Search Results (145)

Background. Cancer treatment-related cognitive impairment (CTRCI) is a frequent and persistent consequence of systemic cancer therapy, adversely affecting quality of life and independence among cancer survivors. Methods. To clarify the relative effectiveness of available treatments, we conducted a systematic review and network meta-analyses of randomized controlled trials evaluating psychological, pharmacological, and other interventions for established CTRCI in adult survivors of non-central nervous system cancers. Eligible trials reported objective outcomes in one or more of eight cognitive domains, including learning, memory, processing speed, word generation, cognitive flexibility, attention, working memory, and abstraction. Results. Eighteen studies met inclusion criteria, with 14 trials (n = 1100) contributing to network meta-analyses of immediate post-intervention effects across seven domains. A therapist-guided group intervention combining patient education and cognitive rehabilitation consistently ranked highest and was associated with significantly improved learning, memory, processing speed, attention, and working memory compared with a waitlist control, although the certainty of evidence (CoE) was low to very low and largely based on a single trial. Mindfulness-based interventions were also associated with improved processing speed (low CoE). Donepezil was associated with no benefit versus placebo for any domain. Conclusions. While findings suggest that structured multimodal group interventions may represent the most promising strategy for CTRCI, CoE was low, and additional rigorous, standardized trials are required. Full article

This paper introduces a novel three-parameter probability model, the unit-Gompertz–Makeham (UGM) distribution, designed for modeling bounded data on the unit interval (0,1). By transforming the classical Gompertz–Makeham distribution, we derive a unit-support distribution that flexibly accommodates a wide range of shapes in both the density and hazard rate functions, including increasing, decreasing, bathtub, and inverted-bathtub forms. The UGM density exhibits rich patterns such as symmetric, unimodal, U-shaped, J-shaped, and uniform-like forms, enhancing its ability to fit real-world bounded data more effectively than many existing models. We provide a thorough mathematical treatment of the UGM distribution, deriving explicit expressions for its quantile function, mode, central and non-central moments, mean residual life, moment-generating function, and order statistics. To facilitate parameter estimation, eight classical techniques, including maximum likelihood, least squares, and Cramér–von Mises methods, are developed and compared via a detailed simulation study assessing their accuracy and robustness under varying sample sizes and parameter settings. The practical relevance and superior performance of the UGM distribution are demonstrated using two real-world engineering datasets, where it outperforms existing bounded models, such as beta, Kumaraswamy, unit-Weibull, unit-gamma, and unit-Birnbaum–Saunders. These results highlight the UGM distribution’s potential as a versatile and powerful tool for modeling bounded data in reliability engineering, quality control, and related fields. Full article

Background: Early childhood caries (ECC) is a common chronic disease in young children, influenced by multiple factors, including the activity of bacteria and other microorganisms, diet, and immune response. Pro-inflammatory cytokines like interleukin-8 (IL-8) and anti-inflammatory cytokines like interleukin-10 (IL-10) play crucial roles in the inflammatory process of caries. However, their relationship with ECC severity remains unclear. This study aimed to compare salivary IL-8 and IL-10 levels in children with and without ECC and analyze their association with caries severity using the International Caries Detection and Assessment System (ICDAS). Children with and without central obesity were included to evaluate the potential influence of nutritional status on cytokine expression. Methods: A cross-sectional study was conducted from March 2022 to December 2023 in San Luis Potosí, México, including 76 children aged 3 to 5 years (40 with ECC and 36 caries-free). Anthropometric measurements were taken to classify children as centrally obese or non-centrally obese. Unstimulated saliva samples were collected, and IL-8 and IL-10 levels were measured using ELISA. Statistical analysis included the Mann–Whitney U test, Spearman’s rank correlation coefficient, and binary logistic regression analysis, considering p < 0.05 as statistically significant. Results: IL-8 levels were higher in the ECC group (85 ± 119 pg/mL) than in the control group (45 ± 74 pg/mL), but this difference was not significant (p = 0.3613). IL-10 levels were lower in the ECC group (3 ± 2 pg/mL) than in the control group (11 ± 44 pg/mL; p = 0.6481). The difference between IL-8 and IL-10 levels was greater in the ECC group (27 ± 41 pg/mL) than in the control group (17 ± 33 pg/mL; p = 0.1709). No significant correlation was found between cytokine levels and ICDAS scores (p > 0.05), and binary logistic regression did not show an association between IL-8, IL-10, WHtR, and cavitated caries lesions. Conclusions: Although IL-8 tended to be elevated and IL-10 reduced in children with ECC, the differences were not statistically significant. The observed trend suggests a possible local immunological imbalance in children with caries, which may contribute to disease progression independently of bacterial activity or behavioral influences. Full article

