Search Results (5,908)

Based on extensive ethnographic fieldwork conducted in Mianning County, Liangshan Yi Autonomous Prefecture between 2023 and 2024, this paper analyzes the “xiō bū” (ꑭꁮ) ritual of the Liangshan Yi people. Framed within contemporary approaches to religious anthropology and social memory theory, the study explores how this ritual constructs Yi ecological ethics, social integration, and cultural identity through nature worship, ancestral spirit beliefs, and ritual practices. The ethnographic evidence reveals that the “xiō bū” ritual, by designating wooded mountains as sacred space and performing sacrifices to nature deities and ancestral spirits, integrates “humans—nature—ancestors” into a symbiotic system of the “community of life.” This reflects the Yi people’s relational ontology and embedded ecological knowledge. The sacrificial offerings, shared meals, and purification practices in the ritual not only reinforce reverence for nature through symbolic acts but also unify the community through Durkheimian “collective effervescence,” thereby restoring the community’s spiritual order. As a carrier of social memory, the “xiō bū” ritual, through epic chanting, symbolic performances (such as clothing, ritual implements), and bodily practices (like the ritual specialist’s movements), embeds individual memories into the collective historical narrative of the group, dynamically constructing the cultural boundaries of the “Yi” people. The ritual specialists (Bimo or Suni), as intermediaries of knowledge and power, maintain religious authority through bricolage-like symbolic reorganization and foster the creative transformation of tradition in response to the challenges of modernity. The study further reveals that while the ritual faces challenges in the contemporary context, such as secularization and population mobility, it continues to activate ethnic identity by simplifying rituals, preserving core symbols, and coupling with ecological discourses, offering a model for the modern adaptation of traditional religions. This paper argues that ritual studies should engage with contemporary theoretical approaches like the ontological turn, focus on the agency of individuals, and reflect on the insights traditional knowledge systems offer in the face of globalization and ecological crises. Full article

Ammonia (NH₃) is a key precursor to secondary particulate matter in Southeast Asia, yet Thailand has lacked a country-specific, policy-focused emission inventory. This study creates the first spatially gridded (12 × 12 km) and monthly resolved national NH₃ inventory for 2019, using detailed agricultural activity data, survey-based livestock management practices, and crop-specific fertilizer application profiles. Satellite-derived burned-area data were included to constrain emissions from open burning. National NH₃ emissions are estimated at 459.1 kt per year, with an overall uncertainty of ±15.3%. Agriculture accounts for 95.8% of total emissions. Livestock and manure management contribute 225.3 kt per year (49.1%), reflecting high densities of poultry, cattle, and pigs, as well as regional differences in manure handling and storage practices that enhance ammonia volatilization. Fertilizer-related emissions total 192.4 kt per year (41.9%), with seasonal peaks during primary planting cycles, in contrast to the more episodic biomass-burning emissions. Comparison with the global EDGARv8.1 inventory shows significant sectoral and temporal differences, including considerably higher livestock emissions and lower fertilizer emissions in this study, due to Thailand-specific emission factors and temporal emission allocation methods. These findings clarify the spatial and temporal drivers of NH₃ emissions in Thailand and offer actionable insights for targeted mitigation—notably improved manure management and optimized nitrogen use in regions where dry-season emissions coincide with severe PM_2.5 episodes. The THAI-NH₃ Inventory provides a strong foundation for chemical-transport modeling and evidence-based policymaking to reduce ammonia-related haze in Thailand. Full article

