Search Results (3,554)

The Global Trade Alert (GTA) website, managed by the United Nations, releases a large number of industrial policy (IP) announcements daily. Recently, leading nations including the United States and China have increasingly turned to IPs to protect and promote their domestic corporate interests. They use both offensive and defensive tools such as tariffs, trade barriers, investment restrictions, and financial support measures. To evaluate how these policy announcements may affect national interests, many countries have implemented logistic regression models to automatically classify them as either IP or non-IP. This study proposes ensemble models—widely recognized for their superior performance in binary classification—as a more effective alternative. The random forest model (a bagging technique) and boosting methods (gradient boosting, XGBoost, and LightGBM) are proposed, and their performance is compared with that of logistic regression. For evaluation, a dataset of 2000 randomly selected policy documents was compiled and labeled by domain experts. Following data preprocessing, hyperparameter optimization was performed using the Optuna library in Python. To enhance model robustness, cross-validation was applied, and performance was evaluated using key metrics such as accuracy, precision, and recall. The analytical results demonstrate that ensemble models consistently outperform logistic regression in both baseline (default hyperparameters) and optimized configurations. Compared to logistic regression, LightGBM and random forest showed baseline accuracy improvements of 3.5% and 3.8%, respectively, with hyperparameter optimization yielding additional performance gains of 2.4–3.3% across ensemble methods. In particular, the analysis based on alternative performance indicators confirmed that the LightGBM and random forest models yielded the most reliable predictions. Full article

Work–family conflicts (WFCs) and family–work conflicts (FWCs) have been found to be important to worker morale and retention as well as family (as defined by the respondents) well-being, with particular importance within the military, as indicated by a number of studies in the United States, Canada, and European countries. However, few studies have focused on the impact of WFC and FWC for high ranking officers and their families. This study involved two samples of officers attending an advanced leadership course at Fort Leavenworth, Kansas, in 2007, featuring a total of 262 Army officers and another 45 officers from other services and countries. The sample of Army officers included 239 men (85.4% of whom were a parent) and 22 women (63.6% of whom were a parent; Fisher’s Exact Test, p < 0.02), with one missing case for sex. Of the men and women, respectively, most were married for the first time (190/11), with some never married (14/5), married but divorced (10/1), married/divorced/remarried (20/4), married/spouse died/remarried (1/0), married/divorced/remarried/divorced/remarried (4/0), and married/divorced/remarried/divorced/remarried (0/1). Measures for cohabitation or same-sex partnerships were not used. Two modified measures of WFC and FWC of four items each were tested and found to represent different factors and to have high internal consistency reliability. In general we found few sex differences, but female officers seemed to be more influenced by family–work conflict than male officers. One of our most substantial findings was that work–family conflict was more prevalent than family–work conflict within our sample. Also, we found that marital satisfaction tended to be higher than parental satisfaction and that officers usually found their own retention intentions to be higher than their perception of that of their spouses. Satisfaction with the military was consistently and strongly related to lower levels of work–family conflict while similar but weaker trends were found for family–work conflict. Most of our results were found to cross-validate with a subsample of non-Army officers in our sample. We found bias from marital social desirability to be lower for our marital process scale and for FWC than for marital satisfaction and WFC. In sum, our results confirm adverse effects of deployments and other stressors on military families and a continuing need for military support for families, even among higher ranking officer families. Full article

Background/Objectives: Pain is a common issue among patients undergoing hemodialysis (HD), and palliative care (PC) aims to improve their quality of life. This study investigates the incidence, nature, and treatment of pain in chronic HD patients in Hungary, along with factors influencing pain intensity and the benefits of PC. Methods: This study used a cross-sectional design involving 159 patients with chronic end-stage kidney disease (ESKD) receiving HD at the National Dialysis Center in Pécs, Hungary. Pain was assessed using a “PQRST” questionnaire, and statistical analyses were performed on clinical and laboratory data to identify potential pain triggers. We also reviewed the latest literature on PC for patients with ESKD undergoing HD. Results: Approximately 57% of patients reported pain, with 88% indicating moderate-to-severe pain levels. While 64% used regular pain medication, only 29% experienced complete pain relief. Non-pharmacological methods, along with adjuvant agents and strong notably different based on parathyroid opioids, were underutilized. Pain intensity was hormone (PTH) and C-reactive protein (CRP) levels. Key factors affecting pain included body mass index (BMI), hypertension (HT), diabetes mellitus (DM), and PTH levels. Research shows that PC is rarely used for patients on HD in many countries, despite being effective in managing symptoms. Conclusions: PC, along with pain assessment and multidisciplinary management, reduces the symptomatic burden for patients with ESKD. Effective management of mild pain should be handled by a nephrologist experienced in PC, while severe, therapy-resistant pain should be managed by PC specialists. Therefore, implementing PC is essential in the treatment of these patients. Full article

