Search Results (13,324)

Background: This study investigates the global burden of early-onset bladder cancer (EOBC) from 1990 to 2021, highlighting regional disparities and the growing role of metabolic risk factors. Early-onset bladder cancer (EOBC), diagnosed before age 50, is an emerging global health concern. While less common than kidney cancer, EOBC contributes substantially to mortality and disability-adjusted life years (DALYs), with marked sex disparities. Its global epidemiology remains unassessed systematically. Methods: Using GBD 1990–2021 data, we analyzed EOBC incidence, prevalence, mortality, and DALYs across 204 countries in individuals aged 15–49. Trends were examined via segmented regression, EAPC, and Bayesian age-period-cohort modeling. Inequality was quantified using SII and CI. Decomposition and SDI-efficiency frontier analyses were introduced. Results: From 1990 to 2021, EOBC incidence rose 62.2%, prevalence 73.1%, deaths 15.3%, and DALYs 15.8%. Middle-SDI regions bore the highest burden. Aging drove trends in high-SDI areas and population growth in low-SDI regions. Over 25% of high-SDI countries underperformed in incidence/prevalence control. Smoking remained the leading risk factor, with rising hyperglycemia burdens in high-income areas. Males carried over twice the female burden, peaking at age 45–49. Conclusions: EOBC shows sustained global growth with middle-aged concentration and significant regional disparities. Structural inefficiencies highlight the need for enhanced screening, early warning, and tailored resource allocation. Full article

Objective: This study aims to investigate the dietary assessment and trends of preschoolers aged 3 to 5 years in Korea from 2012 to 2021 and to provide basic data for early childhood dietary education and policy development. Methods: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2012 to 2021 were analyzed for 2510 children in the 3–5 age group. Dietary intake was assessed using a 24 h recall. Intakes of food groups, dishes, and nutrients were calculated, and trends across years were tested using generalized linear models adjusted for gender, age, household income, energy intake, mother’s age, and mother’s education. Results: Over the tenyear period, intakes of carbohydrates, phosphorus, iron, sodium, potassium, carotene, thiamine, niacin, and vitamin C, as well as the carbohydrate energy ratio, showed significant declines. Meanwhile, protein, fat, retinol, and riboflavin increased, as did the protein and fat energy ratios. Fruit intake decreased by approximately 42 g among food group intakes. Analysis of foods contributing to total food intake revealed that milk, white rice, apples, and eggs consistently accounted for a high proportion of total intake in all survey years. Average calcium intake was approximately 100 mg below the estimated average requirement. Conclusions: The results of this study showed that preschoolers exhibit insufficient intake of certain nutrients, such as calcium, and a decrease in fruit intake. Interventions are needed to establish regular meal patterns, promote plant food intake such as fruit, and improve calcium intake. These results provide valuable evidence for designing dietary education programs and dietary guidelines tailored to early childhood. Full article

As global agriculture seeks to reconcile the dual imperatives of food security and environmental sustainability, this study examines the role of Internet access in promoting green agricultural production, specifically by reducing fertilizer and pesticide use. Using a panel dataset from 16 rural fixed observation points in Henan Province from 2009 to 2022, we find that Internet access significantly lowers per-unit farmland expenditures on fertilizers and pesticides by 6.0% and 7.3%, respectively. Mechanism analysis reveals that these positive effects operate through three main channels: improved information accessibility delivers timely agricultural data and guides input decisions; enhanced technical learning efficiency reduces barriers to adopting green technologies; and stronger market connectivity via e-commerce platforms shortens supply chains and provides price incentives. Heterogeneity analysis further identifies more pronounced effects among farmers with higher human capital (higher education, better health, younger age), higher production capital (greater mechanization, larger farmland, stronger decision-making capacity), lower livelihood capital (lower income, lower consumption, less communication expenditure), and higher spatial capital (residing in urban suburbs, poverty registration villages, and traditional villages). This study provides micro evidence for digital technology to empower sustainable agricultural development and provides policy implications for building a sustainable agri-food system. Full article

