Search Results (91,830)

Background: Healthcare systems contribute significantly to environmental pollution, energy consumption, and resource depletion, making sustainability an increasingly important environmental and public health priority. Nurses, as frontline healthcare professionals, play a critical role in promoting environmentally responsible practices and advocating for sustainable healthcare within clinical settings. Objective: The study aimed to examine the associations between nurses’ sustainability consciousness, green advocacy, and work grit in hospital settings. Methods: A descriptive cross-sectional correlational study was conducted among 377 nurses working in two university-affiliated hospitals in Egypt. Data were collected using validated instruments assessing sustainability consciousness, green advocacy, and work grit. Descriptive statistics were calculated to summarize participant characteristics and study variables. Associations among sustainability consciousness, green advocacy, and work grit were examined using Pearson correlation analysis. Multiple linear regression analysis was conducted to identify significant predictors of green advocacy, while noting that the study design allows for identification of associations rather than causal relationships. Results: The findings indicated generally high levels of sustainability consciousness among nurses. Significant positive associations were observed between sustainability consciousness, green advocacy, and work grit (p < 0.01). Multiple linear regression analysis identified sustainability consciousness and work grit as significant predictors of green advocacy, explaining 34.2% of its variance. Conclusions: These findings highlight the interconnected roles of sustainability awareness, advocacy behaviors, and psychological resilience in promoting environmentally sustainable healthcare practices. Strengthening nurses’ sustainability consciousness and work grit may enhance green advocacy and contribute to the development of sustainable healthcare systems, supporting global environmental and public health goals aligned with the United Nations Sustainable Development Goals. Full article

Aim: The aim of this study was to explore the distribution and driving factors influencing the disparity of health professionals (HPs) at the Centers for Disease Control and Prevention (CDC) in China and to provide a reference for regional health planning and rational allocation of public health resources. Methods: The Gini coefficient was used to measure the equity of HP distribution at CDC sites at the provincial level during 2012–2023 in China. Moran’s I was used to analyze the spatial agglomeration effect, and the geographic detector model was used to explore the factors driving the allocation of HPs at CDC sites in different provinces. Results: The number of HPs at the CDC showed an increasing trend from 2012 to 2023 in China. The average Gini coefficients at the population and geographical areas were 0.16 and 0.58, respectively. The global Moran’s I statistic indicated a notable decline in spatial clustering for the population dimension, decreasing from 0.503 to 0.238; in contrast, spatial clustering for the geographical dimension remained relatively stable, ranging between 0.13 and 0.16. The local Moran’s I statistic revealed that provinces such as Qinghai in the western China consistently exhibited a “low–low” spatial clustering pattern. Six factors were found to explain the variability in the CDC HP distribution based on the 2020 data. In the context of factor interactions, the synergistic effects between education level and health expenditure share (q = 0.9781), and between population aging and per capita GDP (q = 0.9699), substantially exceed the explanatory power attributable to any single factor alone. Conclusions: A significant regional disparity was observed in the distribution of HPs among 31 provinces, with the distribution based on service area being less equitable than that based on population. The shortage of healthcare professionals in the western region is characterized by notably inadequate geographical distribution. Future policy initiatives should prioritize targeted spatial interventions and integrated, multi-factor collaborative strategies. Full article

Arsenic contamination in groundwater is a severe and widespread environmental and public health challenge. Recent years have witnessed rapid advances in catalytic remediation technologies, particularly those integrating advanced oxidation processes (AOPs), bifunctional materials, and field-scale applications. This comprehensive review synthesizes recent developments, emphasizing the synergy between catalytic oxidation and adsorption, the design of innovative and recyclable materials, and the practical translation of laboratory findings to real-world remediation scenarios. Key breakthroughs include dual-function catalysts for combined contaminant removal, scalable systems compatible with renewable energy, and hybrid strategies integrating conventional and catalytic routes. Case studies from arsenic hotspots worldwide demonstrate not only technological feasibility but also highlight knowledge gaps and sustainability challenges. By evaluating catalytic mechanisms, operational performance, and environmental impact, this review identifies promising directions for the next generation of arsenic remediation and offers a critical roadmap to guide future research and practice. Full article

