Search Results (895)

Malignant gastric outlet obstruction (MGOO) is a serious complication arising from advanced gastric or pancreatic head cancer, significantly impairing patients’ quality of life by disrupting oral intake and inducing severe gastrointestinal symptoms. With benign causes such as peptic ulcer disease on the decline, malignancies now account for 50–80% of gastric outlet obstruction (GOO) cases globally. This review outlines the pathophysiology, evolving epidemiology, and treatment modalities for MGOO. Therapeutic approaches include conservative management, endoscopic stenting, surgical gastrojejunostomy (GJ), stomach partitioning gastrojejunostomy (SPGJ), and endoscopic ultrasound-guided gastroenterostomy (EUS-GE). While endoscopic stenting offers rapid symptom relief with minimal invasiveness, it has higher rates of re-obstruction. Surgical options like GJ and SPGJ provide more durable palliation, especially for patients with longer expected survival. SPGJ, a modified surgical technique, demonstrates reduced incidence of delayed gastric emptying and may improve postoperative oral intake and survival compared to conventional GJ. EUS-GE represents a promising, minimally invasive alternative that combines surgical durability with endoscopic efficiency, although long-term data remain limited. Treatment selection should consider patient performance status, tumor characteristics, prognosis, and institutional resources. This comprehensive review underscores the need for individualized, multidisciplinary decision-making to optimize symptom relief, nutritional status, and overall outcomes in patients with MGOO. Full article

Soil sealing and land take are increasingly recognised as critical environmental and land use planning challenges across Europe. Although these issues have received limited attention in Baltic policymaking and the academic literature to date, available data indicate ongoing land consumption despite population decline. This study aims to analyse soil sealing patterns in Estonia, Latvia, and Lithuania between 2018 and 2021 using CLC+ Backbone data, linking them to demographic shifts and local planning frameworks. Results reveal that soil sealing increased in nearly all municipalities across the Baltic states, regardless of population trends. The analysis highlights that shrinking municipalities, constrained by limited resources and declining populations, are structurally disadvantaged in terms of land use efficiency, particularly when measured by sealed area per capita. Moreover, this study discusses emerging policy tensions, including the narrowing conceptual gap between land take and soil sealing in the proposed EU Soil Monitoring and Resilience Directive, as well as the risk of overlooking broader land artificialisation. The findings underscore the need for context-sensitive, multi-scalar approaches to land use monitoring and governance, particularly in sparsely populated and demographically imbalanced regions, such as the Baltic states. Full article

European pig farmers are challenged by increasingly stringent EU regulations to protect the environment from pollution, to meet animal welfare standards and to make pig farming more sustainable. Economic sustainability is defined as the ability to achieve higher profits by respecting social and natural resources. This study is focused on the analysis of the economic resilience of intensive and extensive farming systems, based on data collected from 56 farms located in Denmark, Poland, Italy and Spain. Productive and economic performances of these farms are analyzed, and economic resilience is assessed through a survey including a selection of indicators, belonging to different themes: [i] resilience of resources, [ii] entrepreneurship, [iii] propensity to extensification. The qualitative data from the questionnaire allow for an exploration of how production systems relate to the three dimensions of resilience. Different levels of resilience were found and discussed for intensive and extensive farms. The findings suggest that intensive farms benefit from high standards and greater bargaining power within the supply chain. Extensive systems can achieve profitability through value-added strategies and generally display good resilience. Policies that support investment and risk reduction are essential for enhancing farm resilience and robustness, while strengthening farmer networks can improve adaptability. Full article

Food loss and waste from the European Union’s dairy supply chain, particularly in the management of fresh milk, imposes significant environmental burdens. This study demonstrates that implementing Radio Frequency Identification (RFID)-enabled digital decision-support tools can substantially reduce these impacts across the region. A cradle-to-grave life cycle assessment (LCA) was used to quantify both the additional environmental burdens from RFID (tag production, usage, and disposal) and the avoided burdens due to reduced milk losses in the farm, processing, and distribution stages. Within the EU’s fresh milk supply chain, the implementation of digital tools could result in annual net reductions of up to 80,000 tonnes of CO₂-equivalent greenhouse gas emissions, 81,083 tonnes of PM_2.5-equivalent particulate matter, 84,326 tonnes of land use–related carbon deficit, and 80,000 cubic meters of freshwater-equivalent consumption. Spatial analysis indicates that regions with historically high spoilage rates, particularly in Southern and Eastern Europe, see the greatest benefits from RFID enabled digital-decision support tools. These environmental savings are most pronounced during the peak months of milk production. Overall, the study demonstrates that despite the environmental footprint of RFID systems, their integration into the EU’S dairy supply chain enhances transparency, reduces waste, and improves resource efficiency—supporting their strategic value. Full article

