Search Results (272)

Urban-to-rural migration is reshaping vernacular villages through transformations in both architectural form and everyday life. This study focuses on three villages in Zhejiang Province, China, and their migrants from urban areas, investigating—through field surveys and interviews—how urban-to-rural migrants’ spatial and lifestyle interventions influence the preservation and transformation of traditional architecture and local cultural practices. Findings indicate that urban-to-rural migrants exhibit diverse spatial preferences and lifestyle patterns, leading to varied modes of building adaptation. Some prioritize modern styles and commercial functions, while others emphasize cultural continuity, community engagement, or individual expression. Most buildings undergo incremental modifications rather than complete reconstruction, reflecting a balance among regulatory constraints, financial considerations, and personal aspirations. Furthermore, some migrants retain traditional spatial hierarchies and layout logic in their architectural designs, thereby sustaining vernacular lifestyles such as intergenerational cohabitation and neighborhood interaction. These building practices also have demonstrative effects within the village, encouraging others to value local culture and spatial traditions. In contrast, other migrants, driven by modern aesthetics or commercial objectives, restructure or even disrupt traditional spatial models, resulting in the fragmentation and weakening of established value systems. These insights contribute to a deeper understanding of how urban-to-rural migration reshapes the spatial organization of traditional villages and can inform more flexible and context-sensitive rural planning practices. Full article

Zenker’s diverticulum (ZD) is an esophageal condition that results in an outpouching of the mucosal layer through a weakened area in the hypopharyngeal wall. This condition can cause symptoms like dysphagia, regurgitation, and aspiration, impacting patients’ quality of life. Historically, open surgery was the primary treatment. Although effective, this method is associated with longer recovery times and risks such as infections, nerve damage, and prolonged hospitalization. Rigid endoscopic stapling emerged as a less invasive alternative, offering high success rates for patients with favorable anatomy. Zenker’s peroral endoscopic myotomy (Z-POEM), adapted from treatments for achalasia, represents the latest advancement in ZD management. It involves creating a submucosal tunnel and precisely dividing the cricopharyngeus muscle. Z-POEM is minimally invasive and often provides quick relief with a high success rate of around 92%, while enabling outpatient treatment or brief hospital stays. However, it requires specialized expertise, and long-term data on recurrence rates are still emerging. This review discusses the evolution of these treatment modalities through comprehensive searches of PubMed, MEDLINE, and ScienceDirect databases. Studies reporting on treatment outcomes, complication rates, operative times, and clinical success associated with open surgery, rigid endoscopic stapling, and Z-POEM were included, with emphasis on meta-analyses, multicenter studies, and large case series highlighting Z-POEM’s comparable success to open surgery and increased patient tolerance. Open surgery achieves long-term symptom resolution rates of 90–95% but is associated with higher complication rates (up to 30%) and prolonged recovery times. Rigid endoscopic stapling offers symptom relief in approximately 90% of cases, with lower morbidity and shorter hospital stays (1–2 days), though anatomical limitations restrict its use. Z-POEM has demonstrated clinical success rates of 85.5–93%, with major complications reported in 4.8–5% of cases and recurrence rates as low as 1.4% at one-year follow-up in larger diverticula. Z-POEM’s minimally invasive nature and suitability for high-risk patients make it increasingly preferred in specialized centers. Management of Zenker’s diverticulum has evolved significantly, with endoscopic techniques, particularly Z-POEM, offering comparable success to open surgery but with fewer complications and faster recovery. Ongoing advances in endoscopic equipment and technique, along with emerging data on long-term outcomes, are likely to further refine treatment algorithms for ZD, especially for elderly and high-risk populations. Future directions in ZD management include ongoing research to enhance the safety and efficacy of endoscopic techniques, with new technologies on the horizon that could further improve outcomes and accessibility. Full article

The article aspires to delineate Hegel’s appropriation of Aristotle’s concept of soul in post-Kantian European Philosophy. It showcases the way that Hegel fuses central aspects of Aristotle’s theory and Kant’s account of inner purposiveness in order to deliver a hierarchical account of vegetative-, animal-, and human organisms. The article is divided in six parts. The first part offers an introduction to the subject matter. The second part delivers an overall account of the way that Hegel reconstructs Aristotle’s general theory of the soul and fuses it with Kant’s theory of inner purposiveness. The third part highlights Hegel’s distinctive argumentative strategy for delivering a unified, atemporal account of the connection between the various natural realms, both inorganic and organic. Parts four, five and six proceed to his theory of vegetative-, animal- and human life respectively, while showcasing the underlying logic and the upshot of Hegel’s developmental account of these three kinds of life qua soul. Full article

