Search Results (5,275)

Background/Objectives: Worldwide, millions of infants under 6 months are at increased risk of poor growth and development, illness, and death. We investigated the coherence of global policy characteristics, vulnerability, and continuity of care, which guides the care of vulnerable infants under 6 months and their mothers. Methods: We conducted a scoping review according to PRISMA-ScR guidance. We included English publications with no time limit, applicable to low- and middle-income countries, sourced through Google Scholar, contacts, WHO and UNICEF databases, global networks, and agency websites. The search was conducted from August 2023 to February 2024. We identified 34 documents for review. We categorised policies into guidelines, namely, WHO evidence-based recommendations and multi-source guidance documents with implementation details. We consolidated 49 vulnerability descriptors into 28 vulnerability factors and four sub-groups. We did not assess policy quality. Results: We found rich but fragmented global policy guidance. Multiple terminologies create superficial differences and mask important ones. Growth appraisal was mostly limited to nutrition-oriented guidance and was lacking in health-centric documents. Continuity of care lacked scope and depth. WHO policies are out of sync with each other and the latest evidence on mortality risk markers. WHO procedures need to accommodate non-UN documents to leverage existing guidance potential. A living policy system to manage evidence-to-policy processes and policy interactions is needed. The WHO-INTEGRATE evidence for decision frameworks could help country-led adaptations, system-sensitive global support, and WHO methodological development. Conclusions: There are immediate opportunities for interdisciplinary policy cooperation. Action is urgently needed to secure coherent evidence-based policies for equitable and effective care. Full article

Breast cancer remains a leading cause of global cancer burden, with marked differences in incidence across countries. While biological risk factors are well established, understanding the broader structural and sociocultural influences has been less comprehensive. In this study, we analyzed harmonized data from 183 countries (2017–2023), encompassing 33 variables and 7 subvariables related to demographics, nutrition, environment, health, and healthcare access, drawn from open-access international databases. Spearman correlation analysis identified strong positive associations between breast cancer incidence and discontinued breastfeeding, high LDL cholesterol, out-of-pocket healthcare expenditure, and educational attainment. Conversely, poor sanitation, lack of handwashing facilities, unsafe water, and certain nutritional deficiencies exhibited robust negative correlations, likely reflecting under detection and reporting limitations in lower-resource settings rather than true protective effects. These findings were further explored using multiple linear regression, which explained approximately 73% of the variance in global breast cancer incidence. The final model highlighted discontinued breastfeeding, prevalence of cocaine use, unsafe sanitation, high out-of-pocket healthcare expenditure, limited handwashing access, and high processed meat consumption as the most influential independent predictors. Receiver operating characteristic (ROC) analysis confirmed strong predictive value for discontinued breastfeeding and out-of-pocket expenditure, with sanitation and hygiene variables showing paradoxical inverse associations. Our results emphasize that breast cancer risk is shaped not only by individual behaviors and genetics, but also by larger-scale structural, socioeconomic, and environmental factors. These patterns suggest that targeted interventions addressing both lifestyle behaviors and systemic inequities—such as promoting breastfeeding, reducing financial barriers to healthcare, and strengthening public health infrastructure—could meaningfully reduce the global burden of breast cancer. In conclusion, this study underscores the importance of multisectoral, equity-focused prevention strategies. It also highlights the value of country-level ecological analyses in uncovering upstream determinants of cancer incidence and calls for further research to disentangle individual and contextual effects in cancer epidemiology. Full article

Climate risk, as a significant factor affecting human sustainable development, has emerged as a focal topic of concern for governments and all sectors of society. Using a dataset from China’s Shanghai and Shenzhen A-share markets spanning 2007 to 2019, this study empirically examines how climate risk influences corporate financialization. The empirical results show that heightened climate risk significantly reduces the level of corporate financialization, a finding that remains robust across multiple tests. Further heterogeneity analyses indicate that the suppressive effect of climate risk is particularly evident among state-owned enterprises, firms operating in intensely competitive industries, and those located in regions subject to more stringent environmental policies. Mechanism analysis suggests that climate risk inhibits corporate financialization primarily by intensifying firms’ financing constraints while simultaneously stimulating their innovation capacity. These findings imply that corporate financialization in China is largely driven by profit-maximizing behaviors rooted in “investment substitution” and “real-sector intermediation” motives. Collectively, this research enhances understanding of the channels through which climate risk impacts corporate financial behavior and offers valuable empirical insights for policymakers aiming to optimize climate regulations and redirect financial resources toward productive real-sector activities. Full article