The water sector is facing a convergence of systemic challenges generated by climate change, increasing demand, and increasingly stringent regulations, which threaten its operational and strategic sustainability. In this context, the article examines how ESG (environmental, social, governance) principles are integrated into the governance, financing, and management of water resources, with a comparative focus on Romania and the European Union. It aims to assess the extent to which ESG practices contribute to the sustainable transformation of the water sector in the face of growing environmental and socio-economic challenges. The methodology is based on a systematic analysis of policy documents, regulatory frameworks, and ESG standards applicable to the water sector at both national (Romania) and EU levels. This study also investigates investment strategies and their alignment with the EU Taxonomy for Sustainable Activities, enabling a comparative perspective on implementation, gaps and strengths. Findings reveal that while ESG principles are increasingly recognized across Europe, their implementation remains uneven (particularly in Romania) due to unclear standards, limited funding mechanisms, and fragmented policy coordination. ESG integration shows clear potential to foster innovation, improve governance transparency, and support long-term resilience in the water sector. These results underline the need for coherent, integrated policies and stronger institutional coordination to ensure consistent ESG adoption across Member States. Policymakers should prioritize the development of clear guidelines and supportive funding instruments to accelerate sustainable outcomes. The originality of our study lies in its comparative approach, offering an in-depth analysis of ESG integration in the water sector across different governance contexts. It provides valuable insights for advancing policy coherence, investment alignment, and sustainable water resource management at both national and European levels. Full article

The exponential increase in electronic waste (e-waste) from end-of-life electrical and electronic equipment presents a growing environmental challenge. E-waste contains high concentrations of rare earth elements (REEs), which are classified as critical raw materials (CRMs). Their removal and recovery from contaminated systems not only mitigate pollution but also support resource sustainability within a circular economy framework. The present study proposed the use of hazelnut shells as a biosorbent to reduce water contamination and recover REEs. The sorption capabilities of this lignocellulosic material were assessed and optimized using the response surface methodology (RSM) combined with a Box–Behnken Design (three factors, three levels). Factors such as pH (4 to 8), salinity (0 to 30), and biosorbent dose (0.25 to 0.75 g/L) were evaluated in a complex mixture containing 9 REEs (Y, La, Ce, Pr, Nd, Eu, Gd, Tb and Dy; equimolar concentration of 1 µmol/L). Salinity was found to be the factor with greater significance for REEs sorption efficiency, followed by water pH and biosorbent dose. At a pH of 7, salinity of 0, biosorbent dose of 0.75 g/L, and a contact time of 48 h, optimal conditions were observed, achieving removals of 100% for Gd and Eu and between 81 and 99% for other REEs. Optimized conditions were also predicted to maximize the REEs concentration in the biosorbent, which allowed us to obtain values (total REEs content of 2.69 mg/g) higher than those in some ores. These results underscore the high potential of this agricultural waste with no relevant commercial value to improve water quality while providing an alternative source of elements of interest for reuse (circular economy). Full article

Food safety concerns related to pesticide residues in fruits and vegetables have increased globally, particularly in regions where monitoring programs are scarce or inconsistent. This study provides the first multi-year evaluation of pesticide contamination and associated dietary risks in Cape Verde, an African island nation increasingly reliant on imported produce. A total of 570 samples of fruits and vegetables—both locally produced and imported—were collected from major markets across the country between 2017 and 2020 and analyzed using validated multiresidue methods based on gas chromatography coupled to Ion Trap mass spectrometry (GC-IT-MS/MS), and both gas and liquid chromatography coupled to triple quadrupole tandem mass spectrometry (GC-QqQ-MS/MS and LC-QqQ-MS/MS). Residues were detected in 63.9% of fruits and 13.2% of vegetables, with imported fruits showing the highest contamination levels and diversity of compounds. Although only one sample exceeded the maximum residue limits (MRLs) set by the European Union, 80 different active substances were quantified—many of them not authorized under the current EU pesticide residue legislation. Dietary exposure was estimated using median residue levels and real consumption data from the national nutrition survey (ENCAVE 2019), enabling a refined risk assessment based on actual consumption patterns. The cumulative hazard index for the adult population was 0.416, below the toxicological threshold of concern. However, when adjusted for children aged 6–11 years—taking into account body weight and relative consumption—the cumulative index approached 1.0, suggesting a potential health risk for this vulnerable group. A limited number of compounds, including omethoate, oxamyl, imazalil, and dithiocarbamates, accounted for most of the risk. Many are banned or heavily restricted in the EU, highlighting regulatory asymmetries in global food trade. These findings underscore the urgent need for strengthened residue monitoring in Cape Verde, particularly for imported products, and support the adoption of risk-based food safety policies that consider population-specific vulnerabilities and mixture effects. The methodological framework used here can serve as a model for other low-resource countries seeking to integrate analytical data with dietary exposure in a One Health context. Full article

