Search Results (121)

In recent years, the food processing industry in the Gulf Cooperation Council (GCC) has faced increasing pressures to improve operational efficiency while improving its environmental performance. This research examines whether Lean Six Sigma (LSS) methodologies can be used as tools to incorporate sustainability into current operational processes at a date processing facility in Saudi Arabia. In addition to illustrating the ways in which production was improved, this research developed and preliminarily validated a Sustainability Integration Index (SII) framework to measure the contributions of improvement projects to sustainable practices in terms of their impact on the environment, society, and economy. Furthermore, this research examined the role of organizational culture as a moderator of the effectiveness of integrated LSS–sustainability approaches using a Cultural Readiness Assessment Model (CRAM). This research addressed production bottlenecks and aligned production with selected United Nation Sustainable Development Goals (SDGs) using the Define–Measure–Analyze–Improve–Control (DMAIC) methodology. Production bottlenecked in packaging operations resulted in schedule overruns and excessive overtime; therefore, the intervention focused on improving the production process in these areas. There were three distinct improvement streams: demand-based resource leveling, advanced production planning to allow for pull-based flow, and targeted maintenance to raise Overall Equipment Effectiveness (OEE) from 48.2% to 74.6%. Results indicated a 23% increase in daily processing capacity, a 38 min decrease in the average length of time of production closures, and estimated annual cost savings of 940,000 SAR (approximately USD 250,000). The SII framework showed a 21.2% improvement in sustainability scores, with a total composite score improvement from 0.66 to 0.80. Social sustainability had the greatest relative increase (+24.2%). Exploratory correlation analysis found that improvements in cultural maturity and cross-functional collaboration are possible predictors of successful sustainability integration; however, the limitations of the single case study limit the ability to draw causal inferences. The results provide both empirical evidence and possible measurement tools to an under-explored area: the use of LSS in Middle Eastern food processing industries with specific sustainability goals. Validation of the frameworks across different industries will be necessary to establish generalizability. Full article

Background/Objectives: Incretin-based medications have transformed obesity management by enabling substantial body weight reduction. However, the rapid and pronounced loss of body mass necessitates a comprehensive, multidisciplinary approach incorporating nutritional and physical activity strategies to preserve lean mass, optimize functional outcomes, and prevent long-term complications. This narrative review provides a critical overview of this emerging clinical concern, which is expected to gain increasing relevance in the coming years. Methods: A literature review was conducted up to 31 October 2025, focusing on studies addressing nutritional, physical activity, and adjunctive interventions in adults with obesity treated with incretin-based medications. Results: Incretin-based agents induce significant weight loss, comparable to bariatric surgery, predominantly targeting adipose tissue. Nevertheless, these medications also cause rapid reductions in muscle and bone mass, often accompanied by nutrient deficiencies, which may compromise metabolic health and physical function. Tailored nutritional strategies—including hypocaloric diets enriched in protein and fiber, as well as amino acid, vitamin, and mineral supplementation—are critical to preserve lean mass and support sustained weight maintenance. Concurrently, structured, supervised physical activity, encompassing aerobics, resistance, and strength training, mitigates muscle loss and enhances functional capacity. Emerging pharmacological agents designed to promote adipose tissue reduction while preserving lean mass, as well as interventions targeting gut microbiota modulation, may represent promising adjunctive strategies to optimize long-term outcomes further. Conclusions: While incretin-based medications produce substantial weight loss, their impact on lean mass underscores the necessity of integrating personalized nutrition, supplementation, and structured exercise to preserve muscle, prevent malnutrition, and optimize long-term health and obesity outcomes. Full article

Despite the progressive increase in obesity and associated chronic diseases in children, there is limited evidence on the optimal dosage of most medications for obese children and adolescents. This review analyzes the influence of pathophysiological changes on pharmacokinetics and pharmacodynamics and evaluates the body size descriptors used in clinical practice. Patients with obesity present significant pathophysiological alterations, such as a substantial increase in fat/lean mass ratio, increased blood flow and cardiac output, and changes in plasma protein binding, which may affect the volume of distribution of drugs and the adjustment of the loading dose. In these patients, the distribution volume of hydrophilic drugs appears to slightly increase, while it varies widely—depending on the drug and other factors such as affinity for other tissues—for lipophilic drugs. On the other hand, a reduction in tissue perfusion, alterations to liver enzyme activity, and an increase in liver and kidney mass and blood flow have been reported, indicating a possible modification in drug clearance and necessitating adjustments to maintenance regimens. Furthermore, while there are multiple size descriptors, it is difficult to establish a single dosing strategy for the obese population, given the lack of studies confirming the extent of changes in pharmacokinetic processes, which will also depend on the properties of each drug, such as liposolubility and elimination pathways. New strategies need to be developed to characterize pharmacokinetic and pharmacodynamic changes in the obese pediatric population in order to optimize dosing regimens and improve the safety and efficacy of treatments. Full article

