Search Results (870)

Background and Objectives: Sexual dysfunction (SD) is common in cancer but remains poorly characterized among patients receiving immune checkpoint inhibitors (ICIs). This study aimed to determine the prevalence and predictors of SD in ICI-treated patients using validated instruments. Materials and Methods: In this cross-sectional study, adults with histologically confirmed malignancies who received ≥ 3 cycles of ICIs and reported sexual activity were included. Sexual function was evaluated with the Arizona Sexual Experience Scale (ASEX) and the Golombok–Rust Inventory of Sexual Satisfaction (GRISS). Univariate and multivariate logistic regression analyses identified demographic and clinical predictors of SD. Results: Among 208 patients (median age 59 years; 35.1% female), SD prevalence was 66.3% by ASEX and 59.1% by GRISS. ASEX revealed impairment across five domains—sexual drive, psychological and physiological arousal, orgasm, and satisfaction—while GRISS indicated dysfunction mainly in impotence/orgasmic disorder, avoidance, and satisfaction subscales. In multivariate analysis, age ≥ 60 years (OR: 3.14, 95% CI 1.51–6.53, p = 0.002), female sex (OR: 3.19, 95% CI 1.31–7.74, p = 0.010), Eastern Cooperative Oncology Group (ECOG) performance status ≥ 1 (OR: 2.82, 95% CI 1.39–5.71, p = 0.004), ≥2 metastatic sites (OR: 3.08, 95% CI 1.53–6.19, p = 0.002), and later treatment lines (OR: 2.43, 95% CI 1.20–4.94, p = 0.013) independently predicted ASEX-defined SD. GRISS-based analysis revealed comparable outcomes, identifying ECOG ≥1 and higher metastatic burden as the most prominent predictors of SD, consistent with ASEX findings. Conclusions: SD affected nearly two-thirds of patients receiving ICIs. Female sex, later treatment lines, poor ECOG performance status, and higher metastatic burden were key determinants, emphasizing the importance of routine sexual health evaluation in cancer care. Full article

Multi-agent inverse reinforcement learning (MA-IRL) infers the underlying reward functions or objectives of multiple agents by observing their behavioral data, thereby providing insights into collaboration, competition, or mixed interaction strategies among agents, and addressing the symmetrical ambiguity problem where multiple rewards may correspond to the same strategy. However, most existing algorithms mainly focus on solving cooperative and non-cooperative tasks among homogeneous multi-agent systems, making it difficult to adapt to the dynamic topologies and heterogeneous behavioral strategies of multi-agent systems in real-world applications. This makes it difficult for the algorithm to adapt to scenarios with locally sparse interactions and dynamic heterogeneity, such as autonomous driving, drone swarms, and robot clusters. To address this problem, this study proposes a dynamic heterogeneous multi-agent inverse reinforcement learning framework (GAMF-DHIRL) based on a graph attention mean field (GAMF) to infer the potential reward functions of agents. In GAMF-DHIRL, we introduce a graph attention mean field theory based on adversarial maximum entropy inverse reinforcement learning to dynamically model dependencies between agents and adaptively adjust the influence weights of neighboring nodes through attention mechanisms. Specifically, the GAMF module uses a dynamic adjacency matrix to capture the time-varying characteristics of the interactions among agents. Meanwhile, the typed mean-field approximation reduces computational complexity. Experiments demonstrate that the proposed method can efficiently recover reward functions of heterogeneous agents in collaborative tasks and adversarial environments, and it outperforms traditional MA-IRL methods. Full article

Transport is among the fastest-growing contributors to carbon dioxide (CO₂) emissions in the Gulf Cooperation Council (GCC) region, where rapid urbanization, population growth, and high mobility demand continue to shape energy use. This study aims to quantify the extent to which economic growth and urbanization drive transport-related CO₂ emissions across Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates between 2012 and 2022. Using sector-specific data from the International Energy Agency and World Bank, we apply panel and country-level log–log regression models to estimate long-run and short-run elasticities of transport CO₂ emissions with respect to GDP and urban population. The analysis also includes robustness checks excluding the COVID-19 pandemic year to isolate structural effects from temporary shocks. Results show that transport emissions remain strongly correlated with GDP in most countries, indicating emissions-intensive growth, while the influence of urbanization varies: positive in Kuwait and Saudi Arabia, where expansion is car-dependent, and negative in Oman and Qatar, where compact urban forms and transit investments mitigate emissions. The findings highlight the importance of differentiated policy responses—fuel-pricing reform, vehicle efficiency standards, electrification, and transit-oriented planning—to advance low-carbon mobility. By integrating elasticity-based diagnostics with decoupling analysis, this study provides the first harmonized empirical framework for the GCC to assess progress toward transport-sector decarbonization. Full article

