Search Results (136)

Land urbanization enables a thorough perspective to explore the decoupling of land use environmental efficiency (LUEE) and energy use, thereby supporting the shift into low-carbon land use by emphasizing energy conservation and reducing carbon emissions. This paper first calculates LUEE from 2011 to 2021 by using the EBM-DEA model in China. The geographical detector model is used to examine the driving factors of land use environmental efficiency. The results show the following: (1) China’s LUEE is high in general but shows a clear pattern of spatial differentiation internally, with the highest values in the eastern region represented by Beijing, Jiangsu, and Zhejiang, while the central and western regions show lower LUEE because of their irrational industrial structure and lagging green development. (2) Energy consumption, economic development, industrial upgrading, population size, and urban expansion are the driving factors. Their explanatory power for the spatial stratification heterogeneity of land use environmental impacts varies. (3) Urban expansion has the greatest impact on the spatial differentiation of land use environmental effects, while energy consumption also shows significant explanatory strength. In contrast, economic development and population size exhibit relatively weaker explanatory effects. (4) The interaction of the two driving factors has a greater impact on LUEE than their individual effects, and the interaction is a two-factor enhancement. Finally, we make targeted recommendations to help improve land use environmental efficiency. Full article

Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory infections (ALRIs) in young children, especially bronchiolitis, with significant global health and economic impact. Increasing evidence links early-life RSV infection to long-term respiratory complications, notably recurrent wheezing and asthma. This narrative review examines these associations, emphasizing predictive factors and emerging biomarkers for risk stratification. Early RSV infection can trigger persistent airway inflammation and immune dysregulation, increasing the likelihood of chronic respiratory outcomes. Risk factors include severity of the initial infection, age at exposure, genetic susceptibility, prematurity, air pollution, and tobacco smoke. Biomarkers such as cytokines and chemokines are showing promise in identifying children at higher risk, potentially guiding early interventions. RSV-related bronchiolitis may also induce airway remodeling and promote Th2/Th17-skewed immune responses, mechanisms closely linked to asthma development. Advances in molecular profiling are shedding light on these pathways, suggesting novel targets for early therapeutic strategies. Furthermore, passive immunization and maternal vaccination offer promising approaches to reducing both acute and long-term RSV-related morbidity. A deeper understanding of RSV’s prolonged impact is essential to develop targeted prevention, enhance risk prediction, and improve long-term respiratory health in children. Future studies should aim to validate biomarkers and refine immunoprophylactic strategies. Full article

Colorectal surgery has undergone significant advances over the past few decades, driven by the evolution of minimally invasive techniques, particularly laparoscopy and robotics. While laparoscopy is widely recognized for its short-term benefits and oncological safety, the increasing adoption of robot-assisted surgery (RAS) has generated considerable debate regarding its clinical benefits, economic implications, and overall impact on patient outcomes. This narrative review synthesizes the existing evidence, highlighting the clinical and economic aspects of RAS in colorectal surgery, while exploring areas for future research. The findings suggest that RAS offers potential technical advantages, including increased precision, three-dimensional visualization, and improved ergonomics, particularly in anatomically complex scenarios such as low rectal resections. Still, its superiority over laparoscopy remains inconclusive and current evidence is mixed. For colon cancer, meta-analyses and analyses of large cohorts suggest lower conversion rates and faster recovery with RAS, although data are mostly retrospective and lack long-term oncological endpoints. In rectal cancer, emerging evidence from randomized controlled trials demonstrates improved short-term outcomes. Additionally, the recently published three-year results of the REAL trial are the first to demonstrate enhanced oncological outcomes following RAS. However, findings remain inconsistent due to methodological heterogeneity, the absence of patient stratification, and limited data on long-term survival and cost-effectiveness. The available evidence indicates that RAS may offer advantages in selected patient populations, particularly for anatomically complex procedures. Yet, its overall utility remains uncertain. Future studies should emphasize high-quality randomized trials, stratified subgroup analyses, and standardized economic evaluations to better define the role of RAS in colorectal surgery. Full article