Background: Follicular lymphoma (FL) is the second most common B-cell lymphoma in Western countries, typically presenting as an indolent disease with prolonged overall survival. Despite favorable initial responses to therapy, most patients experience relapse, and early progression is associated with poor outcomes. Methods: This guideline provides evidence-based recommendations from the Spanish GELTAMO group on the diagnosis, staging, treatment, and follow-up of FL. A systematic literature review was conducted, and recommendations were graded according to the GRADE system. Results: Histopathological diagnosis should be based on excisional biopsy. PET-CT is recommended for staging and response evaluation. For localized disease, involved-site radiotherapy (ISRT) remains the treatment of choice. In asymptomatic patients with advanced-stage disease and low tumor burden, a watch-and-wait approach is appropriate, although rituximab monotherapy is also acceptable. For advanced-stage disease with high tumor burden, immunochemotherapy with anti-CD20 antibodies (rituximab or obinutuzumab) combined with CHOP, CVP, or bendamustine is recommended, followed by maintenance therapy. Management of relapsed disease is tailored based on tumor burden, treatment history, and timing of relapse. Although novel immunotherapies (CAR-T therapy and bispecific antibodies) are emerging as promising options, autologous stem cell therapies may still be a valid option in young patients with early relapse who are sensitive to immunochemotherapy. Conclusions: FL is a heterogeneous disease requiring individualized management strategies. Recent advances in immunotherapy and molecular diagnostics are reshaping the therapeutic landscape. These updated GELTAMO recommendations aim to provide practical guidance for optimal FL management in clinical practice. Full article

Background: Osteoradionecrosis (ORN) following head and neck radiotherapy has been demonstrated to induce structural and functional alterations of the upper airway, with the potential to complicate the process of tracheal intubation. Despite its clinical relevance, there is a paucity of systematic evidence on airway characteristics in ORN and reliable predictors of difficult tracheal intubation. This study compares preoperative airway parameters and tracheal intubation outcomes in irradiated patients with and without ORN and introduces a novel preoperative ORN-Difficult-Airway Score for risk stratification. Methods: In this retrospective cohort study, airway assessments, tracheal intubation methods, and perioperative visualization parameters were evaluated in 105 patients following head and neck radiotherapy. Group differences between non-ORN and ORN were analyzed using chi-square tests. A preoperative ORN-Difficult-Airway Score was constructed using exclusively bedside parameters, based on statistically and clinically relevant predictors. Results: Patients with ORN showed significantly restricted mouth opening (p < 0.001), higher Mallampati classes, particularly Mallampati IV, and a greater need for fiberoptic tracheal intubation (p < 0.01). Direct laryngoscopy (DL) was significantly less feasible in ORN, while hyperangulated videolaryngoscopy (VL) yielded consistently positive visualization (first-pass success (FPS) 100% in both groups). Under DL, FPS was lower in ORN (54.2% vs. 79.5%), resulting in an odds ratio of 0.305. Based on observed predictors, ORN status, mouth opening <3 cm, Mallampati class, restricted neck reclination, and history of difficult intubation, a preoperative ORN-Difficult-Airway Score was developed. Conclusions: ORN has been associated with distinct alterations in airway anatomy and visualization, resulting in increased tracheal intubation complexity after head and neck radiotherapy. The proposed ORN-Difficult-Airway Score presents a clinically practical, bedside-applicable approach to stratifying the risk of tracheal intubation in this population. Prior to clinical implementation, prospective validation in larger cohorts is warranted. Full article

People living with and beyond cancer often face ongoing challenges related to nutrition, wellbeing, and long-term health. Many individuals express a need for evidence-based, tailored dietary support, yet practical approaches to sustaining healthy eating behaviours remain limited. Culinary nutrition interventions, which integrate nutrition education with hands-on culinary skills, may help address these needs; however, their effects have not been systematically synthesised. This systematic review evaluates the impact of culinary nutrition interventions, delivered alone or in combination with physical activity or mental health components, on dietary intake, psychosocial and health-related outcomes, anthropometric measures, clinical and metabolic markers, and feasibility among individuals living with or beyond cancer. Following PRISMA guidelines, 18 studies were identified across PubMed, Scopus, EMBASE, CINAHL, and Web of Science (last searched in April 2025) and narratively synthesised. A total of 1173 participants were included, with sample sizes ranging from 4 to 190 participants per intervention. Interventions were well received and rated as highly acceptable, with strong engagement and minimal adverse effects. Across studies, statistically significant improvements were reported in dietary intake (7/13 studies), quality of life (4/5), mental health (5/6), self-efficacy (2/3), symptom management (3/4), self-reported cognitive health (1/1), food-related behaviours (2/2), selected anthropometric measures (4/8), and selected metabolic biomarkers (4/6). The evidence suggests that culinary nutrition interventions hold promise as supportive, behaviour-focused strategies aligned with oncology nutrition guidelines and responsive to patient needs. However, due to heterogeneity across interventions and outcomes, and variability in methodological quality as assessed using the Cochrane risk of bias tool, quantification of effects was not possible, limiting interpretation of the evidence. Further high-quality studies using comparable outcome measures and longer-term follow-up are needed to quantify the magnitude of effects, assess their durability over time, and inform the integration of culinary nutrition programmes into cancer care. This systematic review is registered under the PROSPERO ID CRD42024567041 and was funded by the RCSI Research Summer School Fund. Full article

