Search Results (6,393)

Background: The role of vitamin D deficiency (VDD) in both mothers and neonates has been suggested as a possible factor in the development of allergic conditions in early infancy, however limited research has investigated this link in relation to allergic rhinitis (AR). This study investigates whether VDD in the mother–newborn dyad is associated with the onset of AR in neonates within the first three days after birth. The aim is to contribute to the understanding of neonatal allergic outcomes related to vitamin D status, which may inform future preventive strategies. This study investigates the role of vitamin D in the early onset of allergic rhinitis (AR) in neonates, specifically within the first three days of life. Although AR typically develops after years of allergen exposure and is rare in children under two, we aimed to explore its occurrence at this early stage. While no clear link was found between vitamin D and early AR onset, further research is needed to explore vitamin D levels at later ages and over longer time frames to clarify the relationship. Methods: A cross-sectional study was conducted between September 2019 and January 2022 in a single hospital. The study involved 248 infants born at ≥37 weeks of gestation and their mothers, who were of Greek nationality. The study included mother–infant pairs who met the inclusion criteria. Chi-square tests were applied to analyze the association between maternal or neonatal VDD and the presence of AR in neonates within the first three days after birth. In addition, multiple regression analysis was used to control other potential factors contributing to AR. Results: The results showed an unclear relationship between VDD and the onset of AR in neonates within the first three days of life. Although several factors were analyzed, the effect of VDD on the development of AR remained unclear. Conclusions: The findings highlight the lack of clarity regarding the effect of maternal and neonatal VDD on the incidence of AR in the immediate neonatal period. Few studies to date have specifically examined the role of VDD in neonatal AR. Further research with larger sample sizes is needed to verify these associations and to guide potential interventions aimed at reducing allergic outcomes in neonates. Full article

Background and aim: During the past few decades, the aging population has increased. With aging, there is an increase in functional limitations. The aim of this study was to analyze sociodemographic factors associated with physical functioning impairment in elderly males and females. Methods: This population-based modeling study based on a data from a third national study of health of Serbian inhabitants from 2013 in Serbia included 3540 elderly participants 65 years of age and above from Serbia. Physical functioning for both genders was categorized as follows: PF1—walking half a kilometer on level ground without the assistance of any mobility aids and PF2—walking up or down 12 steps. Modeling of physical functioning for both genders was categorized as follows: Model 1: inability to perform PF1, Model 2: some/a lot of difficulty in performing PF1, Model 3: inability to perform PF2, and Model 4: some/a lot of difficulty in performing PF2. Further variables were evaluated: age, education level, marital status, body mass index (BMI), wealth index, and place of residence. Logistic regression was performed to identify the variables that are factors associated with PF1 and PF2 in elderly males and females. Results: Statistically significant factors were as follows: age (Model 1 (male OR: 2.591; female OR: 4.708); Model 2 (male OR: 1.791; female OR: 2.354); Model 3 (male OR: 2.386; female OR: 4.985); Model 4 (male OR: 1.883; female OR: 2.772)); BMI (Model 2 (female OR: 1.348); Model 4 (female OR: 1.329)), marital status (Model 2 (female OR: 0.713); Model 4 (male OR: 0.688)); education level (Model 1 (male OR: 0.626; female OR: 0.537); Model 2 (male OR: 0.811; female OR: 0.653); Model 3 (male OR: 0.697; female OR: 0.494); Model 4 (male OR: 0.784; female OR: 0.639)); wealth index (Model 2 (male OR: 0.823; female OR: 0.740); Model 3 (male OR: 0.724); Model 4 (male OR: 0.787; female OR: 0.731)); and place of residence (Model 1 (female OR: 1.704); Model 3 (female OR: 1.575)). Conclusions: Increased age, being single, a lower education level, and a lower wealth index were factors associated with functional disability in the elderly of both genders, while an increased BMI and living in another place than a city were factors associated with functional disability in elderly females. Specific social strategies bearing in mind possible gender differences should be created and implemented in order to optimize the physical functioning, mobility, and participation of the elderly. Full article