This study examines the relationship between national open educational resource (OER) policies and Sustainable Development Goal 4 (SDG4) outcomes across 187 countries between 2015 and 2024, with particular attention to the moderating role of artificial intelligence (AI) readiness. Despite widespread optimism about digital technologies as catalysts for universal education, systematic evidence linking formal OER policy frameworks to measurable improvements in educational access and completion remains limited. The analysis employs fixed effects and difference-in-differences estimation strategies using an unbalanced panel dataset comprising 435 country-year observations. The research investigates how OER policies associate with primary completion rates and out-of-school rates while testing whether these relationships depend on countries’ technological and institutional capacity for advanced technology deployment. The findings reveal that AI readiness demonstrates consistent positive associations with educational outcomes, with a ten-point increase in the readiness index corresponding to approximately 0.46 percentage point improvements in primary completion rates and 0.31 percentage point reductions in out-of-school rates across fixed effects specifications. The difference-in-differences analysis indicates that OER-adopting countries experienced completion rate increases averaging 0.52 percentage points relative to non-adopting countries in the post-2020 period, though this estimate remains statistically imprecise (p equals 0.440), preventing definitive causal conclusions. Interaction effects between policies and readiness yield consistently positive coefficients across specifications, but these associations similarly fail to achieve conventional significance thresholds given sample size constraints and limited within-country variation. While the directional patterns align with theoretical expectations that policy effectiveness depends on digital capacity, the evidence should be characterized as suggestive rather than conclusive. These findings represent preliminary assessment of policies in early implementation stages. Most frameworks were adopted between 2019 and 2022, providing observation windows of two to five years before data collection ended in 2024. This timeline proves insufficient for educational system transformations to fully materialize in aggregate indicators, as primary education cycles span six to eight years and implementation processes operate gradually through sequential stages of content development, teacher training, and institutional adaptation. The analysis captures policy impacts during formation rather than at equilibrium, establishing baseline patterns that require extended longitudinal observation for definitive evaluation. High-income countries demonstrate interaction coefficients between policies and readiness that approach marginal statistical significance (p less than 0.10), while low-income subsamples show coefficients near zero with wide confidence intervals. These patterns suggest that OER frameworks function as complementary interventions whose effectiveness depends critically on enabling infrastructure including digital connectivity, governance quality, technical workforce capacity, and innovation ecosystems. The results carry important implications for how countries sequence educational technology reforms and how international development organizations design technical assistance programs. The evidence cautions against uniform policy recommendations across diverse contexts, indicating that countries at different stages of digital development require fundamentally different strategies that coordinate policy adoption with foundational capacity building. However, the modest short-term effects and statistical imprecision observed here should not be interpreted as evidence of policy ineffectiveness, but rather as confirmation that immediate transformation is unlikely given implementation complexities and temporal constraints. The study contributes systematic cross-national evidence on aggregate policy associations while highlighting the conditional nature of educational technology effectiveness and establishing the need for continued longitudinal research as policies mature beyond the early implementation phase captured in this analysis. Full article

The overlapping circulation of influenza (Flu), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; SC2), and respiratory syncytial virus (RSV) continues to challenge clinical laboratories, particularly in settings with limited automation and fragmented healthcare coverage. This study expanded the CDC Flu-SC2 assay by incorporating a laboratory-developed test (LDT) for RSV A/B detection into a fully automated quadruplex RT-qPCR (LDRA) on the Panther Fusion^® Open Access™ system. The design, based on more than 8000 RSV genomic sequences targeting the conserved M gene, achieved optimal amplification efficiencies (97–105%) and full multiplex compatibility. Analytical assessment established limits of detection between 9.6 and 37.8 copies per reaction, absence of cross-reactivity with 30 respiratory pathogens, and inclusivity for 32 viral variants. Commutability and diagnostic performance among the LDRA, CE IVD-marked Allplex™ SARS-CoV-2/FluA/FluB/RSV, and US IVD-marked Panther Fusion^® SARS-CoV-2/Flu A/B/RSV Assays were evaluated using 405 nasopharyngeal UTM-preserved swabs. The LDRA demonstrated excellent concordance (overall agreement ≥ 98%, κ > 0.95), strong diagnostic accuracy, and reliable detection of mixed infections. This quadruplex provides a fully automated, rapid, and accurate solution for the simultaneous detection of influenza A, influenza B, SARS-CoV-2, and RSV viruses, enhancing molecular diagnostic capacity and supporting equitable, timely clinical decision-making in middle-income healthcare systems such as that of the Dominican Republic. Full article

