Search Results (824)

Efforts to reduce food waste in restaurants are crucial for business efficiency, environmental sustainability, and social responsibility. Food waste varies by restaurant type, operations, menu offerings, and customer behavior, yet research on effective reduction strategies remains limited, particularly in Greece and Armenia. This study aims to identify key approaches to minimizing food waste in these countries. Using fuzzy-set Qualitative Comparative Analysis (fsQCA), a method for examining complex causal relationships, we analyzed multiple cases to determine conditions that lead to reduced food waste. Four main paths emerged: (1) digital inventory management combined with educational programs, excluding customer choice enhancement; (2) digital inventory management with flexible dining options, without customer choice enhancement; (3) educational programs with flexible dining, excluding customer choice enhancement; and (4) the combination of digital inventory management, educational programs, and flexible dining. Most cases demonstrating these paths were observed in Greece, indicating more advanced food waste management practices. Interviews highlighted recurring themes such as overordering, portion control, supplier challenges, and the importance of education and policy grounded in social responsibility. The findings provide actionable insights for restaurants and policymakers seeking effective strategies to reduce food waste and promote sustainable practices. Full article

Background: Short-chain fatty acids (SCFAs), the main microbial fermentation products in the colon, have immunometabolic and anti-neoplastic properties. Alterations in fecal SCFA profiles have been proposed as potential non-invasive biomarkers for colorectal cancer (CRC), but previous findings remain inconsistent. This systematic review and meta-analysis aimed to determine whether fecal acetate, propionate, and butyrate concentrations differ between patients with CRC and healthy individuals. Methods: A comprehensive search of PubMed, Web of Science and Cochrane Library was conducted on 18 September 2025. Eligible studies were observational, included adults with histologically confirmed CRC and healthy controls, and reported fecal concentrations of at least one SCFA quantified using validated analytical methods. Two independent reviewers performed study screening, data extraction, and risk-of-bias assessment. Random-effects models were applied to calculate pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs). Results: Thirteen studies met inclusion criteria for qualitative synthesis, and four (141 CRC cases, 98 controls) were eligible for meta-analysis. Compared with healthy controls, patients with CRC had significantly lower fecal acetate (pooled SMD −0.37; 95% CI −0.63 to −0.10; p = 0.006; I² = 0%) and butyrate (pooled SMD −0.59; 95% CI −1.10 to −0.07; p = 0.026; I² = 64.4%), whereas propionate did not differ significantly (pooled SMD −0.02; 95% CI −0.85 to 0.82; p = 0.971; I² = 89%). Conclusions: CRC is associated with reduced fecal butyrate and, to a lesser extent, acetate, suggesting impaired microbial fermentation. Propionate shows no consistent difference. SCFA profiling currently lacks sufficient standardization and validation for clinical application. Future harmonized, longitudinal studies integrating diet, microbiome, and metabolomic data are warranted to confirm SCFAs as reproducible biomarkers of CRC. Full article

The safety of large indoor workspaces hinges on ventilation layout and airflow organization, particularly for dense contaminants that pool near the floor. This qualitative, full-scale case study evaluates chlorine (Cl₂) capture using supporting CFD and visualization experiments in a 20 × 13 × 9 m hall. Four exhaust arrangements—low, mid, high, and all levels combined—were tested under two modes: a single grille at 12,000 m³/h and three co-located grilles at 4000 m³/h each (total 12,000 m³/h), with and without an auxiliary supply (2000 m³/h). Removal performance was sensitive to exhaust elevation: low-level extraction consistently confined the plume near the floor, while distributing the same total flow across three levels achieved comparable or improved capture; mid/high extraction was less effective. A practical extraction radius of ≈5 m was identified, and the auxiliary supply improved outcomes only when steering the plume toward the low grille. CFD results showed that, regardless of the lower grille’s duty, the inlet concentration at the low grille was about twice that at the middle grille and more than four times that at the upper grille; in the three-grille configuration, the upper grille received negligible contaminant. These full-scale findings provide geometry-first guidance for dense-gas control in high-ceiling, large-volume spaces. Full article