This article focuses on the negative evaluation losses resulting from consumers’ dissatisfaction with the traceability level in agricultural product logistics activities. Based on the supply chain (SC) under the “agricultural product cooperative + live-streaming e-commerce” model, and in accordance with previous research, combined with the differences in the dominant role and the bearers of profit and loss in the SC. By applying Stackelberg game theory, different types of decisions are analyzed and solved. The research results show: (1) Centralized decision-making has advantages in terms of traceability level and SC profit performance. (2) In non-centralized decision-making models, when manufacturers bear negative evaluation losses and retailers act as the leaders of the SC, the overall decision-making effect is more ideal. When manufacturers or retailers act as the leaders of the SC and both bear the traceability costs, the decision-making effect is basically the same. (3) The traceability level sensitivity coefficient and the traceability level effect on traceability both have positive effects on the growth of SC profits and the improvement of the traceability level. (4) The maximization of profits for both parties can be achieved through the coordination of contracts. This study can enhance the traceability level of the agricultural product SC, encourage SC members to increase their investment in the traceability, reduce the profit impact from negative evaluations, and provide a reference for the sustainable development of the agricultural product SC. Full article

This study is intended to conduct a comprehensive review of federalism. This study starts from the institutional aspect and analyzes how federalism, as a compound structure, divides power between the central and local governments. Then, this study mentions that federalism also has its normative connotations, which are traceable to the theological concept of a covenant. We also elaborate on how the success of the United States’ federalism strengthened its institutional aspect while overshadowing the older covenant tradition. Next, this study presents a typological framework of federalism, introducing concepts such as coming-together federalism and holding-together federalism; dual federalism and cooperative federalism; decentralization and non-centralization; and asymmetrical federalism, non-territorial autonomy, and consociationalism, presidential and parliamentary federalism, as well as democratic federalism and authoritarian federalism/facade federalism. Next, this study compares monist federalism with multinational federalism. Then, this study examines the specific applications of federalism in fiscal, environmental, health-care, and social-welfare policies. By reviewing the history, theoretical origins, institutional development, and contemporary manifestations of federalism, this study provides a roadmap for scholars in the field of federal studies. Finally, this study also puts forward several testable hypotheses, aiming to provide operational research agendas for future studies. Full article

Wu dialects carry deep regional culture, but due to significant internal variations, automated recognition faces considerable challenges. This study focuses on speech recognition and semantic feedback for Wu dialects, proposing a deep learning system with regional adaptability and semantic feedback capabilities. First, a corpus covering multiple Wu dialect regions (WXDPC) is constructed, and a two-level phoneme mapping and regional difference modeling mechanism is introduced. By incorporating geographical region labels and transfer learning, the model’s performance in non-central regions is improved. Experimental results show that as the training corpus increases, the model’s CER significantly decreases. After the introduction of regional labels, the CER in non-central Wu dialect regions decreased by 4.5%, demonstrating the model’s effectiveness in complex dialect environments. This system provides technical support for the preservation and application of Wu dialects and offers valuable experience for the promotion of other dialect recognition systems. Full article

Objectives: To evaluate the clinical characteristics, complication rates, and predictors of adverse outcomes related to peripherally inserted central catheters (PICC) in newborns over a seven-year period in a tertiary neonatal intensive care unit (NICU). Materials and Methods: This retrospective observational study included all neonates who underwent their first PICC placement between January 2017 and January 2024 in a single tertiary NICU. Demographic, clinical, and procedural data were collected, including birth weight, gestational age, catheter type, insertion site, dwell time, and reason for removal. Primary outcomes were PICC-related complications and catheter dwell time. Statistical analyses included chi-square or Fisher’s exact tests, Student’s t-test or ANOVA, and multivariable logistic regression to identify independent predictors of complications. Results: A total of 610 PICCs were evaluated. The mean gestational age was 31.0 ± 4.7 weeks, and the mean birth weight was 1579 ± 870 g. The majority of catheters (96.1%) terminated at the central location, with a mean dwell time of 12.9 ± 9.0 days. The most common removal reason was completion of therapy (60.3%), followed by mechanical complications (36.7%) and suspected infection (14.6%). Overall complication rate was 34.9%. In multivariable analysis, birth weight > 1000 g was associated with a lower risk of complications compared to <1000 g (1000–1500 g: OR 0.35, 95% CI 0.22–0.56; 1500–2000 g: OR 0.29, 0.15–0.54; >2000 g: OR 0.44, 0.21–0.92). Midline (OR 4.16, 1.76–9.83) and peripheral (OR 3.51, 1.82–6.76) terminations carried higher risk compared to central terminations. Use of antimicrobial-impregnated catheters reduced complication risk (OR 0.44, 0.26–0.74), while temporal vein insertion increased it (OR 4.14, 1.23–13.86). Conclusions: Low birth weight (<1000 g) and non-central catheter tip location are significant predictors of PICC-related complications in neonates, while antimicrobial-impregnated catheters have a protective effect. Targeted preventive strategies, strict adherence to insertion and maintenance bundles, and careful patient selection are recommended to improve outcomes in NICU patients. Full article