This study examines how Green Human Resource Management (GHRM) is linked to sustainable organizational performance, encompassing environmental, economic, and social outcomes through the capability-building mechanisms of green innovation (GI) and green organizational culture (GOCL) in emerging manufacturing systems. Drawing on the Resource-Based View and capability-based sustainability perspectives, GHRM is conceptualized as a strategic organizational capability that enables firms in developing economies to beyond short-term regulatory compliance toward measurable and integrated sustainability performance outcomes. Survey data were collected from 446 managerial and technical respondents in Ethiopia’s garment and textile industrial parks, one of Africa’s fastest-growing industrial sectors facing significant sustainability challenges. Using Partial Least Squares Structural Equation Modeling (PLS-SEM) with bootstrapping-based mediation analysis, the results show that GHRM is positively associated with sustainable organizational performance, with GI and GOCL operating as key mediating mechanisms that translate HR-related practices into measurable sustainability outcomes. The findings highlight the role of GHRM in strengthening firms’ adaptive and developmental sustainability capabilities by fostering pro-sustainability mindsets and innovation-oriented behaviors, which are particularly critical in resource-constrained and weak-institutional contexts. The study contributes to sustainability and management literature by explicitly linking Green HRM to triple-bottom-line performance through a capability-building framework and by providing rare firm-level empirical evidence from a low-income emerging economy. Practically, the results provide guidance for managers and policy makers to design, monitor, and evaluate HRM systems that intentionally cultivate human, cultural, and innovative capabilities to support long-term organizational sustainability transitions. Full article

Background/Objective: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have received widespread attention as effective obesity treatments. However, limited research has examined the perspectives of patients contemplating GLP-1RAs. This study explored perceptions, motivations, and barriers among individuals considering GLP-1RA therapy for obesity treatment, with the goal of informing patient-centered care and enhancing clinician engagement. Methods: Adults completed surveys and interviews between June and November 2025. In this pragmatic mixed-methods study, both survey and interview questions explored perceived benefits, barriers, and decision-making processes. Qualitative data, describing themes based on the Health Belief Model, were analyzed using Dedoose (version 9.0.107), and quantitative data were analyzed using SAS (version 9.4). Participant characteristics included marital status, income, educational attainment, employment status, insurance status, age, race/ethnicity, and sex. Anticipated length on GLP-1RA medication and selected self-reported health conditions (depression, anxiety, hypertension, heart disease, back pain, joint pain), reported physical activity level, and perceived weight loss competency were also recorded. Results: Among the 31 non-diabetic participants who were considering GLP-1RA medication for weight loss, cost emerged as the most significant barrier. Life course events, particularly (peri)menopause among women over 44, were commonly cited as contributors to weight gain. Participants expressed uncertainty about eligibility, long-term safety, and treatment expectations. Communication gaps were evident, as few participants initiated discussions and clinician outreach was rare, reflecting limited awareness and discomfort around the topic. Conclusions: Findings highlight that individuals considering GLP-1RA therapy face multifaceted emotional, financial, and informational barriers. Proactive, empathetic clinician engagement, through validation of prior efforts, clear communication of risks and benefits, and correction of misconceptions, can support informed decision-making and align treatment with patient goals. Full article

Background: Studies on the association between cognitive and physical fitness in older adults from particularly vulnerable settings are scarce. This study aims to analyse the relationship between different protocols for assessing physical fitness and the cognitive function of low-income older adults. Methods: A total of 312 adults aged 60–96 years (M age = 72.63, SD= 7.81) living in the urban area of Amazonas, Brazil, participated in the study. The following measures of physical fitness were assessed: body composition, handgrip strength, the Five Times Sit-to-Stand Test and Senior Fitness Tests. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Linear regression models were used to analyse the relationship between physical function measures and cognitive function. Results: For men, only the 30-chair stand test power (β = 0.33, p < 0.001) presented favourable association with cognitive function. For women, significant associations between MMSE score were observed for every fitness test, except for the chair sit-and-reach test. Conclusions: Physical fitness is differently associated with cognitive function among low-income older men and women from Amazonas. Muscular fitness particularly seems to be an important indicator of cognitive function. It should be considered for monitoring, promoting, and managing health-ageing of low-income elderly populations of both sexes. Full article