Arachidonic acid (AA), an omega-6 polyunsaturated fatty acid, serves as a metabolic precursor for prostaglandins (PGs) such as PGE₂ and PGF_2α, which have been implicated in the regulation of skeletal muscle adaptations to resistance exercise. On this basis, AA supplementation has been proposed as a potential ergogenic aid in resistance training, under the hypothesis that increasing endogenous AA availability through supplementation may enhance PGs synthesis, thereby potentially influencing muscle remodeling and recovery process. However, AA remains a relatively underexplored candidate. This review aimed to summarize and critically evaluate the current evidence regarding the effects of AA supplementation in the context of resistance exercise. The limited available studies provide preliminary mechanistic observations suggesting that AA supplementation may be associated with changes in muscle strength and anaerobic performance and with modulation of the acute inflammatory response to exercise, without affecting chronic inflammation. Conversely, findings related to body composition and muscle hypertrophy remain inconsistent and a significant effect has not been consistently observed. Despite these preliminary insights, the current body of evidence is insufficient and heterogeneous, precluding the recommendation of routine clinical or practice-based use. Future well-designed, long-term investigations are warranted to clarify the efficacy, optimal dosage, and timing of AA supplementation, as well as its safety profile and potential applications across populations differing in age, sex, nutritional status, and training background. Full article

(1) Background: Education serves as a catalyst for social transformation toward sustainability, yet limited empirical evidence exists regarding primary education’s contribution to regional sustainable development, particularly in island contexts facing unique environmental and economic pressures. This study examined primary education teachers’ perceptions, practices, and challenges in implementing Education for Sustainable Development (ESD) in Zakynthos, Greece. (2) Methods: A triangulated quantitative approach surveyed a representative sample of 105 primary education teachers from the Zakynthos Primary Education Directorate using a 28-item structured questionnaire assessing ESD knowledge, teaching practices, barriers, and improvement strategies. Teacher questionnaire data were triangulated with KEPEA (Center for Environmental Education and Sustainability) program documentation (103 programs, 2020–2025) and school implementation records from 75 participating schools. Data were analyzed using descriptive statistics, Mann–Whitney U tests, Kruskal–Wallis tests, and Spearman correlations. (3) Results: Most teachers (65.7%) reported adequate knowledge of sustainable development concepts, with 75.3% incorporating ESD into teaching practice often or very often. Triangulation revealed convergent findings: environmental sustainability dominated teacher perceptions (67.3%) and KEPEA programming (78.4%), while economic sustainability received limited attention (18.1%). Female teachers demonstrated significantly higher ESD knowledge (U = 892.5, p < 0.05, r = 0.34). The majority (98.1%) considered ESD integration important, yet only 48.5% felt adequately prepared to teach sustainability topics. A notable attitude-action gap emerged: while 86.6% valued community partnerships, only 47.6% engaged frequently, and KEPEA documented 33.7% of formal collaborations. Primary barriers included insufficient curriculum time (61.9%) and limited resources (51.4%). Teachers identified training programs (71.4%) and access to educational materials (71.4%) as priority interventions. (4) Conclusions: Primary education teachers in Zakynthos demonstrate strong commitment to ESD but face structural barriers limiting implementation effectiveness. The environmental-economic imbalance suggests a need for professional development, integrating economic sustainability concepts through place-based approaches relevant to the island’s tourism-dependent economy. The attitude-action gap in partnerships indicates structural rather than attitudinal barriers requiring policy intervention. Findings support targeted teacher training, curriculum reform, and strengthened school-community collaboration to enhance ESD’s contribution to regional sustainable development. Full article

