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Search Results (118)

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Keywords = Particular Councils

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15 pages, 294 KiB  
Article
Preservation of Tradition vs. Fidelity and Organic Progress: A Necessary Updating of Certain Elements of the Liturgy of a Greek-Catholic Church
by Simona Stefana Zetea
Religions 2025, 16(8), 989; https://doi.org/10.3390/rel16080989 - 29 Jul 2025
Viewed by 174
Abstract
With good reason, Vatican II encourages the Eastern ecclesial realities to preserve and, if necessary, to rediscover their own traditions (also, even if not only, for ecumenical reasons). There are, however, certain aspects of the heritage of the Eastern Churches that require urgent [...] Read more.
With good reason, Vatican II encourages the Eastern ecclesial realities to preserve and, if necessary, to rediscover their own traditions (also, even if not only, for ecumenical reasons). There are, however, certain aspects of the heritage of the Eastern Churches that require urgent revision in a spirit of consistency with the teachings of the Council. This is undoubtedly the case with regard to the anti-Jewish elements so specific to the entire Christian tradition (more or less generalised insults and judgments; substitutionary and appropriative perspectives; a purely instrumental use of the Jewish scriptures) and, in the absence of full reception of the Council, still reflected in the public prayers of the Romanian Greek-Catholic Church, to the detriment of that spirit of respect, fraternity, and dialogue theoretically embraced throughout the Catholic world today. In the light of Nostra aetate §4 and the subsequent developments that flowed from it, I shall try in this contribution to outline some possible criteria for reforming the offices of Holy Week, aiming to show that—at least in this particular case—it is not enough merely to refer to the OE, let alone to use it to justify a comfortable tendency towards inertia. Apart from the fact that it is this very Decree that speaks of a possible and necessary organic progress, we cannot ignore the more general spirit of renewal of the Council and its other documents (the NA, the SC, the DV, the GS). The challenge would be to engender a creative fidelity, which—while preserving the best of tradition—surpasses certain of its contingent elements. Full article
32 pages, 3188 KiB  
Article
Forty Years After Chernobyl: Radiocaesium in Wild Edible Mushrooms from North-Eastern Poland and Its Relevance for Dietary Exposure and Food Safety
by Iwona Mirończuk-Chodakowska, Jacek Kapała, Karolina Kujawowicz, Monika Sejbuk and Anna Maria Witkowska
Toxics 2025, 13(7), 601; https://doi.org/10.3390/toxics13070601 - 17 Jul 2025
Viewed by 276
Abstract
Wild-growing edible mushrooms are known to bioaccumulate radionuclides from their environment, particularly the natural isotope potassium-40 (40K) and anthropogenic cesium-137 (137Cs). However, region-specific data for commercially relevant species in north-eastern Poland remain limited, despite the cultural and economic importance [...] Read more.
Wild-growing edible mushrooms are known to bioaccumulate radionuclides from their environment, particularly the natural isotope potassium-40 (40K) and anthropogenic cesium-137 (137Cs). However, region-specific data for commercially relevant species in north-eastern Poland remain limited, despite the cultural and economic importance of mushroom foraging and export. This study aimed to assess the radiological safety of wild mushrooms intended for human consumption, with particular attention to regulatory compliance and potential exposure levels. In this study, 230 mushroom samples representing 19 wild edible species were analyzed using gamma spectrometry, alongside composite soil samples collected from corresponding foraging sites. The activity concentration of 137Cs in mushrooms ranged from 0.94 to 159.0 Bq/kg fresh mass (f.m.), and that of 40K from 64.4 to 150.2 Bq/kg f.m. None of the samples exceeded the regulatory limit of 1250 Bq/kg f.m. for 137Cs. The highest estimated annual effective dose was 2.32 µSv from 137Cs and 0.93 µSv from 40K, with no exceedance of regulatory limits observed in any sample. A strong positive correlation was observed between 137Cs activity in soil and mushroom dry mass (Spearman’s Rho = 0.81, p = 0.042), supporting predictable transfer patterns. Additionally, the implications of mushroom drying were assessed considering Council Regulation (Euratom) 2016/52, which mandates radionuclide levels in dried products be evaluated based on their reconstituted form. After such adjustment, even the most contaminated dried samples were found to comply with food safety limits. These findings confirm the radiological safety of wild mushrooms from north-eastern Poland and contribute novel data for a region with limited prior monitoring, in the context of current food safety regulations. Full article
(This article belongs to the Section Agrochemicals and Food Toxicology)
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11 pages, 252 KiB  
Article
Particular Councils and Synodality
by Maria d’Arienzo
Religions 2025, 16(7), 840; https://doi.org/10.3390/rel16070840 - 25 Jun 2025
Viewed by 237
Abstract
This paper underlines the importance of the Particular Councils in the implementation of the principle of synodality, a central theme in Pope Francis’ pontificate. A recovery of the role previously recognised to Particular Councils can, in fact, contribute to a more balanced participation [...] Read more.