This article presents a new evaluation and analysis of the five censuses undertaken at the initiative of philanthropist Sir Moses Montefiore among the Jewish population of Palestine/the Land of Israel between 1839 and 1875. The main purpose of the censuses was to ascertain the composition and needs of a generally poor Jewish population in order to better provide to its welfare. The information collected concerned basic demographic characteristics, countries of origin—namely along the main divide of Ashkenazi and Sephardi/Mizrahi Jews—and periods of immigration, social composition, and religiosity. By combining the different censuses into an integrated database, the authors are able to show changes intervening over time not only regarding the aggregate population, but also concerning individual and household profiles. The data aggregation allows us to better understanding the material conditions of the Jewish population and to outline with greater accuracy the relationship between socio-cultural communities and socio-economic stratification. The analysis unveiled the patterns of Jewish immigration all along the surveyed period and its variations by size and by countries of origin. These data provide important evidence concerning the overall Jewish presence in the Land of Israel and demonstrate that immigration was a significant factor well before the formal beginning of Aliyah in the early 1880s. No such analysis of the whole set of Montefiore censuses had been performed previously. The findings will prove very useful to historians and social scientists in their further investigation of the area and its populations in the 19th century. Full article

Nuclear energy cogeneration, which integrates electricity generation with thermal energy utilization, presents a transformative pathway for enhancing energy efficiency and decarbonizing industrial and urban sectors. This comprehensive review synthesizes advancements in technological stratification, economic modeling, and sectoral practices to evaluate the viability of nuclear cogeneration as a cornerstone of low-carbon energy transitions. By categorizing applications based on temperature requirements (low: <250 °C, medium: 250–550 °C, high: >550 °C), the study highlights the adaptability of reactor technologies, including light water reactors (LWRs), high-temperature gas-cooled reactors (HTGRs), and molten salt reactors (MSRs), to sector-specific demands. Key findings reveal that nuclear cogeneration systems achieve thermal efficiencies exceeding 80% in low-temperature applications and reduce CO₂ emissions by 1.5–2.5 million tons annually per reactor by displacing fossil fuel-based heat sources. Economic analyses emphasize the critical role of cost allocation methodologies, with exergy-based approaches reducing levelized costs by 18% in high-temperature applications. Policy instruments, such as carbon pricing, value-added tax (VAT) exemptions, and subsidized loans, enhance project viability, elevating net present values by 25–40% for district heating systems. Case studies from Finland, China, and Canada demonstrate operational successes, including 30% emission reductions in oil sands processing and hydrogen production costs as low as USD 3–5/kg via thermochemical cycles. Hybrid nuclear–renewable systems further stabilize energy supply, reducing the levelized cost of heat by 18%. The review underscores the necessity of integrating Generation IV reactors, thermal storage, and policy alignment to unlock nuclear cogeneration’s full potential in achieving global decarbonization and energy security goals. Full article

Ria de Arousa, one of the Rias Baixas, presents very high economic value for the Galician communities due to its importance for aquaculture, but the changes associated with climate change are expected to have an impact on its hydrodynamics and consequently on the production of cultivated species. The main objective of this work is to study the impact of climate change on the circulation and hydrography of the Ria de Arousa, considering the SSP5-8.5 scenario defined by IPCC. To achieve this goal, the Delft3D hydrodynamic model was implemented three-dimensionally using the results obtained from the CMIP6 MPI-ESM1-2-HR climate model as boundary conditions. Future changes in the hydrodynamic and hydrographic circulation of this coastal system were analysed. The model results were used to assess the impact of climate change on water temperature, salinity, and density patterns of the Ria de Arousa, as well as on stratification, Brunt–Väisälä frequency, and residual circulation. During summer, the water temperature is higher at the surface and lower at the bottom, likely due to the intrusion of water from the Eastern North Atlantic Central Water (ENAWC). In the future, this pattern will continue, albeit with higher temperatures, as the water temperature is expected to increase by around 2.2 °C by 2100. During winter, the water temperature at the bottom is warmer than at the surface, indicating a thermal inversion typical of this season. In the future, the water temperature will also increase, although the increase will be lower compared to summer, with a value of approximately 0.5 °C. Salinity will decrease in the summer and increase in the winter, especially in the areas closest to the rivers. Density analysis shows vertical homogeneity in the water column during winter and stratification during summer. During winter, the Brunt–Väisälä frequency (N) is higher in the region closest to the river’s mouth and lower near the ocean. In the summer, the N value decreases with depth. In the future, the density will increase in winter and decrease in summer, and stratification is expected to decrease. Regarding the residual circulation, it was observed that it will strengthen in the summer and weaken in the winter due to a decrease in freshwater runoff. However, the positive circulation pattern observed in the present will be maintained in the future. Full article