Background: Despite advances in surgical techniques and perioperative care, pancreatic resections such as pancreaticoduodenectomy (PD) and distal pancreatectomy (DP) remain high-risk procedures. Postoperative complications significantly impact morbidity, mortality, and patient quality of life. Methods: This narrative review summarizes recent literature on major complications following pancreatic surgery, including postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), and post-pancreatectomy hemorrhage (PPH), with an emphasis on incidence, risk factors, outcomes, and current preventive strategies. Results: POPF is a leading complication, occurring in 5–22% of cases and often linked with sepsis and hemorrhage. Key risk factors include high BMI, soft pancreatic texture, and small duct size. Preventive measures like Pasireotide, modified anastomosis techniques, and neoadjuvant therapy show variable success. DGE affects up to 57% of PD patients and is associated with prolonged recovery; antecolic reconstruction and erythromycin may reduce incidence. PPH, though less frequent (3–13%), can be life-threatening, particularly when secondary to POPF. Endovascular approaches are now favored for late arterial bleeding. Other complications include wound infections, abscesses, bile leaks, and pulmonary issues, all contributing to extended hospital stays and diminished quality of life. Conclusions: Pancreatic surgery continues to carry significant risks, with POPF, DGE, and PPH being the most impactful complications. While multiple interventions have shown promise, standardized protocols and predictive tools are still needed. Surgery should be performed in high-volume centers with experienced multidisciplinary teams to optimize outcomes. Full article

Cervical cancer remains a leading cause of mortality among women, particularly in regions with limited resources. Persistent high-risk human papillomavirus (HR-HPV) infection is the main etiological factor for CIN and cervical cancer. This study aimed to evaluate the association between HPV genotypes, age, and cytological findings and the presence of CIN2–3 in women presenting with abnormal cervical cytology. This cross-sectional study included 189 women with abnormal cytology who attended a tertiary center in Peru. All participants underwent partial HPV genotyping using the Cobas 4800 assay, colposcopic evaluation, and colposcopically directed biopsies, which served as the diagnostic reference. Sociodemographic characteristics and reproductive histories were also collected. Multiple logistic regression was performed to assess the associations among specific HPV genotypes, age, cytological results, and CIN2–3 outcomes. Most participants were between 30 and 59 years of age (76.7%), and multiparity was common (77.8%). The most frequent cytological abnormalities were ASC-US (36.0%) and LSIL (28.0%), followed by HSIL (20.1%). HPV16 was detected in 24.3% of cases, HPV18 in 2.1%, and other HR-HPV types in 73.6%. HSIL cytology showed high concordance with histological CIN2–3 (>95%). Logistic regression demonstrated that age ≥ 30 years (aOR 4.50, 95% CI 1.90–10.65) and HPV16 infection (aOR 4.19, 95% CI 1.95–9.00) were the strongest independent predictors of high-grade disease. HPV18 was rare and not significantly associated, whereas other HR-HPV types showed an inverse association with CIN2–3. HPV16 and age ≥ 30 years were the most significant predictors of CIN2–3 in women with abnormal cytology, underscoring the dominant oncogenic role of HPV16. Integrating HPV genotyping, cytological findings, and age into risk-stratified algorithms could optimize cervical cancer prevention, ensuring timely detection of high-grade lesions while minimizing overtreatment in low-risk populations. Full article

Background: Several prognostic factors, including the early recovery pattern of acute low back pain (ALBP), are related to the chronicity of LBP. However, the association between systemic symptoms and ALBP remains underexplored from a holistic perspective. Hence, this study aimed to investigate this relationship and identify novel clinical prognostic predictors for LBP. Methods: This retrospective cross-sectional study included patients with ALBP admitted to the Department of Korean Medicine Rehabilitation at the Dongguk University Bundang Hospital between 1 January 2021 and 30 April 2025. Data extracted from medical records included demographics, treatment-related information, pain characteristics, past medical history, and systemic symptoms. Statistical analyses included independent t-tests, Mann–Whitney U tests, chi-squared tests, Fisher’s exact tests, correlation analysis, and multiple linear regression models. Results: A total of 194 patients with ALBP were included in the analysis. Among systemic symptoms, dyspepsia was significantly associated with higher pain at discharge and smaller absolute and relative pain changes. Although sleep disturbance and constipation showed associations with higher pain at discharge in univariate analyses, these associations were not statistically significant in regression models. Beyond systemic symptoms, alcohol consumption was significantly associated with lower pain at discharge and greater relative pain change, while hospitalization and symptom duration exhibited non-linear relationships. These findings remained robust in sensitivity and subgroup analyses. Conclusions: Systemic symptoms, especially dyspepsia, may serve as prognostic factors impeding ALBP recovery, representing potential early markers for identifying patients at risk of chronicity. The findings highlight the prospect of multidimensional strategies in reducing pain and enhancing patients’ quality of life in clinical practice. Full article