Background: Epithelial–mesenchymal transition (EMT) is a fundamental process that drives invasion and metastasis in patients with diffuse-type gastric cancer (DGC). The role of SMARCD3, a subunit of the SWI/SNF chromatin remodeling complex, in this process is largely unknown. The aim of this study is to elucidate the molecular mechanism through which SMARCD3 integrates with the PI3K-AKT and WNT/β-catenin signaling pathways to promote EMT and gastric cancer progression. Methods: Stable SMARCD3-overexpressing MKN45 and MKN74 cell lines were established. RNA sequencing (RNA-seq) was performed to investigate signaling alterations. Western blot analysis confirmed the expression of EMT markers (Snail and Slug) and the phosphorylation of AKT (Ser473) and GSK3β (Ser9). PI3K dependency was tested using the inhibitor LY294002. Cooperative effects were examined by activating the WNT pathway with WNT3A. Results: SMARCD3 overexpression upregulated PI3K-AKT and WNT signaling, which correlated with increased Snail/Slug expression and increased AKT/GSK3β phosphorylation. GSK3β inactivation (pSer9) stabilizes Snail, driving EMT. LY294002 treatment suppressed Snail/Slug expression, attenuated AKT activation, and reversed the mesenchymal phenotype. Furthermore, WNT3A treatment synergistically increased nuclear Snail accumulation. Conclusions: SMARCD3 acts as a critical epigenetic regulator that promotes EMT in patients with gastric cancer through the integration of the PI3K-AKT and WNT/β-catenin pathways. Targeting this SMARCD3-mediated mechanism offers a promising therapeutic strategy to inhibit metastasis and improve outcomes for patients with gastric cancer. Full article

Aiming at the problem that obstacle avoidance flexibility and formation integrity are difficult to coexist in multi-robot formation motion, a path-deformation mapping mechanism is proposed, which deeply integrates artificial potential field and affine transformation, and drives formation adaptive adjustment in real time through path information. By using the non-uniform scaling characteristics of the affine transformation, the limitation of traditional conformal transformation is broken through, and the unity of flexibility and integrity is realized. The effectiveness of the algorithm is verified by experiments, which provide a practical solution for cooperative obstacle avoidance of multi-robot systems in complex environments. In order to verify the performance of the algorithm, a numerical simulation is carried out, and an experimental platform composed of seven omnidirectional mobile robots is built for physical verification. The simulation and experimental results show that the formation can complete the obstacle avoidance task in the complex static obstacle environment, and the average formation tracking error is maintained below 0.05 m. Compared with the traditional local obstacle avoidance or formation switching method, this algorithm significantly improves the fluency of the obstacle avoidance process and the integrity of the formation while ensuring a success rate of 100% obstacle avoidance. Full article

This study examines co-opetition mechanisms in China’s rapidly expanding bed and breakfast (B&B) sector, where intense competition drives operators to collaborate with rivals. A co-opetition model incorporating size classifications was tested using survey data from 500 clustered B&Bs. Data were analyzed with SPSS 26.0 and AMOS 23.0 through descriptive statistics, reliability testing, exploratory and confirmatory factor analyses, and structural equation modeling (SEM). Results show that perceived benefit (β = 0.230, p < 0.01), cooperation orientation (β = 0.223, p < 0.01), and prior experience (β = 0.232, p < 0.01) significantly drive co-opetition, whereas mutual trust and strategic fit are not significant. Co-opetition strongly enhances sustainable competitive advantage (β = 0.521, p < 0.001), indicating that strategic collaboration can mitigate homogenization in dense markets. The study contributes to co-opetition theory by (1) identifying antecedents specific to small-scale hospitality businesses, (2) challenging conventional assumptions about the role of trust, and (3) establishing empirical links between co-opetition and long-term competitiveness. Practically, the findings provide B&B operators with strategies for navigating competitive yet interdependent environments and offer policymakers evidence-based guidance to foster sustainable tourism clusters through institutional support for cooperative networks. Full article