This paper underlines the importance of the Particular Councils in the implementation of the principle of synodality, a central theme in Pope Francis’ pontificate. A recovery of the role previously recognised to Particular Councils can, in fact, contribute to a more balanced participation of the People of God in carrying out the Church’s mission. Full article
26 pages, 478 KiB  
Article
Physical Disabilities and Impediments to the Priesthood According to Orthodox Canon Law, with a Case Study of the Romanian Orthodox Church
by Răzvan Perșa
Religions 2025, 16(6), 789; https://doi.org/10.3390/rel16060789 - 17 Jun 2025
Viewed by 744
Abstract
This study examines, within the broader context of historical and cultural influences from Byzantine and Western canonical traditions, the canonical and theological treatment of physical disabilities as impediments to the priesthood within modern Orthodox Canon Law. It shows how traditional Orthodox Canon Law, [...] Read more.
This study examines, within the broader context of historical and cultural influences from Byzantine and Western canonical traditions, the canonical and theological treatment of physical disabilities as impediments to the priesthood within modern Orthodox Canon Law. It shows how traditional Orthodox Canon Law, particularly influenced by medieval Roman Catholic canonical understanding, has historically emphasised physical integrity as a requirement for ordination. The study critically examines historical and contemporary canonical attitudes towards candidates with hearing, speech, or visual impairments or with locomotor disability through the analysis of Apostolic canons, Canons of Ecumenical Councils, and later canonical sources. The methods include a critical canonical and historical analysis of primary sources such as the Canons, patristic writings, and synodal legislation, with particular reference to the initiatives of the Romanian Orthodox Church in the modern cultural and pastoral context. The study observes that, although such impairments continue to be recognised as canonical impediments according to traditional Orthodox law, contemporary ecclesial practice increasingly reflects a pastoral sensitivity that allows, in certain contexts, for the inclusion of persons with disabilities in ordained ministry. This is typically achieved through adaptations that preserve the integrity of liturgical function, such as assistance from co-ministers or specialised training. These developments, while not amounting to a formal canonical revision, signal a broader pastoral and ecclesiological openness toward the integration of persons with disabilities within the life of the Church. Full article
18 pages, 3944 KiB  
Article
Creativity and Awareness in Co-Creation of Art Using Artificial Intelligence-Based Systems in Heritage Education
by Francesca Condorelli and Francesca Berti
Heritage 2025, 8(5), 157; https://doi.org/10.3390/heritage8050157 - 30 Apr 2025
Viewed by 1133
Abstract
The article investigates a learning setting contextualising the use of artificial intelligence in heritage education, with a particular focus on AI systems utilising text-to-image processes. The setting is the one of a university interdisciplinary seminar in communication in South Tyrol, a border region [...] Read more.