Background/Objectives: International physical activity (PA) questionnaires require a reliability and validity assessment in many countries to understand cross-cultural differences accurately. The current study examined the reliability and validity of the Japanese version of the WHO Health Behaviour in School-aged Children PA (HBSC-J) survey in adolescent students in Japan. Methods: The participants were 215 Japanese high school students. The HBSC-J was administered twice to measure reliability. The PA in the last week evaluated using the HBSC-J was compared with the PA evaluated using a triaxial accelerometer to measure the concurrent validity. Results: The intraclass correlation coefficients (ICCs) for reliability were 0.74 for the number of days, with 60 min/day or more of moderate-to-vigorous PA (MVPA). For the days with an MVPA of 60 min/day or more, ICCs were lower for girls (0.63 [0.49–0.74]) than boys (0.82 [0.75–0.87]). Positive correlations were observed between the accelerometry MVPA and the number of days, with at least 60 min/day of MVPA (r = 0.44). Conclusions: The HBSC-J questionnaire should be acceptable for evaluating MVPA in Japanese adolescents, with a reasonable reliability and validity. Full article

While international cross-listing locations in host countries have been identified as integral to firm valuation gains, the influence of the home country information environment on firm financial market integration remains underexplored. This study examined how political stability, government effectiveness, and voice and accountability influence cross-listing destination choices amongst emerging-market firms seeking enhanced valuation gains. Using data on cross-listed firms from BRICS countries between 2000 and 2020, the study employed generalized linear models (GLMs), including probit and robit specifications, to analyze this relationship. The researchers found that stronger political stability; government effectiveness; and voice and accountability in home countries significantly increase the likelihood of BRICS firms cross-listing on advanced exchanges characterized by higher valuation gains. These results indicate that reduced political risk, effective government policy implementation and greater media freedom in BRICS emerging market countries facilitate cross-listing firms’ access to more efficient global capital markets by reducing asymmetric information, and help overcome traditional market segmentation barriers. Contrary to the conventional emphasis that home country proximity is significant for cross-listing valuation gains, these results highlight the signaling mechanism of home country governance quality as an appealing factor for firm cross-listing location in advanced exchange markets. Policymakers in emerging markets should consider governance reforms that enhance domestic firm competitiveness in global financial markets for higher valuation gains. Full article

Background/Objectives: Multiple chronic conditions (MCCs) pose global health and social challenges, with caregiving often relying on family members, especially in low- and middle-income countries (LMICs). However, limited evidence exists regarding the factors influencing caregiver contribution (CC) to patient self-care among older adults with MCCs in these settings. Aim: The aim of this study was to examine the associations between caregivers’ and patients’ socio-demographic characteristics and patients’ clinical variables and the CC to patient self-care behaviors in adults with MCCs in an LMIC context. Methods: This multicenter, cross-sectional study included patient–caregiver dyads recruited from outpatient and community settings across Albania, between August 2020 and April 2021. CC was assessed using the Caregiver Contribution to Self-Care of Chronic Illness Inventory scale (CC-SCCII). Three multivariable linear regression models were used to explore associations with the three dimensions of CC to self-care maintenance, monitoring, and management. Results: Caregivers were mostly female, children, or spouses with a high level of education and employed. Patients were primarily female and had low education. Hypertension and diabetes were the most prevalent. Older and employed caregivers contributed less to CC to self-care maintenance, while higher education and caregiving experience increased it. Living with the patient and being a spouse reduced CC to self-care monitoring, whereas more caregiving hours and experience improved it. CC to self-care management was negatively influenced by cohabitation, presence of a second caregiver, and being a spouse, but improved with more caregiving hours. Conclusions: Socio-demographic and caregiving factors differently influence CC to self-care dimensions in older adults with MCCs in an LMIC. Tailored caregiver support programs are essential to enhance caregiver involvement and improve MCC patient outcomes in LMICs. Full article

