Search Results (49)

Background: Adjuvant endocrine therapy (AET) enhances survival outcomes in hormone receptor–positive (HR+) breast cancer. However, this treatment is associated with toxicities that may adversely affect the quality of life (QoL) and impact patient–physician communication. A thorough understanding of symptom-reporting behaviors is essential for optimizing survivorship care. Methods: This cross-sectional study surveyed 191 female patients with HR+ breast cancer undergoing adjuvant AET (tamoxifen or aromatase inhibitors ± ovarian function suppression [OFS]) at Antalya Training and Research Hospital between July and August 2025. QoL, symptom burden, and adverse event (AE) reporting behaviors were assessed using validated instruments (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 [EORTC QLQ-C30], adapted Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events [PRO-CTCAE]). Categorical variables were compared using chi-square tests, and multivariate analyses were performed using logistic regression. Results: The median age was 54 years (interquartile range [IQR]: 46–61 years). The following independent variables were identified as predictors of a higher symptom burden: prior chemotherapy (odds ratio [OR]: 3.75; 95% confidence interval [CI]: 1.46–9.69; p = 0.006), OFS use (OR: 3.29; 95% CI: 1.51–7.15; p = 0.003), AE reporting to physicians (OR: 3.52; 95% CI: 1.80–6.88; p < 0.001), and complementary and alternative medicine (CAM) use (OR: 7.27; 95% CI: 1.57–33.63; p = 0.011). Independent predictors of poor QoL included receiving psychological support (OR: 0.36; 95% CI: 0.19–0.67; p = 0.002) and AE reporting (OR: 0.28; 95% CI: 0.13–0.64; p = 0.001). Conclusions: Symptom burden and QoL in patients with HR+ breast cancer receiving AET are influenced by clinical history, including chemotherapy and OFS; behavioral factors, such as reporting behaviors; and supportive care, including CAM and psychological support. The routine integration of patient-reported outcomes and proactive symptom monitoring is crucial for delivering personalized and effective survivorship care. Full article

Against the backdrop of the dual carbon goals, the construction industry—as the primary source of carbon emissions accounting for 50.9%—is increasingly relying on green technological innovation to drive its sustainable development transformation. However, construction enterprises currently face three core challenges: the significant incremental costs associated with adopting green technologies, insufficient green credit supply from financial institutions, especially banks, and inadequate policy coordination among government departments. Furthermore, misaligned interests among multiple stakeholders exacerbate the implementation challenges of green technological innovation, hindering the industry′s low-carbon transition. Therefore, systematically exploring the interaction patterns and functional mechanisms among construction enterprises, government agencies, and banks in green technology innovation decision-making is crucial. This study will provide theoretical and empirical support for the green transformation of the construction industry within the dual-carbon framework. This study establishes a tripartite game model involving construction companies, governments, and banks, centered around the decision-making phase of green technology innovation. By integrating evolutionary game theory with system dynamics (SD) approaches, it uncovers the evolutionary trajectories and underlying mechanisms of strategies adopted by each stakeholder. Research indicates that construction companies, governments, and banks ultimately maintain equilibrium at the (1,1,1) point. The study underscores the pivotal role of government guidance during the decision-making stage, highlighting that sustained implementation of proactive policies can foster positive interactions and a balance between construction companies’ pursuit of green technology innovation and banks’ provision of green credit. It can shorten the time required for enterprises and banks to evolve their strategies. Suppressing the probability of innovation failure moderates both parties′ strategies, and adjusting parameters such as green credit interest rates and government subsidies can optimize choices. This research not only enhances the theoretical understanding of green technology innovation in the construction sector but also offers practical insights for promoting industry-wide green innovation, improving the quality of green buildings, and regulating market order. Full article