The article investigates a learning setting contextualising the use of artificial intelligence in heritage education, with a particular focus on AI systems utilising text-to-image processes. The setting is the one of a university interdisciplinary seminar in communication in South Tyrol, a border region in the north of Italy shaped by a strong cultural identity. The paper illustrates a didactic experience introducing a highly technical and, for most of the students in the chosen context, challenging topic, such as AI. The teaching addresses a critical approach to AI, such as dataset constraints, sustainability, and authorship, and focuses on text-to-image algorithms and artistic co-creation, namely, the shifting role of the artist from sole creator to initiator/collaborator shaping the AI system’s output. The aim of the paper is to contribute to the debate in heritage education on teaching and learning using AI-based systems. The latter are seen as a potential tool for the engagement of students in understanding heritage and its safeguarding and in the relationship between community, territory, and active participation, as emphasised by both the “UNESCO Convention on Intangible Cultural Heritage” and the “Council of Europe Framework Convention on the Value of Cultural Heritage for Society”. However, the current boundaries of AI, particularly in terms of bias and limitations of datasets, must be addressed and reflected on. Full article
(This article belongs to the Special Issue Progress in Heritage Education: Evolving Techniques and Methods)
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8 pages, 11965 KiB  
Proceeding Paper
Analysis of Points of Interest in Hsinchu Old City Blocks Using Space Syntax
by Shaofu Li
Eng. Proc. 2025, 91(1), 8; https://doi.org/10.3390/engproc2025091008 - 10 Apr 2025
Viewed by 282
Abstract
This study aims to explore how historical attractions in old urban areas effectively contribute to tourism development. In particular, the accessibility and convenience of transport are analyzed using Spatial Syntax. Previous collaborative projects with local community colleges were assessed to obtain recognized spatial [...] Read more.
This study aims to explore how historical attractions in old urban areas effectively contribute to tourism development. In particular, the accessibility and convenience of transport are analyzed using Spatial Syntax. Previous collaborative projects with local community colleges were assessed to obtain recognized spatial boundaries of old districts. The historic buildings and their points of interest were determined by the Hsinchu City Council. Modern cities’ grid patterns and straight roads connect various scenic spots. Using the spots, spatial syntactic analyses were conducted in this study. The impact of spatial features on the assessment was found indirect and dependent on the road network of the Old Town. A social responsibility program was also developed to investigate the rise and fall of cities in the development process. Full article
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34 pages, 6071 KiB  
Review
Can the Beach–Dune Ecosystem Be Preserved Without Protecting the Beach? Ecological Assessment with a Focus on Specialized Beetle Fauna as Environmental Quality Indicators
by Lorenzo Zanella and Fabio Vianello
Sustainability 2025, 17(5), 1922; https://doi.org/10.3390/su17051922 - 24 Feb 2025
Viewed by 1127
Abstract
Anthropogenic development has historically concentrated in coastal areas to exploit resources from fishing and commercial navigation. In recent centuries, intensive tourism has added pressure on sandy shorelines, leading to their modification. This development model has led to the disappearance of most coastal sand [...] Read more.
Anthropogenic development has historically concentrated in coastal areas to exploit resources from fishing and commercial navigation. In recent centuries, intensive tourism has added pressure on sandy shorelines, leading to their modification. This development model has led to the disappearance of most coastal sand dunes and their rich biodiversity, which includes specialized plant and animal species adapted to sandy substrates, harsh arid conditions, and variable levels of salinity. The European Community’s conservation policies, particularly the Habitats Directive (Council Directive 92/43/EEC), have facilitated the preservation and restoration of the few remaining dune systems. However, these policies have unfortunately overlooked the protection of the adjacent beaches, which are integral to the coastal ecosystem. The loss of biodiversity typical of the beach–dune ecosystems is examined in relation to the anthropogenic disturbance factors, with particular attention to mechanical beach cleaning. Indeed, the metabolizable energy generated by this decomposer biomass is crucial for supporting a diverse trophic network of predators, ranging from insects to birds. The rapid disappearance of the specialized beetle fauna is examined, and some essential criteria for defining standard biotic indices suitable for monitoring these ecosystems are suggested. This approach aims to support more effective conservation programs for these fragile environments. We recommend revising the regulatory framework for safeguarding beach–dune ecosystems, while also proposing some key management principles to be incorporated into the protection guidelines. Full article
(This article belongs to the Section Environmental Sustainability and Applications)
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18 pages, 7550 KiB  
Article
Technical Recyclability and Carbon Footprint of Packaging for Butter, Yogurt, and Spreads
by Michelle Klein, Charlotte Neumair, Manfred Tacker and Silvia Apprich
Recycling 2025, 10(2), 31; https://doi.org/10.3390/recycling10020031 - 21 Feb 2025
Viewed by 1266
Abstract
The adoption of the PPWR by the Council of the European Union (EU/2025/40) in 2025 intensifies the regulatory pressure on packaging manufacturers and food producers. This necessitates their adaptation of packaging to the new standards and selection of materials by various sustainability criteria [...] Read more.