Efforts have been made to develop a case definition for Long COVID, with results differing on whether the case definition should be specific and exclusive, or broad and easily generalizable. Each of these methods has been subject to limitations. As most efforts have focused on symptoms, inclusion criteria have often relied on the binary occurrence of a symptom. The current study uses a more detailed measure that considers the frequency and severity of symptoms in a sample of individuals with Long COVID and matched controls who recovered from acute SARS-CoV-2 infection. Patients were diagnosed with Long COVID in a systematic process involving their completion of quantitative questionnaires, qualitative interviews, a physical examination, and general laboratory testing to rule out other diagnoses. Since samples were comparatively small given the number of symptoms investigated, Leave One Out Cross-Validation (LOOCV) was used to develop LASSO regression models to determine which symptoms best distinguished Long COVID from recovered controls. An ideal threshold for classifying Long COVID based on symptomatology was developed using a receiver operator characteristics (ROC) curve. The model presented in this article identified Long COVID with high accuracy. The importance of smell/taste was lessened in the current study, and gastrointestinal symptoms took on greater prominence in our study. It is possible to achieve high accuracy in differentiating those with Long COVID from those who have recovered. It is important to specify criteria of Long COVID and to measure symptoms comprehensively to identify those with Long COVID. Reliably identifying those who have developed Long COVID will help in the formulation of treatment strategies. Full article

Background and Objectives: Advanced epithelial ovarian cancer (AEOC) often requires extensive cytoreductive surgery. Minimally invasive surgery (MIS), especially diagnostic laparoscopy, is increasingly used to assess resectability and guide treatment. This review aimed to evaluate the evidence on MIS in AEOC, focusing on its diagnostic and therapeutic roles in primary and interval debulking surgery (PDS and IDS), and its impact on perioperative and oncologic outcomes. Materials and Methods: A structured literature review was performed using PubMed, MEDLINE, Embase, Scopus, and the Cochrane Library, including studies published between January 2000 and June 2025. Eligible studies involved laparoscopic or minimally invasive cytoreduction in PDS or IDS, reporting surgical feasibility, perioperative results, and oncologic outcomes. Data were synthesized qualitatively due to heterogeneity across studies. Results: Observational studies indicate that diagnostic laparoscopy predicts resectability, reduces futile laparotomies, and improves patient selection for primary surgery. In selected patients, non-randomized cohorts of laparoscopic PDS report R0 resection rates up to 95%, with low morbidity and short hospital stays. In IDS after neoadjuvant chemotherapy, MIS has been associated with reduced blood loss, fewer complications, and faster postoperative recovery, while showing progression-free and overall survival comparable to laparotomy in retrospective series. Conversion to open surgery was generally reported in fewer than 10% of cases when stringent selection criteria were applied. Conclusions: Diagnostic laparoscopy is a valuable tool for accurate preoperative evaluation and surgical planning in EOC. MIS, particularly for IDS, appears to offer reduced morbidity and equivalent survival outcomes when performed in experienced centers, whereas its application in PDS remains investigational and should be reserved for highly selected cases. These conclusions are limited by the predominance of retrospective evidence and the heterogeneity in patient selection and surgical expertise. Full article

Objective: The non-verbal nature of the Clock Drawing Test (CDT) suggests it is a suitable cognitive screening instrument for populations with lower educational levels and/or language barriers. This study evaluates whether the CDT is a valid screening instrument for low-educated patients and includes a qualitative analysis of CDT errors. Method: A total of 503 participants were included, divided into four groups (dementia, MCI, no cognitive impairment, and other diagnosis), based on a clinical diagnosis by a geriatrician. Educational levels were categorized into four groups: no education and low, middle, and high education. CDT scores were assessed using the seven-point scoring system (Freedman), and two cutoff points were evaluated. Results: Results showed that in all education categories, the dementia group scored significantly lower on the CDT compared to the non-dementia group. The difference was smallest in participants with no education. Two cut-off points were assessed: <4 and <3. A cut-off of <4 showed better sensitivity versus <3, particularly for low-educated groups. A cut-off of <3 provided better specificity versus <4. Error analysis showed that errors made by low-educated participants without dementia were similar to those of patients with dementia. Conclusions: These findings show that the CDT (both total score and qualitative error analysis) has limited value in dementia case-finding in low-educated groups. The CDT is recommended primarily for middle- and high-educated groups. Full article