The intensifying global demand for sustainable and nutrient-dense food sources necessitates the exploration of underutilized local resources. Arthrospira platensis var. toliarensis, a cyanobacterium endemic to Madagascar, was evaluated for its nutritional, functional, and environmental potential under small-scale, low-input outdoor cultivation. The study assessed growth kinetics, physicochemical parameters, and composition during two contrasting seasons. Biomass increased 7.5-fold in 10 days, reaching a productivity of 7.8 ± 0.58 g/m²/day and a protein yield of 4.68 ± 0.35 g/m²/day. The hot-season harvest showed significantly higher protein content (65.1% vs. 44.6%), enriched in essential amino acids. On a dry matter basis, mineral profiling revealed high levels of sodium (2140 ± 35.4 mg/100 g), potassium (1530 ± 21.8 mg/100 g), calcium (968 ± 15.1 mg/100 g), phosphorus (815 ± 13.2 mg/100 g), magnesium (389.28 ± 6.4 mg/100 g), and iron (235 ± 9.1 mg/100 g), underscoring its value as a micronutrient-rich supplement. The hydroethanolic extract had the highest polyphenol content (4.67 g GAE/100 g of dry extract), while the hexanic extract exhibited the strongest antioxidant capacity (IC₅₀ = 101.03 ± 1.37 µg/mL), indicating fat-soluble antioxidants. Aflatoxin levels (B1, B2, G1, and G2) remained below EU safety thresholds. Compared to soy and beef, this strain showed superior protein productivity and water-use efficiency. These findings confirm A. platensis var. toliarensis as a promising, ecologically sound alternative for improving food and nutrition security, and its local production can offer substantial benefits to smallholder livelihoods. Full article

This paper presents a numerical simulation study evaluating carbon dioxide capture and storage (CCS) feasibility for the Turceni Power Plant in Oltenia, Romania, using the nearby depleted Bibești-Bulbuceni gas reservoir. A comprehensive reservoir model was developed using Petrel software, integrating geological and reservoir engineering data for the formations of the Bibești-Bulbuceni structure, which is part of the western Moesian Platform. The static model incorporated realistic petrophysical inputs for the Meotian reservoirs. Dynamic simulations were performed using Eclipse compositional simulator with Peng–Robinson equation of state for a CH4-CO₂ system. The model was initialized with natural gas initially in place at 149 bar reservoir pressure, then produced through depletion to 20.85 bar final pressure, achieving 80% recovery factor. CO₂ injection simulations modeled a phased 19-well injection program over 25 years, with individual well constraints of 100 bar bottom-hole pressure and 200,000 Sm³/day injection rates. Results demonstrate successful injection of a 60 Mt CO₂, with final reservoir pressure reaching 101 bar. The modeling framework validates the technical feasibility of transforming Turceni’s power generation into a net-zero process through CCS implementation. Key limitations include simplified geochemical interactions and relying on historical data with associated uncertainties. This study provides quantitative evidence for CCS viability in depleted hydrocarbon reservoirs, supporting industrial decarbonization strategies. The strategy not only aligns with the EU’s climate-neutral policy but also enhances local energy security by repurposing existing geological resources. The findings highlight the potential of CCS to bridge the gap between current energy systems and a sustainable, climate-neutral future. Full article