As a multi-ethnic border region of China, Xinjiang hosts revolutionary cultural tourism resources (RCTRs) that embody historical memory and the spirit of frontier reclamation, while also playing a strategic role in strengthening national identity and maintaining regional stability. Yet, their spatial distribution is highly uneven due to geographical, historical, and socio-economic constraints. This study analyzes 135 representative sites using a dual framework of spatial pattern analysis and driving mechanism quantification. Nearest neighbor index, imbalance index, Lorenz curve, geographic concentration index, kernel density estimation, and hotspot analysis results reveal a clustered “multi-core–peripheral attenuation” pattern with pronounced regional disparities. GIS-based overlay analysis identifies natural thresholds of moderate elevation (834–2865 m) and gentle slopes (0–8.65°), while socio-economic factors such as transportation corridors and population density amplify clustering effects. Geographic Detector results confirm road network density (q = 0.85, p < 0.01) and historical site density (q = 0.79, p < 0.01) as dominant drivers, with interactions between natural and social factors enhancing explanatory power above 0.90. These findings highlight the coupled influence of topographic suitability and socio-economic accessibility. Policy recommendations include optimizing road network layouts, adopting tiered heritage protection, and fostering cross-regional cooperation. The study provides scientific evidence for balanced development and sustainable conservation of RCTRs, contributing to the achievement of sustainable development goals (SDGs) related to cultural heritage, regional equity, and inclusive growth. Full article

The Yangtze River fishing ban policy is a central measure in China’s watershed governance, and the adaptability of its policy tools and collaborative mechanisms directly influences the sustainability and effectiveness of basin management. This study systematically examines the evolution of policy themes, the characteristics of policy tool combinations, and their alignment with intergovernmental collaborative governance needs, drawing on 120 central government policy texts issued between 2002 and 2024. Using frequency analysis and policy tool coding, the findings reveal that (1) policy themes have shifted from fishery resource control to comprehensive ecological protection and, more recently, to integrated watershed management, thereby driving progressively higher demands for intergovernmental collaboration. (2) The policy tool structure has long been dominated by environmental tools, supplemented by supply-side tools, while demand-side tools remain underdeveloped. Imbalances persist, such as excessive emphasis on resource inputs over capacity building in supply-side tools, rigid constraints with limited flexibility in environmental tools, and a reliance on publicity while underutilizing market incentives in demand-side tools. (3) Tool combinations have adapted to changing collaboration needs, evolving from rigid constraints and fiscal subsidies to institutional frameworks and cross-regional cooperation, ultimately forming a governance model characterized by systemic guarantees and diversified collaboration. Based on these findings, this study recommends strengthening long-term governance mechanisms, improving cross-regional collaborative structures, authorizing local governments to design context-specific implementation details, enhancing fishermen’s livelihood security and social development, expanding public participation and oversight, and exploring market mechanisms for realizing ecological product value. These measures aim to advance collaborative governance in the Yangtze River Basin and foster a balanced integration of ecological protection and social development. Full article

Cultivated land (CL) is essential for human survival, as its coordinated utilization plays a crucial role in both food production and ecological protection. In this study, we focus on Aksu, a typical oasis in arid areas of Xinjiang, to explore how to improve the eco-efficiency of cultivated land utilization (ECLU) from the perspective of carbon emissions under different ownership structures. The goal is to provide policy support for the sustainable intensification of CL in Aksu. The super-efficiency slack-based measure (Super-SBM) model was used to calculate the ECLU, while the carbon emissions coefficient method was employed to estimate cultivated land carbon emissions (CLCE). Additionally, the random forest regression (RFR) model was utilized to analyze differences in CLCE between collective and state-owned cultivated lands. Finally, a Geo-detector analysis was conducted to identify driving factors of CLCE. The findings indicate that the overall ECLU values in Aksu initially increased and subsequently decreased over time. During the study period, Kalpin showed the highest ECLU, followed by Wensu and Wushi. The total CLCE in Aksu demonstrated an initial increase followed by a decrease, but the overall trend was growth, from 3.7 t in 2008 to 5.63 t in 2019, on average. It was observed that carbon emissions from state-owned cultivated land were greater than those from collective cultivated land, and carbon emissions from non-food crops were higher than those from food crops. Furthermore, spatial heterogeneity was evident in the CLCE. The single factor detection results showed that the Local_GDP (q = 0.763, representing the explanatory power of the Local_GDP on cultivated land carbon emissions) was identified as the main driver of CLCE in Aksu. The interactive detection results indicated that the Local_GDP and Farmer income (0.839) had stronger effects on CLCE in Aksu than any other two factors. It was also found that ownership of CL directly affects CLCE and indirectly affects the ECLU. In conclusion, it is necessary to formulate corresponding countermeasures for improving the ECLU involving government intervention, as well as cooperation with farmers and other stakeholders, to address these issues effectively within Aksu’s agricultural sector. Full article