Dengue has emerged as a significant global health threat. Despite decades of research, only two dengue vaccines—CYD-TDV (Dengvaxia) and TAK-003 (Qdenga)—have been licensed to date, with limited implementation. This paper explores and outlines strategies for integrating dengue vaccines into routine immunization programs, particularly in high-burden regions. TAK-003, a tetravalent live-attenuated vaccine, has demonstrated 61% efficacy against virologically confirmed dengue and 84% efficacy against hospitalizations in endemic settings. However, concerns remain about vaccine-enhanced disease, particularly among seronegative individuals exposed to DENV3 and DENV4. WHO recommends targeted introduction in high-transmission settings without pre-vaccination screening, while ongoing post-introduction studies will further clarify long-term safety and efficacy. Effective vaccine rollout requires a multi-pronged approach, including school-based immunization, integration with adolescent health services, and strong community engagement. Decision-making for vaccine introduction should be guided by National Immunization Technical Advisory Groups (NITAGs), local epidemiological data, and cost-effectiveness assessments. While future vaccines, including mRNA and virus-like particle candidates, are under development, optimizing the use of currently available vaccines is crucial to reducing dengue’s public health impact. Given the continued rise in cases, immediate action—combining vaccination with vector control—is essential to prevent further morbidity and mortality. Full article

Ecological security is integral to national security strategies, making the construction of ecological security patterns essential for mitigating ecological risks. However, predictive research on ecological security patterns (ESPs) remains limited. This study integrates the Patch-generating Land Use Simulation (PLUS) model with ecological security pattern analysis to provide scientific insights into spatial governance and optimization in the Poyang Lake Ecological and Economic Zone (PLEEZ). First, the PLUS model simulated land use changes in 2030 under three scenarios: natural development (ND), economic development (ED), and ecological protection (EP). Based on these projections, ecological security patterns were constructed using the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model, the Morphological Spatial Pattern Analysis (MSPA) method, Conefor 2.6, the Minimum Cumulative Resistance (MCR) model, and resistance theory. The results indicate: (1) 19, 18, and 21 ecological source areas were identified under different scenarios, covering 6093.16 km², 5973.21 km², and 6702.56 km², respectively, with 9, 8, and 10 important source sites, primarily in the north. (2) 37, 35, and 43 ecological corridors were delineated, exhibiting a spiderweb-like distribution. (3) 94, 62, and 107 ecological pinch points and 116, 121, and 104 ecological barrier points were detected. The Ecological Node Aggregation Area was identified as a critical zone for targeted ecological protection and restoration. Finally, the ecological zoning management strategy of “Four Cores, Two Zones, and One Belt” was proposed. This study offers valuable insights for sustainable land use planning and ecological risk mitigation. Full article

Against the backdrop of the steady advancement of the national rural revitalization strategy and the dual-carbon goals, the low-carbon transformation of rural energy systems is of critical importance. This study first proposes a comprehensive architecture for rural energy supply systems, incorporating four key dimensions: investment, system configuration, user demand, and policy support. Leveraging the abundant wind, solar, and biomass resources available in rural areas, a low-carbon optimization model for rural energy system operation is developed. The model accounts for diverse load characteristics and the integration of elevated water towers, which serve both energy storage and agricultural functions. The optimization framework targets the multi-energy demands of rural production and daily life—including electricity, heating, cooling, and gas—and incorporates the stochastic nature of wind and solar generation. To address renewable energy uncertainty, the Fisher optimal segmentation method is employed to extract representative scenarios. A representative rural region in China is used as the case study, and the system’s performance is evaluated across multiple scenarios using the Gurobi solver. The objective functions include maximizing clean energy benefits and minimizing carbon emissions. Within the system, flexible resources participate in demand response based on their specific response characteristics, thereby enhancing the overall decarbonization level. The energy storage aggregator improves renewable energy utilization and gains economic returns by charging and discharging surplus wind and solar power. The elevated water tower contributes to renewable energy absorption by storing and releasing water, while also supporting irrigation via a drip system. The simulation results demonstrate that the proposed clean energy system and its associated operational strategy significantly enhance the low-carbon performance of rural energy consumption while improving the economic efficiency of the energy system. Full article