The European Health Technology Assessment (HTA) regulation (HTAR) came into effect in January 2025 and impacts the HTA process in all European Member States. Member States must give due consideration to the joint clinical assessment (JCA) report. This may require adaptations at the national level. This paper describes the anticipated changes to the Dutch national HTA process and how the Dutch National Health Care Institute (Zorginstituut Nederland, ZIN) prepared for this, because sharing experience between Member States can be of general interest for future expansion of the EU HTAR. ZIN’s implementation activities were facilitated by a project-governance structure and by a continuous gap analysis of the current national assessment and appraisal process of medicinal products, resulting in a concrete action plan. The implementation of the HTAR has two major implications for ZIN’s HTA process, namely that the scoping phase starts much earlier and that the JCA report is the starting point for the national assessment. Gaps, challenges and issues were identified in the categories: information and knowledge, IT and template, communication and stakeholder engagement, capacity and resources, and financial aspects. Based on a thorough and well-defined implementation plan, ZIN is ready to implement the HTAR in national HTA processes and to take on (co-)assessor roles for JCA of medicinal products in 2025. Full article

In 2022, the Russia–Ukraine conflict has severely impacted the EU’s energy supply chain, and the EU’s natural gas import pattern has begun to reconstruct, and exploring the spatiotemporal differentiation of EU natural gas trade and its driving factors is the basis for improving the resilience of its supply chain and ensuring the stable supply of energy resources. This paper summarizes the law of the change of its import volume by using the complex network method, constructs a multi-dimensional index system such as demand, economy, and security, and uses the geographic detector model to mine the driving factors affecting the spatiotemporal evolution of natural gas imports in EU countries and propose different sustainable development paths. The results show that from 2000 to 2023, Europe’s natural gas imports generally show an upward trend, and the import structure has undergone great changes, from pipeline gas dominance to LNG diversification. After the conflict between Russia and Ukraine, the number of import source countries has increased, the market network has become looser, France has become the core hub of the EU natural gas market, the importance of Russia has declined rapidly, and the status of countries in the United States, North Africa, and the Middle East has increased rapidly; natural gas consumption is the leading factor in the spatiotemporal differentiation of EU natural gas imports, and the influence of import distance and geopolitical risk is gradually expanding, and the proportion of energy consumption is significantly higher than that of other factors in the interaction with other factors. Combined with the driving factors, three different evolutionary directions of natural gas imports in EU countries are identified, and energy security paths such as improving supply chain control capabilities, ensuring export stability, and using location advantages to become hub nodes are proposed for different development trends. Full article

The Qiubudong silver deposit on the western margin of the Fuping ore cluster in the central North China Craton is a representative breccia-type deposit characterized by relatively high-grade ores, thick mineralized zones, and extensive alteration, indicating considerable potential for economic resource development and further exploration. Previous studies on this deposit have not addressed its genetic mineralogical characteristics. This study focuses on pyrite and quartz to investigate their typomorphic features, such as crystal morphology, trace element composition, thermoelectric properties, and luminescence characteristics, and their implications for ore-forming processes. Pyrite crystals are predominantly cubic in early stages, while pentagonal dodecahedral and cubic–dodecahedral combinations peak during the main mineralization stage. The pyrite is sulfur-deficient and iron-rich, enriched in Au, and relatively high in Ag, Cu, Pb, and Bi contents during the main ore-forming stage. Rare earth element (REE) concentrations are low, with weak LREE-HREE fractionation and a strong negative Eu anomaly. The thermoelectric coefficient of pyrite ranges from −328.9 to +335.6 μV/°C, with a mean of +197.63 μV/°C; P-type conduction dominates, with an occurrence rate of 58%–100% and an average of 88.78%. A weak–low temperature and a strong–high temperature peak characterize quartz thermoluminescence during the main mineralization stage. Fluid inclusions in quartz include liquid-rich, vapor-rich, and two-phase types, with salinities ranging from 10.11% to 12.62% NaCl equiv. (average 11.16%) and densities from 0.91 to 0.95 g/cm³ (average 0.90 g/cm³). The ore-forming fluids are interpreted as F-rich, low-salinity, low-density hydrothermal fluids of volcanic origin at medium–low temperatures. The abundance of pentagonal dodecahedral pyrite, low Co/Ni ratios, high Cu contents, and complex quartz thermoluminescence signatures are key mineralogical indicators for deep prospecting. Combined with thermoelectric data and morphological analysis, the depth interval around 800 m between drill holes ZK3204 and ZK3201 has high mineralization potential. This study fills a research gap on the genetic mineralogy of the Qiubudong deposit and provides a scientific basis for deep exploration. Full article

