Search Results (1,457)

Background: Cervical cancer poses a threat to the health of women globally. Adolescent girls are the primary target population for HPV vaccination, and guardians’ attitude towards the HPV vaccine plays a significant role in determining the vaccination status among adolescent girls. Objectives: This study aimed to explore the factors influencing guardians’ HPV vaccine acceptance for their girls and provide clues for the development of health intervention strategies. Methods: Combining the health belief model as a theoretical framework, a questionnaire-based survey was conducted. A total of 2157 adolescent girls and their guardians were recruited. The multivariable logistic model was applied to explore associated factors. Results: The guardians had a high HPV vaccine acceptance rate (86.7%) for their girls, and they demonstrated a relatively good level of awareness regarding HPV and HPV vaccines. Factors influencing guardians’ HPV vaccine acceptance for girls included guardians’ education background (OR = 0.57, 95%CI = 0.37–0.87), family income (OR = 1.94, 95%CI = 1.14–3.32), risk of HPV infection (OR = 3.15, 95%CI = 1.40–7.10) or importance of the HPV vaccine for their girls (OR = 6.70, 95%CI = 1.61–27.83), vaccination status surrounding them (OR = 2.03, 95%CI = 1.41–2.92), awareness of negative information about HPV vaccines (OR = 0.59, 95%CI = 0.43–0.82), and recommendations from medical staff (OR = 2.32, 95%CI = 1.65–3.25). Also, guardians preferred to get digital information on vaccines via government or CDC platforms, WeChat platforms, and medical knowledge platforms. Conclusions: Though HPV vaccine willingness was high among Chinese guardians, they preferred to vaccinate their daughters at the age of 17–18 years, later than WHO’s recommended optimal age period (9–14 years old), coupled with safety concerns. Future work should be conducted based on these findings to explore digital intervention effects on girls’ vaccination compliance. Full article

Acromegaly is caused by an excessive secretion of growth hormone and the secondary elevation of IGF-1 levels, leading to progressive changes in multiple body systems, including the craniofacial region and oral cavity. Dental manifestations such as mandibular overgrowth, macroglossia, malocclusion, periodontal disease, and prosthetic difficulties represent not only a clinical component of the disease but also a significant therapeutic and diagnostic challenge. The aim of this review is to present the current state of knowledge on the relationship between acromegaly and oral health and to analyze the role of interdisciplinary collaboration between endocrinologists and dentists in patient care. For this narrative review, a literature search was conducted in the PubMed, Scopus, and Web of Science databases covering the period from 2000 to 2025. Sixty-two peer-reviewed publications meeting the methodological and thematic criteria were included in the analysis, including original studies, meta-analyses, systematic reviews, and case reports. The results indicate significant correlations between disease activity and the severity of periodontal and microbiological changes, while effective endocrine treatment only results in the partial regression of morphological changes. Particular attention was given to the role of the dentist in recognizing the early symptoms of the disease, planning prosthetic and surgical treatment, and monitoring therapy-related complications. Interdisciplinary collaboration models, including integrated clinics and co-managed care, were also described as optimal systemic solutions for improving treatment quality. The conclusion drawn from the analysis are as follows: there is a need for the permanent integration of dentistry into the standard of interdisciplinary care for patients with acromegaly, in both diagnostic and therapeutic dimensions. Increasing awareness among dentists and developing integrated collaboration models may reduce the time to diagnosis, improve patients’ quality of life, and enable the more effective management of craniofacial complications in the course of this rare disease. Full article

In lace textile manufacturing, the dyeing process in parallel machine environments faces challenges from sequence-dependent setup times due to color family transitions, machine eligibility constraints based on weight capacities, and probabilistic re-dyeing operations arising from quality inspection failures, which often lead to increased tardiness. To tackle this multi-constrained problem, a stochastic integer programming model is formulated to minimize total estimated tardiness. A novel symmetry-driven two-population collaborative differential evolution (TCDE) algorithm is then proposed. It features two symmetrically complementary subpopulations that achieve a balance between global exploration and local exploitation. One subpopulation employs chaotic parameter adaptation through a logistic map for symmetrically enhanced exploration, while the other adjusts parameters based on population diversity and convergence speed to facilitate symmetry-aware exploitation. Moreover, it also incorporates a symmetrical collaborative mechanism that includes the periodic migration of top individuals between subpopulations, along with elite-set guidance, to enhance both population diversity and convergence efficiency. Extensive computational experiments were conducted on 21 small-scale (optimally validated via CVX) and 15 large-scale synthetic datasets, as well as 21 small-scale (similarly validated) and 20 large-scale industrial datasets. These experiments demonstrate that TCDE significantly outperforms state-of-the-art comparative methods. Ablation studies also further verify the critical role of its symmetry-based components, with computational results confirming its superiority in solving the considered problem. Full article