Common prosperity is the fundamental driving force of rural revitalization, as well as the foundation for achieving sustainable economic development. The e-commerce to the countryside policy has energized the rural economy, helping to improve household economic resilience and reduce income stratification, thereby promoting the inclusive and sustainable development of the digital economy. Drawing on panel data collected from rural fixed observation points in Henan Province during 2009–2022, this study employs a staggered difference-in-differences (DID) approach to evaluate the impact of China’s e-commerce to the countryside policy on farmers’ income and income inequality. The empirical results reveal that the rural e-commerce policy significantly increases farmers’ income while mitigating income inequality. The underlying mechanisms function through three synergistic pathways: industrial structural upgrading, manifested through tri-sector integration driven by rural enterprise development; factor allocation restructuring, evidenced by productivity gains from optimized labor–capital reallocation; and enhanced market inclusion through digital technology empowerment that lowers participation barriers. Heterogeneity analysis indicates that the e-commerce to the countryside policy exhibits pro-poor characteristics, with its income-enhancing and equalizing effects being particularly pronounced in agricultural areas, traditional villages, county-level civilized villages, underdeveloped regions, registered poverty-stricken villages, and households with low human, physical, and financial capital endowments. These findings confirm the inclusive development efficacy of rural e-commerce among vulnerable populations. Consequently, the study provides a replicable policy implementation framework for achieving common prosperity objectives. Full article

Understanding the evolution of societal values is crucial amidst globalization and migration. This study aimed to (1) map Portugal’s basic human values (BHVs) profile in 2020 through comparison with six European countries (Bulgaria, France, United Kingdom, Hungary, Italy, and Norway) and (2) analyze Portugal’s BHVs trajectory from 2002 to 2020. Drawing on Schwartz’s theory and European Social Survey (ESS) data, we applied descriptive statistics, similarity indices, post-stratification weighting, and trend analysis after extensive data cleaning. Results indicate that in 2020, Portugal displayed high self-transcendence and relatively high openness to change, aligning most closely with the United Kingdom and Hungary. Longitudinal analysis revealed a shift after 2012, marked by rising hedonism, stimulation, and self-direction, and declining conformity. These value dynamics offer insights into future societal demands and potential tensions. Moreover, Portugal’s emerging value configuration—balancing self-transcendence with growing openness—may foster economic opportunities by enhancing attractiveness for innovation ecosystems (linked to self-direction and stimulation), experience-driven tourism (hedonism), and investments aligned with sustainable and social goals (universalism and benevolence). Monitoring value changes remains essential to anticipate societal transformations and inform policy design. Full article

This study examines the intersection of race, class, and gang violence in Singapore, with a particular focus on the structural dynamics linking racial minorities, street gangs, and institutionalized Chinese secret societies—the archetype of organized crime in the city-state. By integrating race as both an ideology and a system of social relations into the study of gang formation, this research sheds light on why and how racial minorities become disproportionately involved in gang violence. The study revealed that beyond economic marginalization, racialized hierarchies embedded within gang contexts shape the motivations, participation, and mobility of minority individuals in both street gangs and the broader criminal underworld. Drawing on the concept of racialized masculinity, it is argued that racial minorities mobilize their gender and racial resources to compensate for status disparities resulting from structural exclusion in both legitimate and illegitimate spheres. In a postcolonial, multiracial society, like Singapore, where racial and class marginalization intersect, gang affiliation emerges as a means of negotiating power and social standing. The findings contribute to scholarship on race, crime, and social stratification while informing policies aimed at addressing racial inequalities and reducing gang violence. Full article