Emerging evidence indicates that large-scale forest restoration exhibits dual hydrological effects: direct reduction of local water availability through elevated evapotranspiration (ET) and indirect augmentation of water resources via enhanced atmospheric moisture recycling. However, the quantitative assessment of these counteracting effects remains challenging due to the limited observational constraints on moisture transport. Here, we integrate the Budyko model with the Lagrangian-based UTrack moisture-tracking dataset to disentangle the direct (via ET) and indirect (via precipitation) large-scale hydrological impacts of China’s four-decade forest restoration campaign across eight major river basins. Multisource validation datasets, including gauged runoff records, hydrological reanalysis products, and satellite-derived forest cover maps, were systematically incorporated to verify the Budyko model at the nested spatial scales. Our scenario analyses reveal that during 1980–2015, extensive afforestation individually reduced China’s terrestrial water yield by −28 ± 25 mm yr⁻¹ through dominant ET increases. Crucially, atmospheric moisture recycling mechanisms attenuated this water loss by 12 ± 5 mm yr⁻¹ nationally, with marked spatial heterogeneity across the basins. In some moisture-limited watersheds in the Yellow River Basin, the negative ET effect was compensated for to a certain extent by precipitation recycling, demonstrating net positive hydrological outcomes. We conclude that China’s forest expansion imposes local water stress (direct effect) by elevating ET, while the concomitant strengthening of continental-scale moisture recycling generates compensatory water gains (indirect effect). These findings advance the mechanistic understanding of the vegetation-climate-water nexus, providing quantitative references for optimizing forestation strategies under atmospheric water connectivity constraints. Full article

Outpatient parenteral antimicrobial therapy (OPAT) is increasingly used to manage a broad range of infections, enabling patients to receive intravenous antibiotics safely outside inpatient settings. In this review, we examine the current landscape of OPAT practice across the United Kingdom (UK), assessing its clinical, economic, and operational impact. The benefits of OPAT for patients and the National Health Service (NHS), as well as its associated risks, are discussed. Additionally, we explore the challenges hindering its broader implementation within the UK. Finally, we highlight recent innovations and emerging applications of OPAT relevant to the NHS, underscoring key considerations for its future expansion and emphasising the need for a nationally coordinated strategy to realise its full potential. Full article

With the rapid development of society and technology, the physical health of university students has become a critical concern, influencing both individual well-being and the national talent pool. This study employs an improved K-means algorithm integrated with machine learning models to analyze university students’ fitness data and develop personalized health intervention strategies. The enhanced K-means algorithm overcomes the limitations of traditional clustering approaches, leading to improved clustering accuracy and stability. Machine learning models—including Random Forest, decision trees, Gradient Boosting Trees, and logistic regression—were utilized to validate the clustering outcomes and to identify key health indicators associated with different student groups. Based on the clustering and model analysis, targeted intervention programs are proposed, such as strength training for groups with low muscular explosiveness, endurance training for those with stamina deficiencies, and flexibility exercises for groups exhibiting limited mobility. This integrated analytical framework provides a scientifically grounded tool for comprehensive health assessments and offers actionable, data-driven recommendations for student health management. Future research will focus on optimizing algorithmic performance, enhancing data diversity, and broadening the application scope to further improve the effectiveness and feasibility of health interventions. Full article

The 2012 Emilia earthquake highlighted the vulnerability of fortified architecture. Based on the observed seismic behaviors, this research proposes a GIS geodatabase, designed with a proactive approach, for the prediction and prevention—at a territorial scale—of the most frequent damage mechanisms of the investigated typology. The designed geo-database allows for the identification of possible correlations between constructive features and the occurrence of damage, through statistical and geo-referenced analysis. Moreover, the designed geodatabase, by enabling the comparison of the damage level data with the seismic action of the site, through INGV (National Institute of Geophysics and Volcanology) shakemaps, allowed the definition of experimental fragility curves, for three of the most common damage mechanisms. By applying these functions to castles in the province of Parma, it was possible to define future seismic risk scenarios for the mechanisms considered, thanks to the use of the seismic hazard map. Therefore, the described methodology could be functional to identify the most urgent and high-priority interventions in order to optimize the management of economic resources. The final aim is to promote the application of the concept of minimum intervention, and more in general to preserve the architectural heritage, avoiding emergency interventions and aiming instead to apply planned conservation strategies. Full article