The management of rheumatoid arthritis (RA) has undergone several practice-defining evolutions, beginning with the approval of low-dose methotrexate and continuing through the introduction of numerous disease-modifying antirheumatic drugs (DMARDs). With increasing capability to target pro-inflammatory pathways, successive therapeutics have carried the promise of improved disease control for patients with RA; however, many patients still fail to meet treatment objectives, leading to the recognition of clinical phenotypes that remain therapeutically challenging under the current treat-to-target standard of care, including preclinical inflammatory arthritis, late-onset RA, and treatment-resistant RA. Precision medicine approaches are beginning to characterize the pathogenesis of RA in such populations, and to inform effective tailoring of DMARD therapy to individual patients. Simultaneously, observational data derived from clinical practice are increasingly being used to understand the risks and benefits of long-term DMARD therapy under real-world conditions of use, with registries and other observational sources confirming long-term effectiveness, revising safety profiles, and estimating the costs of treatment for approved therapies. Together, these strategies offer opportunities to address unmet needs in the care of patients with RA. In this review of peer-reviewed clinical and translational research in RA, we identify several clinical phenotypes that demonstrate inadequate response to guideline-directed therapy and review frontiers in clinical research in RA emerging over the last decade, highlighting the use of precision medicine and real-world evidence-based approaches to advance individualized, patient-centered care. Full article

Background: Innovative training strategies aimed at improving physiological efficiency are of growing interest in kinesiology and sports performance. Elevation training masks (ETMs) offer a practical means of inducing hypoxia-like stress. However, evidence of their effectiveness in recreationally active populations remains limited. This pilot study examined the efficiency of a five-week progressive ETM protocol combined with high-intensity interval training (HIIT) in eliciting physiological, hematological, and body-composition adaptations relevant to endurance performance. Methods: Nine recreationally active men completed a five-week intervention consisting of three treadmill-based sessions per week: one weekly incremental Conconi test and two structured aerobic–anaerobic HIIT sessions performed with an ETM. Mask resistance was progressively increased to simulate altitudes of approximately 900–3600 m. Hematological variables (erythrocytes, hemoglobin, hematocrit, erythrocyte indices, leukocytes, and platelets), body composition, maximal heart rate (HRmax), and peripheral oxygen saturation (SpO₂) were assessed pre- and post intervention. Data were analyzed using paired-sample t-tests and repeated-measures ANOVA, with effect sizes reported (Cohen’s d, ω²). Results: A significant main effect of time on SpO₂ was observed (F(1, 8) = 130.61, p < 0.001, ω² = 0.69), along with a significant effect of training week (F(4, 32) = 17.41, p < 0.001, ω² = 0.43), and a significant Time × Week interaction (F(4, 32) = 15.20, p < 0.001, ω² = 0.42), indicating progressively greater post-exercise oxygen desaturation with increasing simulated altitude. Significant post-intervention increases were found in erythrocyte count, hemoglobin concentration, and hematocrit (p ≤ 0.009, d = 1.15–1.55), alongside increases in mean corpuscular volume and mean corpuscular hemoglobin. Platelet count increased significantly (p = 0.001, d = 1.68), while leukocyte values remained unchanged (p > 0.05). Body mass index (p = 0.049, d = 0.77) and body fat percentage (p = 0.012, d = 1.08) decreased following the intervention. HRmax tended to be lower at higher simulated altitudes. Conclusions: A five-week progressive ETM-HIIT protocol efficiently induced hematological and body-composition adaptations associated with improved oxygen transport and metabolic efficiency in recreationally active men. These findings support ETM-based training as an accessible strategy for enhancing physiological efficiency in endurance-oriented kinesiology practice, warranting confirmation in larger randomized controlled studies. Full article