Electric vehicles are key to sustainable mobility, but their limited range remains a major obstacle to widespread adoption. Extending driving distance requires optimizing energy use across subsystems. This study combines bibliometric mapping (2017–2024, Scopus) with a focused qualitative review to structure recent research. Results highlight a strong emphasis on energy efficiency, with China leading due to its market size, industrial base, and supportive policies. Major research directions tied to range extension include energy storage, motion control, thermal regulation, cooperative driving, and grid interaction. Among these, hybrid energy storage systems and motor control stand out for their measurable impact and industrial relevance, while thermal management, regenerative braking, and systemic approaches (V2V and V2G) remain underexplored. Beyond mapping contributions, the study identifies ongoing gaps and calls for integrated strategies that combine electrical, thermal, and mechanical aspects. As EV adoption accelerates and battery demand increases, the findings emphasize the need for battery-aware, multi-objective energy management strategies. This synthesis provides a vital framework to guide future research and support the development of robust, integrated, and industry-ready solutions for optimizing EV energy use and extending driving range. Full article

To resolve the inherent coupling conflict between trajectory tracking and lateral stability in distributed electric drive buses, this paper proposes a hierarchical cooperative control framework. A simplified two-degree-of-freedom (2-DOF) vehicle model is first established, and kinematically derived reference states for stable motion are computed. At the upper level, a model predictive controller (MPC) generates real-time steering commands while explicitly minimizing lateral tracking error. At the lower level, a proportional integral derivative (PID)-based roll moment controller and a linear quadratic regulator (LQR)-based direct yaw moment controller are designed, with four-wheel torque distribution achieved via quadratic programming subject to friction circle and vertical load constraints. Co-simulation results using TruckSim and MATLAB/Simulink demonstrate that, during high-speed single-lane-change maneuvers, peak lateral error is reduced by 11.59–18.09%, and root-mean-square (RMS) error by 8.67–14.77%. Under medium-speed double-lane-change conditions, corresponding reductions of 3.85–12.16% and 4.48–11.33% are achieved, respectively. These results fully validate the effectiveness of the proposed strategy. Compared with the existing MPC–direct yaw moment control (DYC) decoupled control framework, the coordinated control strategy proposed in this paper achieves the optimal trade-off between trajectory tracking and lateral stability while maintaining the quadratic programming solution delay below 0.5 milliseconds. Full article

Under the Belt and Road Initiative, China and Kazakhstan have developed a strategic partnership in the automotive industry that has progressed through three distinct phases. This study provides a comprehensive analysis of the evolution and future of this cooperation, structured into the Export and Assembly phase (2014 to 2017), the Technology Partnership phase (2018 to 2021), and the Localization and Joint Ventures phase (2022 to 2024). Based on qualitative content analysis of policy documents, industry reports, and media coverage, the paper examines how China’s drive for industrial upgrading aligns with Kazakhstan’s goals of economic diversification and industrial growth. The findings indicate that Chinese automotive companies, such as JAC Motors, have transitioned from exporting vehicles to assembling them locally, transferring technology, and investing in joint ventures, thereby strengthening Kazakhstan’s automotive production and market potential. However, challenges remain, including overcapacity, market saturation, and the need for skilled local labor. The study concludes with recommendations to enhance cooperation through joint research and development, the creation of localized parts manufacturing clusters, and the harmonization of technical standards, offering a replicable model for bilateral partnerships within the Belt and Road framework. Full article