Strengthening climate resilience constitutes a foundational approach through which cities adapt to climate change and mitigate associated environmental risks. However, research on the influence of economic policy environments on climate resilience remains limited. Guided by institutional theory and dynamic capability theory, this study employs a panel dataset comprising 272 Chinese cities at the prefecture level and above, covering the period from 2009 to 2023. It constructs a composite index framework for evaluating the green business environment (GBE) and urban climate resilience (UCR) using the entropy weight method. Employing a two-way fixed-effect regression model, it examined the impact of GBE optimization on UCR empirically and also explored the underlying mechanisms. The results show that improvements in the GBE significantly enhance UCR, with green innovation (GI) in technology functioning as an intermediary mechanism within this relationship. Moreover, climate policy uncertainty (CPU) exerts a moderating effect along this transmission pathway: on the one hand, it amplifies the beneficial effect of the GBE on GI; on the other hand, it hampers the transformation of GI into improved GBEs. The former effect dominates, indicating that optimizing the GBE becomes particularly critical for enhancing UCR under high CPU. To eliminate potential endogenous issues, this paper adopts a two-stage regression model based on the instrumental variable method (2SLS). The above conclusion still holds after undergoing a series of robustness tests. This study reveals the mechanism by which a GBE enhances its growth through GI. By incorporating CPU as a heterogeneous factor, the findings suggest that governments should balance policy incentives with environmental regulations in climate resilience governance. Furthermore, maintaining awareness of the risks stemming from climate policy volatility is of critical importance. By providing a stable and supportive institutional environment, governments can foster steady progress in green innovation and comprehensively improve urban adaptive capacity to climate change. Full article

Objectives: Anisakidosis is an emerging, cosmopolitan, and underdiagnosed parasitic disease caused by the accidental ingestion of third-stage anisakid larvae when consuming raw or improperly prepared seafood. Within hours to days of consuming infected raw seafood, patients may develop acute gastrointestinal symptoms including pain, nausea, vomiting, diarrhea and/or constipation, as live anisakid larvae attach to the gastric, or more rarely, the intestinal mucosa. Cases have been reported in which the nematodes succeed at migrating from the stomach upwards to the esophagus and then the oral cavity. Therefore, the purpose of the present literature review is to collect, analyze, summarize and present the relevant epidemiological, clinical, diagnostic, parasitological, therapeutic, and prognostic data concerning anisakidosis localized inside the oral cavity. Methods: An electronic search of the PubMed, Scopus, and Ovid databases was performed with them being accessed for the last time on 29 March 2025. Results: The present literature review identified 13 individual case reports of oral mucosa anisakidosis, which were published in the period 1971–2022. Conclusions: Our review aims to summarize the relevant epidemiological, clinical, diagnostic, parasitological, therapeutic, and prognostic data regarding the oral localization of anisakidosis, a helminthic infection caused by the accidental ingestion of live anisakid larvae and which manifests mainly with gastrointestinal symptoms. Its localization in the oral mucosa appears to be exceptionally rare and, in most cases, occurs with a characteristic clinical picture, defined by the onset of acute mouth or throat pain immediately after the consumption of raw seafood and by the observation of one or more larvae, either lying on or penetrating the oral mucosa. Despite its rarity, dental health professionals and other clinicians should be aware of this disease and the possibility of its intraoral localization, since environmental factors on the one hand, and the adoption of foreign dietary habits on the other, will likely make anisakidosis a much more common disease worldwide in the near future. Full article