The HIV-1 epidemic continues to challenge global public health, especially in sub-Saharan Africa. The rise in drug-resistant viruses, particularly pan-resistant strains, threatens treatment effectiveness, hindering progress toward UNAIDS viral suppression goals. This is critical in low-to-middle income countries (LMICs) like Zimbabwe, where treatment options and access to drug resistance testing are limited. This cross-sectional study analyzed 102 genotypes from patients with HIV-1 RNA ≥ 1000 copies/mL after at least 6 months on a dolutegravir (DTG)-based ART. HIV-1 genotyping and drug resistance interpretation were performed using the Stanford HIV Drug Resistance Database. Overall, 62% of genotypes harbored at least one drug resistance mutation, with 27% showing integrase strand transfer inhibitor (INSTI)-associated mutations. High-level resistance to DTG and cabotegravir was found in 14% and 23% of integrase sequences, respectively, primarily driven by G118R and E138K/T mutations. Pan-resistance was observed in 18% of complete genotypes, with one case of four class resistance. These results highlight the emergence of INSTI resistance in LMICs. The study underscores the urgent need for enhanced HIV drug resistance testing, continuous surveillance, and strategic optimization of ART regimens in resource-constrained settings to ensure effective HIV management. Full article

Recovery from disasters is the complex process requiring coordinated measures to restore infrastructure, services and quality of life. While remote sensing is a well-established means for damage assessment, so far very few studies have shown how satellite imagery can be used by technical officers of affected countries to provide crucial, up-to-date information to monitor the reconstruction progress and natural restoration. To address this gap, the present study proposes a multi-temporal observatory method relying on GIS, change detection techniques and open and free multi-sensor satellite imagery to generate thematic maps documenting, over time, the impact and recovery from hydrological disasters such as hurricanes, tropical storms and induced flooding. The demonstration is carried out with regard to Hurricane Matthew, which struck Haiti in October 2016 and triggered a humanitarian crisis in the Sud and Grand’Anse regions. Synthetic Aperture Radar (SAR) amplitude change detection techniques were applied to pre-, cross- and post-disaster Sentinel-1 image pairs from August 2016 to September 2020, while optical Sentinel-2 images were used for verification and land cover classification. With regard to inundated areas, the analysis allowed us to determine the needed time for water recession and rural plain areas to be reclaimed for agricultural exploitation. With regard to buildings, the cities of Jérémie and Les Cayes were not only the most impacted areas, but also were those where most reconstruction efforts were made. However, some instances of new settlements located in at-risk zones, and thus being susceptible to future hurricanes, were found. This result suggests that the thematic maps can support policy-makers and regulators in reducing risk and making the reconstruction more resilient. Finally, to evaluate the replicability of the proposed method, an example at a country-scale is discussed with regard to the June 2023 flooding event. Full article

Globally, orchard soils are facing multiple severe health issues. However, different countries and regions have adopted their own soil classification standards, making many studies only useful for improving soil health in local orchards but not widely applicable to other regions. This fragmentation highlights the urgent need for internationally comparable approaches to orchard soil health assessment. Furthermore, there are currently no unified standards for screening orchard soil health indicators or establishing comprehensive evaluation indices. Many proposed orchard soil health assessment frameworks lack practical applicability. This review introduces and compares several soil health assessment methods, critically analyzes their limitations, and explores directions for improvement in their application to orchards. Additionally, it addresses the primary challenges, currently and in the future, facing orchard soil health—climate change and emerging contaminants. This review also evaluates current orchard soil health management practices, focusing on their advantages and limitations. Finally, this paper offers recommendations for data acquisition and analysis in future orchard soil health assessment frameworks and encourages the establishment of a Decision-Making Platform for Soil Health with Cross-Border Cooperation and Feedback, thereby promoting a more globally consistent perspective on orchard soil health. Full article

Background and Objectives: Young people of all ages are now prematurely overexposed to a tech-addicted life, with negative psychological, physiological, sociological, and educational effects. Ease of access to and normalization of exposure to technology are indicated as the main causes of internet addiction and a mental health concern, especially in Romania, a country with widespread and easy access to the internet. Methods: This exploratory cross-sectional study with 132 participants investigated the relationship between emotional regulation difficulties (ERDs) and the risk of internet addiction (IA) among medical and technical students—two educational cultures defined by intense educational and emotional stress—with the aim of identifying specific patterns of variability. Standardized self-report data were collected, and specific descriptive and correlational statistical methods were used. Results: Key findings suggest similar moderate difficulty in emotional regulation for each student sample and normal-to-mild internet use for technical and medical students. A moderately strong Pearson correlation was observed between internet addiction and emotional regulation difficulties across the entire group of students (r = 0.54, p < 0.001). However, higher levels of emotional dysregulation and internet addiction risk were evident for the medical students. Conclusions: These results suggest that IA is closely linked to ERD rather than to the exposure to technology itself, as we presumed in the case of technical students. Moreover, medical students have a greater need for institutional support measures than their technical peers to cope with a highly challenging educational environment that exceeds individual levels of effective self-regulation. Full article