Background/Objectives: Haemoadsorption has recently emerged as an extracorporeal treatment option for sepsis, septic shock, intoxications, and cardiac surgery to modulate dysregulated inflammatory responses or remove a wide range of circulating molecules. To ensure appropriate clinical use of the CytoSorb^® haemoadsorber, it is essential to understand the extent to which specific drugs are adsorbed by the device. Methods: We conducted a systematic literature review using the PubMed and Ovid MEDLINE database to identify studies on drug binding to the CytoSorb^® haemoadsorber, including both in vivo and in vitro studies. Publications in English language, available up to 31 December 2025 that reported or enabled calculation of percentage of drug removal, CytoSorb^® clearance or half-life during CytoSorb^® therapy were included. Records were screened, eligibility and quality were assessed, and data were extracted independently by two reviewers. Results: We found that 26 studies reported on the binding of 56 drugs to CytoSorb^®, with most available information relating to antibiotics used in the treatment of sepsis and septic shock. CytoSorb^® appears to remove vancomycin and linezolid but not meropenem, although data for other antibiotics are insufficient to assess clinical relevance. Data on the removal of anticoagulant and antithrombotic drugs with CytoSorb^® before and during cardiac surgery indicate that using this procedure to reduce complications associated with apixaban and ticagrelor is feasible and safe. The available evidence on the use of CytoSorb^® for drug poisoning is of very low quality. Conclusions: Although the number of studies on drug binding to the CytoSorb^® is increasing, the review is limited by the marked heterogeneity among the included studies. It is advised to use therapeutic drug monitoring whenever possible during CytoSorb^® treatment. Research of binding of drugs to CytoSorb^® is crucial for its safe and effective clinical use, but adequate methodology is necessary. Full article

The synergistic effects of soil acidification and heavy metal pollution present major challenges for global agroecosystems. To systematically trace the evolution of research and identify key topics in this field, this study employed CiteSpace to visualize and analyze 691 records from the China National Knowledge Infrastructure (CNKI) and 6747 highly relevant articles or reviews from the Web of Science (WOS) Core Collection database from 2005 to 2025. The results indicate a steady to rapid rise in global publications, with China contributing the largest share, at 2468 publications. This has produced a research cluster centered around the Chinese Academy of Sciences (CAS); however, the centrality of its international cooperation remains limited. Studies in the CNKI database are driven by agricultural needs, focusing on national food security, rice yield stability, improvement of arable land, and heavy metal passivation and remediation, with a concentration on basic agricultural science. By contrast, research in the WOS database emphasizes fundamental mechanisms and interdisciplinary integration, addressing aluminum toxicity, microbial communities, the nitrogen cycle, and global climate change, intersecting fields such as environmental science, soil science, ecology, and microbiology. The evolution of research hotspots shows a clear trajectory: from acidity regulation and chemical speciation analysis of heavy metals (2005–2013), to heavy metal passivation, remediation, and phytoremediation (2014–2018), and then to biochar materials, microbiome analysis, and the synergistic role of carbon sequestration (2019–2025). This study argues that future research should move beyond single remediation measures and adopt integrated strategic management to jointly improve bioremediation efficiency, promote soil carbon sequestration and soil health, and enhance microbial adaptation to global climate change. Full article

