MPa, while higher GP contents resulted in significant strength reductions. Thermal conductivity improved substantially, decreasing from 0.99 to 0.25 W/Mk (66% RH) with increasing GP content, indicating enhanced insulation properties. The sound insulation performance showed a single-value sound reduction index (Rw) of 41–43 dB for all compositions, making them suitable for facade applications. Statistical analysis revealed significant correlations between GP content and material properties. The results indicate an optimal GP content of around 5%, which balances mechanical integrity, thermal performance, and durability while providing environmental benefits through the valorization of agro-waste. This research offers a sustainable approach for producing low-energy, eco-friendly building materials by incorporating grape pomace into unfired adobe, promoting waste valorization and improved thermal and acoustical insulation for green construction. Further research is needed to assess durability performance, standardize production methods, and evaluate large-scale implementation. Full article

Floating and offshore photovoltaic (FPV) installations present a promising solution for addressing land-use conflicts while enhancing renewable energy production. With an estimated global offshore PV potential of 4000 GW, FPV systems offer unique advantages, such as increased efficiency due to water cooling effects and synergy with other offshore technologies. However, challenges related to installation costs, durability, environmental impacts, and regulatory gaps remain. This review provides a comprehensive and critical analysis of FPV advancements, focusing on inland, nearshore, and offshore applications. A systematic evaluation of recent studies is conducted to assess technological innovations, including material improvements, mooring strategies, and integration with hybrid energy systems. Furthermore, the economic feasibility of FPVs is analysed, highlighting cost–benefit trade-offs, financing strategies, and policy frameworks necessary for large-scale deployment. Environmental concerns, such as biofouling, wave-induced stress, and impacts on aquatic ecosystems, are also examined. The findings indicate that while FPV technology has demonstrated significant potential in enhancing solar energy yield and water conservation, its scalability is hindered by high capital costs and the absence of standardised regulations. Future research should focus on developing robust offshore floating photovoltaic (OFPV) designs, optimising material durability, and establishing regulatory guidelines to facilitate widespread adoption. By addressing these challenges, FPVs can play a critical role in achieving global climate goals and accelerating the transition to sustainable energy systems. Full article

This research investigates the extent to which behavioral biases—specifically overconfidence and representativeness heuristic—affect linguistic tone, narrative structure, and predictive accuracy of financial reports produced by investment analysts operating across diverse global markets. Drawing upon a comprehensive dataset comprising 1575 equity recommendation reports authored by 15 analysts from four major international investment banks between 2019 and 2022, the study evaluates how cognitive tendencies shape report composition and forecast precision. A mixed-methods approach was employed, incorporating qualitative textual analysis and quantitative modeling through random-effects panel regressions. Key constructs assessed include narrative complexity, optimism, visual content usage, and forecast deviation metrics. Our findings reveal that overconfidence significantly influences the tone and detail of analyst reports but does not demonstrably impact projection accuracy. Conversely, representativeness heuristics were not found to consistently affect either report language or earnings-per-share forecast errors. Institutional affiliation emerged as a significant determinant of predictive success, while demographic factors such as gender, native language, and geographic region had limited explanatory power. These findings imply that investors should treat report tone as an indicator of analyst disposition rather than forecast quality, while financial institutions may benefit from training programs aimed at mitigating narrative and stylistic biases in analyst communication. Full article

Background/Objective: Cancer significantly impairs physical function and quality of life. Exercise has gained recognition as a therapeutic strategy; however, its long-term efficacy in terms of multidimensional outcomes in patients with cancer remains underexplored. This review aimed to evaluate and summarize the available evidence regarding the effects of multicomponent exercise programs on pain and psychosocial outcomes in individuals with cancer. Methods: A systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD42022321183). Comprehensive searches were performed in MEDLINE, OVID, LILACS, Scopus, PEDro, OTseeker, The Cochrane Library, EBSCO, and Google Scholar, without date restrictions. Search terms included “exercise” and “cancer.” Only randomized controlled trials (RCTs) were included. Methodological quality and risk of bias were assessed using the PEDro scale. Results: Sixteen randomized controlled trials met the inclusion criteria. Multicomponent exercise programs combining aerobic, resistance, and flexibility training significantly improved muscle strength, balance, and quality of life. Several studies reported meaningful reductions in pain intensity and interference, whereas others found no significant changes. Overall, exercise interventions demonstrated superior effects compared with usual care or educational controls across physical and psychosocial outcomes. Conclusions: Multicomponent exercise is a safe and feasible intervention for adults with cancer, including those with advanced disease or complex clinical profiles. Evidence supports consistent benefits in physical function and quality of life, with partially consistent yet favorable effects on pain. Programs integrating multiple exercise modalities appear most effective and should be considered as part of comprehensive oncological care to enhance therapeutic outcomes and long-term well-being. Full article