Obesity remains a major global health challenge, with glucagon-like peptide-1 receptor agonists (GLP-1RAs) providing substantial yet sensitive benefits in weight reduction, glycemic control, and cardiovascular protection. Despite robust trial data, real-world persistence is limited by cost, tolerability, and hedonic adaptation. Intermittent fasting and time-restricted eating offer physiologically complementary, low-cost strategies that enhance fat oxidation, insulin sensitivity, and metabolic flexibility while engaging behavioral mechanisms of self-control and dietary regularity. This narrative review synthesizes current evidence and proposes a pragmatic, phased framework integrating GLP-1RA therapy with structured intermittent fasting and protein-optimized nutrition. The model emphasizes sequential initiation, transition, and maintenance phases designed to align pharmacologic appetite suppression with lifestyle-driven metabolic remodeling. Mechanistically, GLP-1RAs target vascular and neuroendocrine pathways, whereas fasting activates nutrient-sensing networks (AMPK, mTOR, sirtuins) associated with autophagy and longevity. Combined application may preserve lean mass, improve psychological autonomy, and reduce healthcare costs. Future research should validate this hybrid strategy in randomized trials assessing long-term weight durability, functional outcomes, and cost-effectiveness. By uniting pharmacologic potency with behavioral sustainability, phased GLP-1–fasting integration may represent an effective, affordable, and longevity-oriented paradigm for metabolic health. Full article

Perimenopause and the menopausal transition are characterised by hormonal fluctuations that disrupt thermoregulation, metabolism, and sleep, contributing to adverse changes in body composition and increased cardiometabolic risk. Despite these challenges, food-based strategies to support sleep, appetite regulation, and metabolic health remain underexplored. This narrative review synthesised current evidence on the nutritional factors influencing these outcomes, with emphasis on the potential role of eggs as a nutrient-dense, accessible dietary option for midlife women. Literature searches identified studies examining hormonal mechanisms and the effects of nutrients abundant in eggs, including high-quality protein, choline, tryptophan, melatonin, vitamin D, and antioxidants. Evidence suggests that adequate protein and choline intake may enhance sleep duration, satiety, and preserve lean mass, while vitamin D and antioxidant compounds may support muscle function and mitigate oxidative stress associated with hormonal decline. Collectively, eggs represent a practical whole-food source of nutrients that may play a role in supporting sleep, appetite regulation, and body-composition maintenance during the menopausal transition; however, further high-quality intervention studies are needed to confirm these effects. Full article

Background: Malnutrition is a significant national health problem in countries with low and intermediate incomes and was announced in the United Nations’ 2030 Agenda for Sustainable Development Goals. Chemotherapy may have adverse effects on nutritional health issues and quality of life experience, particularly in patients with gastrointestinal (GIT) cancer. Our research’s objective was to determine the beneficial effects of oral nutrition supplements on nutritional status assessed by maintenance of whole-body composition and patient-generated subjective global assessment (PG-SGA) in all GIT cancer patients treated with chemotherapy medications. Methods: Among the patients, the nutrition support (NS) group (n = 75) received 500 kcal daily of a balanced oral nutrition supplement formula for 12 weeks, while the control (C) group (n = 75) did not. Anthropometric measures, whole-body composition, nutritional status biomarkers, and the PG-SGA questionnaire were assessed. Additionally, this study analyzed whole-body composition, skeletal mass, fat mass, laboratory data, the complete lipid profile, albumin, total protein, adverse effects, and therapy delays. Results: After 12 weeks, the NS group showed a significant increase in body weight, with a mean difference of 1.27 ± 3.39, while the C group showed a mean difference of only 0.15 ± 0.42. Moreover, fat mass increased in the NS group, showing a mean difference of 0.55 ± 3.69, while the C group showed a fat mass loss with a mean difference of −0.21 ± 2.93. The fat mass index (FMI) indicated statistical significance between the two groups. There was a statistically significant difference in the lean mass index between the two groups, favoring a steady increase in the NS group. The NS group showed improvements in the PG-SGA and nutritional biochemical markers, such as albumin. The initial findings from our study include data from a total of 150 patients, including 75 patients in the NS group and 75 patients in the C group. These results are consistent with earlier research. Conclusions: Early oral nutrition supplements for GIT cancer may enhance nutritional outcomes and reduce the delay of disease-related therapy. Additionally, they may help maintain body composition. Full article