Background/Objectives: Gastric cancer (GC) remains a leading cause of cancer mortality worldwide. While most cases are sporadic, approximately 10% show familial clustering with only a minority explained by known hereditary syndromes. The remaining, termed familial non-hereditary gastric cancer (FNHGC), lack a defined high-penetrance germline mutation. This review aims to summarize current knowledge regarding the diagnosis, risk factors, molecular characteristics and management of FNHGC. Methods: A comprehensive narrative review of the literature was conducted focusing on epidemiologic, molecular and clinical studies addressing families with multiple GC cases but no identified germline mutation. Results: The etiology of FNHGC is multifactorial, and H. pylori, with its related chronic gastritis, is probably the key driver. Familial clustering likely occurs when combined with other elements such as genetic polymorphisms, shared exposures to risk factors or even epigenetic phenomena. Molecular profiling reveals distinct patterns in familial tumors such as more frequent microsatellite instability; somatic CDH1 promoter hypermethylation; and recurrent somatic mutations in TP53, RHOA and DNA repair genes. Current management focuses on genetic testing to rule out hereditary syndromes, endoscopic surveillance and mitigation of risk factors, with eradication of H. pylori paramount. Conclusions: FNHGC represents a distinct subgroup of GC characterized by a multifactorial etiology related to exposure to risk factors and genetic susceptibility although significant gaps remain in fully explaining the condition. Ongoing research holds promise to provide tools for better detection and prevention in order to reduce the burden of GC in familial settings. Full article

Statistical factor models are widely applied across various domains of the financial industry, including risk management, portfolio selection, and statistical arbitrage strategies. However, conventional factor models often rely on unrealistic assumptions and fail to account for the fact that financial markets operate under multiple regimes. In this paper, we propose a regime-switching factor model estimated via a particle filtering algorithm, which is a Monte Carlo-based method well-suited for handling nonlinear and non-Gaussian systems. Our empirical results show that incorporating dynamic structure and a regime-switching mechanism significantly enhances the model’s ability to detect structure breaks and adapt to evolving market conditions. This leads to improved performance and reduced drawdowns in the equity statistical arbitrage strategies. Full article

Background: Obesity is a well-established risk factor for numerous chronic diseases, including heart disease and type 2 diabetes, and its impact is particularly acute among Black/African American men. According to the Centers for Disease Control and Prevention (CDC), 70.9% of Black men aged 20 and older are overweight or obese. Despite this alarming prevalence, there remains a limited number of studies that specifically investigate the root causes of obesity in this population. Addressing this gap is critical to developing culturally relevant interventions that promote health equity. The purpose of this study was to assess dietary patterns, that are associated with overweight/obesity, in Black men aged 18–65 across the United States of America, to gain an in-depth understanding of variables influencing BMI in Black men. Methods: This study utilized a quantitative approach to collect information from participants. A survey questionnaire was developed and administered via Qualtrics to participants using a web link. The survey collected information across 18 dietary variables. Data was exported to Microsoft Excel for statistical analysis. A simple linear regression was used to determine dietary variables correlation strength and significance with BMI. A significance level of p < 0.05 was used to determine if a variable was statistically significant. Variables were then organized based on significance vs. non significance and correlation strength. Result: The study sample consisted of 466 Black men aged 18 to 65 years. The mean BMI was 30.21. Approximately 19% (n = 87) had a BMI within the healthy range (18.5–24.9), 41% (n = 190) were categorized as overweight (BMI 25.0–29.9), and another 41% (n = 189) were classified as obese (BMI ≥ 30.0). The findings revealed that fruit and vegetable consumption and whole grain cereal consumption were significantly and positively correlated with BMI. Other variables, such as fried foods, processed foods, and sugary drinks, though historically associated with obesity, did not show statistical significance in this population. Conclusions: Results suggest that while multiple dietary factors influence BMI, fruit, vegetable, and whole grain consumption are significantly correlated with BMI in Black men living in America. The findings from this study serve as a foundational step for designing targeted, culturally sensitive interventions aimed at reducing obesity-related health disparities. Future research should further explore how tailored public health messaging and community-based programming can address the specific needs of this population. Full article