This study investigates the impact and mechanisms of digital inclusive finance (DIF) on high-quality economic development in China. Drawing on panel data from 281 prefecture-level cities between 2011 and 2021, we employ a Spatial Durbin Model (SDM) to analyze both the direct effects and spatial spillovers of DIF. The results indicate that (1) DIF has a significantly positive effect on high-quality development, which remains robust after conducting various stability and endogeneity tests; (2) DIF strongly contributes to economic upgrading in eastern regions, while its impact is weaker or even negative in central and western regions, revealing notable regional disparities exist; (3) a key finding is the identification of a double-threshold effect, suggesting that the positive influence of DIF only emerges when financial and industrial development surpass certain thresholds; (4) results from the two-regime SDM further show that spillover effects are more prominent in non-central cities than in central ones; and (5) mechanism analysis reveals that DIF facilitates high-quality growth primarily by promoting industrial structure upgrading. These findings underscore the importance of region-specific policy strategies to enhance the role of DIF and reduce spatial disparities in development across China. Full article

Green finance is widely promoted as a tool for supporting low-carbon development, but its effects on innovation efficiency remain unclear. This study examines the impact of China’s Green Finance Reform and Innovation Pilot Zones (GFRIPZ) on green innovation efficiency at the city level. Using the GFRIPZ policy as a quasi-natural experiment, we employ a difference-in-differences approach to identify the causal effects of the policy and explore the underlying mechanisms and contextual moderators. The results indicate that the policy significantly reduces green innovation efficiency in pilot cities, with the negative impact being more pronounced in non-central cities, provincial capitals, and cities in western China. Mechanism analysis reveals two key pathways: increased environmental costs contribute to resource lock-in, and strategic shifts toward quantity-focused innovation reduce overall efficiency. Furthermore, we find that the institutional environment plays a critical role—market integration mitigates the policy’s adverse effects by improving resource allocation, while administrative environmental pressure intensifies distortions. These findings suggest that rigid green finance regulations may unintentionally suppress innovation performance. We propose that more flexible policy design, better cross-regional coordination, and refined local governance incentives are essential for aligning green finance tools with innovation-driven sustainability goals in emerging economies. Full article

We derive an infinite-series representation for the transition probability density function (PDF) of the time-inhomogeneous 3/2 model, expressing all coefficients in terms of Bell-polynomial and generalized Laguerre-polynomial formulas. From this series, we obtain explicit expressions for all conditional moments of the variance process, recovering the familiar time-homogeneous formulas when parameters are constant. Numerical experiments illustrate that both the density and moment series converge rapidly, and the resulting distributions agree with high-precision Monte Carlo simulations. Finally, we demonstrate that the same approach extends to a broad family of non-affine, time-varying diffusions, providing a general framework for obtaining transition PDFs and moments in advanced models. Full article

Background: Celiac disease (CD) is an autoimmune condition triggered by gluten ingestion. The only effective treatment is adherence to a gluten-free diet (GFD), which is challenging due to the widespread presence of gluten in foods and the lack of physical and financial access to gluten-free options, among other factors that can lead to food nutrition insecurity (FNI). FNI, defined as the difficulty in accessing adequate food, is a factor that not only affects the need to adhere to a GFD but also compromises adherence itself. Objective: Review the scientific literature on the association between FNI, celiac disease, and adherence to a gluten-free diet. Methodology: This integrative review was conducted systematically using the PubMed, Scopus, and Web of Science databases, selecting studies that evaluated food security and insecurity among celiac patients. The keywords used with the Boolean operators were “celiac disease” AND/OR “gluten-free diet” AND “food insecurity” AND/OR “food security”. The search did not restrict language or geographic location, and studies were selected independently by two reviewers. Results: Ten publications met the inclusion criteria and were selected for the integrative review. FNI has been studied over the last five years in CD patients, but there is a lack of studies in different regions. FNI negatively affects the quality of life for those with CD and contributes to more severe symptoms and lower adherence to the GFD, especially in children and low-income families. Factors associated with higher risks of FNI in those with celiac disease include income, education, living in rural or non-central areas, and availability. These factors reinforce the negative impact of the association between FNI and adherence to the GFD in CD patients. Conclusions: The study of FNI in celiac individuals is a relatively recent development. The prevalence of FNI in this population is concerning and higher than in the general population, and it is associated with adherence to the GFD. Therefore, this topic demands extensive public policies to improve the health, quality of life, adherence, and treatment of CD patients. Full article