Background: Kidney-related pain can be chronic, disabling and negatively impact quality of life. In this prospective case series, we assessed whether a stepwise multidisciplinary treatment protocol, originally developed to treat ADPKD-related pain, can provide significant pain relief in non-ADPKD patients with kidney-related pain. Methods: Patients were eligible if they had incapacitating kidney-related pain with a visual analogue scale (VAS) score ≥50 out of 100, lasting ≥3 months and with insufficient response to previous treatments. The main exclusion criterion was ADPKD. Treatment options were, in order when indicated, nonpharmacological treatments, analgesics, cyst aspiration and fenestration, nerve blocks and nephrectomy. The effect of treatment on pain was investigated by means of VAS scores, defined daily dose of pain medication and quality-of-life scores. Results: Twelve patients (67% female, median age 50 [IQR: 36–59] years), with a median duration of pain of 1.9 [1.0–4.7] years, were included. In 50% of cases, chronic pain remained after an acute episode of kidney stones. Median follow-up after treatment was 3.8 [IQR: 2.5–4.4] years. The VAS before treatment (70 (48–90)) was reduced at short-term (35 [28–53], p = 0.01) and long-term follow-up (40 [38–53], p = 0.01). In addition, the defined daily dose of both opioids and non-opioids was reduced at short-term follow-up (p = 0.04 and 0.04, respectively) as well as at long-term follow-up (p = 0.03 and p = 0.02, respectively). Conclusions: We found that our multidisciplinary treatment protocol is effective in achieving sustained pain relief as well as a reduction in the use of pain medication in non-ADPKD patients with chronic, refractory kidney-related pain. Full article

Henri Lefebvre’s “right to the city” has rarely been examined through an intersectional feminist lens, leaving unnoticed the uneven burdens that urban design and policy place on women. This article bridges that gap by combining constitutional analysis, survey data (n = 736), in-depth interviews, and participatory observation to assess how Quito’s public spaces affect women’s safety and mobility. Quantitative results show that 81% of respondents endured sexual or offensive remarks, 69.8% endured obscene gestures, and 38% endured severe harassment in the month before the survey; 43% of these incidents occurred only days or weeks beforehand, underscoring their routine nature. Qualitative narratives reveal behavioral adaptations—altered routes, self-policing dress codes, and distrust of authorities—and identify poorly lit corridors and weak institutional presence as spatial amplifiers of violence. Analysis of Quito’s “Safe City” program exposes a gulf between its ambitious rhetoric and its narrow, transport-centered implementation. We conclude that constitutional guarantees of participation, appropriation, and urban life will remain aspirational until urban planning mainstreams gender-sensitive design, secures intersectoral resources, and embeds women’s substantive participation throughout policy cycles. A feminist reimagining of Quito’s public realm is therefore indispensable to transform the right to the city from legal principle into lived reality. Full article

In the contemporary big data era, data-driven prognostic and health management (PHM) methodologies have emerged as indispensable tools for ensuring the secure and reliable operation of complex equipment systems. Central to these methodologies is the accurate prediction of remaining useful life (RUL), which serves as a pivotal cornerstone for effective maintenance and operational decision-making. While significant advancements in computer hardware and artificial intelligence (AI) algorithms have catalyzed substantial progress in AI-based RUL prediction, extant research frequently exhibits a narrow focus on specific algorithms, neglecting a comprehensive and comparative analysis of AI techniques across diverse equipment types and operational scenarios. This study endeavors to bridge this gap through the following contributions: (1) A rigorous analysis and systematic categorization of application scenarios for equipment RUL prediction, elucidating their distinct characteristics and requirements. (2) A comprehensive summary and comparative evaluation of several AI algorithms deemed suitable for RUL prediction, delineating their respective strengths and limitations. (3) An in-depth comparative analysis of the applicability of AI algorithms across varying application contexts, informed by a nuanced understanding of different application scenarios and AI algorithm research. (4) An insightful discussion on the current challenges confronting AI-based RUL prediction technology, coupled with a forward-looking examination of its future prospects. By furnishing a meticulous and holistic understanding of the traits of various AI algorithms and their contextual applicability, this study aspires to facilitate the attainment of optimal application outcomes in the realm of equipment RUL prediction. Full article

