Search Results (174)

Food security is crucial for social stability and economic development. Ensuring food security in the arid region of Northwest China presents unique challenges due to limited water and soil resources. This study addresses these challenges by integrating a comprehensive water and soil resource matching assessment with grain production forecasting. Based on data from 2000 to 2020, this research projects the food security status to 2035 using the GM(1,1) model, incorporating a comprehensive index of soil and water resource matching and regression analysis to inform production forecasts. Key assumptions include continued historical trends in population growth, urbanization, and dietary shifts towards an increased animal protein consumption. The findings revealed a consistent upward trend in grain production from 2000 to 2020, with an average annual growth rate of 3.5%. Corn and wheat emerged as the dominant grain crops. Certain provinces demonstrated comparative advantages for specific crops like rice and wheat. The most significant finding is that despite the projected growth in the total grain output by 2035 compared to 2020, the regional grain self-sufficiency rate is projected to range from 79.6% to 84.1%, falling below critical food security benchmarks set by the FAO and China. This projected shortfall carries significant implications, underscoring a serious challenge to regional food security and highlighting the region’s increasing vulnerability to external food supply fluctuations. The findings strongly signal that current trends are insufficient and necessitate urgent and proactive policy interventions. To address this, practical policy recommendations include promoting water-saving technologies, enhancing regional cooperation, and strategically utilizing the international grain trade to ensure regional food security. Full article

Background: Faced with the profound impact of major infectious diseases on public life and economic development, humans have long sought to understand disease transmission and intervention strategies. To better explore the impact of individuals’ different coping behaviors—triggered by changes in their psychological security due to public information and external environmental changes—on the spread to infectious diseases, the model will place greater emphasis on quantifying psychological factors to make it more aligned with real-world situations. Methods: To better understand the interplay between information dissemination and disease transmission, we propose a two-layer network model that incorporates psychological safety factors. Results: Our model reveals key insights into disease transmission dynamics: (1) active defense behaviors help reduce both disease spread and information diffusion; (2) passive resistance behaviors expand disease transmission and may trigger recurrence but enhance information spread; (3) high-timeliness, low-fuzziness information reduces the peak of the initial infection but does not significantly curb overall disease spread, and the rapid dissemination of disease-related information is most effective in limiting the early stages of transmission; and (4) community structures in information networks can effectively curb the spread of infectious diseases. Conclusions: These findings offer valuable theoretical support for public health strategies and disease prevention after government information release. Full article

The management of adult spinal deformity (ASD) has evolved dramatically over the past century, transitioning from external bracing and in situ fusion to complex, technology-driven surgical interventions. This review traces the historical development of spinal deformity correction and highlights contemporary enabling technologies that are redefining the surgical landscape. Advances in stereoradiographic imaging now allow for precise, low-dose three-dimensional assessment of spinopelvic parameters and segmental bone density, facilitating individualized surgical planning. Robotic assistance and intraoperative navigation improve the accuracy and safety of instrumentation, while patient-specific rods and interbody implants enhance biomechanical conformity and alignment precision. Machine learning and predictive modeling tools have emerged as valuable adjuncts for risk stratification, surgical planning, and outcome forecasting. Minimally invasive deformity correction strategies, including anterior column realignment and circumferential minimally invasive surgery (cMIS), have demonstrated equivalent clinical and radiographic outcomes to traditional open surgery with reduced perioperative morbidity in select patients. Despite these advancements, complications such as proximal junctional kyphosis and failure remain prevalent. Adjunctive strategies—including ligamentous tethering, modified proximal fixation, and vertebral cement augmentation—offer promising preventive potential. Collectively, these innovations signal a paradigm shift toward precision spine surgery, characterized by data-informed decision-making, individualized construct design, and improved patient-centered outcomes in spinal deformity care. Full article