Background: The Democratic Republic of the Congo accounts for approximately 12–13% of the global malaria burden. While international guidelines oppose the use of Artemisia annua infusions due to risks of sub-therapeutic dosing and resistance selection, the plant remains widely used in resource-limited regions. This study evaluates the clinical acceptability and perceptions of healthcare providers regarding the integration of Artemisia annua tea into formal malaria control in the Maniema province. Methods: A cross-sectional survey was conducted among 337 healthcare professionals in the Kalima health district using the KoboCollect digital platform. Multivariate logistic regression was employed to identify the primary socio-professional determinants of clinical acceptability. Results: The overall clinical acceptability of Artemisia annua integration was 81.0%, with 82.8% of providers perceiving the preparation as effective. Rural residency was the strongest predictor of adherence (AOR = 6.847; p = 0.003), reflecting a pragmatic response to frequent ACT stockouts and high treatment costs. Despite high acceptability, 49.0% of providers identified the lack of clinical evidence as a major barrier, and 91.4% demanded formal training on standardized dosage and biological mechanisms. Conclusions: A significant “policy–practice gap” exists between international guidelines and field realities in the DRC. Healthcare providers demonstrate high readiness for integration but emphasize the absolute necessity of galenic standardization to mitigate resistance risks. To address these concerns, a complementary genomic investigation is currently underway in the same study area, comparing PfKelch13 mutation prevalence among Artemisia tea users versus ACT-treated patients. This molecular surveillance will provide essential evidence to define safety parameters for future phytopharmaceutical integration. Full article

The transformation of religious authority in the digital age is shaped by the interactions between human actors, digital media and algorithmic systems. This study uses digital ethnography to examine how religious authority is constructed and negotiated on digital platforms used by Muslims in Indonesia and globally. This study focuses on seven authoritative figures in the digital Islamic landscape, representing different spectra of authority, from traditional pesantren in Indonesia to transnational apologetics and urban liberalism. The findings reveal patterns of authority delegation in which digital platforms replace human roles in da’wah and Islamic institutions. Religious authority is formed through articulative work that connects the Sunnah, intermediaries (religious scholars), and congregations. Public search data show that digital spaces function as a medium of distribution, where religious authority is shaped by audience responses, message repetition, symbolic affiliation, and the dynamics of debate. This study highlights the role of algorithmic culture and authority representation aesthetics in mediating religious authority in the digital age. Algorithms shape exposure and reach audiences, and representational aesthetics are crucial for disseminating religious content. The study concludes that clerical authority in the digital era results from technocultural mediation, in which the cleric becomes both a figure and representation calculated by machines and validated by the audience’s participation. Full article

Recent global events have slowed progress toward achieving the Sustainable Development Goals (SDGs), making robust sustainability reporting (SR) systems critical for monitoring and corrective actions. While research on the link between corporate sustainability performance (CSP) and corporate financial performance (CFP) is extensive, the specific role of sustainability reporting as a communication channel remains insufficiently explored. Therefore, the objective of this paper is to address this gap in the literature by assessing the relevance of sustainability reporting for modeling the relationship between CSP and CFP. In this study, a univariate meta-analysis based on a PRISMA screening framework was performed to assess the unidirectional relationship between SR and CFP, specifically investigating whether SR acts as a moderating or mediating factor in the CSP-CFP nexus. The analysis is limited to 19 high-quality articles published in top-tier accounting journals between 2014 and 2024 to minimize publication bias and ensure reliability. The meta-analysis reveals no statistically significant moderating effect of SR on CFP. Instead, the results confirm a significant mediating effect, particularly when considering the presence of sustainability reports rather than just their specific content. These findings suggest that SR serves as a vital catalyst for corporate communication, providing more positive effects in voluntary compared to mandatory disclosure settings. This paper has both theoretical and practical implications, which are mainly relevant to standard-setters for assessing the efforts of SR disclosure regulation, and is of fundamental importance to managers as it indicates that SR does not relate solely to the practice of conformity, but rather to essential channels of communication and value creation. Full article

Micro-public space (MPS) regeneration is typically evaluated at the point of delivery, yet long-term performance depends on whether everyday stewardship can be sustained thereafter. This study reframes neighbourhood social capital as a governance–environment signal reflecting coordination capacity and examines whether residents’ willingness to participate in post-regeneration co-management is primarily appraisal-driven (perceived value, attitude, and perceived behavioural control) or coordination-driven via a residual direct channel consistent with routine governance. A cross-sectional survey of adults residing within walkable catchments of five regenerated MPS sites in Nan’an District, Chongqing, China ($N=477$), was conducted. An integrated Stimulus–Organism–Response × TPB model was estimated using WLSMV with ordered categorical indicators; indirect effects were assessed via bias-corrected bootstrap confidence intervals. Coordination capacity was strongly associated with perceived value, participation attitude, and perceived behavioural control. In the joint model, only perceived value retained a statistically reliable positive association with stewardship willingness, whereas the incremental contributions of attitude and perceived behavioural control were negligible once the stimulus was included. A residual direct association from coordination capacity to willingness persisted beyond the appraisal block, supporting a direct-dominant interpretation; bootstrap analyses yielded no robust evidence for mediation (BCa 95% CIs crossed zero). These findings suggest that sustaining regenerated micro-spaces requires low-friction governance designs that minimise coordination costs, reinforce soft accountability, and render institutional responsiveness visible to residents. Full article