This review examines the vast opportunities and key challenges in renewable waste management across the Gulf region, with a particular emphasis on Saudi Arabia. As global demand for sustainable energy intensifies, driven by technological advancements and environmental concerns, the Gulf Cooperation Council nations, notably Saudi Arabia, are beginning to acknowledge the urgency of transitioning from fossil fuel reliance to renewable waste management. This review identifies the abundant renewable resources in the region and highlights progress in policy development while emphasizing the need for comprehensive frameworks and financial incentives to drive further investment and innovation. Waste-to-energy (WTE) technologies offer a promising avenue for reducing environmental degradation and bolstering energy security. With Saudi Arabia targeting the development of 3 Gigawatts of WTE capacity by 2030 as part of national sustainability initiatives, barriers such as regulatory complexities, financial constraints, and public misconceptions persist. Ultimately, this review concludes that advancing renewable waste management in the Gulf, particularly through stronger policies, stakeholders’ collaboration, investment in WTE and an enhancement in public awareness and education, is critical for achieving sustainability goals. By harnessing these opportunities, the region can take decisive steps toward achieving sustainability, positioning Saudi Arabia as a leader in the global fight against climate change and resource depletion. Full article

Against the backdrop of global agricultural transformation, rural China faces the critical challenge of reconciling economic development with environmental conservation and social well-being. This study, grounded in the rural revitalization strategy, investigates the internal mechanisms, level measurement, and sustainable development paths of rural industrial integration based on the “Triple Integration of Production, Livelihood and Ecology” (PLE) philosophy. Firstly, we discussed the suitability and the mechanisms of this philosophy on China’s rural industrial integration. Secondly, based on a textual corpus extracted from academic journals and policy documents, we employed an LDA topic model to cluster the themes and construct an evaluation indicator system comprising 29 indicators. Then, utilizing data from the China Statistical Yearbook and the China Rural Statistical Yearbook (2013–2022), we measured the level of China’s rural industrial integration using the entropy method. The composite integration index displays a continuous upward trend over 2013–2022, accelerating markedly after the 2015 stimulus policy, yet a temporary erosion of “production–livelihood–ecology” synergy occurred in 2020 owing to an exogenous shock. Lastly, combining the system dynamics model, we simulated over the period 2023–2030 the three sustainable development scenarios: green ecological development priority, livelihood standard development priority and production level development priority. Research has shown that (1) the “Triple Synergy of Production, Livelihood and Ecology” philosophy and China’s rural industrial integration are endogenously unified, and they form a two-way mutual mechanism with the common goal of sustainable development. (2) China’s rural industrial integration under this philosophy is characterized by production-dominated development and driven mainly by processing innovation and service investment, but can be constrained by ecological fragility and external shocks. (3) System dynamics simulations reveal that the production-development priority scenario (Scenario 3) is the most effective pathway, suggesting that the production system is a vital engine driving the sustainable development of China’s rural industrial integration, with digitalization and technological innovation significantly improving integration efficiency. In the future, efforts should focus on transitioning towards a people-centered model by restructuring cooperative equity for farmer ownership, building community-based digital commons to bridge capability gaps, and creating market mechanisms to monetize and reward conservation practices. Full article

In recent years, numerous constrained multi-objective evolutionary algorithms (CMOEAs) have been proposed to tackle constrained multi-objective optimization problems (CMOPs). However, most of them still struggle to achieve a good balance among convergence, diversity, and feasibility. To address this issue, we develop an adaptive constraint-boundary learning-based two-stage dual-population evolutionary algorithm for CMOPs, referred to as CL-TDEA. The evolutionary process of CL-TDEA is divided into two stages. In the first stage, two populations cooperate weakly through environmental selection to enhance the exploration ability of CL-TDEA under constraints. In particular, the auxiliary population employs an adaptive constraint-boundary learning mechanism to learn the constraint boundary, which in turn enables the main population to more effectively explore the constrained search space and cross infeasible regions. In the second stage, the cooperation between the two populations drives the search toward the complete constrained Pareto front (CPF) through mating selection. Here, the auxiliary population provides additional guidance to the main population, helping it escape locally feasible but suboptimal regions by means of the proposed cascaded multi-criteria hierarchical ranking strategy. Extensive experiments on 54 test problems from four benchmark suites and three real-world applications demonstrate that the proposed CL-TDEA exhibits superior performance and stronger competitiveness compared with several state-of-the-art methods. Full article