Background/Objectives: Food allergy (FA) is a growing concern in pediatric care, requiring effective avoidance strategies and timely emergency responses. The role of caregivers is central to the daily management of FA. This study aimed to assess parental knowledge, preparedness, and behaviors regarding pediatric FA management, focusing on both prevention and emergency readiness. Methods: A cross-sectional survey was conducted from December 2024 to April 2025 through the SurveyMonkey^® platform, promoted by the Italian Society of Pediatric Allergology and Immunology (SIAIP). The anonymous, structured questionnaire was distributed online and in two Italian university hospitals. A total of 129 fully completed responses from caregivers of children with FA were analyzed. The survey explored self-perceived knowledge, symptom recognition, preventive actions, emergency preparedness, and communication practices. Results: Only 9.3% of parents considered themselves “very informed,” while 54.3% reported limited or no knowledge. Just 16.0% recognized all symptoms of an allergic reaction, and only 24.0% could distinguish mild reactions from anaphylaxis. Notably, 67.4% reported not knowing how to respond to anaphylaxis, and 83.7% did not possess an epinephrine auto-injector. Preventive measures at home were inconsistently applied, and 41.1% took no precautions when eating out. Communication with external caregivers was often informal or absent. Only 33% updated physicians regularly. Conclusions: The findings reveal significant gaps in parental preparedness and highlight critical areas for educational intervention. Enhanced caregiver training, standardized communication protocols, and improved clinical follow-up are essential to strengthen pediatric FA management and safety. Full article

Background/Objectives: Successful discourse relies not only on linguistic but also on prosodic information. Difficulty recognizing emotion conveyed through prosody (receptive affective aprosodia) following right hemisphere stroke (RHS) significantly disrupts communication participation and personal relationships. Growing evidence suggests that damage to white matter in addition to gray matter structures impairs affective prosody recognition. The current study investigates lesion–symptom associations in receptive affective aprosodia during RHS recovery by assessing whether disruptions in distinct white matter structures impact different underlying affective prosody recognition skills. Methods: Twenty-eight adults with RHS underwent neuroimaging and behavioral testing at acute, subacute, and chronic timepoints. Fifty-seven healthy matched controls completed the same behavioral testing, which comprised tasks targeting affective prosody recognition and underlying perceptual, cognitive, and linguistic skills. Linear mixed-effects models and multivariable linear regression were used to assess behavioral performance recovery and lesion–symptom associations. Results: Controls outperformed RHS participants on behavioral tasks earlier in recovery, and RHS participants’ affective prosody recognition significantly improved from acute to chronic testing. Affective prosody and emotional facial expression recognition were affected by external capsule and inferior fronto-occipital fasciculus lesions while sagittal stratum lesions impacted prosodic feature recognition. Accessing semantic representations of emotions implicated the superior longitudinal fasciculus. Conclusions: These findings replicate previously observed associations between right white matter tracts and affective prosody recognition and further identify lesion–symptom associations of underlying prosodic recognition skills throughout recovery. Investigation into prosody’s behavioral components and how they are affected by injury can help further intervention development and planning. Full article

Aims: To systematically review and synthesize qualitative research exploring the Breast Cancer Survivors (BCSs)’ perception of health promotion interventions and informing strategies to mitigate recurrence risk within five years post-treatment and improve clinical outcomes. Specifically, this study addresses the question: “How do women diagnosed with breast cancer perceive health promotion interventions for recurrence prevention?” Design: A systematic review and qualitative meta-synthesis were performed. Data Sources: A systematic search of scientific databases (CINAHL, MEDLINE, and Scopus) was undertaken in November 2024. The reference list was cross-referenced and hand-searched to identify additional articles. Review Methods: Studies were included if they met the following criteria: they were primary qualitative studies focusing on BCSs within five years post-treatment, involving participants who had completed surgery, radiotherapy, or chemotherapy in the same time frame, as this period is critical for monitoring recurrence and implementing health promotion interventions. Only studies published in peer-reviewed journals and written in Italian, English, French, or Spanish were considered, provided that an abstract and the full text were available. Moreover, eligible studies had to be conducted in high-income or middle-income countries. Studies were excluded if they focused exclusively on advanced or metastatic breast cancer, if they involved mixed cancer populations without reporting separate data for BCSs, or if they were non-qualitative studies or gray literature. The review study protocol was registered in the PROSPERO database (CRD42024626033). Results: The literature search identified 490 records, 13 articles from databases, and 3 articles identified via other methods (web and citation searching) that met inclusion criteria. A narrative synthesis approach allowed the emerging five themes: (I) Challenges, (II) Self-motivation and empowerment, (III) The relationships as a facilitator, (IV) Barriers to change, and (V) Proactive support strategies. Conclusions: Addressing internal and external factors that influence health behaviors is essential to improve adherence, reduce recurrence risk, and enhance quality of life. Tailored interventions, social support, and healthcare engagement are crucial in this effort. Impact: Our meta-synthesis highlighted significant challenges as well as valuable resources for health promotion among BCSs, suggesting practical and tailored approaches to improving the adoption of healthy behaviors, supported by relationships and targeted support strategies. Full article