In an era where digitalization shapes economic and social landscapes, the intersection of digital skills, ethics, and integrity plays a crucial role in understanding the vulnerability of youth classified as NEET (Not in Education, Employment, or Training). This study explores how risky internet use and digital skill gaps contribute to socio-economic exclusion, integrating a multivariate and spatial approach to assess regional disparities in Europe. This study adopts a systems thinking perspective to explore digital exclusion as an emergent outcome of multiple interrelated subsystems. The research employs logistic regression, Principal Component Analysis (PCA) with Promax rotation, and Geographic Information Systems (GIS) to examine the impact of digital behaviors on NEET status. Using Eurostat data aggregated at the country level for the period (2000–2023) across 28 European countries, this study evaluates 24 digital indicators covering social media usage, instant messaging, daily internet access, data protection awareness, and digital literacy levels. The findings reveal that low digital skills significantly increase the likelihood of being NEET, while excessive social media and internet use show mixed effects depending on socio-economic context. A strong negative correlation between digital security practices and NEET status suggests that youths with a higher awareness of online risks are less prone to socio-economic exclusion. The GIS analysis highlights regional disparities, where countries with limited digital access and lower literacy levels exhibit higher NEET rates. Digital exclusion is not merely a technological issue but a multidimensional socio-economic challenge. To reduce the NEET rate, policies must focus on enhancing digital skills, fostering online security awareness, and addressing regional disparities. Integrating GIS methods allows for the identification of territorial clusters with heightened digital vulnerabilities, guiding targeted interventions for improving youth employability in the digital economy. Full article

Fragile X syndrome (FXS) is the most common form of X-linked intellectual disability (ID). This study aimed to share 30 years of experience in diagnosing FXS and determine its frequency in Thailand. We retrospectively reviewed 1480 unrelated patients (1390 males and 90 females) with ID, developmental delay, or autism spectrum disorder, or individuals referred for FXS DNA testing at Songklanagarind Hospital, Thailand, over a 30-year period. The samples were analyzed using cytogenetic methods, PCR-based techniques, and/or Southern blot analysis. Full mutations (>200 CGG repeats) were identified in 100 males (7.2%) and three females (3.3%). An intermediate allele was detected in one male, while no premutation was found in the index cases. Two males were suspected to have FMR1 gene deletions. Twelve families underwent prenatal testing during this study. Most families undergoing prenatal FXS diagnosis involved mothers who were premutation carriers and had given birth to children affected by FXS. This study represents the largest series of molecular genetic FXS testing cases reported in Thailand. The frequency of FXS identified in different cohorts of Thai patients across various periods was approximately 7%. This study enhances public awareness of at-risk populations and highlights the importance of prenatal testing and genetic counseling for vulnerable families. Full article

Background: Cardiac involvement is common in Fabry disease (FD) and typically manifests with left ventricular hypertrophy (LVH). Patients with FD are frequently misdiagnosed, and this is mainly related to the lack of disease awareness among clinicians. The aim of this study was to determine whether providing a targeted educational intervention on FD may enhance FD diagnosis. Methods. This research was designed as a single-arm before-and-after intervention study and evaluated the impact of providing a specific training on FD to cardiologists from different Italian centers, without experience in rare diseases. In the 12-month period after the educational intervention, the rate of FD screening and diagnosis was assessed and compared with those conducted in the two years preceding the study initiation. Results: Fifteen cardiologists participated to this study, receiving a theoretical and practical training on FD. In the two previous two years, they conducted 12 FD screening (6/year), and they did not detect any cases of FD. After the training, they performed 45 FD screenings, with an eight-fold rise in the annual screening rate. The screened population (age: 61 ± 11 years, men: 82%) was mainly composed of patients with unexplained LVH (n = 43). There were four new FD diagnoses and, among of them, three had a late-onset GLA variant. After the cascade genetic screening, 11 affected relatives and 8 heterozygous carriers were also detected. Conclusions: A targeted educational intervention for cardiologists allowed the identification of four new families with FD. Enhancing FD awareness is helpful to reduce the diagnostic and therapeutic delay. Full article

