Search Results (668)

Although technological innovations are often intended to improve quality and efficiency, they can exacerbate systemic challenges when not aligned with the principles of value-based care. As a result, healthcare systems in many countries face persistent inefficiencies stemming from the overuse, underuse, misuse, and waste associated with the adoption of health technology. This narrative review examines the dual impact of healthcare technology and evaluates how contract mechanisms can serve as strategic tools for promoting cost-effective, outcome-oriented integration. Drawing from healthcare management, and supply chain literature, this paper analyzes various payment and contract models, including performance-based, bundled, cost-sharing, and revenue-sharing agreements, through the lens of stakeholder alignment. It explores how these mechanisms influence provider behavior, patient access, and system sustainability. The study contends that well-designed contract mechanisms can align stakeholder incentives, reduce inefficiencies, and support the delivery of high-value care across diverse healthcare settings. We provide concrete examples to illustrate how various contract mechanisms impact the integration of health technologies in practice. Full article

Marine biomass, particularly from waste streams, by-products, underutilized, invasive, or potential cultivable marine species, offers a sustainable source of high-value biopolymers such as collagen and chitin. These macromolecules have gained significant attention due to their biocompatibility, biodegradability, functional versatility, and broad applicability across health, food, wellness, and environmental fields. This review highlights recent advances in the uses of marine-derived collagen and chitin/chitosan. In alignment with the United Nations Sustainable Development Goals (SDGs), we analyze how these applications contribute to sustainability, particularly in SDGs related to responsible consumption and production, good health and well-being, and life below water. Furthermore, we contextualize the advancement of product development using marine collagen and chitin/chitosan within the European Union’s Blue bioeconomy strategies, highlighting trends in scientific research and technological innovation through bibliometric and patent data. Finally, the review addresses challenges facing the development of robust value chains for these marine biopolymers, including collaboration, regulatory hurdles, supply-chain constraints, policy and financial support, education and training, and the need for integrated marine resource management. The paper concludes with recommendations for fostering innovation and sustainability in the valorization of these marine resources. Full article

Background: Since the election of Hamas in 2006, Gaza has endured eight major military conflicts, culminating in the ongoing 2023–2025 war, now surpassing 520 days. This protracted violence, compounded by a 17-year blockade, has resulted in the near-total collapse of Gaza’s health system. Over 49,000 deaths, widespread displacement, and the destruction of more than 60% of health infrastructure have overwhelmed both local capacity and international humanitarian response. Objectives: This narrative review aims to examine and synthesize the current literature (October 2023–April 2025) on the health crisis in Gaza, with a specific focus on identifying key themes and knowledge gaps relevant to rebuilding a sustainable health system. The review also seeks to outline strategic pathways for recovery in the context of ongoing conflict and systemic deprivation. Methods: Given the urgency and limitations of empirical data from conflict zones, a narrative review approach was adopted. Fifty-two sources—including peer-reviewed articles, editorials, reports, and correspondence—were selected through targeted searches using Medline and Google Scholar. The analysis was framed within a public health and political economy perspective, also taking health system building blocks into consideration. Results: The reviewed literature emphasizes emergency needs: trauma care, infectious disease control, and supply chain restoration. Innovations such as mobile clinics and telemedicine offer interim solutions. Gaps include limited attention to mental health (including that of health workers), local governance, and sustainable planning frameworks. Conclusions: Sustainable reconstruction requires a durable ceasefire; international stewardship aligned with local ownership; and a phased, equity-driven strategy emphasizing primary care, mental health, trauma management, and community engagement. Full article

Increasing the shelf-life of fruits and vegetables using edible natural substances after harvest is economically important and can be useful for human health. Postharvest techniques help maintain the quality of edible tissues resulting in extended marketing periods and reduced food waste. The edible coating on perishable commodities is a common technique used by the food industry during the postharvest supply chain. The objective of this research was to study the effect of edible oil to minimize the loss of postharvest physio-chemical and nutritional attributes of bananas. The study selected two banana cultivars (Musa, ‘Cavendish’ and ‘Milk’) to conduct this experiment, and two edible oils (olive oil (Olea europaea) and moringa oil (Moringa peregrina)) were applied as an edible coating under two different storage conditions (15 and 25 °C). The fruit’s physio-chemical properties including weight loss, firmness, color, total soluble solids (TSS), pH, titratable acidity (TA), TSS: TA ratio, and mineral content were assessed. The experiment lasted for 12 days. The physicochemical properties of the banana coated with olive and moringa oils were more controlled than the non-coated (control) banana under both storage temperatures (15 °C and 25 °C). Coated bananas with olive and moringa oils stored at 15 °C resulted in further inhibition in the ripening process. There was a decrease in weight loss, retained color, and firmness, and the changes in chemical parameters were slower in banana fruits during storage in the olive and moringa oil-coated bananas. Minerals were highly retained in coated Cavendish bananas. Overall, the coated samples visually maintained acceptable quality until the final day of storage. Our results indicated that olive and moringa oils in this study have the potential to extend the shelf-life and improve the physico-chemical quality of banana fruits. Full article