An accurate assessment of alcohol consumption is essential for identifying at-risk individuals and informing prevention and intervention strategies. The present study aimed to validate the Italian version of the Alcohol Use Questionnaire (AUQ), a self-report instrument designed to assess both general alcohol intake and binge drinking patterns. A sample of 378 Italian participants (54.5% female; M_age = 26.76 years, SD = 8.44) completed the AUQ along with additional measures assessing binge eating and psychological vulnerabilities related to addiction. Confirmatory factor analysis supported a bifactor model reflecting two distinct but related dimensions: general intake and binge drinking. Network analysis highlighted the central role of perceived frequency of intoxication within the structure of alcohol-related behaviors. Both AUQ indices showed good internal consistency and significant associations with external variables, particularly impulsivity, dissociation, and affect dysregulation, supporting construct validity. The Italian AUQ emerges as a valid and reliable tool for assessing alcohol use patterns and may be useful in both research and clinical practice. Full article

With the rapid development of the Internet, the speed and scope of sudden public events disseminating in cyberspace have grown significantly. Current methods of quantifying public opinion heat often neglect emotion-driven factors and user interaction behaviors, making it difficult to accurately capture fluctuations during dissemination. To address these issues, first, this study addressed the complexity of interaction behaviors by introducing an approach that employs the information gain ratio as a weighting indicator to measure the “interaction heat” contributed by different interaction attributes during event evolution. Second, this study built on SnowNLP and expanded textual features to conduct in-depth sentiment mining of large-scale opinion texts, defining the variance of netizens’ emotional tendencies as an indicator of emotional fluctuations, thereby capturing “emotional heat”. We then integrated interactive behavior and emotional conflict assessment to achieve comprehensive heat index to quantification and dynamic evolution analysis of online public opinion heat. Subsequently, we used Hodrick–Prescott filter to separate long-term trends and short-term fluctuations, extract six key quantitative features (number of peaks, time of first peak, maximum amplitude, decay time, peak emotional conflict, and overall duration), and applied K-means clustering algorithm (K-means) to classify events into three propagation patterns, which are extreme burst, normal burst, and long-tail. Finally, this study conducted ablation experiments on critical external intervention nodes to quantify the distinct contribution of each intervention to the propagation trend by observing changes in the model’s goodness-of-fit ($R^2$) after removing different interventions. Through an empirical analysis of six representative public opinion events from 2024, this study verified the effectiveness of the proposed framework and uncovered critical characteristics of opinion dissemination, including explosiveness versus persistence, multi-round dissemination with recurring emotional fluctuations, and the interplay of multiple driving factors. Full article

Healthcare is a dynamic and ever-changing phenomenon and is subject to multiple challenges, particularly concerning sustainability and cost issues. The literature identifies bed space and problems related to the lack of hospital beds as being directly or indirectly related to both admission and discharge processes, with delays in in-patient discharges being identified as a variable of significance when it comes to a health system’s overall performance. In this respect, the aim of this research was to explore factors related to delayed discharges in an acute hospital setting in Malta, a small European member state, through the perspectives of health professionals. This study followed a qualitative approach. Semi-structured interviews (n = 8) and focus groups (n = 2) were conducted with a diverse group of experienced health professionals. Informed consent was obtained from all participants, and all data were treated with strict confidentiality throughout the study. The sample was limited to professionals working in adult, non-specialized healthcare settings. Manual thematic analysis was carried out. Codes were grouped to derive seven main themes, which were identified after carrying out the thematic analysis process on the transcripts of the interviews/focus groups. The derived themes are the following: (a) a faulty system, which is open to abuse and inefficiency, (b) procedural delays directly impacting delayed discharges, (c) long-term care/social cases as a major cause of delayed discharges, (d) the impact of external factors on delayed discharges, (e) stakeholder suggestions to management to counteract delayed discharges, (f) the impact of COVID-19 on delayed discharges, and (g) inter-professional relationships. Factors related to delayed discharges and the effects of delayed discharges on the hospital emerged from the main findings, together with specific potential interventions to minimise delays in discharge. Health professional interactions and the effects of inter-professional relationship setbacks on delayed discharges were explored, and the impact of the COVID-19 pandemic on hospital dynamics and additional delays were also addressed. This information is intended to provide hospital administrators with data-driven internal organisational evidence to guide them through changes and to inform future decisions regarding hospital performance and efficiency from a discharge delay perspective. Full article