Background: Globally, uncorrected refractive errors are recognized as the primary cause of visual impairment and blindness. According to a report by the World Health Organization (WHO), providing spectacle lenses at an affordable cost remains a significant challenge, particularly for underprivileged populations in developing countries. This challenge contributes to the low compliance with spectacle wear worldwide. However, the benefits of wearing spectacles are influenced by the perceptions of the population regarding spectacle use. Methods: A quantitative, cross-sectional survey-based study was conducted at a superior educative center in Oman, the University of Buraimi. Participants were recruited from the four major colleges, namely, the College of Health Sciences (COHS), College of Business (COB), College of Engineering (COE), and College of Law (COL), and the Center for Foundation Studies (CFS). This study was conducted over the period from 18 December 2022 to 18 December 2023. Essential data were collected using an electronic questionnaire facilitated by the Google platform. The initial section of the questionnaire outlines this study’s objectives and its benefits to the community. The digital survey comprises three sections: the first section addresses the sociodemographic profile of the participants; the second section explores perceptions related to spectacles; and the third section examines visual symptoms associated with spectacle wear. In this study, a pre-tested survey was administered following consultation with a panel of three subject matter experts who reviewed the clarity and content validity of the test items. Data analyses were performed using descriptive statistics, and linear regression was applied to assess the effect of socioeconomic profile on perceptions of spectacles. Additionally, data entry, processing, and analysis were conducted using SPSS 25 software. The overall mean score for spectacle-related visual symptoms was 2.51 ± 0.75, indicating a moderate level of symptom occurrence. Results: A total of 415 participants (N = 415) were included in this study, comprising 133 males (32.0%) and 282 females (68.0%). The most prominent symptoms related to spectacle perception were “light sensitivity” and “eye pain”, with mean values of 3.03 ± 1.30 and 3.04 ± 1.25, respectively. Additionally, 249 participants (60%) reported moderate concern regarding spectacle-related visual symptoms. Among female participants, 118 (41.8%) exhibited little concern about visual symptoms associated with spectacle wear, whereas this was observed in 25.6% of male participants. Descriptive statistics indicated the mean perceived spectacle-related disadvantages score measured on a scale of 0 to 4 was 2.88 ± 1.16 (57.69% ± 23.15% in percentages), reflecting a moderate perception of such disadvantages. The linear regression model demonstrated statistical significance, as indicated by the likelihood ratio chi-square = 199.194 (df = 15, p < 0.001). The most significant predictor was study major (χ² = 72.922, p < 0.001). Conclusions: The present study indicates that undergraduate students generally exhibit a low perception of the disadvantages associated with wearing spectacles. Randomized sampling should be preferred in future studies to the convenience sampling technique. The most frequently reported visual symptoms include “light sensitivity and eye pain” among spectacle wearers. Therefore, it is imperative to implement health education programs and foundational studies across colleges to address these issues among undergraduate university students. Full article

Background/Objectives: Subjective well-being (SWB) in pre-adolescents declines with age due to rising school-related stress and boredom. Outdoor physical activity (PA) may mitigate these effects, yet age-specific associations remain understudied. This study investigated age differences in relationships between outdoor PA and school emotional well-being (stress and arguments) using multinational data. Methods: Cross-sectional secondary analysis of the International Survey of Children’s Well-Being (ISCWeB) third wave (2017–2019) involved 128,184 pre-adolescents (mean age 10.24 years, SD 1.70; 49.56% boys) from 35 countries, stratified by age (8, 10, 12 years). Outdoor PA was assessed on a 0–6 frequency scale; stress and arguments on 0–10 scales, with 8-year-olds’ responses harmonized from 5-point emoticons. Descriptive statistics and stratified Spearman correlations were calculated (p < 0.05). Results: Outdoor PA peaked at age 10 (mean 3.17, SD 1.62), while stress varied with age (mean 3.99, SD 0.50 at 8 years; 4.20, SD 2.50 at 12 years). Very small associations emerged: Weak negative stress correlations (r = −0.02 to −0.07, p ≤ 0.045; r² < 0.005) across ages, alongside positive argument associations (r = 0.03–0.08, p < 0.001). Conclusions: Outdoor PA modestly associates with lower stress in older pre-adolescents but may be associated with elevated peer conflicts. This dual effect adds nuance to interventions, highlighting supervision needs. Age-tailored, supervised school interventions could optimize emotional benefits during late pre-adolescence. Full article