Ensuring the safety and quality of perishable agrifood products throughout the supply chain is essential. Key parameters, such as temperature and humidity, must be consistently monitored to prevent spoilage, maintain nutritional value, and minimise health risks. Fluctuations in transportation conditions can compromise product integrity, leading to deterioration and an increased risk of foodborne illness. Monitoring agrifood supply chains is essential, from packaging to last-mile delivery. Distribution methods that rely on non-automated monitoring systems, such as manual temperature measurements, are error-prone due to the failure of manual treatments and increase the likelihood of product deterioration. Emerging sensor technologies and the rapid development of Information and Communication Technologies offer new possibilities for real-time tracking, enabling stakeholders to maintain optimal conditions and monitor aesthetic, physicochemical, and nutritional quality. This paper proposes a cost-effective temperature and humidity traceability system that utilises wireless sensor networks (WSN) and Internet of Things (IoΤ) services to monitor perishable products within the agrifood supply chain ecosystem. It also provides an overview of recent innovations in sensor technologies, along with food quality indicators relevant to real-time monitoring of food quality. The proposed research examines the available sensor technologies and methodologies that enable continuous monitoring of agrifood supply chains. Moreover, the paper presents a pilot full-scale project from both functional and technological perspectives. Full article

In 2020, Directive (EU) 2020/2184 was published and subsequently transposed into Italian legislation via Legislative Decree 18/23 (Lgs.D. 18/23). The Directive aims to protect public health through a proactive approach based on a site-specific risk analysis along the entire water supply chain (Water Safety Plan, WSP). Between February and November 2024, a survey was conducted in Italy to assess both hospitals’ knowledge of Lgs.D. 18/23 and the application of the WSP in these facilities. A total of 300 hospitals were asked to complete an anonymous questionnaire containing 60 questions about the characteristics of the facility and the management of the water network, including the chemical–physical and microbiological monitoring of Legionella and other microbiological parameters. A total of 102 questionnaires were sent out (response rate: 34%), but only 72 were properly completed and analyzed. The results of the chemical–physical monitoring are not presented in this manuscript. Overall, 52.8% of the hospitals were built before 2000, and most are aware of Directive (EU) 2020/2184, Lgs.D.18/23 (80.6%), in particular, Article 9 on the risk assessment and management of internal water systems and the guidelines for its implementation (77.8%). All hospitals perform annual microbiological water testing, including Legionella analysis, with a detection rate of <50%. National guidelines for the implementation of WSPs are known in 75% of the hospitals, but only 38.9% have started planning to implement them, and 13.9% organize staff training on the subject. The questionnaire responses highlight the need to train hospital staff in water system risk management and WSP planning, which will be mandatory by 2029. Full article

Escherichia coli (E. coli) remains a major concern in poultry production due to its ability to incite foodborne illness and public health crisis, zoonotic potential, and the increasing prevalence of antibiotic-resistant strains. The contamination of poultry products with pathogenic E. coli, including avian pathogenic E. coli (APEC) and Shiga toxin-producing E. coli (STEC), presents risks at multiple stages of the poultry production cycle. The stages affected by E. coli range from, but are not limited to, the hatcheries to grow-out operations, slaughterhouses, and retail markets. While traditional detection methods such as culture-based assays and polymerase chain reaction (PCR) are well-established for E. coli detection in the food supply chain, their time, cost, and high infrastructure demands limit their suitability for rapid and field-based surveillance—hindering the ability for effective cessation and handling of outbreaks. Biosensors have emerged as powerful diagnostic tools that offer rapid, sensitive, and cost-effective alternatives for E. coli detection across various stages of poultry development and processing where detection is needed. This review examines current biosensor technologies designed to detect bacterial biomarkers, toxins, antibiotic resistance genes, and host immune response indicators for E. coli. Emphasis is placed on field-deployable and point-of-care (POC) platforms capable of integrating into poultry production environments. In addition to enhancing early pathogen detection, biosensors support antimicrobial resistance monitoring, facilitate integration into Hazard Analysis Critical Control Points (HACCP) systems, and align with the One Health framework by improving both animal and public health outcomes. Their strategic implementation in slaughterhouse quality control and marketplace testing can significantly reduce contamination risk and strengthen traceability in the poultry value chain. As biosensor technology continues to evolve, its application in E. coli surveillance is poised to play a transformative role in sustainable poultry production and global food safety. Full article