Background: Pediatric Crohn’s Disease (CD) affects more than physical health, influencing emotional well-being, social integration, and developmental milestones, with an impact on disease management. This study aimed to explore adolescents’ lived experiences with CD and identify factors influencing their motivation for self-management. Methods: A descriptive, cross-sectional qualitative study was conducted using a semi-structured, self-administered online questionnaire. Participants (n = 10) were adolescents with CD who had been diagnosed for over three years and were recruited from a tertiary pediatric gastroenterology center. Data included demographics, clinical characteristics, IMPACT-III (HRQOL), and PROMIS short forms. Open-ended responses underwent thematic analysis using the framework developed by Braun and Clarke. Results: Participants (80% female, median age 16.2 years, median disease duration 4.6 years) were all in clinical remission (median PCDAI = 2) and with good quality of life (median IMPACT-III = 80.7). Six themes emerged: (1) disease knowledge, (2) emotional responses, (3) coping and adaptation, (4) social support, (5) daily life and school impact, and (6) transition to adult care. Most participants demonstrated strong disease literacy and reported effective coping strategies. Emotional responses to diagnosis ranged from relief (60%) to distress (40%); relapses commonly triggered anxiety and fear. Therapeutic changes and disease monitoring were perceived as beneficial (100%) but with concern. Diagnostic procedures were viewed as burdensome by 70% of respondents. School performance and extracurricular participation were negatively affected in 40% during flares. Concerns regarding the future were reported by 40% of participants, with 30% believing that CD might limit life aspirations. While 60% managed their disease independently, 30% relied on parental support. All acknowledged the need for transition to adult care, though readiness varied. Conclusions: This study illustrates the overall impact of disease on pediatric CD patients. It reports significant emotional challenges and difficulties, as well as an impact on daily life, despite good disease knowledge. The findings underscore the importance of psychosocial well-being, ongoing mental health assessment, non-invasive monitoring, and holistic care, emphasizing the patient perspective, in managing pediatric CD. Full article

Background: Poststroke dysphagia is a common condition that can lead to complications such as aspiration pneumonia and malnutrition, significantly affecting the quality of life. Most patients recover their swallowing function spontaneously, but in others difficulties persist beyond six months. Can we predict this in advance? On the other hand, there have been recent attempts to use machine learning to predict disease prognosis. Therefore, this study aims to investigate whether machine learning can predict the long-term prognosis for poststroke dysphagia using early videofluoroscopic swallowing study (VFSS) data. Methods: Data from VFSSs performed within 1 month of onset and swallowing status at 6 months were collected retrospectively in patients with dysphagia who experienced their first acute stroke at a university hospital. We selected 14 factors (lip closure, bolus formation, mastication, apraxia, tongue-to-palate contact, premature bolus loss, oral transit time, triggering of pharyngeal swallow, vallecular residue, laryngeal elevation, pyriform sinus residue, coating of the pharyngeal wall, pharyngeal transit time, and aspiration) from the VFSS data, scored them, and analyzed whether they could predict the long-term prognosis using five machine learning algorithms: Random forest, CatBoost classifier, K-neighbor classifier, Light gradient boosting machine, Extreme gradient boosting. These algorithms were combined through an ensemble method to create the final model. Results: In total, we collected data from 448 patients, of which 70% were used for training and 30% for testing. The final model was evaluated using accuracy, precision, recall, F1-score, and Area Under the Receiver Operating Characteristic Curve (AUC), resulting in values of 0.98, 0.94, 0.84, 0.88, and 0.99, respectively. Conclusions: Machine learning models using early VFSS data have shown high accuracy and predictive power in predicting the long-term prognosis of patients with poststroke dysphagia, and they are likely to provide useful information for clinicians. Full article

This study investigates the yield-seeking behavior of income-oriented institutional investors, who are essential players in financial markets. While external pressures compelling firms to “reach for yield” are well-documented, the firm-level behavioral drivers underlying this phenomenon remain largely underexplored. Drawing on the behavioral theory of the firm, this study argues that an investor’s performance relative to their social aspiration level (the peer average) influences their yield-seeking decisions, and that this effect is moderated by “portfolio slack,” defined as unrealized gains or losses. To test this theory in the context of persistent low-yield pressure, this study constructs and analyzes a panel dataset of Japanese life insurance companies from 2000 to 2019. The analysis reveals that these investors increase their portfolio income yield after underperforming their peers and decrease it after outperforming. Furthermore, greater portfolio slack amplifies yield increases after underperformance and mitigates yield decreases after outperformance. In contrast, organizational slack primarily mitigates yield reductions after outperformance. This research extends the behavioral theory of the firm to the asset management context by identifying distinct performance feedback responses and proposing portfolio slack as an important analytical construct, thereby offering key insights for investment managers and financial regulators. Full article

