Search Results (2,980)

Cervical cancer remains a significant global public health challenge, with human papillomavirus (HPV) as its primary cause. In response, the World Health Organization (WHO) launched a global strategy to eliminate cervical cancer by 2030 and, in its 2022 position paper, recommended a single-dose vaccination schedule. The objective of this review is to critically examine the current HPV vaccination landscape in China, including vaccination policies, immunization schedules, supply–demand dynamics, and the feasibility of transitioning to a single-dose regimen. By synthesizing recent developments in HPV virology, epidemiology, vaccine types, and immunization strategies, we identify both opportunities and barriers unique to the Chinese context. Results indicate that China primarily adheres to a three-dose vaccination schedule, with an optional two-dose schedule for girls aged 9–14, leaving a notable gap compared to the most recent WHO recommendation. The high prevalence of HPV types 52 and 58 contributes to a distinct regional infection pattern, underscoring the specific need for nine-valent vaccines tailored to China’s epidemiological profile. Despite the growing demand, vaccine supply remains inadequate, with an estimated annual shortfall of more than 15 million doses. This issue is further complicated by strong public preference for the nine-valent vaccine and the relatively high cost of vaccination. Emerging evidence supports the comparable efficacy and durable protection of a single-dose schedule, which could substantially reduce financial and logistical burdens while expanding coverage. This review advocates for the adoption of a simplified single-dose regimen, supported by catch-up strategies for older cohorts and the integration of HPV vaccination into China’s National Immunization Program (NIP). Sustained investment in domestic vaccine development and centralized procurement of imported vaccines may also possibly alleviate supply shortage. These coordinated efforts are critical for strengthening HPV-related disease prevention and accelerating China’s progress toward the WHO’s cervical cancer elimination targets. Full article

Direct preference optimization (DPO) has been successfully applied to align large language models (LLMs) with human preferences. In recent years, DPO has also been used to improve the generation quality of text-to-image diffusion models. However, existing techniques often rely on a single type of reward model. They are also prone to overfitting to inaccurate reward signals. As a result, model quality cannot be continuously improved. To address these limitations, we propose xDPO. This method introduces a novel regularization approach that implicitly defines reward functions for both preferred and non-preferred samples. This design greatly enhances the flexibility of reward modeling. The experimental results show that, after fine-tuning Stable Diffusion v1.5, xDPO achieves significant improvements in human preference evaluations compared to previous DPO methods. It also improves training efficiency by approximately 1.5 times. Meanwhile, xDPO maintains image–text alignment performance that is comparable to the original model. Full article

As industrial companies transition from the Industry 4.0 stage to the more human-centric and resilient Industry 5.0 paradigm, there is a growing need for structured assessment tools to prioritize modern technologies. This paper presents an integrated multi-criteria decision analysis (MCDA) approach to support the strategic assessment of technologies from three complementary perspectives: economic, organizational, and technological. The proposed model encompasses six key transformation areas and 22 technologies representing both the Industry 4.0 and 5.0 paradigms. A hybrid approach combining the DEMATEL (Decision-Making Trial and Evaluation Laboratory) and PROMETHEE II (Preference Ranking Organization Method for Enrichment Evaluation) methods is used to identify cause–effect relationships between the transformation areas and to construct technology rankings in each of the assessed perspectives. The results indicate that technologies such as the Internet of Things (IoT), cybersecurity, and supporting IT systems play a central role in the transition process. Among the Industry 5.0 technologies, hyper-personalized manufacturing, smart grids and new materials stand out. Moreover, the economic perspective emerges as the dominant assessment dimension for most technologies. The proposed analytical framework offers both theoretical input and practical decision-making support for companies planning their transformation towards Industry 5.0, enabling a stronger alignment between implemented technologies and long-term strategic goals. Full article