High density old districts at the urban fringes of Asian megacities, such as Shenzhen, face significant thermal challenges due to dense building clusters, limited airflow, and heat retention. This study adopts an integrated approach combining Phoenics wind simulation, geographic information system (GIS) modeling, and spatial prototype analysis to assess and optimize the wind and thermal environments in these urban areas. It investigates how spatial configurations, including building density, height distribution, orientation, and green space integration, influence wind flow and thermal comfort. The results demonstrate that optimized spatial arrangements, including reduced building density, height adjustments, and strategic landscape design, improve ventilation and temperature regulation. Comparative analyses of different spatial prototypes reveal that radial configurations effectively channel external winds into the urban core, enhancing internal airflow, whereas rectangular layouts create wind shadows that hinder ventilation. Adjustments to building façades and vertical arrangements further mitigate pedestrian-level heat accumulation. Interventions in public spaces, including green roofs and vertical greening, offer cooling benefits and mitigate urban heat island effects. This study underscores the importance of aligning urban design with natural wind flow and offers a framework for sustainable landscape and architectural strategies in high-density, heat-prone environments. The findings offer valuable insights for urban planners and policymakers seeking sustainable development in similar megacities. Full article

This study examines culture-led urban regeneration as a strategy for revitalizing Meezan Chowk, a historically significant yet deteriorating public space in Quetta, Pakistan. Once a central site of social and commercial exchange, the area suffered from infrastructural decline, overcrowding, and the erosion of its architectural identity. The research proposes a design intervention to restore the site’s heritage value while enhancing its functional and social relevance. A qualitative approach is adopted, incorporating surveys, focus group discussions, and site observations to assess user needs and spatial dynamics. A SWOT analysis serves as the analytical framework to identify the site’s internal strengths and weaknesses, as well as external opportunities and threats. By utilizing the Geographic Information Systems (GIS) and OpenStreetMap data, further information can enhance understanding of the site’s urban morphology. The proposed design integrates vernacular elements, such as arched facades, shaded corridors, and communal courtyards, with contemporary features, including cafes, local artisan shops, and accessible public amenities. Full article

Background/Objectives: The assessment of relationships between trunk muscle activity and thoraco-lumbar movements during sagittal bending has demonstrated that low back pain (LBP) subgroups (flexion pattern and active extension pattern motor control impairment) reveal distinct relationships that differentiate these subgroups from control groups. The study objective was to establish whether such relationships exist during various daily activities. Methods: Fifty participants with non-specific chronic low back pain (NSCLBP) (27 flexion pattern (FP), 23 active extension pattern (AEP)) and 28 healthy controls were recruited. Spinal kinematics were analysed using 3D motion analysis (Vicon™, Oxford, UK) and the muscle activity recorded via surface electromyography during a range of activities (box lift, box replace, reach up, step up, step down, stand-to-sit, and sit-to-stand). The mean sagittal angles for upper and lower thoracic and lumbar regions were correlated with normalised mean amplitude electromyography of bilateral transversus abdominis/internal oblique (IO), external oblique (EO), superficial lumbar multifidus (LM), and erector spinae (ES). Relationships were assessed via Pearson correlations (significance p < 0.01). Results: In the AEP group, increased spinal extension was associated with altered LM activity during box-replace, reach-up, step-up, and step-down tasks. In the FP group, increased lower lumbar spinal flexion was associated with reduced muscle activation, while increased lower thoracic flexion was associated with increased muscle activation. The control group elicited no significant associations. Correlations ranged between −0.812 and 0.754. Conclusions: Differential relationships between muscle activity and spinal kinematics exist in AEP, FP, and pain-free control groups, reinforcing previous observations that flexion or extension-related LBP involves distinct motor control strategies during different activities. These insights could inform targeted intervention approaches, such as movement-based interventions and wearable technologies, for these groups. Full article