Background/Objectives: This study examines trends in appendectomy utilization in US emergency departments (EDs) from 2012 to 2021 using National Emergency Department Sample (NEDS) data. The objective is to explore appendectomy frequency, appendicitis management, disease progression, and resource distribution in EDs. A predictive model was developed to forecast trends from 2022 to 2032, aiming to improve patient outcomes and support operational planning in EDs. Methods: A cross-sectional analysis was conducted using NEDS data from 2012 to 2021. Appendectomy trends were assessed in four ways: first, comparing the total number of appendectomies with total ED visits to determine relative frequencies; second, comparing trends in Complicated Appendicitis (CA) and Uncomplicated Appendicitis (UA) patients; third, categorizing each appendicitis type based on clinical complications and comorbidities; and finally, using a linear regression model to predict trends through 2032. Results: During the study period, the overall appendectomy rate decreased, while the proportion of patients with Complicated Appendicitis rose. Appendectomies in patients without complications or comorbidities showed a decline, while those in patients with complications or comorbidities increased. Predictive modeling suggests that trends in all subgroups will continue to rise until 2032. Conclusions: This study highlights evolving appendicitis management trends in EDs. The results advocate for fast-track appendectomy pathways and better resource allocation to enhance efficiency, reduce complications, and improve patient care. These findings assist healthcare systems in preparing for ED throughput challenges and refining surgical management strategies. Full article

Imitating nature’s mechanisms has enormous potential to improve our lives and tools. Biomimetics emulates nature’s proven patterns and strategies to develop novel solutions widely applied in various fields. This study aims to propose an overall perspective and research direction for innovation using biomimetics. Using text network analysis and topic modeling, we analyzed the evolution of 5202 Korean R&D projects in biomimetics. The results indicate significant interdisciplinary collaborations between bioengineering, drug development, polymer chemistry, and robotics. Moreover, biomimetic national R&D has primarily focused on fundamental research and its trends reveal interconnection with topic clusters around intelligent robotics, biomedical engineering, and materials science. This study provides guidelines for governments and R&D organizations to establish biomimetic R&D plans and select convergence topics for innovation. Full article

The transition to clean energy is at the heart of the European Union’s climate strategy, with citizen participation promoted as a key driver. Clean energy communities (CECs) are central to this vision, yet their uptake across Europe remains limited. This study provides a novel comparative perspective on perceived barriers to CEC participation by examining two distinct groups: current members (early adopters) and the general public (potential adopters). Using a cross-national mixed-methods approach, we integrate data from semi-structured interviews with CEC members and a representative survey of citizens in six European countries. The results show that awareness of CECs is generally low and that initiatives are still in the early stages of adoption. While interviewees highlighted regulatory complexity and institutional barriers, survey respondents were more likely to cite lack of awareness, knowledge gaps, and financial concerns. The findings reveal distinct patterns in perceived barriers across adopter groups and national contexts. To support broader engagement, we propose a dual strategy: addressing structural challenges through regulatory and policy reform, while strengthening targeted communication and outreach. We also highlight the role of early adopters as trusted messengers who can help bridge the gap between innovation and mainstream adoption. Full article