The problem of global climate change is becoming increasingly serious, drawing worldwide attention to the need for carbon emissions reduction. As a primary mode of transport, maritime shipping accounts for 2% of global carbon emissions. Therefore, researchers have turned their attention to marine carbon emissions. Specifically, lifecycle assessment (LCA) has attracted wide attention due to its comprehensiveness and objectivity. This article reviews alternate fuels like biodiesel, liquefied natural gas (LNG), methanol, ammonia, and hydrogen. These fuels generate fewer Tank-to-Wake (TTW) carbon emissions than conventional diesel but higher emissions in the Well-to-Tank (WTT) stage owing to production-related emissions, resulting in varying overall carbon footprints. Most carbon emissions in marine transportation come from fuel consumption. Selecting the shortest route can cut fuel use and emissions. Port greening and electrification are vital for emission cuts. Current marine LCA research exhibits key gaps, including fragmented case studies, a lack of methodological standardization, and insufficient dynamic predictive capacity, severely constraining its guiding value for industry decarbonization pathways. This study systematically reviews and categorizes marine LCA research from the past decade in both Chinese and English from the Web of Science and CNKI databases through a Ship-Route-Port framework. Specifically, 34 papers underwent quantitative or qualitative analysis, comprehensively comparing the full lifecycles of six mainstream marine alternative fuels: biodiesel, LNG, methanol, ammonia, hydrogen, and electricity. This study also underscores the need for unified standards to boost low-carbon fuel use and explores the unique challenges and uncertainties involved in applying LCA to the marine sector. LCA applied to the maritime sector shows promise as a valuable tool for guiding low-carbon transition strategies. Full article

This research conducts a comparative analysis of the Environmental Impact Assessment’s (EIA’s) legal frameworks in Laos and China, utilising a qualitative methodological approach rooted in comparative law. This research systematically examines primary legal documents, case studies from the hydropower and mining sectors, and recent government data to evaluate the two systems based on three core criteria: the robustness of the legal structure, the effectiveness of enforcement mechanisms, and the depth of public participation. The analysis indicates that although both countries require Environmental Impact Assessments (EIAs), China’s framework is more structured and efficient, as demonstrated by its clearer legal hierarchy, strict penalties for non-compliance, and established public disclosure procedures. In contrast, Laos’s framework, although established, is marked by its early stage of development, evident in fragmented legislation, limited enforcement due to capacity constraints, and reduced public engagement. The study contributes by providing a direct bilateral comparison and empirically demonstrating how institutional divergences account for disparities in environmental outcomes and foreign investment. Recommendations are provided to improve transparency, enforcement capabilities, and substantive public engagement in both nations. This research is based on comparative legal theory and institutional analysis to transcend a mere descriptive narrative. It utilises a qualitative comparative methodology that combines doctrinal research of legal texts with practical case studies from the hydropower and mining industries. This method enables us to systematically investigate how differing institutional capacity, enforcement mechanisms, and governance models between an emerging and a developed system account for variations in EIA outcomes. The study questions are formulated to evaluate theoretical claims regarding the influence of legal frameworks and administrative authority on the attainment of good environmental governance, providing a transferable analytical model for analogous developing environments. Full article

Educational construction projects face the dual challenge of achieving sustainability targets while remaining cost-effective, yet existing studies often analyze supply chain drivers in isolation. This research addresses this gap by developing and validating a comprehensive model that examines five critical drivers—material selection, stakeholder engagement, waste management, energy efficiency, and digital technologies—within the context of educational infrastructure. Using a mixed-methods approach, data were collected through surveys with 100 industry professionals (35% project managers, 30% architects/designers, and 35% policymakers/consultants), 20 semi-structured interviews, and comparative analysis of three international case studies (Egypt, Singapore, and the United States). Partial Least Squares Structural Equation Modeling (PLS-SEM) was applied to test hypothesized relationships, supported by thematic analysis for qualitative depth. Results show that stakeholder engagement (β = 0.31), material selection (β = 0.28), and digital technologies (β = 0.23) exert the strongest influence on sustainability performance, while energy efficiency (β = 0.19) and waste management (β = 0.16) demonstrate weaker but still significant effects. Regional variations highlight the role of contextual factors such as governance, policy support, and infrastructure readiness. Unlike prior studies that focus on single aspects, this research offers an integrated framework for evaluating and implementing sustainable supply chain practices in educational construction. The findings provide both theoretical advancement and actionable insights for policymakers and practitioners seeking to accelerate sustainable transformation in the education sector. Full article