This study aims to provide insights into how physical activity is associated with sleep patterns in youth populations, in particular, Slovak adolescents, and how gender (boys vs. girls) and age (≤16 vs. ≥18) moderate this relationship, using an extreme-group comparison approach that excludes 17-year-olds to enhance contrast between developmental stages. Using a cross-sectional design, self-reported data were collected from 2504 (100%) high school students (aged 15–19; 45.6% boys, 54.4% girls) using the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Pittsburgh Sleep Quality Index (PSQI). Participants aged 17 years were excluded from age-stratified analysis to create clearer separation between early/mid and late adolescence. The primary outcome was global sleep quality (PSQI > 5). Secondary outcomes included sleep duration and PSQI component scores. All other analyses (age- and gender-stratified comparisons and interaction models) were predefined as exploratory and hypothesis-generating to examine potential effect modification. Age-stratified analyses among girls showed that, within the low PA group, good sleep was reported by 37.7% of younger girls (≤16) and 28.6% of older girls (≥18). Among older girls, the proportion reporting good sleep increased to 49.8% in the high PA group (χ² = 29.16, p < 0.001). No consistent associations between PA and sleep quality were observed among boys; however, significant association was identified among younger boys (≤16 years), which was not observed in older boys. Logistic regression revealed a modest interaction between age and PA level in predicting sleep quality among girls (β = 0.346, p = 0.049), suggesting small age-dependent variation in the association. This effect should be interpreted cautiously given its borderline statistical significance. Component-level PSQI analyses showed that girls experienced higher rates of sleep disturbances (χ² = 91.40, p < 0.001), longer sleep latency (χ² = 26.71, p < 0.001), and greater daytime dysfunction (χ² = 79.90, p < 0.001). These findings provide region-specific evidence from Central and Eastern Europe and underscore the need for age- and gender-sensitive public health strategies targeting both physical activity promotion and better sleep outcomes, given their observed associations. Full article

Fine particulate matter PM_2.5 continues to pose a critical public health risk in Northern Thailand, particularly in Chiang Mai, where traditional filtration methods often face limitations in cost and efficiency for large-scale applications. This study introduces a novel “Evaporator Condensation Growth Particle Scrubber (ECGP)” designed to enhance the collection efficiency of sub-micron particles by enlarging their physical size through a pressure-driven growth mechanism. The ECGP system utilizes synergistic effects between solid nuclei, high relative humidity, and mechanical pressure modulation. The ECGP system integrates solid nuclei, ~95% relative humidity and mechanical pressure modulation within a single chamber. Using incense smoke as a PM surrogate, the process utilizes controlled adiabatic cycles to induce stable heterogeneous condensation. The results indicate that the integrated process effectively shifts particle size distribution, reducing the PM_2.5/PM₁₀ mass ratio from 1.00 to 0.83. This indicates that approximately 17.5% (with a standard deviation < 1% across 10 trials, p < 0.05) of the fine mass successfully transitioned into the larger, more filterable PM₁₀ fraction and exhibited high physical stability and resistance to re-evaporation, effectively overcoming the low-efficiency threshold (typically <10%) of standard mechanical scrubbers and cyclones for sub-micron dust. This study concludes that ECGP technology offers a promising, cost-effective alternative for improving indoor air quality in large public infrastructures by leveraging particle inertia for enhanced removal, providing a scalable solution to the persistent smog crisis. Full article