Background/Objectives: Efficient postoperative recovery room care in pediatric patients is crucial for optimizing perioperative safety, patient outcome, and effective pain management. However, this area is frequently underemphasized, leading to higher complication rates compared to the operating room, which in turn increases healthcare costs. Improving pediatric recovery room care offers a significant opportunity to enhance the quality and safety of perioperative pediatric care. From an economic perspective, this is prudent; however, more importantly, every child has the right to the highest attainable standard of health, as outlined by the United Nations. Key aspects of recovery room care include ensuring adequate staffing and equipment, while also prioritizing the child’s privacy and parental presence, both of which are crucial for enhancing patient well-being. A +multimodal approach to postoperative pain management is essential for minimizing fear and stress, alongside strict adherence to established guidelines for the management of postoperative nausea, vomiting, and emergence delirium. Furthermore, addressing risk factors such as hypothermia and airway complications, as well as promoting early intake of clear fluids, plays a crucial role in optimizing pediatric recovery. Organizational strategies such as quality improvement initiatives, structured handovers, standardized care protocols with checklists, continuous staff training, and well-defined discharge criteria are further essential components to reduce translational gaps and to enhance postoperative pediatric safety. Conclusions: Improving pediatric postoperative anesthetic care is a multifaceted challenge for all healthcare providers that can significantly enhance care quality and safety while also reducing costs. Success in this area requires addressing both structural and medical factors. Full article

This study aimed to develop a strategic management model for the agricultural sector to effectively reduce greenhouse gas emissions in the future, primarily focusing on increasing agricultural waste. This study was built upon a model known as the Path Analysis with Simultaneous Equation System based on Full Information Maximum-Likelihood (Path-SFIML) Model, which has been thoroughly validated for its validity, measurement of model fit, and absence of spurious results. The findings revealed that the environmental sector is with the has low capacity to readjust to equilibrium, requiring thousands of years to recover. Therefore, this study proposes a new policy scenario for urgent national management through scenario planning. Based on the research results, the key indicators identified for scenario planning include clean technology, waste biomass, organic waste treatments, and renewable energy. These indicators must be prioritized to effectively manage the increase in agricultural waste. This study demonstrates that implementing these measures would reduce the growth rate of agricultural waste to 30.38% (2037/2018) and decrease the growth rate of greenhouse gas emissions to 36.20% (2037/2018). These rates remain within the national safety threshold, which is set at 1302 Gg CO₂e. This study also derived strategic guidelines from stakeholders to enhance the dissemination of research findings and address gaps in quantitative research, enabling more appropriate strategy formulation. It was found that the key approach to defining the new scenario policy in this research is suitable but requires improvements in criminal law, administrative law, and environmental law to ensure they are relevant and enforceable in the present context. Hence, the 20 Year National Strategy must urgently adopt this critical tool for decision-making to achieve sustainable green environmental goals. Full article

Amid global economic transformation, a persistent productivity gap exists between developed and developing nations in agriculture sector, shaped by technological advancements and shifting resource allocation patterns. Agricultural socialized services (ASS), defined as organized systems providing technical support, mechanization assistance, information services, market linkages, and resource optimization to farmers, have emerged as critical mechanisms for agricultural development. In developing economies, these services catalyze gains in agricultural labor productivity through the integration of advanced technologies and the mechanization of farming practices. Using panel data from 30 Chinese provinces during 2011 to 2022, this study investigates the relationship between ASS and ALP, focusing on regional heterogeneity, threshold effects, and spatial spillovers. The combination of spatial econometric methods and threshold analysis was selected for its unique capacity to capture both the geographic interdependencies and nonlinear relationships that characterize agricultural development processes. These thresholds at 5.254 and 8.478 represent critical points where the impact of ASS on ALP significantly changes in magnitude, revealing a nonlinear relationship that evolves across different stages of agricultural development. The study highlights notable regional disparities in the impact of ASS. Specifically, ASS is more effective on ALP in eastern, central and key food-producing regions, while its impact is relatively weak in western and non-food-producing regions. Spatial spillover analysis indicates that advancements in ASS create positive externalities, extending beyond their immediate implementation zones and facilitating inter-provincial agricultural cooperation and development. These findings provide crucial guidance for policymakers and agricultural service providers to optimize resource allocation and service delivery strategies. By identifying critical development thresholds and regional variations, this research offers evidence-based support for government officials designing targeted agricultural policies and enterprises developing region-specific service models to foster sustainable agricultural growth across diverse regional landscapes. Full article