Strong emotional bonds within families are foundational to children’s academic, psychological, and social development. While family cohesion is widely recognized as a protective factor across these domains, there remains a need to understand the specific mechanisms and interventions that foster such cohesion, particularly in diverse socioeconomic and cultural contexts. This systematic review examines global evidence on factors influencing family cohesion and evaluates intervention strategies designed to strengthen familial relationships. Drawing on 41 peer-reviewed studies published between 2015 and 2023, this review adheres to PRISMA guidelines and applies the Mixed Methods Appraisal Tool (MMAT) to assess methodological quality. The findings are organized around four core dimensions of family cohesion—emotional bonding, adaptability, communication, and support—and highlight both common patterns and culturally specific mechanisms. Studies were drawn from a range of settings including North America, sub-Saharan Africa, Latin America, East and Southeast Asia, and Europe, enabling a cross-cultural analysis of how family cohesion operates under different social, cultural, and economic conditions. Intervention strategies are reviewed separately following the synthesis of correlations, with attention to their effectiveness, cultural relevance, and contextual adaptability. Community-based programs, trauma-informed therapies, and parenting interventions emerge as key approaches, though their success has varied by regional and structural context. Studies consistently demonstrate that higher family cohesion correlates with improved academic outcomes, as supportive home environments promote motivation, reduce stress, and enhance learning. Mental health benefits are also evident, with cohesive and adaptable families mitigating risks of anxiety and depression through open communication and emotional availability. Social competence is fostered through observed and practiced interpersonal skills within family settings. Socioeconomic status emerges as both a challenge and a moderating factor, with lower-SES families facing greater barriers to cohesion but also displaying notable resilience when supported through external interventions. Effective strategies identified include family therapy, parenting education, community-based programs, culturally sensitive approaches, and socioeconomic policy supports. Family cohesion and adaptability are critical to nurturing children’s academic success, emotional well-being, and social development. This review contributes to a more culturally nuanced and policy-relevant understanding of family cohesion by integrating empirical findings across global contexts and identifying both shared and differentiated pathways to resilience. The results inform future program design and suggest priorities for cross-cultural family research and intervention development. Full article

Background: Colorectal cancer (CRC) remains one of the leading causes of cancer-related mortality worldwide, with growing evidence linking risk to lifestyle and dietary factors. However, nutrition-related exposures have rarely been integrated into existing CRC risk prediction models. This study aimed to develop and validate a lifestyle-based 10-year CRC risk prediction model using longitudinal data from a large-scale population-based screening cohort to facilitate early risk stratification and personalized screening strategies. Methods: Data were obtained from 21,358 individuals participating in a CRC screening program in Shanghai, China, with over 10 years of active follow-up until 30 June 2021. Of these participants, 16,782 aged ≥40 years were used for model development, and 4576 for external validation. Predictors were selected using random survival forest (RSF) and elastic net methods, and the final model was developed using Cox regression. Machine learning approaches (RSF and XGBoost) were additionally applied for performance comparison. Model performance was evaluated through discrimination, calibration, and decision curve analysis (DCA). Results: The final model incorporated twelve predictors: age, gender, family history of CRC, diabetes, fecal immunochemical test (FIT) results, and seven lifestyle-related factors (smoking, alcohol use, body shape, red meat intake, fried food intake, pickled food intake, and fruit and vegetable intake). Compared to the baseline demographic-only model (C-index = 0.622; 95% CI: 0.589–0.657), the addition of FIT improved discrimination, and further inclusion of dietary and lifestyle variables significantly enhanced the model’s predictive accuracy (C-index = 0.718; 95% CI: 0.682–0.762; ΔC-index = 0.096, p = 0.003). Conclusions: Incorporating dietary and lifestyle variables improved CRC risk stratification. These findings highlight the value of dietary factors in informing personalized screening decisions and providing an evidence-based foundation for targeted preventive interventions. Full article

Background/Objectives: The human insula is a key structure implicated in integrating internal states and external food cues, yet its precise role remains unclear, in part due to the temporal limitations of neuroimaging techniques like fMRI. To address this gap, we conducted an exploratory study using an intracranial EEG (iEEG) to investigate how the insula encodes both the subjective and objective properties of food-related stimuli, and how this encoding is modulated by hunger and satiety. Methods: Eight patients with drug-resistant epilepsy undergoing a pre-surgical evaluation between 2017 and 2023 participated in this study. Depth electrodes implanted in the insular cortex recorded event-related potentials (ERPs) in response to visual food cues. The sessions were conducted in two prandial states (hungry and satiated). The subjective ratings (appetite and palatability) and objective nutritional values (e.g., calories, carbohydrates) were collected and analyzed using paired t-tests, MANOVAs, and partial correlations. Results: Hunger increased the ERP amplitudes within the 350–450 ms interval, consistent with the EPIC model and positive alliesthesia, while satiety unexpectedly enhanced the early responses (150–250 ms). Importantly, the neural activity related to nutritional values was largely uncorrelated with the subjective ratings, suggestive of distinct processing streams. The mid- and posterior insula showed greater sensitivity to both subjective and nutritional information than the anterior insula. Conclusions: These findings offer novel electrophysiological insights into how the insula differentiates between implicit and explicit food-related signals, depending on the homeostatic state. This work supports a dual-route model of food cue processing, and may inform interventions targeting insular activity in disordered eating. Full article