Climate change is profoundly impacting human health in South Africa, aggravating existing health challenges and creating new threats, particularly in vulnerable populations. This scoping review aims to comprehensively map existing evidence of climate change and diverse human health impacts to assist in the equipping of health systems to address evolving challenges of climate change. The scoping review will inform the development of evidence-based policy, improve public health preparedness, and ensure that adaptation strategies are effectively tailored to South Africa’s socio-economic and environmental conditions. This scoping review protocol will be conducted using the Joanna Briggs Institute (JBI) methodology, following five steps: (1) defining the research question, (2) search strategy, (3) setting inclusion criteria, (4) extracting data, (5) assessing, summarizing, and presenting findings. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) tool will be used. A comprehensive peer-reviewed literature search, including PubMed, Scopus, ScienceDirect, and Google Scholar, will be conducted by two independent reviewers. The review will be conducted over eight weeks, focusing on English studies published between 2015 and 2025, and conducted within South Africa. A two-stage screening process will determine article eligibility. Disagreements will be resolved through consensus and consultation of a third reviewer. The results of this review will be presented as tables, including a narrative synthesis of the findings. Full article

The cosmetic industry faces a critical need to balance commercial innovation with scientific validation, especially regarding the safety and efficacy of raw materials. Plant-derived materials (PDMs) offer a promising alternative to animal-derived ingredients in cosmetics, particularly due to their safety and compliance with vegan and ethical standards. Unlike compounds such as polydeoxyribonucleotide (PDRN), which is derived from the testis or seminal fluid of Salmonidae species and raises concerns regarding its origin, sustainability, and consumer acceptability, PDMs provide a cleaner, ethically preferable profile. In this study, we evaluated 50 PDM candidates using in vitro cell viability, wound healing, and immunocytochemistry assays, along with primary skin irritation tests in human participants. None of the samples showed harmful effects. Notably, sample Nos. 38 and 42 demonstrated significant wound-healing capacity and upregulated filaggrin expression without causing notable irritation in clinical testing. These findings support the biological activity and safety of specific PDMs as functional cosmetic ingredients. This study presents scientifically validated evidence for plant-based alternatives to animal-derived materials and offers a new milestone in the shift toward sustainable and ethical cosmetic development. By bridging the gap between consumer demand and scientific rigor, this study provides a robust platform for future innovations in vegan cosmetics. Full article

Background: Sirolimus (SRL, rapamycin) is a clinically important mTOR inhibitor used in immunosuppression, oncology, and cardiovascular drug-eluting devices. Despite its long-standing FDA approval, the human metabolic profile of SRL remains incompletely characterized. SRL is primarily metabolized by CYP3A enzymes in the liver and intestine, but the diversity, pharmacokinetics, and biological activity of its metabolites have been poorly explored due to the lack of structurally identified standards. Methods: To investigate SRL metabolism, we incubated SRL with pooled human liver microsomes (HLM) and isolated the resulting metabolites. Structural characterization was performed using high-resolution mass spectrometry (HRMS) and ion trap MSⁿ. We also applied Density Functional Theory (DFT) calculations to assess the energetic favorability of metabolic transformations and conducted molecular dynamics (MD) simulations to model metabolite interactions within the CYP3A4 active site. Results: We identified 21 unique SRL metabolites, classified into five major structural groups: O-demethylated, hydroxylated, didemethylated, di-hydroxylated, and mixed hydroxylated/demethylated derivatives. DFT analyses indicated that certain demethylation and hydroxylation reactions were energetically preferred, correlating with metabolite abundance. MD simulations further validated these findings by demonstrating the favorable orientation and accessibility of key sites within the CYP3A4 binding pocket. Conclusions: This study provides a comprehensive structural map of SRL metabolism, offering mechanistic insights into the formation of its metabolites. Our integrated approach of experimental and computational analyses lays the groundwork for future investigations into the pharmacodynamic and toxicodynamic effects of SRL metabolites on the mTOR pathway. Full article