The rapid growth of urban populations and the disorderly expansion of city sizes present severe challenges to China’s urban environment. This paper explores the value of urban agriculture (UA) in China for promoting sustainable urban development through a framework spanning national, city, and case study levels. At the national level, it details the crises facing Chinese cities and the historical development of UA. At the city level, it outlines the development and current status of UA in three cities. At the case study level, it introduces the fundamental contexts of three cases and analyses their commonalities and distinctive features through an examination of their ecological, managerial, social, and productive contributions. Concurrently, this study designs a comprehensive UA evaluation system to quantify research data. The assessment framework encompasses four dimensions of UA, comprising twelve indicators. Employing a hierarchical literature analysis combined with qualitative-quantitative methodologies, the research aims to explore the value of China’s urban agricultural advantages from multiple perspectives. Through comparative analysis of case data, this paper further clarifies the significance of developing UA for China’s sustainable urban development. Full article

Background and Objectives: Cement-retained implant restorations are widely used because they offer favorable esthetics and a passive fit. Their long-term performance is strongly influenced by cement selection and surface conditioning. This study compared the clinical performance of a resin-modified glass ionomer cement (Fuji Plus^®) with a provisional acrylic-urethane cement (DentoTemp™) in partial implant restorations. Materials and Methods: A retrospective cohort of 40 patients with three-unit implant-supported fixed dental prostheses was followed for at least three years. Restorations were fabricated from zirconia or metal-ceramic frameworks and cemented with either Fuji Plus^® or DentoTemp™. Clinical outcomes included retention, failure events, marginal adaptation, and peri-implant tissue response. In order to illustrate the impact of cement type and abutment height, mechanical testing was also carried out on standardized in vitro models; however, these tests were not powered for formal hypothesis testing. Although OCT images were included in this study only as illustrative examples from our clinical database and were not obtained from the analyzed cohort, OCT may be a useful tool for non-invasive assessment of marginal fit. Results: Zirconia restorations showed a retention rate of 95 percent, while metal-ceramic restorations reached 85 percent. All four failures occurred in cases cemented with DentoTemp™, giving an overall retention rate of 80 percent for this group. Fuji Plus^® achieved complete retention in all cases. Re-cementation with Fuji Plus^® successfully resolved the failures. Marginal adaptation was evaluated qualitatively because radiographic analysis did not enable accurate measurement of marginal gaps. When cement remnants were found, mild peri-implant inflammation was seen. Conclusions: Within the limitations of this small retrospective, non-randomized cohort, Fuji Plus^® demonstrated a tendency toward better peri-implant tissue response and longer-term retention than DentoTemp™. These findings should be interpreted as preliminary and exploratory rather than conclusive. Fuji Plus^® may be a suitable option for definitive cementation in partial implant restorations, while DentoTemp™ may be considered in selected situations where retrievability is important. Full article