Long-term spaceflight induces multisystem stress, including cardiovascular deconditioning, skeletal muscle atrophy, immune suppression, and neuro-ocular syndromes. Current countermeasures reduce symptoms but cannot replicate the synergistic resilience needed for extended missions or critical illness. Hibernating animals, specifically brown bears (Ursus arctos), survive prolonged immobility, starvation, and bradycardia without resultant pathology. This review incorporates adaptations observed in bears and certain torpid species, including reversible insulin resistance, suppression of muscle atrophy genes MuRF1 and Atrogin-1, and maintenance of the heart despite seasonal production decline. The thirteen-lined ground squirrels (Ictidomys tridecemlineatus) maintain retinal structure and synaptic stability throughout torpor, avoiding neuro-ocular complications despite prolonged inactivity. Mechanisms span from RBM3-dependent synaptic maintenance, titin isoform remodeling under the control of RBM20, mTOR and FOXO pathway regulation, remodeled hydrogen sulfide metabolism, and microbiome-mediated nitrogen salvage. These adaptations are different from human adaptation to microgravity and disuse and offer translational candidates for synthetic torpor, probiotic engineering, neuroprotection, and protein-sparing therapy. Hibernators are not passive stress subjects; they perform coordinated anticipatory responses in multiple organs. Comparing these systems in large and small hibernators, we aim to uncover a biologically realistic path to human resilience. These findings guide a shift from reactive, pharmacological measures for preserving human health during space flight, intensive care, and extreme environments towards proactive, biologically initiated measures. Full article

The rise in atmospheric CO₂ intensified the urgency for carbon capture and storage (CCS), yet uncertainties remain in predicting evolution of reservoir properties under CO₂ injection. This study investigates how CO₂–brine–rock interactions alter porosity and permeability in carbonate and sandstone reservoirs. We quantify pore-scale changes and effects of CO₂-saturated brine on rock. In calcite-rich carbonates, CO₂-induced acidification enhances permeability through selective dissolution. Dolomite-rich samples and sandstones exhibit suppressed permeability response due to slower dissolution and pore clogging. μCT and SEM reveal that although bulk porosity changes are small, local changes—especially formation of micropores and mineral occlusions—substantially influence permeability. Geochemical modeling confirms three-stage evolution: early dissolution, intermediate buffering with onset of precipitation, and long-term mineral trapping with near-steady porosity. The results indicate that early injectivity gains may be temporary and that proactive monitoring and management are required to safeguard long-term storage integrity. The findings provide actionable insight for sustainable CCS design, risk assessment, and reservoir stewardship. Full article

To gain a comprehensive understanding of the current research landscape in the field of new energy vehicle (NEV) fires and to explore its knowledge base and emerging trends, bibliometric methods—such as co-occurrence, clustering, and co-citation analyses—were employed to examine the relevant literature. A research knowledge framework was established, encompassing four primary themes: thermal management and performance optimization of power batteries, battery materials and their safety characteristics, thermal runaway (TR) and fire risk assessment, and fire prevention and control strategies. The key research frontiers in this domain could be classified into five categories: mechanisms and propagation of TR, development of high-safety battery materials and flame-retardant technologies, thermal management and thermal safety control, intelligent early warning and fault diagnosis, and fire suppression and firefighting techniques. The focus of research has gradually shifted from passive identification of causes and failure mechanisms to proactive approaches involving thermal control, predictive alerts, and integrated system-level fire safety solutions. As the field advances, increasing complexity and interdisciplinary integration have emerged as defining trends. Future research is expected to benefit from broader cross-disciplinary collaboration. These findings provide a valuable reference for researchers seeking a rapid overview of the evolving landscape of NEV fire-related studies. Full article