Urban green spaces (UGSs) and forests play a vital role in shaping sustainable and livable cities, offering not only ecological benefits but also spaces that are essential for human well-being, social interactions, and everyday life. Understanding the landscape features that resonate most with public preferences is essential for enhancing the appeal, accessibility, and functionality of these environments. However, traditional approaches—such as surveys or single-data analyses—often lack the nuance needed to capture the complex and multisensory nature of human responses to green spaces. This study explores a cross-modal methodology that integrates natural language processing (NLP) and deep learning techniques to analyze text and image data collected from public reviews of 19 urban parks in Nanjing. By capturing both subjective emotional expressions and objective visual impressions, this study reveals a consistent public preference for natural landscapes, particularly those featuring evergreen trees, shrubs, and floral elements. Text-based data reflect users’ lived experiences and nuanced perceptions, while image data offers insights into visual appeal and spatial composition. By bridging human-centered insights with data-driven analysis, this research provides a robust framework for evaluating landscape preferences. It also underscores the importance of designing green spaces that are not only ecologically sound but also emotionally resonant and socially inclusive. The findings offer valuable guidance for the planning, design, and adaptive management of urban green infrastructure in ways that support healthier, more responsive, and smarter urban environments. Full article

Expatriates and missionaries in China played a significant role in the development and transformation of Chinese architecture in the Late Qing period. However, a systematic comparison of their discourses and proposals on Chinese architecture has been hindered by a lack of historical literature and the complexities of fragmented data and methodologies. This article examines and compares the two most influential non-native newspapers: The North-China Daily News in English, edited by expatriates, and The Review of the Times in Chinese, founded by missionaries. By analyzing these two groups’ discourses and narratives on Chinese architecture, the study explores their similarities and distinctions, revealing the characteristics, strategies, attitudes, interests, and opinions of expatriates, missionaries, and non-missionaries in China on the transmission and transformation of architecture knowledge. The research highlights differences in their preferences for specific text types, subjects, and themes on Chinese architecture, as well as their attitudes toward native and foreign architecture, professional education, and architecture regulations in individual and official spheres. Despite these differences, overlapping characteristics and proposals existed among the three groups. The study further investigates the underlying reasons and mechanisms for their similar or divergent mindsets and behavioral patterns, drawing on human responsive psychology rather than relying on postcolonial or cultural theories. Full article

Early medical traditions include those of ancient Babylonia, China, Egypt, and India. The roots of modern Western medicine, however, go back to ancient Greece. During the Renaissance, physicians increasingly relied on observation and experimentation to understand the human body and develop new techniques for diagnosis and treatment. The discovery of antibiotics, antiseptics, and other drugs in the 19th century accelerated the development of modern medicine, the latter being fueled further by advances in technology, research, a better understanding of the human body, and, most recently, the introduction of evidence-based medicine (EBM). The EBM model de-emphasized intuition, unsystematic clinical experience, and pathophysiologic rationale as sufficient grounds for clinical decision-making and stressed the examination of evidence from clinical research. A later EBM model additionally incorporated clinical expertise and the latest model of EBM patients’ preferences and actions. In this review article, we argue that in the era of precision medicine, major EBM principles must be based on (a) the systematic identification, analysis, and utility of big data using artificial intelligence; (b) the magnifying effect of medical interventions by means of the physician–patient interaction, the latter being guided by the physician’s expertise, intuition, and philosophical beliefs; and (c) the patient preferences, since, in healthcare under precision medicine, the patient will be a central stakeholder contributing data and actively participating in shared decision-making. Full article

Ontologies are essential tools for representing, organizing, and sharing knowledge across various domains. This study presents a methodology for ontology construction supported by large language models (LLMs), with an initial application in the automotive sector. Specifically, a user preference ontology for adaptive interfaces in autonomous machines was developed using ChatGPT-4o. Based on this case study, the results were generalized into a reusable methodology. The proposed workflow integrates classical ontology engineering methodologies with the generative and analytical capabilities of LLMs. Each phase follows well-established steps: domain definition, term elicitation, class hierarchy construction, property specification, formalization, population, and validation. A key innovation of this approach is the use of a guiding table that translates domain knowledge into structured prompts, ensuring consistency across iterative interactions with the LLM. Human experts play a continuous role throughout the process, refining definitions, resolving ambiguities, and validating outputs. The ontology was evaluated in terms of logical consistency, structural properties, semantic accuracy, and inferential completeness, confirming its correctness and coherence. Additional validation through SPARQL queries demonstrated its reasoning capabilities. This methodology is generalizable to other domains, if domain experts adapt the guiding table to the specific context. Despite the support provided by LLMs, domain expertise remains essential to guarantee conceptual rigor and practical relevance. Full article