Background: The use of prosthetic caps in screw-retained implant restorations aims to enhance passivity and protect abutment threads; however, these components may increase prosthetic volume and impair esthetics. Advances in high-strength zirconia have raised the question of whether such caps remain necessary. Methods: A retrospective clinical analysis was conducted on 20 partial screw-retained zirconia restorations comparing cases fabricated with and without a prosthetic cap. All restorations were followed for 3–5 years. Clinical outcomes included screw stability, marginal adaptation, esthetics (VAS), hygiene access, and biological response. A supplementary mechanical verification was performed on four standardized zirconia crowns fabricated through digital and conventional impression workflows to qualitatively assess their behavior under 30 N·cm torque and compressive loading above 1200 MPa. Results: Throughout follow-up, no mechanical or biological complications were recorded in either group. One restoration with a cap required screw re-tightening, while none failed in the cap-free group. Radiographic analysis showed smaller mean marginal gaps in cap-free restorations (0.183 mm) compared to those with caps (0.289 mm; p < 0.01). Esthetic satisfaction scores were higher in the cap-free group (VAS = 9.3 ± 0.1 vs. 8.2 ± 0.1; p < 0.001). Mechanical verification confirmed that all zirconia crowns tolerated torque and compressive loads without visible fracture or deformation. Conclusions: Within the study limitations, cap-free screw-retained zirconia restorations exhibited excellent 5-year clinical stability, improved esthetics, and better hygiene access compared with capped designs. The small-scale mechanical verification supported the clinical findings, indicating that cap omission does not compromise mechanical performance when accurate fit and digital workflow precision are ensured. Full article

This study investigates the integration of forestry into strategic planning across territorial levels in the context of the bioeconomy, using the Czech Republic as a case study of an EU member state. This is examined through a qualitative content analysis of regional and territorial local plans, to identify which topics are associated with forestry (n = 67). Using the example of a private forest owner, the specific implementation is then shown. To gather feedback on the assessed strategic documents, we compared economic results for state, municipal, and private forest owners. The research assumption is that the lower the territorial local level, the greater the importance local governments attach to forestry. The main featured topics are the water regime, sustainable forestry, biodiversity support, climate change, maintenance infrastructure, social functions, and economic competitiveness. The results show that the assumption that the lower the territorial planning level, the more forestry is featured in strategies was not confirmed. The relationship is rather the opposite. The presented economic results clearly demonstrate that financial contributions to forest management are a logical consequence of policies. These results correlated with those of the content analysis. The multi-level approach and use of economic data provide valuable empirical depth, and the main finding challenges common assumptions about policy emphasis at lower governance levels. Full article

In educational settings, the transfer of knowledge to daily life and the permanence of learning outcomes are essential goals. In this context, Outdoor Learning (OL) has gained growing attention as an approach that connects students with real-life experiences. This study compares OL practices in Türkiye and Belgium, examining their impact on educational sustainability and cultural heritage awareness through multiple stakeholder perspectives. Using a qualitative case study design with a holistic multiple-case approach, data were collected through field observations and semi-structured interviews conducted between January and June 2025. The research included five OL activities in Türkiye and six in Belgium, involving students, teachers, administrators, and external observers. Data were analyzed using descriptive and content analysis. The findings show that OL fosters environmental awareness, respect for cultural heritage, local–European identity, collaboration, and responsibility, while enhancing learning retention and motivation. In Belgium, OL is implemented systematically within educational programs, whereas in Türkiye it is expanding rapidly under new policy guidelines. However, challenges such as large class sizes, safety concerns, logistics, and financial limitations hinder consistent practice. The study concludes that OL should be organically integrated into curricula, supported by in-service teacher training and institutional financial–logistical frameworks to ensure sustainable and meaningful implementation. Full article

Objective: This study examines pathways for suicide ideation identification and suicidal behavior intervention among Chinese young adults. Methods: It used qualitative comparative analysis (QCA) to analyze the cases of 47 Chinese young people (aged 18–28) with suicidal experiences. The outcome variables are suicide ideation identification and suicidal behavior intervention, and condition variables include psychological disorders, suicidal history, suicidal communication, suicidal time, suicidal location, suicidal methods, family support, peer support, and school support. Results: There are two successful identification pathways and five effective intervention pathways, contrasted with four failed identification pathways and one failed intervention pattern. These results reveal that continuous supervision of individuals with psychological disorders and multi-group participation in intervention are important to decrease the suicide risk of Chinese young people. Meanwhile, a lack of proactive identification of individuals without warning signals, insufficient attention from families and communities to young people with psychological disorders, and inadequate physical limitations on fatal suicidal behaviors are major risk factors. Conclusions: This study highlights the measures of strengthening continuous attention to suicide signals among high-risk youth groups, limiting lethal suicide methods, promoting network monitoring and suicide risk warning, increasing psychological services in the community, and improving the collaborative synergy of peers, families, and schools. Full article