Background: Caesarean section (CS) is a critical intervention, yet stark inequities in access persist across low- and middle-income countries (LMICs). Over the last decade, governments have introduced policies to eliminate or subsidize user fees; however, the collective impact of these initiatives on utilization, equity, and financial protection has not been fully synthesized. Methods: We conducted a systematic review in line with PRISMA 2020 guidelines. Searches were conducted in PubMed, Dimensions, Google Scholar, Scopus, Web of Science, and government portals for studies published between 1 January 2009 and 30 May 2025. Eligible studies evaluated government-initiated financing reforms, including full user-fee exemptions, partial subsidies, vouchers, insurance schemes, and provider-payment restructuring. Two reviewers independently applied the PICOS criteria, extracted data using a 15-item template, and assessed the study quality. Given heterogeneity, results were synthesized narratively. Results: Thirty-seven studies from 28 LMICs were included. Most (70%) evaluated fee exemptions. Mixed-methods and cross-sectional designs predominated, while only six studies employed interrupted time series designs. Twenty-two evaluations (59%) reported increased CS uptake, ranging from a 1.4-fold rise in Senegal to a threefold increase in Kano State, Nigeria. Similar surges were also observed in non-African contexts such as Iran and Georgia, where reforms included incentives for vaginal delivery or punitive tariffs to curb overuse. Fourteen of 26 fee-exemption studies documented pro-rich or pro-urban drift, while catastrophic expenditure persisted for 12–43% of households, despite the implementation of “free” policies. Median out-of-pocket costs ranged from USD 14 in Burkina Faso to nearly USD 300 in Dakar’s slums. Only one study linked reforms to a reduction in neonatal mortality (a 30% decrease in Mali/Benin), while none demonstrated an impact on maternal mortality. Qualitative evidence highlighted hidden costs, delayed reimbursements, and weak accountability. At the same time, China and Bangladesh demonstrated how demographic reforms or voucher schemes could inadvertently lead to CS overuse or expose gaps in service readiness. Conclusions: Government-led financing reforms consistently increased CS volumes but fell short of ensuring equity, financial protection, or sustained quality. Effective initiatives combined fee removal with investments in surgical capacity, timely reimbursement, and transparent accountability. Future CS policies must integrate real-time monitoring of equity and quality and adopt robust quasi-experimental designs to enable mid-course correction. Full article

This study presents a bibliometric and thematic analysis of economic convergence analysis from 1982 to 2025, based on a corpus of 2924 Scopus-indexed articles. Using VOSviewer and the bibliometrix R package, this research maps the field’s intellectual structure, identifying five main thematic clusters: (1) formal statistical models, (2) institutional-contextual approaches, (3) theoretical–statistical foundations, (4) nonlinear historical dynamics, and (5) normative and policy assessments. These reflect a shift from descriptive to explanatory and prescriptive frameworks, with growing integration of sustainability, spatial analysis, and institutional factors. The most productive journals include Journal of Econometrics (121 articles), Applied Economics (117), and Journal of Cleaner Production (81), while seminal contributions by Quah, Im et al., and Levin et al. anchor the co-citation network. International collaboration is significant, with 25.99% of publications involving cross-country co-authorship, particularly in European and North American networks. The field has grown at a compound annual rate of 14.4%, accelerating after 2000 and peaking in 2022–2024, indicating sustained academic interest. These findings highlight the maturation of convergence analysis as a multidisciplinary domain. Practically, this study underscores the value of composite indicators and spatial econometric models for monitoring regional, environmental, and technological convergence—offering policymakers tools for inclusive growth, climate resilience, and innovation strategies. Moreover, the emergence of clusters around sustainability and digital transformation reveals fertile ground for future research at the intersection of transitions in energy, digital, and institutional domains and sustainable development (a broader sense of structural change). Full article

This study investigates whether digital economy imports can mitigate the environmental costs of foreign direct investment (FDI) in developing economies. While FDI typically increases carbon emissions, particularly in countries with weak infrastructure and limited technological capabilities, digital imports can provide a compensatory mechanism by enhancing energy efficiency, facilitating the diffusion of green technologies, and strengthening environmental regulations. Our contribution lies in shifting the focus from domestic “digitalization levels” to cross-border digital absorption as a moderating factor in environmental relations. Furthermore, this paper proposes a compensation mechanism for developing countries’ digital economy imports, explaining how they can mitigate environmental costs associated with FDI by alleviating structural constraints such as inadequate infrastructure and limited technological capabilities. The findings indicate that while FDI inflows exacerbate carbon emissions, digital economy imports play a new moderating role by addressing structural deficiencies in developing economies. This study advances the debate on FDI and the environment, revealing the short-term environmental value of digital economy imports. Full article