The curative management of localized esophageal and esophagogastric junction (EGJ) cancers has undergone major changes over the past decade, shaped by multimodal strategies integrating chemotherapy, chemoradiotherapy, surgery, and more recently, immunotherapy. For esophageal squamous cell carcinoma (SCC), neoadjuvant or definitive chemoradiotherapy remains the standard of care in Western countries. In contrast, for adenocarcinoma (AC) of the esophagus and EGJ, perioperative chemotherapy has emerged as the preferred strategy. Despite these advances, long-term outcomes remain suboptimal, and recurrence continues to pose a major challenge, highlighting the need to optimize patient selection and treatment sequencing. The integration of immunotherapy in the perioperative or adjuvant setting has recently led to improvements in surrogate endpoints yet overall survival benefit remains under investigation. For patients with tumors harboring microsatellite instability-high (MSI-H) or mismatch repair deficiency (dMMR), checkpoint inhibitors show exceptional activity, and non-operative management may be feasible in select cases. Conversely, human epidermal growth receptor 2 (HER2)-targeted strategies, although effective in metastatic disease, have not yet translated into practice-changing benefit in the curative setting. The role of circulating tumor deoxyribo nucleic acid (DNA) and functional imaging as real-time tools to assess response and guide treatment adaptation is also being actively explored. This review provides a comprehensive overview of current standards, ongoing developments, and future directions for the treatment of localized esophageal and EGJ cancers, with a focus on emerging personalization strategies and biomarker-driven approaches aimed at improving cure rates and minimizing treatment-related morbidity. Full article

Chronic gastritis (CG) is a prevalent digestive disorder. It progresses through multiple stages, has an insidious onset, and can lead to severe complications if untreated. Modern treatments primarily aim to eradicate Helicobacter pylori and relieve symptoms. However, drug resistance and adverse effects often limit their effectiveness. As a primary traditional Chinese medicine (TCM) therapy, acupuncture treats CG through multi-target mechanisms. This review systematically outlines the classification and pathology of CG. It also comprehensively analyzes animal and clinical studies on acupuncture for CG from the past decade. The study summarizes the mechanisms of acupuncture and related therapies for CG, covering gastric mucosal function, metabolism, intestinal flora, gastrointestinal hormones, apoptosis, inflammation, and oxidative stress. It further explores the relationships among diseases, interventions, acupoints, and molecular pathways. Additionally, it compares the therapeutic profiles of different external therapies. The review also examines the current state of clinical research, including the selection of acupoints, treatment duration, and outcome assessment. The results demonstrate that external therapies effectively alleviate common CG symptoms such as abdominal distension, acid reflux, and stomach pain. These treatments also improve gastric mucosal health and modulate serum levels of inflammatory factors, oxidative stress markers, and gastrointestinal hormones. In vivo experiments using chronic non-atrophic gastritis (CNAG) and chronic atrophic gastritis (CAG) models confirm these benefits, showing changes in key biomarkers and elucidating potential mechanisms. Nevertheless, future high-quality, large-sample clinical trials are still needed to firmly establish efficacy. Further mechanistic studies are also needed to validate the interconnections among relevant signaling pathways. Full article