The adoption of the PPWR by the Council of the European Union (EU/2025/40) in 2025 intensifies the regulatory pressure on packaging manufacturers and food producers. This necessitates their adaptation of packaging to the new standards and selection of materials by various sustainability criteria and minimum standards. The legal text places particular emphasis on recyclability and the carbon footprint. The dairy industry holds significant economic importance in the DACH region (Germany, Austria, and Switzerland); this study therefore analyzed and compared the recyclability and carbon footprint of selected product categories and diverse packaging options for butter, yogurt, spreads, curd cheese, and cottage cheese. This study found large differences within the product categories, and also between the assessed countries, due to differing waste management systems (collection, sorting, and recycling) and waste streams. A key finding is the substantial discrepancy in glass packaging, which significantly exceeds the emission values of other packaging systems. In terms of recyclability, glass packaging performs well due to the effectiveness of the recycling systems regarding the future effective PPWR. However, significant variations in recyclability were observed between Germany and Austria for tray and cup materials made of PP and PS. Notably, there is a preference for packaging systems without a cardboard sleeve over those with one. This study provides critical insights into the environmental performance of packaging materials in the dairy sector. It highlights the challenges posed by regulatory changes and the urgent need for region-specific strategies. By identifying key areas for improvement in packaging design and waste management, this work lays the foundation for achieving compliance with the PPWR and advancing the transition toward a circular economy in the DACH region. Full article
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15 pages, 872 KiB  
Review
Psychiatric Home Hospitalization: The Role of Mental Health Nurses—A Scoping Review
by Marisa Soares, Vânia Martins, Margarida Tomás, Luís Sousa, Tiago Nascimento, Patrícia Costa, Graça Quaresma and Pedro Lucas
Healthcare 2025, 13(3), 231; https://doi.org/10.3390/healthcare13030231 - 24 Jan 2025
Cited by 1 | Viewed by 2133
Abstract
The lack of evidence synthesis studies on the role of psychiatric mental health nursing in the context of psychiatric home hospitalization underscores the limited research on nurses providing care in these teams, particularly concerning their experiences and responsibilities and the actual role of [...] Read more.