This study developed internally consistent scenarios for tourism village development to strengthen destination competitiveness and support the local economy. Using an exploratory–constructive design and the Cross-Impact Balance method, the study structured the relationships among development elements, competitiveness, and local economic development into 13 descriptors with 52 states. Expert judgment was used to construct a cross-impact matrix, and ScenarioWizard identified 18 consistent scenarios and their Total Impact Scores. Four scenarios showed positive consistency scores, with one high-road scenario emerging as the most consistent pathway toward very high competitiveness and a stronger role for tourism villages in the local economy. This scenario was characterized by a clear value proposition, full integration of local MSMEs and products, diversified revenue sources, equitable benefit distribution, strong managerial and digital capacity, transparent governance, multi-stakeholder partnerships, strategic use of public funds, and a structured digital marketing and booking system. These findings suggest that policy efforts should prioritize coordinated improvements in value proposition, MSME integration, revenue diversification, governance, partnerships, and digital management to move tourism villages toward the high-road scenario. Full article

Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) is characterized by an extensive desmoplastic microenvironment; however, reproducible stromal-associated biomarkers linked to disease progression remain limited. This study therefore aimed to identify and validate a biologically relevant stromal/extracellular matrix (ECM)-associated candidate biomarker for PDAC. Methods: Three GEO bulk transcriptomic PDAC cohorts (GSE15471, GSE16515, and GSE62452) were integrated for differential expression, functional enrichment, protein–protein interaction, and hub-gene analyses. Candidates identified as a promising biomarker were further evaluated using the following: public proteomic and survival resources; head-to-head receiver operating characteristic (ROC) comparisons against COL1A1, COL3A1, and COL5A1; a progression cohort (GSE43288); and single-nucleus RNA sequencing data (GSE202051). Results: Among 206 shared differentially expressed genes, COL5A2 was the only consensus hub retained across multiple network-ranking methods. COL5A2 protein expression was found to be elevated in tumor tissue and associated with worse overall and disease-free survival. In ROC analyses, COL5A2 exhibited stable tumor-versus-non-tumor discrimination across GSE15471, GSE16515, and GSE62452 (AUC = 0.932, 0.760, and 0.782, respectively) and significantly outperformed COL3A1 in two cohorts. In GSE43288, COL5A2 expression increased along the normal–pancreatic intraepithelial neoplasia–PDAC axis and remained positively associated with ECM and cancer-associated fibroblast (CAF) signature scores after adjustment for disease group. Reanalysis of GSE202051 restricted to the original 18 untreated PDAC specimens revealed that COL5A2 expression was concentrated in fibroblast-lineage compartments, with CAFs accounting for the largest overall contribution and myCAFs demonstrating the strongest per-specimen expression enrichment. Conclusions: COL5A2 is a reproducible stromal/ECM-associated candidate biomarker linked to PDAC progression, with predominant expression in fibroblast/CAF compartments. Full article

Natural gas hydrate is a clean energy resource critical for global energy security and low-carbon transition. Understanding its geological accumulation mechanisms is essential for exploration and development. However, the current research on NGH geological accumulation lacks a systematic and quantitative analysis of its global research evolution, hotspots, and frontiers. To fill this gap, this study conducts a bibliometric analysis of 5891 articles (1999–2025) from the Web of Science Core Collection using CiteSpace and VOSviewer to map research trends, contributions, and frontiers. The results show that annual publications followed a three-stage trajectory: slow initiation, rapid growth, and stable development, with key boosts from production tests in Japan (2013) and China (2017). Marine and Petroleum Geology emerged as the most cited journal. China, the United States, and Germany lead research output, with the Chinese Academy of Sciences serving as the central hub (centrality: 0.46). Core researchers such as Jinqiang Liang have established foundational knowledge through highly cited studies on accumulation theory and resource–environment interactions. Research focus has shifted from early resource assessment to controlling factors, and recently toward production technologies and parameter optimization, highlighting a transition from basic to applied research with strong interdisciplinary integration. While bibliometrics reveals structural evolution and hotspots, limitations in data sources and analytical scope remain. Future efforts should integrate multi-source data and deepen content analysis to address unresolved challenges in NGH geological accumulation. Full article