Objectives: This study aimed to evaluate the effects of exercise on cognitive function in individuals with intellectual disabilities (ID) and to identify the optimal exercise prescription. Methods: A comprehensive search of PubMed, Web of Science, EBSCO, Cochrane, and Scopus was conducted through 13 May 2025. The Cochrane risk assessment tool was used to evaluate the methodological quality of the included studies. Results: Twenty studies fulfilled the inclusion criteria, of which six were rated as high quality and eleven as moderate quality. A meta-analytic synthesis of 14 eligible studies demonstrated that exercise elicited a significant improvement of cognitive function in ID patients (Hedges’ g = 0.85, p < 0.001), with the greatest effect observed for cognitive speed (Hedges’ g = 0.93, p < 0.01). Subgroup analyses indicated that interventions lasting ≥12 weeks (Hedges’ g = 0.92, p < 0.001), performed <3 times per week (Hedges’ g = 1.22, p < 0.01), with sessions ≥60 min (Hedges’ g = 1.91, p < 0.01), and >180 min per week in total (Hedges’ g = 3.10, p < 0.01) yielded the most pronounced benefits. Adolescents with ID exhibited greater cognitive gains (Hedges’ g = 1.01, p < 0.001). Conclusions: Exercise significantly improved cognitive function in ID patients. Our findings suggested that ID patients may benefit from exercise sessions lasting at least 60 min, performed fewer than three times per week, and sustained for at least 12 weeks. Achieving an exercise target of more than 180 min per week may further enhance cognitive function. Moreover, younger ID patients may experience greater improvements in cognitive function. Future studies should focus on standardizing exercise protocols and cognitive assessment tools to ensure consistency and comparability of findings in this population. Full article

With growing global demand for sustainable decarbonization, hydrogen energy systems have emerged as a key pillar in achieving carbon neutrality. This study assesses the greenhouse gas (GHG) reduction efficiency of Republic of Korea’s hydrogen ecosystem from a life-cycle perspective, focusing on production and utilization stages. Using empirical data—including the national hydrogen supply structure, fuel cell electric vehicle (FCEV) deployment, and hydrogen power generation records, the analysis compares hydrogen-based systems with conventional fossil fuel systems. Results show that current hydrogen production methods, mainly by-product and reforming-based hydrogen, emit an average of 6.31 kg CO₂-eq per kg H₂, providing modest GHG benefits over low-carbon fossil fuels but enabling up to a 77% reduction when replacing high-emission sources like anthracite. In the utilization phase, grey hydrogen-fueled stationary fuel cells emit more GHGs than the national grid. By contrast, FCEVs demonstrate a 58.2% GHG reduction compared to internal combustion vehicles, with regional variability. Importantly, this study omits the distribution phase (storage and transport) due to data heterogeneity and a lack of reliable datasets, which limits the comprehensiveness of the LCA. Future research should incorporate sensitivity or scenario-based analyses such as comparisons between pipeline transport and liquefied hydrogen transport to better capture distribution-phase impacts. The study concludes that the environmental benefit of hydrogen systems is highly dependent on production pathways, end-use sectors, and regional conditions. Strategic deployment of green hydrogen, regional optimization, and the explicit integration of distribution and storage in future assessments are essential to enhancing hydrogen’s contribution to national carbon neutrality goals. Full article

Background/Objectives: Pharmacological prevention is an evidence-based strategy to reduce the incidence of hormone receptor-positive breast cancer in high-risk women. Despite strong data from randomized trials, clinical uptake remains low. This review aims to summarize the efficacy, safety, and clinical implementation of pharmacoprevention and explore novel approaches to improve uptake. Methods: A comprehensive literature review was conducted on pharmacologic agents used for breast cancer risk reduction, including selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs). The review also examines risk assessment models, guideline recommendations, barriers to implementation, and emerging strategies such as low-dose therapies and digital decision aids. Results: Tamoxifen, raloxifene, and AIs significantly reduce the incidence of estrogen receptor-positive breast cancer in high-risk populations. However, adverse effects and poor awareness limit their use. Personalized risk models and newer approaches, including low-dose tamoxifen, digital health tools, and emerging agents such as SERDs and GLP-1 receptor agonists, may improve acceptability and adherence. Conclusions: Pharmacoprevention offers substantial benefits in appropriately selected women. Future efforts should focus on new drugs, precision risk stratification, individualized decision-making, and overcoming barriers to implementation to maximize the impact of preventive strategies in breast cancer control. Full article