In the context of Industry 4.0, the transformative integration of intelligent digitalization, sustainable practices, and cross-sectoral industrial convergence within manufacturing systems constitutes a strategic imperative for addressing global climate emergencies and accelerating resource scarcity. Using panel data from 279 prefecture-level cities and the multiperiod difference-in-differences (DID) approach, this study investigates the impact of intelligent manufacturing on urban green innovation efficiency and its heterogeneous effects. The results reveal that intelligent manufacturing significantly enhances urban green innovation efficiency through scale agglomeration, economic agglomeration, and talent agglomeration, with robustness confirmed by propensity score matching DID tests and double machine learning. In addition, financial development has a nonlinear moderating effect on this relationship. When financial development surpasses the critical threshold of 3.817, its positive moderating effect becomes significantly enhanced. Heterogeneity analyses demonstrate that the benefits of intelligent manufacturing are more pronounced in the middle and western regions, noncentral cities, and cities with advanced industrial intelligence, robust digital finance ecosystems, or stringent environmental regulations. These findings provide novel insights into the dynamic mechanisms through which intelligent manufacturing fosters green innovation, offering policymakers in developing economies a framework to tailor regional strategies, optimize governance systems, and harness intelligent manufacturing as a catalyst for sustainable, innovation-driven growth. Full article

Background/Objectives: Breast cancer chemotherapy patients and survivors face cognitive side effects that are not fully understood. Neuroimaging can provide a unique way to study these effects; however, it can be difficult to recruit large numbers of subjects. Our meta-analysis aims to synthesize volumetric neuroimaging data to highlight consistent findings in regional brain volume changes to further advance our understanding of the chemotherapy-related cognitive impairments faced by breast cancer patients and survivors. Methods: An Activation Likelihood Estimation analysis was conducted across the data from eight voxel-based morphometry experiments examining changes in the brains of breast cancer patients and survivors exposed to chemotherapy over time and three voxel-based morphometry experiments comparing chemotherapy-exposed subjects to controls with and without breast cancer. Results: There were consistent volume reductions across the whole brain in both experiment groups. The subjects’ over-time analysis showed peak consistency among the studies in the right inferior frontal gyrus and the left insula. Conclusions: Chemotherapy for non-central nervous system cancers such as breast cancer can cause physical changes throughout the brain that can be quantitatively measured by neuroimaging methodologies and may underlie persistent cognitive deficits in some individuals. Full article

Based on the data of the non-central districts in Shanghai, this paper investigates the determinants of the commercial land leases of district governments from the government–market perspective and how these determinants affect the price and area of commercial land leasing. A kernel density analysis is used to analyze the agglomeration degree and density distribution of commercial land leasing. The variables are considered as the factors impacting commercial land leases based on a literature review and land development in Shanghai. The mathematical models used for multiple linear regression for the leased price and area of the influencing factors of commercial land leases from the perspective of the government and market are proposed. The results show that Shanghai’s multi-center development strategy aims to optimize the city’s commercial layout by developing the key areas of non-central districts. The construction area and plot ratio of land; the distances from the land to the city center, district center, airports, the nearest middle schools, the nearest park, and the nearest industrial zone; and the quantity of subway stations and highways affect commercial land leases. Policies are proposed to improve commercial land lease efficiency, make more suitable land planning strategies, and optimize urban spatial structures. Full article

Quantifying the extent and distribution of aquaculture ponds has become the key to management in the aquaculture industry, thereby contributing to the sustainable development of the region. However, accurate extraction of individual aquaculture pond boundaries from mesoscale remote sensing images remains a significant challenge. In this work, we developed the Multi-source Object-oriented Framework for extracting Aquaculture ponds (MOFA) to address mapping challenges in the Chaohu Lake basin, China. The MOFA combined Sentinel-1 synthetic aperture radar (SAR) with Sentinel-2 data, applying an object-oriented approach with adaptive threshold segmentation for robust and automated aquaculture pond delineation. Our performance evaluation results showed that the overall accuracy is as high as 90.75%. The MOFA is thus capable of distinguishing seasonal water bodies, lakes, reservoirs, and rivers from individual (non-centralized, contiguous) aquaculture ponds. Our results showed that the central and south sections of the Chaohu Lake basin are characterized by denser aquaculture pond distributions, relative to those in the western basin. The total area of aquaculture ponds across the entire basin decreased from 19,297.86 hm² in 2016 to 18,262.77 hm² in 2023, which is likely attributed to local policy adjustments, resource optimization, shifting market demands, or natural environmental changes. The abandonment and unregulated expansion of aquaculture ponds threaten sustainable development. Local governments must implement adaptive governance strategies to balance ecological preservation with economic growth. Overall, the MOFA can quickly and accurately extract and map aquaculture ponds, and further support the scientific planning of sustainable aquaculture development. Full article