Background/Objectives: The COVID-19 (Coronavirus Disease, 2019) pandemic affected all countries in a variety of ways, and forced policymakers to adapt national health infrastructure. In this context, the strategic adaptation and policy evolution of small island states are understudied. Therefore, the objective of this study was to quantitatively analyse the relationship between confirmed COVID-19 cases and health policy decisions in Northern Cyprus. We also examined the shifting management strategies employed during the pandemic using a replicable statistical analysis framework. Methods: In this mixed-methods study, we used systematic thematic analysis to categorise official policy decisions from March 2020 to December 2022. Yearly linear regression models using SPSS and Python correlated the monthly number of decisions with the number of confirmed COVID-19 cases. The analyses included R² values, p-values, and visualisations with 95% confidence intervals. Results: The findings of this study highlight a three-phase strategic period. In 2020, the results (R² = 0.03, p = 0.63) showed no significant relationship, indicating initial uncertainty. The results (R² = 0.60, p = 0.003) indicate a strong negative correlation in 2021, which reflects the consistency of the proactive suppression strategies adopted. Conversely, for 2022, the results (R² = 0.79, p < 0.001) show a strong positive correlation representing the shift to a reactive mitigation strategy, in which the government responded based on case peaks. Conclusions: This study’s primary finding is that strategic agility was key to managing the pandemic. For small island states in particular, the effectiveness of geographic advantages like border control depends on a coherent strategy that transcends initial uncertainty. Our data-driven framework provides a tool for analysing this strategic evolution and guiding responses to future pandemics. Full article

Selection history significantly influences attentional processes. Current debates center on whether different components of selection history influence attention through shared learning-dependent mechanisms or via independent mechanisms. Recent research suggests that aversive associative learning and statistical learning, two key components of selection history, modulate attentional selection independently. The present study investigates how these two components influence attentional selection under different search strategies. In Experiment 1, participants engaged in a singleton detection task, searching for a unique shape singleton while ignoring an irrelevant color singleton. In Experiment 2, they employed a feature search strategy, targeting a predefined attribute among varied shapes while disregarding a distracting color singleton. Results showed that under the singleton detection mode, two learning processes exert independent effects on attentional selection toward salient distractors. Conversely, under the feature search mode, the two learning processes interacted, with the interaction primarily driven by aversive associative learning. These findings highlight the critical role of search strategies in modulating how selection history affects attentional processes. They offer new insights into the mechanisms of attentional selection and the interplay between different forms of learning in complex visual search environments. Full article

Objective: In the digital age, short-video platforms are key channels for adolescents’ sex education, yet content strategies and their effects remain unclear. This study analyzes Douyin using an integrated source–content–effect framework, identifies infotainment strategies by creator type, and examines their impact on interaction and topic engagement. Methods: Quantitative content analysis of 465 sex-education videos. Content was coded on informational and entertainment value. Four information–entertainment combinations were tested. Engagement outcomes (likes, comments, favorites, shares) were modeled with negative binomial regression; the likelihood that comments were sex-education–related was modeled with logistic regression. Creator type (medical professionals vs. individual creators) entered as a covariate. Results: A functional-infotainment pattern emerged. High information–high entertainment performed best across all interaction metrics. Low information–high entertainment (pure entertainment) performed worst, significantly suppressing deeper engagement and topical discussion. Medical professionals emphasized medicalized, low-risk knowledge; individual creators covered more diverse topics yet likewise avoided sensitive issues. Conclusions: Under algorithmic incentives and cultural norms, Douyin’s sex-education content is not entertainment-first. Dissemination is driven by information-rich content delivered through a functional-infotainment model. Findings refine infotainment theory and offer data-driven guidance: prioritize informational value while pairing it with engaging forms (creators), support high-information content and proactive governance (platforms), and inform education policy. Full article

Conventional unconditional random field (URF) models were shown to neglect in-situ monitoring data and thus misrepresent real slope stability. To address this, a conditional random field (CRF) generator was proposed, in which Fast Fourier Transform (FFT) filtering was coupled with co-Kriging to assimilate site observations. A representative three-bench slope was adopted, and the failure-mode distribution and the statistics of the factor of safety (FoS) produced by the URF, the independent random field (IRF), and the CRF were examined across bedding-dip angles of 15–75° and two cross-correlation states ($\rho$ = −0.2, 0). It was found that eliminating cross-correlation decreased the mean FoS by 0.006, increased its standard deviation by 10.26%, and raised the frequency of low-FoS events from 7.49% to 12.30%. When field constraints were imposed through the CRF, the probability of through-going failure was reduced by 12%, the mean FoS was increased by 0.01, the standard deviation was reduced by 15.38%, and low-FoS events were suppressed to 2.30%. The CRF framework was thus demonstrated to integrate stochastic analysis with field measurements, enabling more realistic reliability assessment and proactive risk management of slopes. Full article