Global warming poses a growing threat to winter wheat production in Henan Province, a critical region for China’s food security, necessitating a quantitative assessment of climate impacts. This study aimed to quantify the dominant climatic drivers of winter wheat yield and assess its spatiotemporal evolution and future risks under climate change, thereby providing a scientific basis for targeted adaptation strategies. Thus, the APSIM model in combination with the Geodetector method was applied to quantify the spatiotemporal response of winter wheat yield to climate change in Henan Province under historical (1957–2020) and SSP245 scenarios. The study results demonstrated significant trends in climatic factors during the winter wheat growing season: precipitation decreased by an average of 3.09 mm/decade, sunshine hours declined by 36 h/decade, wind speed reduced by 0.447 m/(s·decade), and evaporation decreased by 14.7 mm/decade. In contrast, the accumulated temperature ≥ 0 °C significantly increased by 70.9 °C·d/decade. Geodetector analysis further identified accumulated temperature as the dominant climatic driver (q = 0.548), followed by precipitation (q = 0.340) and sunshine hours (q = 0.261). Yield simulations from 1960 to 2018 indicated that most regions maintained stable or slightly increasing yields (<50 kg·ha⁻¹·decade⁻¹), though some areas experienced fluctuating declines. Under future scenarios, major production regions in Henan Province (Zhengzhou, Xinxiang, Luoyang) are projected to see substantial yield increases, with growth rates of 147.2–148.9 kg·ha⁻¹·decade⁻¹. Specifically, Xinxiang is expected to achieve yields of 6200 kg·ha⁻¹. The frequency of climate-induced negative yield years decreased by approximately 35% after 2003, highlighting the role of improved agricultural technologies in enhancing climate resilience. This study clarifies how multiple climatic factors jointly affect winter wheat yield, identifying rising accumulated temperature and water stress as key future constraints. It recommends optimizing varietal selection and cultivation practices according to regional climate patterns to improve policy relevance and local applicability. Full article

Microplastics (MPs) are plastic particles smaller than 5 mm that accumulate in ecosystems and can cause toxicity in organisms by affecting multiple biological processes. This study investigates the effects of poly(methyl methacrylate) microplastic microspheres (MPs, 200 µm diameter) on Caenorhabditis elegans, a widely used model in ecotoxicology. Nematodes were exposed to MPs at concentrations of 0.01, 0.1, 1, and 10 mg/mL, and various toxicological endpoints were assessed. The uptake of MPs was evaluated by µFT-IR analysis. The results indicate that MPs induce a concentration-dependent reduction in body length and alterations in the reproduction rate. Lifespan was also significantly reduced, with a 20% decrease at the highest concentration. Intestinal permeability assays revealed disruption of gut integrity at higher concentrations, and oxidative stress analysis showed a 1.8-fold increase in reactive oxygen species (ROS) levels at 10 mg/mL. Gene expression analysis via real-time qPCR indicated the upregulation of genes involved in oxidative stress and in DNA repair mechanisms. Additionally, the longevity-related transcription factors daf-16 and skn-1 were modulated, suggesting an adaptive stress response. These findings suggest that MPs impair growth, reproduction, and oxidative stress response in C. elegans, emphasizing the potential risks associated with microplastic exposure. Full article

Background/Objectives: An elevated level of lipoprotein(a) [Lp(a)] is a genetically determined risk factor for cardiovascular disease. The atherogenic properties of Lp(a) include attribution to its role as a carrier of oxidized phospholipids (OxPL). Despite genetic control, Lp(a) levels increase with dietary saturated fat (SFA) reduction. However, little is known about the impact of dietary factors on Lp(a) risk properties. Methods: We assessed total Lp(a)-OxPL concentration, Lp(a)-OxPL subspecies abundance, and Lp(a) lipidomics in response to SFA reduction in two multicenter, randomized, controlled, crossover feeding trials, DELTA (Dietary Effects on Lipoproteins and Thrombogenic Activity) 1 (96 healthy individuals) and 2 (79 metabolically challenged individuals). In both trials, significant increases in Lp(a) levels were reported previously. Results: While no between-diet differences in the concentrations of total Lp(a)-OxPL and four major OxPL subspecies (ALDOPC, POVPC, PAzPC, and PGPC) were observed in DELTA 1, ALDOPC decreased significantly in DELTA 2 when SFA was replaced with carbohydrates (p = 0.014). Of 440 individual lipid species annotated in an untargeted analysis of the Lp(a) lipidome, 87 lipids differed significantly (p < 0.05 adjusted for multiplicity) between diets, with triacylglycerol species showing the most pronounced changes in both trials. For all intervention diets, triacylglycerol species with a higher average number of carbon atoms and double bonds increased the most in abundance with SFA reduction. Conclusions: In parallel with an increase in plasma Lp(a) levels, significant changes in Lp(a) lipid composition occurred. The findings demonstrate the dynamic nature of intraindividual Lp(a) lipid composition in response to diet interventions. Full article