The COVID-19 pandemic sparked changes globally, as leaders scrambled to protect wellbeing and safety. With many U.S. students sent away from their campuses, undergraduate students still grappled with the time-old question: “what will I do after college,” except during an unprecedented time in history rife with heightened career uncertainty. This qualitative study presents the results of a survey administered as part of a mind–body health project conducted in the wake of the pandemic, speaking directly to undergraduate college students’ health-related career aspirations. Two open-ended survey questions—(1) what is your intended career, and (2) how (if at all) has the COVID-19 pandemic changed your perspective about your future career—were administered with thematic analysis conducted. Qualitative analysis using hybrid data and theory-driven approaches revealed several themes around an increased desire to work within health-related fields, decreased desire to work in healthcare, non-medical to medical career shift, and additional undecidedness. Connecting theory to practice, Super’s Life-Space, Life-Span Career Theory and Krumboltz’s Social Learning Theory of Career Decision-Making guide practical implications and grander discussion around career development during periods of crisis. Full article

Education-to-work transition among war-affected youth in post-conflict settings is fraught with challenges, not least compounded by the little attention placed on individual agency and mental health. This review examines the debate on war-affected youth skilling programmes in post-conflict settings, which neglect the roles of individual agency and mental health in the education-to-work transition. Building on Albert Bandura’s Self-Efficacy Theory (SET) and the Cumulative Stress Hypothesis (CSH), the review presents an integrated approach to skills development for improving education-to-work transition among war-affected youth. According to SET, the development of self-efficacy is anchored on enactive mastery, vicarious experience, verbal persuasion, and physiological arousal. Moreover, individual agency factors such as motivation, aspiration, goal orientation, active efforts, and alignment of intentions with skills are protective factors for effective education-to-work transition, but they are also eroded by the adverse consequences of violent conflicts. Similarly, the CSH also suggests that the effects of exposure to protracted violent conflicts are cumulative and may lead, in turn, to a plethora of mental health problems in the aftermath of violent conflicts. Mental health problems like depression, anxiety, and PTSD are linked to, inter alia, behaviours such as aggression, substance abuse, and apathy, all related to poor employment outcomes. To increase the employability of young people affected by war, skills training institutions and work settings need to prioritise the mental health and individual agency of the youth, as well as skills acquisition for specific trades. Consequently, we propose an integrated model of reintegrating war-affected and vulnerable youth anchored on professional technical and vocational skills training; recognition of individual agency; provision of mental and psychosocial support; and life skills training, all nested within the local economic realities. Full article

Background: Wolfram syndrome (WFS), also known as DIDMOAD, is a rare monogenic neurodegenerative disorder characterized by four key components: non-autoimmune insulin-dependent diabetes mellitus (DM), optic atrophy, sensorineural hearing loss, and diabetes insipidus. Although it significantly affects quality of life, gonadal dysfunction, particularly hypogonadism, remains underrecognized. Methods: In total, 45 patients (25 men, 20 women) with genetically confirmed WFS from a single tertiary-care center were prospectively followed to assess gonadal function. Men underwent hormonal evaluations, semen analysis, imaging tests, and testicular biopsies. In women, data on age at menarche, menstrual irregularities, and age at menopause were recorded. Hormonal analyses, including anti-Müllerian hormone (AMH) levels, and imaging tests were also conducted. Results: Hypogonadism was identified in 19 men (76.0%), of whom 17 (68.0%) had hypergonadotropic hypogonadism and 2 (8.0%) had hypogonadotropic hypogonadism. Testicular biopsies showed seminiferous tubule damage, Sertoli cell predominance, and reduced Leydig cells. Azoospermia was observed in 12 patients, whereas others presented with oligozoospermia, teratozoospermia, or asthenozoospermia. Most patients exhibited low testosterone levels along with elevated LH and FSH, suggesting primary testicular failure, except for two cases of hypogonadotropic hypogonadism. Correlations between biomarkers, onset age and severity have been analyzed and provide important insights regarding medical treatment. In women, menstrual irregularities were universal, with 20% experiencing premature menopause. Four patients had low AMH levels, with ovarian atrophy in three and a postmenopausal uterus in two, indicating early hypogonadism risk. Conclusions: Gonadal dysfunction is a significant yet overlooked feature of WFS, requiring systematic evaluation during puberty and beyond. Proper management is essential to mitigate metabolic disturbances and psychological impacts, including infertility distress, relationship challenges, and quality of life concerns. Addressing sexual health is crucial as WFS patients live longer and aspire to establish relationships or start families. Full article