Maritime transportation plays a critical role in global containerized cargo logistics, with seaports serving as key nodes in this system. Ports are responsible for container loading and unloading, along with inspection, storage, and timely delivery to the destination, all of which heavily depend on the performance of the container handling equipment (CHE). Inefficient maintenance strategies and unplanned maintenance of the port equipment can lead to operational disruptions, including unexpected delays and long waiting times in the supply chain. Therefore, the maritime industry must adopt intelligent maintenance strategies at the port to optimize operational efficiency and resource utilization. Towards this end, this study presents a machine learning (ML)-based approach for predicting faults in CHE to improve equipment reliability and overall port performance. Firstly, a statistical model was developed to check the status and health of the hydraulic system, as it is crucial for the operation of the machines. Then, several ML models were developed, including artificial neural networks (ANNs), decision trees (DTs), random forest (RF), Extreme Gradient Boosting (XGBoost), and Gaussian Naive Bayes (GNB) to predict inverter over-temperature faults due to fan failures, clogged filters, and other related issues. From the tested models, the ANNs achieved the highest performance in predicting the specific faults with a 98.7% accuracy and 98.0% F1-score. Full article

The global consumption of fresh and ready-to-eat (RTE) fruits and vegetables has surged due to increasing awareness of their nutritional benefits. However, this trend has been accompanied by a rise in foodborne illness outbreaks linked to microbial contamination. This narrative review synthesizes current knowledge on the prevalence and diversity of foodborne pathogens in fresh produce, including bacterial, viral, and fungal agents. It critically evaluates both conventional and emerging detection methods, ranging from culture-based techniques and immunoassays to advanced molecular diagnostics, biosensors, flow cytometry (FC), and hyperspectral imaging (HSI). Additionally, this review discusses cutting-edge control strategies, such as natural antifungal agents, essential oils, biocontrol methods, and non-thermal technologies like cold plasma and UV-C treatment. Emphasis is placed on sampling methodologies, sustainability, One Health perspectives, and regulatory considerations. By highlighting recent technological advances and their limitations, this review aims to support the development of integrated, effective, and safe microbial control approaches for the fresh produce supply chain. Full article

Retrofitting the existing housing stock to a high level of energy efficiency will not be limited to achieving the decarbonisation of 80.3 MtCO2e residential emissions and reducing fuel poverty in 4.16 million households, but also improving the health and well-being of UK residents and their overall quality of life. The current progress of housing retrofitting is poor, at less than 1%. The UK expects to achieve net zero by 2050, and the challenge is immense as there are more than 30 million houses. The challenge is similar in other global contexts. Even if the required technology, supply chain, skilled labour, and finance could have been provided, the retrofitting would not move forward without positive engagement from the clients. Proper strategies are required to retrofit at scale. Focusing on the challenges of stakeholder engagement in housing retrofitting, this study focused on developing a hybrid one-stop shop solution through design science research. A theoretical artefact and an empirical system requirement specification document were developed to propose a one-stop shop solution. This was tested through retrofit industry stakeholders. Findings reveal that the one-stop shop model will be a good answer to retrofitting at scale, providing the resident engagement of 30.1 million households. The model can support residents with or without computer literacy due to its hybrid approach. The proposed theoretical and industrial models can be used as base models for developing one-stop shops for housing retrofitting by adapting them for context-specific requirements. Full article

The global sleep aids market has grown significantly due to rising stress and increased awareness of sleep’s importance. Melatonin, available in the EU as a prescription or over-the-counter medicine, depending on the country, is also permitted in dietary supplements with country-specific limits. Recent reports indicate concerning levels of excessive melatonin in EU dietary supplements, necessitating accurate quantification methods. We developed and validated, by applying accuracy profiles, ISO17025-compliant, rapid ultra-high performance liquid chromatography (UHPLC) methodologies coupled with either diode array detection (DAD) or high-resolution accurate mass spectrometry (HRAM MS). The cost-effective UHPLC-DAD method is suitable for medicines and most dietary supplements, except those more complex herbal matrices containing passionflower, hop, hemp, lime tree or lavender or their extracts, where UHPLC-HRAM MS is recommended due to selectivity issues of the DAD methodology. To demonstrate the applicability, we analyzed 50 dietary supplements claiming to contain melatonin—25 from legal supply chains and 25 from suspicious sources claiming therapeutic melatonin content. Our findings confirmed previous reports of high melatonin content in online products, especially when purchased through rogue internet pharmacies. Moreover, 12% of legal supply chain samples violated current legislation through unauthorized health claims or contained at least triple the melatonin amount permitted in Belgium. This research provides reliable analytical methods for regulatory bodies and confirms the circulation of non-compliant melatonin-containing dietary supplements in the EU market, even in the legal supply chain. Full article