The lack of evidence synthesis studies on the role of psychiatric mental health nursing in the context of psychiatric home hospitalization underscores the limited research on nurses providing care in these teams, particularly concerning their experiences and responsibilities and the actual role of nurses in this context. This knowledge has the potential to improve the quality of mental healthcare by guiding nursing practices. Objective: To map the concepts related to the role of mental health nurses in psychiatric home hospitalization. Methods: A scoping review was conducted using the methodology proposed by the JBI, involving five methodological stages. No search limits were applied except for language. Results: The review identified five key dimensions of nursing in psychiatric home hospitalization: satisfaction; care models; the therapeutic relationship; the care environment; the organization of care. These interconnected dimensions influence quality care. Satisfaction among nurses, patients, and families is associated with improved outcomes and reduced stigma. The therapeutic relationship is characterized by a humanistic approach, emphasizing dialogue, empathy, and shared decision making. Additionally, the importance of care organization is highlighted, including individualized care plans, medication management, and intersectoral collaboration. Discussion: The five nursing dimensions align with the Quality Standards of the Portuguese Nursing Council and are consistent with the scientific literature. Conclusions: Although there is a shortage of studies on this topic, this review allows for the synthesis of nursing interventions and reflection on the paradigm shift in care within the scope of psychiatric mental health nursing interventions. Future studies highlighting the value of mental health nursing interventions, with a particular focus on nursing-sensitive indicators and employing quantitative or mixed methods, will be crucial to furthering the analysis conducted thus far. Full article
(This article belongs to the Section Healthcare Quality and Patient Safety)
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23 pages, 4318 KiB  
Article
The Socio-Economic Impact of University in Thailand: Evidence from Chiang Mai University
by Warattaya Chinnakum, Chanamart Intapan, Jittima Singvejsakul, Mattana Wongsirikajorn, Banjaponn Thongkaw, Paponsun Eakkapun and Chukiat Chaiboonsri
Economies 2024, 12(12), 339; https://doi.org/10.3390/economies12120339 - 11 Dec 2024
Cited by 2 | Viewed by 2598
Abstract
For the success of efficient socioeconomic development, it is crucial that budget allocation in higher education is effectively managed, with a clear focus on targeting SDG 4 (Quality Education), which is vital for every country and should be prioritized globally. This research article [...] Read more.
For the success of efficient socioeconomic development, it is crucial that budget allocation in higher education is effectively managed, with a clear focus on targeting SDG 4 (Quality Education), which is vital for every country and should be prioritized globally. This research article attempts to assess the socio-economic impact of Chiang Mai University based on the impact of both its expenditure and teaching and training programs on the Northern Thailand economy. Moreover, it also aims to develop the best model to predict the SROI for academic projects before investing the budget for efficient financial management. All the data utilized in this research article come from official organizations such as Chiang Mai University, the Office of the National Economic and Social Development Council (NESDC), and the Provincial Comptroller’s Office of each province in Northern Thailand, with the data collection covering the study period from 2023 to 2025. The key finding is that Chiang Mai University played a significant role in creating a socioeconomic impact on Northern Thailand’s economy, both in the industry sector and the service sector, totaling more than an average of THB 3 billion per year for direct and indirect effects. In addition, every THB 1 million that this university spends can create more than 703 jobs in the agribusiness sector, and, for the same budget spending, it can create 241 jobs in the service sector and 113 jobs in the industry sector, respectively. Technically, for the prediction model to predict the SROI value, it was found that the best model is the Decision Tree model. If the findings of this research can be applied to other universities in Thailand or globally, it would represent a significant initiative in optimizing budget allocation, with a particular emphasis on supporting SDG 4 (Quality Education) as a priority. Full article
(This article belongs to the Section Economic Development)
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18 pages, 240 KiB  
Article
International Regulatory Framework for Black Carbon Emissions from Arctic Shipping: Current Situation, Problems, and Development
by Xin Yang, Ziqing Zhang, Zhiyuan Cui and Siyang Cai
Sustainability 2024, 16(23), 10656; https://doi.org/10.3390/su162310656 - 5 Dec 2024
Cited by 2 | Viewed by 1513
Abstract
Black carbon, a short-lived climate forcer, has the dual impact of intensifying global warming and polluting the atmosphere. The further opening of Arctic shipping routes has resulted in a severe issue of black carbon emissions in this fragile region. The use of fuel, [...] Read more.