The escalating threat of climate-driven wildfires, land abandonment, wildland–urban interface expansion, and inadequate forest management poses an existential challenge to Mediterranean oak ecosystems, for which traditional fire suppression has proven insufficient. This paper presents a combination of integrated fire management (IFM) and closer-to-nature forest management (CTNFM) in a representative mixed Pyrenean oak (Quercus pyrenaica) forest at Quinta da França (QF), in Portugal. It is structured around three main objectives designed to evaluate this pioneer integrated approach: (1) to describe the integration of IFM and CTNFM within an agro-silvo-pastoral landscape; (2) to qualitatively assess its ecological, operational, and socio-economic outcomes; and (3) to quantitatively evaluate the effectiveness of two key nature-based solutions (NbSs), that is, prescribed burning and planned grazing, in reducing wildfire risk and enhancing forest resilience and biodiversity. By strategically combining proactive fuel reduction with biodiversity-oriented silviculture, the QF case provides a replicable model for managing analogous Mediterranean forested areas facing similar risks. This integrated approach supports forest multifunctionality, advancing both prevention and adaptation goals, and directly contributes to the ambitious targets set by the European Union’s New Forest and Biodiversity Strategies for 2030, marking a significant step towards a more sustainable and fire-resilient future for such Mediterranean landscapes. Full article

Thermal stress poses escalating threats to aquatic ecosystems, yet current biomonitoring tools lack real-time integration of multidimensional physiological responses. To address this gap, we developed the Physiological and Ecological Comprehensive Analyzer (PECA), an integrated platform combining non-contact impedance sensors for behavior analysis, dissolved gas probes for metabolic monitoring, and wearable devices for cardiac signal acquisition in freely swimming fish. Using koi carp (Cyprinus carpio var. koi) under controlled thermal regimes (22 °C, 26 °C, 32 °C) with ethical compliance, the PECA calculated a novel Physiological Stress Index (PSI) integrating behavioral strength, the respiratory quotient, and electrocardiographic parameters. The results demonstrated significant PSI reductions under acute thermal stress, correlating with suppressed metabolism and altered cardiac function. This system provides a real-time solution for detecting thermal anomalies in aquatic environments, enabling proactive water resource management in climate-vulnerable ecosystems. Full article

Prostate cancer (PCa) is the second most frequently diagnosed malignancy in men worldwide. Although traditionally considered a disease of older men, the incidence of early-onset PCa (diagnosis < 55 years) is steadily rising. Advances in screening and therapy have significantly improved survival, creating a growing cohort of younger survivors for whom post-treatment quality of life—notably reproductive function—is paramount. Curative treatments such as radical prostatectomy, pelvic radiotherapy, androgen-deprivation therapy (ADT), and chemotherapy often cause irreversible infertility via multiple mechanisms, including surgical disruption of the ejaculatory tract, endocrine suppression of spermatogenesis, direct gonadotoxic injury to the testes, and oxidative sperm DNA damage. Despite these risks, fertility preservation is frequently overlooked in pre-treatment counseling, leaving many patients unaware of their options. This narrative review synthesizes current evidence on how PCa therapies impact male fertility, elucidates the molecular and physiological mechanisms of iatrogenic infertility, and evaluates both established and emerging strategies for fertility preservation and restoration. Key interventions covered include sperm cryopreservation, microsurgical testicular sperm extraction (TESE), and assisted reproductive technologies (ART). Psychosocial factors influencing decision-making, novel biomarkers predictive of post-treatment spermatogenic recovery, and long-term offspring outcomes are also examined. The review underscores the urgent need for timely, multidisciplinary fertility consultation as a routine component of PCa care. As PCa increasingly affects men in their reproductive years, proactively integrating preservation into standard oncologic practice should become a standard survivorship priority. Full article