Background: Bilateral total knee arthroplasty (B-TKA) is a surgical option for patients with bilateral osteoarthritis, offering potential efficiency and cost advantages but with increased perioperative risk. Methods: We conducted a retrospective analysis of 2,299,979 elective TKA cases from the Nationwide Inpatient Sample (2016–2019). Propensity score matching (PSM) was used to compare 83,980 B-TKA patients with matched unilateral TKA (U-TKA) patients. Outcomes included in-hospital mortality, complications, length of stay, and hospital charges. Results: B-TKA patients had higher rates of complications such as deep vein thrombosis (OR 1.798) and pulmonary embolism (OR 1.883), longer hospital stays (3.03 vs. 2.49 days), and higher charges (USD 83,639 vs. USD 59,215; all p < 0.001). Conclusions: Although B-TKA is associated with increased perioperative risk, it may offer logistical and economic advantages in well-selected patients. These findings support the need for risk stratification in surgical decision-making. Full article

Over the past two decades, research on residential segregation and environmental justice has evolved from spatial assimilation models to include class theory and social stratification. This study leverages recent advances in machine learning to examine how environmental, economic, and demographic factors contribute to ethnic segregation, using Las Vegas as a case study with broader urban relevance. By integrating traditional econometric techniques with machine learning and deep learning models, the study investigates (1) the correlation between housing prices, environmental quality, and segregation; (2) the differentiated impacts on various ethnic groups; and (3) the comparative effectiveness of predictive models. Among the tested algorithms, LGBM (Light Gradient Boosting) delivered the highest predictive accuracy and robustness. To improve model transparency, the SHAP (SHapley Additive exPlanations) method was employed, identifying key variables influencing segregation outcomes. This interpretability framework helps clarify variable importance and interaction effects. The findings reveal that housing prices and poor environmental quality disproportionately affect minority populations, with distinct patterns across different ethnic groups, which may reinforce these groups’ spatial and economic marginalization. These effects contribute to persistent urban inequalities that manifest themselves in racial segregation and unequal environmental burdens. The methodology of this study is generalizable, offering a reproducible framework for future segregation studies in other cities and informing equitable urban planning and environmental policy. Full article

There has been a proliferation of novel treatments for the management of advanced prostate cancer (PCa), including androgen receptor pathway inhibitors (ARPI). Although there are health economic analyses of novel PCa treatments, such as ARPIs for specific health states, there is a lack of sequential analyses. Our paper aims to fill this gap. We developed a Monte Carlo Markov model to simulate the management of advanced PCa to end-of-life. We modeled patients who begin in metastatic and nonmetastatic castration-sensitive PCa (mCSPC and nmCSPC), with risk stratification for mCSPC, progressing to metastatic castration-resistant PCa (mCRPC). Using current guidelines and recent literature, we simulated admissible treatment sequences over these states along a 15-year horizon. We report the best treatment sequences in terms of efficacy and cost-effectiveness. We find that the most cost-effective use of ARPIs is early in advanced PCa for a cost-effectiveness threshold (CET) of CAD 100K per QALY. For a CET of CAD 50K per QALY, early ARPI use is most cost-effective in mCSPC-starting patients but not nmCSPC-starting. We conclude that the most cost-effective way to use ARPIs is when patients first enter advanced PCa. The most cost-effective ARPI at current Canadian prices is abiraterone, mostly due to abiraterone’s lower price level. Full article