Black carbon, a short-lived climate forcer, has the dual impact of intensifying global warming and polluting the atmosphere. The further opening of Arctic shipping routes has resulted in a severe issue of black carbon emissions in this fragile region. The use of fuel, especially heavy fuel oil, in international shipping has generated enormous black carbon emissions, posing a serious threat to the climate in the Arctic and beyond. As the international community continues to pay attention to air pollution control and greenhouse gas emissions reduction, the need for effective global governance of black carbon emissions from Arctic shipping has become increasingly evident. This issue has emerged as a critical part of the broader effort to address ocean and climate governance through the lens of international law. Despite the efforts made by both the International Maritime Organization (IMO) and the Arctic Council (AC) to reduce black carbon emissions, the current international legal framework remains fragmented, with weak enforcement mechanisms and limited capacity for coordinated governance. The findings of this research underscore the importance of strengthening international legal instruments aimed at reducing black carbon emissions from Arctic shipping. In particular, there is a pressing need for the development of a dedicated international treaty with enhanced binding force to mitigate the ecological degradation in the Arctic, address global warming, and realize sustainable development goals. Full article
46 pages, 3013 KiB  
Article
When Local Governments Plan to Give Their Past a Future: A State-Wide Analysis of Heritage Strategy Documents in New South Wales (Australia)
by Dirk H. R. Spennemann
Land 2024, 13(11), 1955; https://doi.org/10.3390/land13111955 - 19 Nov 2024
Viewed by 1005
Abstract
The authorized heritage discourse sensu Smith asserts that cultural heritage, and in particular heritage places, can be managed for the benefit of present and future generations through appropriate measures of identification, protection and conservation. Comprehensive planning at the individual place as well as [...] Read more.
The authorized heritage discourse sensu Smith asserts that cultural heritage, and in particular heritage places, can be managed for the benefit of present and future generations through appropriate measures of identification, protection and conservation. Comprehensive planning at the individual place as well as community/local government level is the backbone to good management if ad hoc decisions are to be avoided. While all local government authorities (councils) in New South Wales (Australia) are mandated to produce Local Strategic Planning Statements with a ten-year horizon that may include statements related to heritage management, some councils also promulgated dedicated heritage strategies. So far, the nature and comprehensiveness of such planning instruments have never been formally investigated. This paper provides a state-wide analysis of Local Strategic Planning Statements and council heritage strategies in NSW. The review shows that the priorities expressed in heritage strategies are often mundane, with none of the strategies expressing aspirational priorities or actions. The value of heritage to a community is assumed axiomatically, with very few heritage strategies expressing a vision for why heritage management is of community relevance. Only a few heritage strategies demonstrate how they, and their strategic priorities, are interlinked with other local, let alone state-level, strategies and policies. Very few of the documents provide evidence for the basis on which the strategies are founded, such as canvassing public opinion, situational analysis or projections of demographic, social, societal and economic trajectories based on strategic foresight. This review highlights much room for improvement. In a post-modernist age of alternative truths, where trust in governments is declining, it is imperative that local government heritage strategies be grounded in the community, offer transparency in how priorities are decided and, above all, provide a clear and aspirational vision for the role that cultural heritage shall play in the community. Full article
(This article belongs to the Special Issue Co-Benefits of Heritage Protection and Urban Planning)
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18 pages, 349 KiB  
Article
The Involvement of the Catholic Laity in the Promotion of Peace
by Lóránd Ujházi
Religions 2024, 15(11), 1336; https://doi.org/10.3390/rel15111336 - 31 Oct 2024
Cited by 1 | Viewed by 1552
Abstract
In accordance with their constitutional prerogatives, members of the Church engage in activities that align with their designated roles and responsibilities. A review of both the history of the Church and the documents in force reveals that the Church, in its broadest sense, [...] Read more.