This study presents the design and validation of an integrated fire safety system that leverages edge AI, hybrid sensing, and precision suppression to overcome the latency and collateral limitations of conventional smoke detection and sprinkler systems. The proposed platform features a dual-mode sensor array for early fire recognition, motorized ventilation units for rapid smoke extraction, and a 360° directional nozzle for targeted agent discharge using a residue-free clean extinguishing agent. Experimental trials demonstrated an average fire detection time of 5.8 s and complete flame suppression within 13.2 s, with 90% smoke clearance achieved in under 95 s. No false positives were recorded during non-fire simulations, and the system remained fully functional under simulated cloud communication failure, confirming its edge-resilient architecture. A probabilistic risk analysis based on ISO 31000 and NFPA 551 frameworks showed risk reductions of 75.6% in life safety, 58.0% in property damage, and 67.1% in business disruption. The system achieved a composite risk reduction of approximately 73%, shifting the operational risk level into the ALARP region. These findings demonstrate the system’s capacity to provide proactive, energy-efficient, and spatially targeted fire response suitable for high-value infrastructure. The modular design and SmartThings Edge integration further support scalable deployment and real-time system intelligence, establishing a strong foundation for future adaptive fire protection frameworks. Full article

Amid AI-driven organizational transformation, employees’ subjective evaluations of AI technologies—referred to as AI awareness—have become a critical psychological factor influencing innovation behavior. This study aims to uncover how AI awareness affects employee innovation performance through behavioral pathways and examines the moderating role of individual achievement motivation in this process. Grounded in Cognitive Appraisal Theory and the Dual Pathway Model, we construct a dual-path mediation model, in which proactive and withdrawal behaviors act as mediators, and achievement motivation serves as a boundary condition. Based on a two-wave survey of 413 knowledge workers in China’s high-tech sector, the proposed model was empirically tested using moderated mediation analysis (PROCESS macro). The results reveal that AI awareness has a significant dual-path effect on innovation behavior: on the one hand, it promotes innovation by stimulating proactive behavior; on the other hand, it may suppress innovation by inducing withdrawal behavior. Moreover, achievement motivation plays a crucial moderating role in this mechanism by strengthening the positive mediating effect of proactive behavior and weakening the negative mediating effect of withdrawal behavior. This study conceptualizes AI awareness as a psychological input encompassing both perceived opportunity and perceived threat, clarifies the behavioral response mechanisms of employees facing AI, and highlights the boundary-regulating role of individual motivation in organizational adaptability. Practically, the study suggests designing differentiated HR interventions based on employees’ cognitive appraisals and motivational profiles to enhance human–AI collaboration, foster innovation resilience, and improve organizational adaptability amid digital transformation. Full article

In recent years, land degradation has become a major challenge for human society, with negative impacts on the natural habitat, the economy, and human well-being. A variety of anthropogenic and natural factors are exacerbating the processes of land degradation in the era of climate change. Land restoration is an important and proactive strategy to combat this negative situation. Among the many approaches, the use of vegetation plays a central role in restoring soil health, preventing erosion, promoting biodiversity, and improving water retention. Therefore, the identification of new plant species that have the properties to contribute to land restoration is a necessity today. The plant proposed in this conceptual review for land restoration is the cup plant (Silphium perfoliatum L.). After a brief presentation of the agronomy, adaptability, and multiple uses of this plant species, its potential to provide important ecosystem services useful for land restoration to combat land degradation is herein emphasized. Recent studies have shown that this plant has great potential for phytoremediation of soils contaminated with heavy metals (Zn, Pb, Cr, Cd, Ni, Hg, and Co), especially in post-mining areas where pollution exceeds ecological limits. Most studies have shown that the accumulation of heavy metals is higher at the lamina stage. There is also some evidence that the cup plant thrives in flood-prone areas and contributes to their restoration. Cup plant cultivation can also reduce greenhouse gasses and increase the organic carbon content of the soil. Another method of land restoration related to the establishment of the cup plant in a given area is the suppression of weeds, particularly the prevention of the invasion of exotic weed species. Further research under different soil–climatic conditions is needed to investigate cup plant cultivation as a promising strategy for land restoration in a time when the climate is constantly changing. Full article