Bone conduction hearing implant systems (BCHIs) are established treatments for patients with conductive or mixed hearing loss or single-sided deafness when conventional hearing aids are unsuitable. This study evaluated the cost-effectiveness of the active transcutaneous system Sentio versus a similar system, i.e., Osia in an Australian setting. Scenario analyses also compared Sentio to other systems, i.e., Ponto and Baha Attract. A Markov cohort model was adapted from a previously published source to reflect Australian practice, incorporating device acquisition, surgery, maintenance, battery replacement and adverse event management over a 15-year horizon from a healthcare perspective. Effectiveness inputs were derived from published evidence using a naïve indirect comparison. Extensive sensitivity analyses and external validation tested robustness. In the base case, Sentio was associated with lower costs and a small modelled incremental quality-adjusted life years (QALYs) gain versus Osia. Scenario analyses confirmed cost-effectiveness relative to Ponto and Baha Attract, with outcomes below the Australian willingness-to-pay threshold. Health state utility, device price and reimplantation assumptions were the most influential drivers, yet Sentio remained cost-effective in over 95% of simulations. These findings support Sentio as a clinically and economically efficient BCHI in Australia and highlight the need for direct utility and long-term durability data. Full article

Children and adolescents in hot and humid climates face increasing health risks due to climate change. Although the concept of Health-Promoting Schools (HPSs) is widely recognized, a systematic framework that integrates climate adaptability, child-specific needs, and multidimensional environmental design is still lacking. To address this gap, this study conducted a systematic literature review of 89 publications with three objectives: (1) synthesize research from the past decade on the impact of school physical environments on the health and academic performance of children and adolescents; (2) develop an evidence-based synergistic design framework with a categorized indicator system; and (3) integrate qualitative and quantitative evidence on how these indicators influence different health dimensions. The resulting framework emphasizes multidimensional, synergistic optimization and provides climate-responsive design strategies tailored to educational settings in hot and humid regions. By offering a theory-to-practice pathway, the framework complements existing healthy building guidelines for K–12 schools and supports designers and policymakers in creating environments that enhance thermal resilience, cognitive performance, and holistic child development. Full article

This study formulates and verifies a network-based evaluation methodology for appraising the sustainable competitiveness of community enterprises. Based on Social Capital Theory, the Resource-Based View (RBV), and Network Theory, the model defines high-quality networks as structural relational circumstances that facilitate resource sharing and knowledge sharing, serving as mediating mechanisms that improve competitive outcomes. A quantitative study approach was utilized, gathering survey data from 451 representatives of community enterprises around Thailand, and Structural Equation Modeling (SEM) was applied to assess both measurement features and structural relationships. The model demonstrates satisfactory internal reliability, convergent validity, and discriminant validity, affirming measurement adequacy. Empirical evidence indicates that high-quality networks are positively correlated with sustainable competitiveness, both directly and indirectly, with 49.2% of the overall effect conveyed through resource and knowledge exchange, emphasizing the practical value of network-based processes. The suggested model offers practical utility for policymakers and development agencies in search of evidence-based instruments to enhance competitiveness, network capacity, and long-term resilience in community enterprises. The cross-sectional methodology and lack of contextual control variables restrict causal inference and external generalizability, highlighting the necessity for longitudinal or quasi-experimental expansions. By emphasizing model creation and empirical validation, this study develops a systematic and reproducible methodological framework for assessment. Full article