Infrared spectroscopic analysis of palygorskite clay from the Dashkovskoye and Borshchevskoye deposits yielded key insights into the sedimentation conditions prevailing in the study area. In this paper, the composition, structure, and adsorption properties of smectite–palygorskite clays from the Steshevian sub-stage of the Lower Carboniferous (Russia) are investigated. The study applied X-ray diffraction, infrared spectroscopy, scanning electron microscopy, assessment of cation exchange capacity by adsorption of [Cu(trien)²⁺], assessment of Cs sorption, and particle size analysis. It is demonstrated that the Al–palygorskite of the Dashkovskoye deposit was formed by sedimentation from suspended matter in a shallow-water basin in the Steshevian sub-age, despite a different genesis (chemogenic in the case of the palygorskites, clastic/redeposited in the case of the smectites). The palygorskites of the Borschovskoye deposit have a complex terrigenous genesis and were formed from redeposited chemogenic Al–palygorskites transported into the basin from the surrounding region of the Dashkovskoye deposit. With increasing depth of the basin in the Steshevian sub-age, the volume of incoming palygorskite material decreases, and the proportion of smectite material increases. The Fe–palygorskites entered the Borschovskoye deposit due to the redeposition of sediments from soils upstream of water flows. All the studied clays have considerable adsorption properties (32–49 mg-eq/100 g) and can be used in various industries. Full article

Access to ecologically grown, nutritious food remains limited in low-income U.S. communities due to cost, structural inequities, and the dominance of industrial food systems. Stone Barns Center’s Leading an Ecological and Accessible Food System (LEAF) program—developed through a community-based participatory partnership in the South Bronx—aims to address these challenges through biweekly distributions of regeneratively grown produce, seasonal gardening kits, and culturally responsive nutrition education. This study presents findings from the first two years (2023 and 2024) of a multi-timepoint repeated cross-sectional evaluation using six household-level surveys (n = 79–80 families per round). The surveys captured changes in fruit and vegetable consumption, gardening comfort, emotional well-being, participation in SNAP and WIC programs, food purchasing behaviors, and unmet needs. Statistically significant (p < 0.05) improvements were observed across key outcomes: mean fruit and vegetable intake increased from 3.8 to 4.5 (1–5 scale), comfort with growing food increased from 3.1 to 4.6, emotional response to gardening from 4.1 to 4.6. SNAP participation increased from 15% (12 of 79 households) to 33% (26 of 79 households), and purchasing shifted toward local access points. Notably, 99% (79 of 80 households) of Year 1 families returned for Year 2, reflecting strong engagement and trust. These results highlight the potential of integrated, community-partnered, and climate-aligned interventions to advance health equity, ecological literacy, and food justice. The LEAF program offers a replicable model that may support pathways towards more sustainable and community-aligned food systems in other under-resourced settings. Full article

In African countries and many developing countries, communal farmers rely on livestock such as cattle, goats, and sheep to support food security, income, and agricultural activities. Fertility in these animals is often limited by poor semen quality, which reduces sperm concentration, total motility, and morphology. Assisted reproductive biotechnologies, including semen cryopreservation and artificial insemination, are increasingly essential to enhance reproductive efficiency and productivity. Although cryopreservation preserves valuable genetic material, it can damage sperm cells, making high-quality extenders critical for protection. Common extenders, such as Tris-egg yolk glucose, citrate-sugar-based, and skimmed milk solutions, supply nutrients and protect sperm membranes. To further minimize oxidative stress, antioxidants are incorporated, with growing interest in plant-derived compounds. Many plants contain bioactive substances, including antioxidants and phytomelatonin, which can enhance sperm quality safely and effectively. This review examines the use of plant-based antioxidants during semen cryopreservation and highlights their potential to improve fertility in mammalian livestock. Full article