In accordance with their constitutional prerogatives, members of the Church engage in activities that align with their designated roles and responsibilities. A review of both the history of the Church and the documents in force reveals that the Church, in its broadest sense, is concerned with the promotion of peace. Such areas are, by definition, those which fall within the purview of laypeople. The Second Vatican Council accorded particular attention to the promotion of social justice and peace, as well as to the apostolate of lay faithful. Consequently, the two areas were brought into contact and underwent further development. This paper presents the historical trajectory that has culminated in the most comprehensive positioning of the laity in the promotion of social justice, elucidating the legal distinctions pertaining to the most prevalent methods through which they can promote peace. Full article
23 pages, 283 KiB  
Article
Sovereign ESG and Foreign Direct Investment in the GCC: The Amplifying Role of Trade Openness in Economic Diversification
by Souad Bannour and Nagwa Amin Abdelkawy
Sustainability 2024, 16(21), 9326; https://doi.org/10.3390/su16219326 - 27 Oct 2024
Cited by 3 | Viewed by 3172
Abstract
This study examines the relationship between Sovereign Environmental, Social, and Governance (SESG) initiatives and foreign direct investment (FDI) within the context of the Gulf Cooperation Council (GCC) countries from 2000 to 2022. The research explores how national ESG performance influences the attractiveness of [...] Read more.
This study examines the relationship between Sovereign Environmental, Social, and Governance (SESG) initiatives and foreign direct investment (FDI) within the context of the Gulf Cooperation Council (GCC) countries from 2000 to 2022. The research explores how national ESG performance influences the attractiveness of these countries to foreign investors, with a particular focus on the moderating role of trade openness. Using a comprehensive panel data analysis, the study finds that strong SESG frameworks are positively correlated with higher FDI inflows, with trade openness amplifying the positive impact of SESG. Additionally, the use of Instrumental Variables (IV) estimation addresses endogeneity concerns, further confirming the robustness of the results. Moreover, the analysis reveals that trade openness amplifies the positive impact of SESG on FDI, suggesting that GCC countries with liberal trade policies and robust ESG practices are more successful in attracting sustainable and responsible investments. These findings contribute to the growing body of literature on ESG and FDI, offering valuable insights for policymakers seeking to enhance economic growth through strategic investments in sustainability and governance. The findings offer valuable insights for policymakers in aligning SESG frameworks with global ESG standards and leveraging global liquidity conditions to enhance FDI inflows, particularly in light of ongoing economic diversification efforts in the GCC. Full article
13 pages, 1056 KiB  
Review
Pathophysiology and Prevention of Manual-Ventilation-Induced Lung Injury (MVILI)
by Luke A. White, Steven A. Conrad and Jonathan Steven Alexander
Pathophysiology 2024, 31(4), 583-595; https://doi.org/10.3390/pathophysiology31040042 - 12 Oct 2024
Cited by 1 | Viewed by 4434
Abstract
Manual ventilation, most commonly with a bag-valve mask, is a form of short-term ventilation used during resuscitative efforts in emergent and out-of-hospital scenarios. However, compared to mechanical ventilation, manual ventilation is an operator-dependent skill that is less well controlled and is highly subject [...] Read more.
Manual ventilation, most commonly with a bag-valve mask, is a form of short-term ventilation used during resuscitative efforts in emergent and out-of-hospital scenarios. However, compared to mechanical ventilation, manual ventilation is an operator-dependent skill that is less well controlled and is highly subject to providing inappropriate ventilation to the patient. This article first reviews recent manual ventilation guidelines set forth by the American Heart Association and European Resuscitation Council for providing appropriate manual ventilation parameters (e.g., tidal volume and respiratory rate) in different patient populations in the setting of cardiopulmonary resuscitation. There is then a brief review of clinical and manikin-based studies that demonstrate healthcare providers routinely hyperventilate patients during manual ventilation, particularly in emergent scenarios. A discussion of the possible mechanisms of injury that can occur during inappropriate manual hyperventilation follows, including adverse hemodynamic alterations and lung injury such as acute barotrauma, gastric regurgitation and aspiration, and the possibility of a subacute, inflammatory-driven lung injury. Together, these injurious processes are described as manual-ventilation-induced lung injury (MVILI). This review concludes with a discussion that highlights recent progress in techniques and technologies for minimizing manual hyperventilation and MVILI, with a particular emphasis on tidal-volume feedback devices. Full article
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