This study documents the ethnomedicinal knowledge of Konak (Malatya, Eastern Anatolia, Türkiye), a region with rich plant diversity but no prior comprehensive research. The aim of the study is to systematically document and analyze the ethnomedicinal practices of Konak village, focusing on plant taxa (species, subspecies and varieties) used, preparation methods, and therapeutic applications. Data were collected through semi-structured interviews with 68 local informants. Quantitative analysis was performed using Informant Consensus Factor (F_IC) and Use Value (UV) indices. Plant specimens were collected, identified, and deposited in the herbarium. The study documented 86 plant taxa from 35 families used in 230 therapeutic applications. Lamiaceae, Asteraceae, and Rosaceae were the most represented families. High F_IC values were recorded for colds (F_IC = 0.95), stomach pain (F_IC = 0.92), and inflammation (F_IC = 0.90), indicating strong community consensus. The most frequently cited species were Origanum vulgare subsp. gracile, Mentha spp., and Rosa canina. There are novel or locally specific uses, with 13 taxa having no previously recorded ethnomedicinal applications in the reviewed literature. The findings reveal Konak as a significant repository of ethnomedicinal knowledge. High-F_IC taxa represent prime candidates for phytochemical and pharmacological research to validate traditional uses and support evidence-based phytotherapy. This study enriches regional ethnopharmacological data and highlights candidate taxa for pharmacological validation. Full article

Curcumin, the major polyphenolic constituent of Curcuma longa, has been widely investigated as a hepatoprotective adjunct due to its antioxidant and immunomodulatory properties. This review evaluates the relevance of curcumin for the prevention and management of liver dysfunction and hepatitis in pigs by synthesizing available porcine evidence and integrating mechanistic insights from translational liver injury models where pig-specific data remain limited. Across experimental hepatic injury contexts, curcumin administration is most consistently associated with reduced biochemical and structural indicators of hepatocellular damage, including decreased aminotransferase activity, attenuation of lipid peroxidation, and enhancement of endogenous antioxidant defenses. These effects are mechanistically linked to suppression of pro-inflammatory signaling pathways, particularly NF-κB-related transcriptional activity and inflammasome-associated responses, together with reduced expression of key cytokines such as TNF-α, IL-1β, and IL-6. Concurrent activation of Nrf2-centered cytoprotective pathways and induction of phase II antioxidant enzymes (including HO-1, GST, and NQO1) appear to constitute a conserved axis supporting hepatic oxidative stress resilience. In swine-relevant infectious settings, available data further support antiviral activity against selected porcine pathogens, including classical swine fever virus and porcine reproductive and respiratory syndrome virus, potentially mediated through interference with lipid-dependent stages of viral replication and modulation of Kupffer cell activation. Although combination strategies with established hepatoprotective approaches are conceptually attractive, current synergy evidence remains heterogeneous and largely extrapolated. Overall, curcumin represents a plausible adjunct candidate for supporting porcine liver health; however, translation into practice will depend on resolving formulation-dependent bioavailability constraints and strengthening the pig-specific evidence base. Full article

Contemporary medical practitioners increasingly recognize the critical impact of healing-environment design on patients’ recovery, positioning it as a pivotal consideration in healthcare facility planning. While existing research has predominantly focused on enhancing the functionality and efficiency of healthcare environments, it has often overlooked the significance of individual patient needs and their distinct experiences. This paper aims to utilize the principles of epidemiology and empirical analysis to explore the application and research trends of the patient-centered care (PCC) concept in healthcare facility design, to promote interdisciplinary collaboration and achieve customized healthcare environments. Based on bibliometric analysis and key literature review methods, this paper systematically examines and interprets the research development trends of PCC in healing environment design, integrating both macro and micro perspectives, and reveals how design factors in therapeutic environments support the realization of PCC principles, thereby improving patients’ rehabilitation experiences and health outcomes. The results indicate that current research on PCC is trending towards increasingly diversified integration via high-frequency keywords such as recovery, healing environment, and evidence-based design, highlighting the shift from functional optimization to emotional care, technological integration, and nature-based interactions in design. Notably, patient-centered care has become a consensus and core integrating concept in this field. This paper not only reveals the key role of healing environments in constructing PCC practice pathways but also provides theoretical support and strategic reference for the planning of healthcare spaces and the collaborative design of nursing processes, and demonstrates that healing environments have evolved from passive spaces into active rehabilitation mediums through interdisciplinary collaboration, thereby facilitating the implementation of the patient-centered healthcare philosophy. Full article