Self-medication is a subject of global importance. If practiced responsibly, self-medication represents a part of self-care or positive care of an individual or a community in promoting their own health. However, today’s practices of self-medication are often inappropriate and irresponsible, and as such appear all over the world. Inappropriate self-medication can be connected with possible serious health risks and consequences. Therefore, it represents a global health issue. It can even generate additional health problems, which will eventually become a burden to healthcare systems and can induce significant costs, which also raises socioeconomic concerns. Hence, self-medication attracts the attention of researchers and practitioners globally in efforts to clarify the current status and define feasible measures that should be implemented to address this issue. This narrative review aims to give an overview of the situation in the field of self-medication globally, including current practices and attitudes, as well as implications for actions needed to improve this problem. A PubMed/MEDLINE search was conducted for articles published in the period from 1995 up to March 2025 using keywords “self-medication” or “selfmedication” alone or in combinations with terms related to specific subthemes related to self-medication, such as COVID-19, antimicrobials, healthcare professionals, and storing habits of medicines at home. Studies were included if self-medication was their main focus. Publications that only mentioned self-medication in different contexts, but not as their main focus, were excluded. Considering the outcomes of research on self-medication in various contexts, increasing awareness of responsible self-medication through education and informing, together with surveillance of particular medicines and populations, could lead to more appropriate and beneficial self-medication in the future. Full article

The eastern North Pacific Ocean coastline (from the Salish Sea to the western Aleutian Islands) is highly glaciated with relic sediment deposits scattered throughout a highly contoured and variable bathymetry. Oceanographic conditions feature strong currents and tidal exchange. Sand wave fields are prominent features within these glaciated shorelines and provide critical habitat to sand lance (Ammodytes spp.). Despite an awareness of the importance of these benthic habitats, attributes related to their structure and characteristics remain undocumented. We explored the micro-bathymetric morphology of a subtidal sand wave field known to be a consistent habitat for sand lance. We calculated geomorphic attributes of the bedform habitat, analyzed sediment composition, and measured oceanographic properties of the associated water column. This feature has a streamlined teardrop form, tapered in the direction of the predominant tidal current. Consistent flow paths along the long axis contribute to well-defined and maintained bedform morphology and margin. Distinct patterns in amplitude and period of sand waves were documented. Strong tidal exchange has resulted in well-sorted medium-to-coarse-grained sediments with coarser sediments, including gravel and cobble, within wave troughs. Extensive mixing related to tidal currents results in a highly oxygenated water column, even to depths of 80 m. Our analysis provides unique insights into the physical characteristics that define high-quality habitat for these fish. Further work is needed to identify, enumerate, and map the presence and relative quality of these benthic habitats and to characterize the oceanographic properties that maintain these benthic habitats over time. Full article

This study focuses on surface wind analysis at the small regional airport in Svidnik, used primarily for pilot training under daytime VFR conditions. Due to the complex local terrain and lack of prior meteorological data, an automatic weather station was installed, collecting over 208,000 wind measurements over a two-year period at ten-minute intervals. The dataset was processed using hierarchical filtering and statistical selection, and visualized via wind rose diagrams. The results confirmed a dominant southeastern wind component, supporting the current runway orientation (01/19). However, a less frequent easterly wind direction was identified as a safety concern, causing turbulence near the runway due to terrain and vegetation. This is particularly critical for trainee pilots during final approach and landing. Statistical analysis showed that easterly winds, though less common, appear year-round with a peak in summer. Pearson correlation and linear regression confirmed a significant relationship between the number of easterly wind days and their measurement frequency. Daytime winds were stronger than nighttime, justifying the focus on daylight data. The study provides practical recommendations for training flight safety and highlights the value of localized wind monitoring at small airports. The presented methodology offers a framework for improving operational awareness and reducing risk in complex environments. Full article

Using LULC change detection analysis, it is possible to identify changes due to urbanization, deforestation, or a natural disaster in an area. As population growth and urbanization increase, real-time solutions for the effects of urbanization on land use are required to assess its implications for food security and livelihood. This study seeks to identify and quantify recent LULC changes in Limbe, Cameroon, and to measure rates of conversion between agricultural, forest, and urban lands between 1986 and 2020 using remote sensing and GIS. Also, there is a deficiency of research employing these data to evaluate the efficiency of LULC satellite data and a lack of awareness by local stakeholders regarding the impact on LULC change. The changes were identified in four classes utilizing maximum supervised classification in ENVI and ArcGIS environments. The classification result reveals that the 2020 image has the highest overall accuracy of 94.6 while the 2002 image has an overall accuracy of 89.2%. The overall gain for agriculture was approximately 4.6 km², urban had an overall gain of nearly 12.7 km², while the overall loss for forest was −16.9 km² during this period. Much of the land area previously occupied by forest is declining as pressures for urban areas and new settlements increase. This study’s findings have significant policy implications for sustainable land use and food security. It also provides a spatial method for monitoring LULC variations that can be used as a framework by stakeholders who are interested in environmentally conscious development and sustainable land use practices. Full article