As global climate change intensifies and the transition to clean energy accelerates, lithium-ion batteries—critical components of electric vehicles—are becoming increasingly vital in international trade networks. This study investigates the structural evolution and determinants of the electric vehicle lithium-ion battery trade network among European Union (EU) member states from 2012 to 2023, employing social network analysis and the multiple regression quadratic assignment procedure method. The findings demonstrate the transformation of the network from a centralized and loosely connected structure, with Germany as the dominant hub, to a more interconnected and decentralized system in which Poland and Hungary emerge as the leading players. Key network metrics, such as the density, clustering coefficients, and average path lengths, reveal increased regional trade connectivity and enhanced supply chain efficiency. The analysis identifies geographic and economic proximity, logistics performance, labor cost differentials, energy resource availability, and venture capital investment as significant drivers of trade flows, highlighting the interaction among spatial, economic, and infrastructural factors in shaping the network. Based on these findings, this study underscores the need for targeted policy measures to support Central and Eastern European countries, including investment in logistics infrastructure, technological innovation, and regional cooperation initiatives, to strengthen their integration into the supply chain and bolster their export capacity. Furthermore, fostering balanced inter-regional collaborations is essential in building a resilient trade network. Continued investment in transportation infrastructure and innovation is recommended to sustain the EU’s competitive advantage in the global electric vehicle lithium-ion battery supply chain. Full article

The European Union’s developing rural development plan places digital and precision agriculture at the centre of agricultural modernisation and economic development. This article examines how agricultural practices in rural EU regions are being influenced by smart technology, such as drones, IoT sensors, satellite-based research, and AI-driven platforms, through an analysis of recent data from sources across the European Union. This study applies a mixed-methods approach, combining quantitative analysis of strategic policy documents and EU databases, to evaluate the ways in which precision agriculture reduces input consumption, increases productivity, reduces labour shortages and rural area depopulation, and improves sustainability. By investing in infrastructure, developing communities for data exchange, and organising training for farmers, European policies such as the Strategic Plans of the Common Agricultural Policy (CAP), the SmartAgriHubs initiative, and the AgData program actively encourage the transition to digital agriculture. Cyprus is analysed as a case study to show how targeted investments and initiatives supported by the EU can help smaller countries, with limited natural resources, to realise the benefits of digital transformation in agriculture. A special focus is placed on how solutions adapted to agro-climatic and socioeconomic conditions can contribute to strengthening the competitiveness of the agricultural sector, attracting young people to get involved in this field and opening up new economic opportunities. The results of previous research indicate that digital agriculture not only improves productivity but also proves to be a strategic mechanism for attracting and retaining young people in rural areas. Thus, this work additionally contributes to the broader goal of the European Union—the development of smart, inclusive, and sustainable rural areas, in which digital technologies are not only seen as tools for efficiency but also as key means for integrated and long-term rural development. Full article

Electric passenger vehicles are set to dominate the European car market, driven by EU climate policies and the 2035 ban on internal combustion engine production. This study assesses the sustainability of this transition, focusing on global warming potential and Critical Raw Material (CRM) extraction throughout its life cycle. The intensive use of CRMs raises environmental, economic, social, and geopolitical concerns. These materials are scarce and are concentrated in a few politically sensitive regions, leaving the EU highly dependent on external suppliers. The extraction, transport, and refining of CRMs and battery production are high-emission processes that contribute to climate change and pose risks to ecosystems and human health. A Life Cycle Assessment (LCA) was conducted, using OpenLCA software and the Ecoinvent 3.10 database, comparing a Peugeot 308 in its diesel and electric versions. This study adopts a cradle-to-grave approach, analyzing three phases: production, utilization, and end-of-life treatment. Key indicators included Global Warming Potential (GWP100) and Abiotic Resource Depletion Potential (ADP) to assess CO₂ emissions and mineral resource consumption. Technological advancements could mitigate mineral depletion concerns. Li-ion battery recycling is still underdeveloped, but has high recovery potential, with the sector expected to expand significantly. Moreover, repurposing used Li-ion batteries for stationary energy storage in renewable energy systems can extend their lifespan by over a decade, decreasing the demand for new batteries. Such innovations underscore the potential for a more sustainable electric vehicle industry. Full article