Knowledge of the habitat characteristics of endangered species is an important basis for in situ conservation, release-site selection, and habitat modification. Although the Chinese pangolin (Manis pentadactyla) is one of the world’s most endangered species, little is known about its habitat preferences, and the results of past studies differ greatly. To clarify the habitat characteristics of the Chinese pangolin, we conducted habitat surveys in Guangdong, Jiangxi, and Zhejiang provinces of China using the transect method. A total of 520 burrow sites of Chinese pangolins were recorded in three study areas. The resulting data were analyzed using a generalized additive model, principal coordinate analysis, and Kruskal–Wallis tests. Nine ecological factors (elevation, slope, soil type, canopy coverage, surface coverage, number of trees, number of logs, tree diameter at breast height, and distance to a settlement) were found to affect pangolins’ distribution. Burrows were preferentially distributed at elevations of 50–150 m (62.3%), in silty soil (88.1%), on 20–40° slopes (83.3%), within young and medium-aged broadleaved forests with a canopy coverage exceeding 70% (65.8%), and close to water (less than 300 m). Among the three study regions, pangolin habitats differed significantly in seven environmental factors: elevation, canopy coverage, surface coverage, number of trees, distance to water, distance to a road, and distance to a settlement. Our findings imply that the Chinese pangolin appears to tolerate a broad range of ecological characteristics; however, food resources may be the key factor affecting its habitat selection, and other factors may indirectly affect its distribution by affecting food abundance. Finally, aside from hunting, a low level of human disturbance does not affect the presence of this species. Full article

Background: This systematic review aimed to comprehensively evaluate the clinical, diagnostic, and therapeutic features of synchronous acute cholecystitis (AC) and acute appendicitis (AAP). Methods: The review protocol was prospectively registered in PROSPERO (CRD420251086131) and conducted in accordance with PRISMA 2020 guidelines. A systematic search was performed across PubMed, MEDLINE, Web of Science, Scopus, Google Scholar, and Google databases for studies published from January 1975 to May 2025. Search terms included variations of “synchronous,” “simultaneous,” “concurrent,” and “coexistence” combined with “appendicitis,” “appendectomy,” “cholecystitis,” and “cholecystectomy.” Reference lists of included studies were screened. Studies reporting human cases with sufficient patient-level clinical data were included. Data extraction and quality assessment were performed independently by pairs of reviewers, with discrepancies resolved through consensus. No meta-analysis was conducted due to the descriptive nature of the data. Results: A total of 44 articles were included in this review. Of these, thirty-four were available in full text, one was accessible only as an abstract, and one was a literature review, while eight articles were inaccessible. Clinical data from forty patients, including two from our own cases, were evaluated, with a median age of 41 years. The gender distribution was equal, with a median age of 50 years among male patients and 36 years among female patients. Leukocytosis was observed in 25 of 33 patients with available laboratory data. Among 37 patients with documented diagnostic methods, ultrasonography and computed tomography were the most frequently utilized modalities, followed by physical examination. Twenty-seven patients underwent laparoscopic cholecystectomy and appendectomy. The remaining patients were managed with open surgery or conservative treatment. Postoperative complications occurred in five patients, including sepsis, perforation, leakage, diarrhea, and wound infections. Histopathological analysis revealed AAP in 25 cases and AC in 14. Additional findings included gangrenous inflammation and neoplastic lesions. Conclusions: Synchronous AC and AAP are rare and diagnostically challenging conditions. Early recognition via imaging and clinical evaluation is critical. Laparoscopic management remains the preferred approach. Histopathological examination of surgical specimens is essential for identifying unexpected pathology, thereby guiding appropriate patient management. Full article