The increasing emphasis on integrating sustainability into corporate operations has prompted supply chain managers to incorporate not only economic objectives but also environmental and social considerations into their network designs. This study presents a structured six-stage methodology to develop a fuzzy multi-objective optimization model for the sustainable design of a multi-level, multi-product forward supply chain network. The model incorporates two conflicting objectives: minimizing total network costs and reducing environmental impact. To quantify environmental performance, a comprehensive life cycle assessment is conducted in accordance with the ISO 14040 standard and the ReCiPe 2016 method, focusing on three impact categories: human health, resources, and ecosystems. To address uncertainty in demand and production costs, fuzzy mixed-integer linear programming is employed. The model is validated and applied to a real-world case study of a dairy small-to-medium enterprise in Ecuador. Using the epsilon-constraint method, a Pareto frontier is generated to illustrate the trade-offs between the economic and environmental objectives. This research provides a robust decision-making tool for uncertain environments and advances knowledge on the integration of life cycle assessment with supply chain optimization and network design methodologies for sustainable development. Full article

The COVID-19 pandemic intensified existing structural challenges in Africa, including poverty, weak healthcare systems, and fragile agricultural supply chains. Consequently, examining its effects remains a critical area of study. This research investigates the effect of food prices on the prevalence of malnutrition in the context of the COVID-19 pandemic in sub-Saharan Africa. The findings indicate a significant long-term relationship between the number of COVID-19 cases, food prices, and the prevalence of undernourishment. Specifically, increases in food prices are associated with a rise in undernourishment rates over the long term. These results are corroborated by estimations using Fully Modified Ordinary Least Squares (FMOLS). To mitigate malnutrition in the face of potential future health shocks, governments could create and operationalize food price stabilization funds to cushion against sharp increases in food prices. These funds can be used to subsidize key staples during periods of price volatility, ensuring affordability for vulnerable populations. Full article

Chicory (Cichorium intybus L.) roots are valued in medicine for their potential health benefits. Producing callus from chicory roots through tissue culture technology can streamline bioactive metabolites production and ensure a sustainable supply chain. The current study explored the impact of plant growth regulators (PGRs) and light conditions on the characteristics of callus induced from C. intybus root explants. The effect of fungal elicitors [yeast extract (YE), Fusarium oxysporum, and Aspergillus niger] on bioactive metabolite production from root-derived callus was investigated. Callus color varied notably between a 16/8 h light/dark cycle and complete dark, with differences in texture based on PGR concentrations and light conditions. High weights of callus formed were generally recorded under the 16/8 h light/dark cycle. Low concentrations of YE (1 g/L) and F. oxysporum (0.25 g/L) enhanced callus biomass fresh weight, while high concentrations of A. niger (1 g/L) improved callus dry matter significantly. The content and productivity of total phenolic were maximized at 1 g/L of YE and 1 g/L of F. oxysporum. Callus cultures elicited with a higher level of A. niger recorded the higher values of total flavonoid production. High-performance liquid chromatography (HPLC) analysis revealed significant variations in chlorogenic acid, catechin, and caffeic acid levels among the different elicited cultures. A. niger at 1 g/L notably increased chlorogenic acid content, while catechin levels were enhanced by specific concentrations of YE. Catalase (CAT) activity was significantly affected by different elicitors, while only the higher level of F. oxysporum and A. niger showed a significant increase in peroxidase (POD) activity. DPPH scavenging activity was elevated by all fungal elicitors. Principal Component Analysis delineated distinct variations in callus traits in response to different elicitors, with specific treatments showcasing enhanced biomass production, bioactive compound accumulation, and antioxidant activities. Through meticulous experimentation, this study paves the way for enhancing chicory root-derived products, ensuring sustainable production and potent bioactivity. Full article

Vegetables are commodities frequently sold in local markets and have been associated with foodborne outbreaks in short and local supply outlets worldwide. These outbreaks could potentially be mitigated through the implementation of good handling practices (GHPs) at points of sale. Numerous studies have assessed microbiological contamination in small-scale vegetable outlets in developing countries. In contrast, research on these risks in developed countries is comparatively scarce. However, with the increasing demand for vegetables, along with the increasing popularity of local markets, there is potential for an increase in foodborne outbreaks in developed countries. This study aimed to perform a microbiological assessment in local and short supply chain outlets of farmers in Portugal, as a case study, and to observe behaviors regarding GHPs in these outlets. The study was performed before and after the implementation of improved GHPs. This research employed quantitative analysis to measure the microbial load on vegetables, bench surfaces, and vendors’ hands. Additionally, a qualitative analysis was conducted to understand farmers’ behavior regarding GHPs using observational methods. Microbial hazards were detected in vegetables, on surfaces, and on hands both before and after the implementation of these practices, although the implementation of GHPs reduced the number of contaminations potentially associated with the practices used at the outlets. The results of this study highlight the importance of implementing GHPs in local and short supply chain markets for vegetables and fruits in developed countries, not only to protect consumers’ health, but also the farmers’ businesses. Full article