Sets play a foundational role in organizing, understanding, and interacting with the world in our daily lives. They also play a critical role in the functioning and behavior of social robots and artificial intelligence systems, which are designed to interact with humans and their environments in meaningful and socially intelligent ways. A multitude of non-classical set theories emerged during the last half-century aspiring to supplement Cantor’s set theory, allowing sets to be true to the reality of life by supporting, for example, human imprecision and uncertainty. The aim of this paper is to continue this effort of introducing oSets, which are sets depending on the perception of their observers. Our main objective is to align set theory with human cognition and perceptual diversity. In this context, an accessible set is a class of objects for which perception is passive, i.e., it is independent of perception; otherwise, it is called an oSet, which cannot be known exactly with respect to its observers, but it can only be approximated by a family of sets representing the diversity of its perception. Thus, the new introduced membership function is a three-place predicate denoted ${\in }_i$, where the expression “$x{\in }_{i}X$” indicates that the “observer” i perceives the element x as belonging to the set X. The accessibility notion is related to perception and can be best summarized as follows: “to be accessible is to be perceived”, presenting a weaker stance than Berkeley’s idealism, which asserts that “to be is to be perceived”. Full article

Thyroid cancer (TC) invariably remains the most prevalent endocrine cancer in the world. Major histological forms of TC include papillary (PTC), follicular (FTC), medullary (MTC), and anaplastic thyroid carcinoma (ATC), each of which has a unique clinical and molecular profile. The incidence rate of TC is higher in females, and unfortunately, it has tended to increase over the last several years. Yet the treatment of advanced or aggressive TC forms has improved recently because of developments in immunotherapy and targeted medicines, including PD-1 inhibitors and tyrosine kinase inhibitors (e.g., lenvatinib, sorafenib). Imaging, fine-needle aspiration biopsies, and molecular testing are implemented in the diagnostic process, e.g., in search of mutations that might affect prognosis and provide the most successful treatment option. Chemotherapy, immunotherapy, radioactive iodine therapy (RAI), surgery (such as a total thyroidectomy), and molecularly targeted therapies are currently standard treatment modalities in TC. Optimizing patient outcomes requires better diagnostic precision and individualized treatment regimens based on the genetic profile and tumor subtype. To improve survival and quality of life, it is critical to comprehend the complex etiology of TC and the changing therapeutic landscape. Full article

Urban regeneration is pivotal to sustainable development, requiring innovative strategies that align social dynamics with spatial configurations. Traditional paradigms increasingly fail to tackle systemic challenges—neighborhood alienation, social fragmentation, and resource inequality—due to their inability to integrate human-centered spatial governance. This study addresses these shortcomings with a novel multidimensional framework that merges social perception (life satisfaction) analytics with spatial quality (GIS-based) assessment. At its core, we utilize geospatial and machine learning models, deploying an ensemble of Gradient Boosted Decision Trees (GBDT), Random Forest (RF), and multiscale geographically weighted regression (MGWR) to decode nonlinear socio-spatial interactions within Suzhou’s community environmental matrix. Our findings reveal critical intersections where residential density thresholds interact with commercial accessibility patterns and transport network configurations. Notably, we highlight the scale-dependent influence of educational proximity and healthcare distribution on community satisfaction, challenging conventional planning doctrines that rely on static buffer-zone models. Through rigorous spatial econometric modeling, this research uncovers three transformative insights: (1) Urban environment exerts a dominant influence on life satisfaction, accounting for 52.61% of the variance. Air quality emerges as a critical determinant, while factors such as proximity to educational institutions, healthcare facilities, and public landmarks exhibit nonlinear effects across spatial scales. (2) Housing price growth in Suzhou displays significant spatial clustering, with a Moran’s I of 0.130. Green space coverage positively correlates with price appreciation (β = 21.6919 ***), whereas floor area ratio exerts a negative impact (β = −4.1197 ***), highlighting the trade-offs between density and property value. (3) The MGWR model outperforms OLS in explaining housing price dynamics, achieving an R² of 0.5564 and an AICc of 11,601.1674. This suggests that MGWR captures 55.64% of pre- and post-pandemic price variations while better reflecting spatial heterogeneity. By merging community-expressed sentiment mapping with morphometric urban analysis, this interdisciplinary research pioneers a protocol for socio-spatial integrated urban transitions—one where algorithmic urbanism meets human-scale needs, not technological determinism. These findings recalibrate urban regeneration paradigms, demonstrating that data-driven socio-spatial integration is not a theoretical aspiration but an achievable governance reality. Full article