Radioactive iodine (RAI) therapy plays a fundamental role in the management of differentiated thyroid cancer (DTC) following appropriate surgical intervention. High levels of TSH are required in order to achieve maximum RAI uptake in residual thyroid tissue or metastatic cells. The two techniques that are most commonly used are thyroid hormone withdrawal (THW), which induces endogenous TSH elevation by creating a hypothyroid state, and exogenous stimulation with recombinant human TSH (rhTSH). This review compares both approaches over a range of DTC risk categories. Extensive evidence demonstrates that rhTSH and THW yield equivalent oncological outcomes, including remnant ablation success, recurrence-free survival, and overall survival, in low-, intermediate-, and high-risk disease. Additionally, rhTSH maintains quality of life by avoiding hypothyroid symptoms. While THW continues to be an excellent option when there is a lack of availability of rhTSH, its disadvantages, particularly the transient hypothyroid state, must be carefully weighed against the demonstrated equivalence in efficacy. In current clinical practice, rhTSH is frequently the preferred option for its convenience, safety, and patient-centered benefits; however, the selection of the optimal approach should be based on individual clinical circumstances and patients’ preferences, as well as resource considerations. Full article

Background: Female Sexual Dysfunction (FSD) encompasses a range of conditions that can profoundly impact quality of life and intimate relationships. The primary classifications of FSD include female sexual interest and arousal disorder (FSIAD), genitopelvic pain and penetration disorder (GPPPD), female orgasmic disorder (FOD), and substance or medication-induced sexual dysfunction (SM-ISD). Despite its prevalence, FSD is often underdiagnosed and undertreated. Objectives: This scoping review follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to evaluate the existing literature on both U.S. Food and Drug Administration (FDA)-approved and off-label pharmacotherapies for FSD by study type, outcomes, and limitations. Eligibility Criteria: Eligible studies comprised randomized controlled trials (RCTs), systematic reviews, and cohort studies involving adult women (≥18 years) with any subtype of FSD. These studies assessed pharmacologic interventions against a comparator and reported at least one treatment efficacy outcome. Studies outside this scope were excluded. Sources of Evidence: A 25-year literature search was conducted using PubMed/MEDLINE, the Cochrane Library, reference lists of relevant articles, academic handbooks, and targeted journals. Charting Methods: Three independent reviewers screened and extracted data. Risk of bias was assessed using the Cochrane Risk of Bias Tool. Findings were organized into summary tables and categorized by pharmaceutical agent, pertinent study information, outcomes, and limitations. Results: A total of 44 human-based pharmacologic studies met inclusion criteria. FDA-approved agents were the most thoroughly studied pharmacotherapies. Hormonal, topical, and adjunctive agents demonstrated less robust evidence. Heterogeneity in outcome measures and inadequate long-term data were common limitations. Conclusions: Pharmacologic treatment for FSD shows promise but requires further research. Individualized, multifaceted care is essential for optimizing FSD outcomes. Full article

Nowadays, food traceability represents an important issue in the current context of trade agreements, which influence global food prices. Many consumers prefer to pay a higher price for a traditional cultivation regime of a certain food product that comes from a certain region, appreciating the taste of the respective foodstuff. The potato is now the world’s fourth most important food crop in terms of human consumption, after wheat, maize, and rice. In this context, 100 potato samples from the Romanian market were collected. While 68 samples came from Romania, the rest of the 32 were from abroad (Hungary, France, Greece, Italy, Germany, Egypt, and Poland). The countries selected for potato sample analysis are among the main exporters of potatoes to the Romanian market. The samples were investigated by their multi-elemental and isotopic (²H, ¹⁸O and ¹³C) fingerprints, using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and Isotope Ratio Mass Spectrometry (IRMS). Then, to distinguish the geographical origin, the experimental results were statistically processed using linear discriminant analysis (LDA). The best markers that emphasize Romanian potatoes were identified to be δ¹³C_bulk, δ²H_water, and Sr. Full article