This study examines the potential implications of the EU–Mercosur free trade agreement for the Polish horticultural sector, with particular emphasis on sustainability, trade competitiveness, and structural complementarities between the regions. Drawing on production, trade, and demographic data for the EU, Poland, and Mercosur countries, the analysis evaluates the alignment of horticultural supply and demand structures, the degree of intra-industry exchange, and the economic conditions shaping bilateral trade. The research applies the Grubel–Lloyd index and a Poisson Pseudo-Maximum Likelihood (PPML) gravity model to assess the determinants of Poland’s horticultural exports to Mercosur. The results indicate that trade remains predominantly inter-industry, reflecting substantial differences in agricultural specialisation and regulatory frameworks. At the same time, rising income levels in Mercosur, together with selected product-level complementarities, indicate emerging export opportunities for Poland. Poland’s trade with the Southern Common Market remains mainly as inter-industry, with the greatest export potential concentrated in high-value-added processed goods. Divergent sustainability standards, particularly in pesticide use, environmental regulation, and carbon-intensive transport, pose structural challenges that may affect the competitiveness and environmental footprint of expanded trade. Overall, the findings provide evidence that closer integration with Mercosur may support export diversification, but requires careful alignment with the EU’s sustainability objectives to ensure resilient and environmentally responsible development of the horticultural sector. Full article

Reducing urban–rural income inequality is a central objective of sustainable development and a critical challenge for inclusive growth in emerging economies. This study examines the impact of the digital economy on urban–rural income inequality in China. Using panel data across 279 cities in China and Chinese Household Income Project (CHIP) data, we find that the digital economy significantly widens urban–rural income inequality. Specifically, digital industries and innovations are the main drivers, contrasting with inclusive infrastructure. Although we observe a positive association between the digital economy and educational attainment among rural residents, such improvements do not appear to be fully translated into higher income. One possible explanation is that the digital economy is more effective in alleviating skill mismatch among urban residents than among their rural counterparts. Finally, our results suggest that Public Employment Services may help mitigate this negative effect through channels such as fiscal subsidies and improving skills training accessibility. Our findings highlight the need for caution regarding the inequality implications of digital economy development in emerging economies and underscore the crucial role of institutional arrangements in promoting socially sustainable and inclusive development. Full article

Electric vehicles (EVs) are widely promoted as a key strategy for reducing carbon dioxide (CO₂) emissions and advancing sustainable development. However, the real-world benefits of EV adoption may vary across countries with different income levels and energy systems. This study investigates the relationship between EV adoption and CO₂ emissions per capita, as well as overall sustainable development performance (SDG Index), across 50 countries from 2010 to 2023. Using panel quantile regression, we find that EV adoption is significantly associated with reduced CO₂ emissions particularly in the high-emitting countries in high-income countries (interaction coefficient at the 90th quantile = −0.24, p < 0.05) but positively associated with emissions in lower- and middle-income countries at lower quantiles of the emissions distribution. Similarly, while EV adoption correlates positively with the SDG Index in high-income countries, it shows negative effects at the median and several quantiles. These findings challenge the “zero-emission” assumption and demonstrate that the climate and development benefits of EV diffusion are context-dependent and unevenly distributed, highlighting the need for policies that link electrification to renewable energy deployment, infrastructure development, and equitable access. Full article

Social media addiction (SMA) and social phobia (SP) are significant adolescent mental health concerns. In Saudi Arabia, despite high social media penetration, the association between these two constructs remains under-researched, particularly in the Aseer region. This cross-sectional study, conducted from January to March 2025, recruited 384 Saudi adolescents aged 11–19 from schools in the Aseer region using multistage cluster sampling. Participants completed validated self-report measures, including the Social Phobia Inventory (SPIN) and the Al-Menayes Social Media Addiction Scale. A refined “Core SMA” subscale was created based on expert consensus criteria to enhance measurement precision. The prevalence of moderate-to-severe social phobia was 15.6%. A significant, moderate positive correlation emerged between SP and SMA (Spearman’s ρ = 0.294, p < 0.001). After adjusting for age, gender, and family income, adolescents with moderate social phobia had 2.15 times the odds of probable SMA compared to those with no SP (adjusted odds ratio [AOR] = 2.15, 95% CI: 1.15–4.04, p < 0.05), and this effect was more pronounced for those with severe social phobia (AOR = 2.56, 95% CI: 1.04–6.30, p < 0.05). This study demonstrates a clear relationship between social phobia severity and social media addiction among Saudi adolescents in the Aseer region. These findings support the urgent need for integrated mental health and digital literacy interventions that proactively screen for both conditions. Full article