Colorectal cancer (CRC) remains a major global health burden, necessitating continuous advancements in diagnostic methodologies. Traditional screening techniques, including barium enema and fecal occult blood tests, have been progressively replaced by more precise modalities, such as colonoscopy, liquid biopsy, and artificial intelligence (AI)-assisted imaging. Objective: This review explores the evolution of CRC diagnostic tools, from conventional imaging methods to cutting-edge AI-driven approaches, emphasizing their clinical utility, cost-effectiveness, and integration into multidisciplinary healthcare settings. Methods: A comprehensive literature search was conducted using the PubMed, Medline, and Scopus databases, selecting studies that evaluate various CRC diagnostic tools, including endoscopic advancements, liquid biopsy applications, and AI-assisted imaging techniques. Key inclusion criteria include studies on diagnostic accuracy, sensitivity, specificity, clinical outcomes, and economic feasibility. Results: AI-assisted colonoscopy has demonstrated superior adenoma detection rates (ADR), reduced interobserver variability, and enhanced real-time lesion classification, offering a cost-effective alternative to liquid biopsy, particularly in high-volume healthcare institutions. While liquid biopsy provides a non-invasive means of molecular profiling, it remains cost-intensive and requires frequent testing, making it more suitable for post-treatment surveillance and high-risk patient monitoring. Conclusions: The future of CRC diagnostics lies in a hybrid model, leveraging AI-assisted endoscopic precision with molecular insights from liquid biopsy. This integration is expected to revolutionize early detection, risk stratification, and personalized treatment approaches, ultimately improving patient outcomes and healthcare efficiency. Full article

Monitoring the evolution of freshwater lakes is critical for understanding and mitigating eutrophication, a major environmental issue driven by excessive nutrient inputs, primarily nitrogen and phosphorus. This study focuses on Lake Lanalhue, where rising frequencies and intensities of algal blooms highlight significant ecological imbalances. By evaluating spatio-temporal variations in water quality and quantity parameters, meteorological conditions, and land use changes, we aim to uncover the drivers of eutrophication and their complex interactions. Nutrient concentrations, dissolved oxygen levels, and phytoplankton biomass are analyzed alongside hydrological parameters such as water level, volume, and surface area. The influence of meteorological factors, including temperature, precipitation, and wind speed, is assessed to determine their role in stratification, mixing, and nutrient cycling. Additionally, land use changes in the watershed, such as urbanization and agricultural practices, are examined to understand external nutrient inputs. This integrative approach provides a comprehensive understanding of the mechanisms driving changes in Lake Lanalhue, offering critical insights into the development of sustainable management strategies to mitigate eutrophication and its ecological and socio-economic impacts. Full article

Cancer is the second leading cause of death worldwide, after cardiovascular disease, claiming not only a staggering number of lives but also causing considerable health and economic devastation, particularly in less-developed countries. Therapeutic interventions are impeded by differences in patient-to-patient responses to anti-cancer drugs. A personalized medicine approach is crucial for treating specific patient groups and includes using molecular and genetic screens to find appropriate stratifications of patients who will respond (and those who will not) to treatment regimens. However, information on which risk stratification method can be used to hone in on cancer types and patients who will be likely responders to a specific anti-cancer agent remains elusive for most cancers. Novel developments in 3D bioprinting technology have been widely applied to recreate relevant bioengineered tumor organotypic structures capable of mimicking the human tissue and microenvironment or adequate drug responses in high-throughput screening settings. Parts are autogenously printed in the form of 3D bioengineered tissues using a computer-aided design concept where multiple layers include different cell types and compatible biomaterials to build specific configurations. Patient-derived cancer and stromal cells, together with genetic material, extracellular matrix proteins, and growth factors, are used to create bioprinted cancer models that provide a possible platform for the screening of new personalized therapies in advance. Both natural and synthetic biopolymers have been used to encourage the growth of cells and biological materials in personalized tumor models/implants. These models may facilitate physiologically relevant cell–cell and cell–matrix interactions with 3D heterogeneity resembling real tumors. Full article