Background and Objectives: Long-acting cabotegravir and rilpivirine (LA-CAB/RPV) offers an alternative to daily oral antiretroviral therapy (ART) for people living with HIV (PLWH). Although LA-CAB/RPV has been approved in Turkey, the country remains in the pre-rollout period, and national data on patient perspectives are lacking. This is the first nationwide study from Turkey, a setting of increasing HIV incidence, assessing PLWH perspectives on switching to LA-CAB/RPV and the influence of motivational factors on treatment preferences. Materials and Methods: A prospective, multicenter, cross-sectional study was conducted across 11 HIV treatment centers representing all regions of Turkey. Virologically suppressed PLWH meeting current eligibility criteria for LA-CAB/RPV were included. Treatment preferences (switch to LA-CAB/RPV or remain on oral ART) and five anticipated motivational domains, namely perceived efficacy, safety, convenience, privacy, and cost, were systematically assessed through structured, face-to-face interviews. Results: Among 200 eligible participants, 86% (n = 172) preferred switching to LA-CAB/RPV. In all subgroups, LA-CAB/RPV was preferred over oral ART, except for those with no formal literacy. Prior awareness of LA-CAB/RPV was significantly associated with the switching preference (p < 0.001), with healthcare providers being the most common source of information, at 45.5% (n = 172) (p < 0.001). Residential proximity to the healthcare center (p = 0.018) and all motivational factors significantly influenced the preference (p < 0.05). Notably, when participants who initially chose to remain on oral ART were asked whether they would reconsider switching if injections were administered every six months, overall preference for long-acting therapy increased from 86% to 98%. Conclusions: High clinical eligibility and strong acceptability for LA-CAB/RPV were observed among Turkish PLWH. Our findings demonstrate that structured motivational factors significantly influence the treatment preference. Addressing these patient-centered factors and logistical barriers may support the successful integration of long-acting therapies into routine HIV care. Future longer-interval agents may improve patient-centered acceptability. Full article

Modern heritage (MH) is a key component of our built environment; however, it currently lacks widespread recognition and a clear, universally accepted definition, placing it in an emerging phase. This category of heritage, understood within the context of modernisation processes and the changes characteristic of the late modern period, remains underrepresented and warrants further study. The objective of this article is to fill the identified research gap, thereby fostering awareness of MH, improving its accessibility and enhancing its visibility and appreciation. It offers a diagnostic analysis of the corpus on MH through the design and development of a concrete methodology, which is transferable to the other heritage categories. This study reveals insights into the present understanding of the term ‘Modern Heritage’ and its relevance within an international framework. This understanding prompts a reflection on the terminology used to describe this concept, which serves not only as a significant result in itself but also as a foundation for future research. Despite the close association of modern heritage with the 20th century, this research identifies a cross-cutting nature that needs to be recognised, encompassing a wide range of periods, themes and typologies in this category. Full article

In order to fulfill the commitment to the “dual carbon goal” at an early date, China has implemented a series of carbon control policies. However, the actual impact of these policy combinations on green innovation in Chinese cities remains unknown. Taking the implementation of the low-carbon pilot policy (LCP) and the carbon emission trading pilot policy (CET) as the research opportunity, this paper uses panel data from 276 prefecture-level cities and a multiple-period difference-in-differences (DID) model to explore the impact of carbon control policy combination on green innovation in China and their mechanisms. The results indicate the following: A single LCP or CET can significantly boost green innovation. However, the impact of cross-tool carbon control policy combination on green innovation is notably greater than that of a single policy, with a trend of increasing effectiveness over time. Even after a series of robustness tests, this conclusion remains valid. Heterogeneity analysis shows that the promotion effect is more significant in the eastern region and high-level administrative cities. The policy combination incentivizes green innovation through fiscal technology expenditure and public environmental awareness, focusing more on fostering strategic green innovation. Consequently, the Chinese government should tailor policy combinations to specific contexts, expand their implementation judiciously, and consistently drive forward green innovation. Full article