Cold-air pooling (CAP) and frost risk represent significant climate-related hazards in karstic and agricultural environments, where local topography and surface cover strongly modulate microclimatic conditions. This study focuses on the Mohos sinkhole, Hungary’s cold pole, situated on the Bükk Plateau, to investigate the formation, structure, and persistence of CAPs in a Central European karst depression. High-resolution terrain-based modeling was conducted using UAV-derived digital surface models combined with multiple GIS tools (Sky-View Factor, Wind Exposition Index, Cold Air Flow, and Diurnal Anisotropic Heat). These models were validated and enriched by multi-level temperature measurements and thermal imaging under various synoptic conditions. Results reveal that temperature inversions frequently form during clear, calm nights, leading to extreme near-surface cold accumulation within the sinkhole. Inversions may persist into the day due to topographic shading and density stratification. Vegetation and basin geometry influence radiative and turbulent fluxes, shaping the spatial extent and intensity of cold-air layers. The CAP is interpreted as part of a broader interconnected multi-sinkhole system. This integrated approach offers a transferable, cost-effective framework for terrain-driven frost hazard assessment, with direct relevance to precision agriculture, mesoscale model refinement, and site-specific climate adaptation in mountainous or frost-sensitive regions. Full article

Human activities have accelerated the extinction of species, driving biodiversity loss and ecosystem degradation. Establishing protected areas (PAs) that encompass habitats of endangered species is essential for achieving biodiversity conservation and ecosystem protection goals. This study aimed to identify and prioritize critical conservation areas for the endangered long-tailed goral (Naemorhedus caudatus) in five regions of Gangwon and Gyeongbuk Provinces, South Korea. The MaxEnt model was applied to predict the potential habitat of the species, considering key environmental factors such as topographic, distance-related, vegetation, and land cover variables. The InVEST Habitat Risk Assessment (HRA) model was used to quantitatively assess cumulative risks within the habitat from the impacts of forest development and anthropogenic pressures. Subsequently, the Zonation software was employed for spatial prioritization by integrating the outputs of the models, and core conservation areas (CCAs) with high ecological value were identified through overlap analysis with 1st-grade areas from the Ecological and Nature Map (ENM). Results indicated that suitable habitats for the long-tailed goral were mainly located in forested regions, and areas subjected to multiple stressors faced elevated habitat risk. High-priority areas (HPAs) were primarily forested zones with high habitat suitability. The overlap analysis emphasized the need to implement conservation measures targeting CCAs while also managing additional HPAs outside CCAs, which are not designated as ENM. This study provides a methodological framework and baseline data to support systematic conservation planning for the long-tailed goral, offering practical guidance for future research and policy development. Full article

Against the backdrop of climate change and the accelerated process of urbanization, the risks of extreme weather and natural disasters that cities are facing are increasing day by day. Based on the framework of the local climate zone (LCZ), this paper studies the spatio-temporal evolution of the urban surface morphology and the heat island effect of Tongren City. Using the comprehensive mapping technology of remote sensing and GIS, combined with the inversion of surface temperature, the distribution of LCZs and the changes in heat island intensity were analyzed. The results show that: (1) The net increase in forest coverage area leads to a decrease in shrub and grassland area, resulting in an ecological deficit. (2) The built-up area expands along transportation routes, and industrial areas encroach upon natural space. (3) The urban heat island pattern has evolved from a single core to multiple cores and eventually becomes fragmented. (4) Among the seasonal dominant driving factors of urban heat islands, the impervious water surface is in summer, the terrain roughness and building height are in winter, and the building density is in spring and autumn. These findings provide feasible insights into mitigating the heat island effect through climate-sensitive urban planning. Full article