Background: Degenerin proteins, such as Acid-Sensing Ion Channel 2 (ASIC2) and β Epithelial Na⁺ Channel (βENaC), have been implicated in cardiovascular function. We previously demonstrated that mice lacking normal levels of βENaC and ASIC2 are protected from diet-induced obesity, metabolic disruption, and hepatic steatosis. Methods: To investigate the specific role of βENaC proteins in the progression of metabolic disease, we examined the impact of a high-fat diet (HFD) in the βENaC hypomorph mouse model (βMUT). Body composition and metabolic and behavioral phenotypes were examined in male and female and βMUT and WT mice (n = 6–14/group) fed a normal chow diet (NFD) from weaning until 16 weeks of age, then a 60% kcal-fat diet for 5 weeks. Results: Compared to WT mice, βMUT male mice have reduced lean and total body mass. No remarkable differences in energy expenditure, motor activity, or food consumption patterns were detected. HFD-fed male βMUT mice exhibited reduced liver fat content (mass and Oil Red O staining) yet increased abdominal fat depots. HFD-fed female βMUT mice exhibited lower heart mass. Conclusions: These novel findings suggest a role for βENaC in the maintenance of metabolic homeostasis and adipose tissue distribution. Full article

In the industrial internet environment, the operation and control of production equipment have become increasingly complex, and their performance directly affects the efficiency, benefits and sustainable development of manufacturing enterprises. From the three-dimensional perspective of “asset-application-maintenance”, this paper constructs a performance analysis framework for the operation and control of production equipment, systematically identifies the combination of core factors affecting performance, and fills the research gap in the current lack of empirical analysis from the configuration perspective in this field. On the basis of data from 82 manufacturing enterprises, the fsQCA method was used to identify three performance improvement paths: the high-load output mode, the lean management and control mode, and the low-failure operation mode. These paths clarify the equivalent approaches to achieve high performance in the operation and control of production equipment under the interaction of multiple factors. On this basis, the study demonstrates the operability and effectiveness of the proposed strategies in actual industrial scenarios through empirical verification in a manufacturing workshop of aero-engine transmission units. In contrast to existing studies, this study introduces the fsQCA method in the field of industrial equipment management and control for the first time to reveal the influencing paths; its originality and methodology have significant innovative significance. The research results provide new ideas and methodological guidance for enterprise managers to improve the performance of production equipment operations and controls in the industrial internet environment, which helps to enhance the sustainable development capability of manufacturing enterprises. Full article

The urgent global challenge of environmental sustainability has intensified interest in integrating Lean Management practices with environmental objectives, particularly within the automotive industry, a sector known for both innovation and high environmental impact. This study investigates the systemic relationships between 16 lean practices and three environmental performance metrics: energy consumption, CO₂ emissions, and waste generation. Using the Fuzzy Decision-Making Trial And Evaluation Laboratory (DEMATEL) methodology, data were collected from seven lean experts in the Italian automotive industry to model the cause–effect dynamics among the selected practices. The analysis revealed that certain practices, such as Total Productive Maintenance (TPM), just-in-time (JIT), and one-piece-flow, consistently act as influential drivers across all environmental objectives. Conversely, practices like Statistical Process Control (SPC) and Total Quality Management (TQM) were identified as highly dependent, delivering full benefits only when preceded by foundational practices. The results suggest a strategic three-step implementation roadmap tailored to each environmental goal, providing decision-makers with actionable guidance for sustainable transformation. This study contributes to the literature by offering a structured perspective on lean and environmental sustainability in the context of the automotive sector in Italy. The research is supported by a data-driven method to prioritize practices based on their systemic influence and contextual effectiveness. Full article

Early pest detection in edible crops demands sensing solutions that can run at the edge under tight power, budget, and maintenance constraints. This review synthesizes peer-reviewed work (2015–2025) on three modality families—vision/AI, spectroscopy/imaging spectroscopy, and indirect sensors—restricted to edible crops and studies reporting some implementation or testing (n = 178; IEEE Xplore and Scopus). Each article was scored with a modality-aware performance–cost–implementability (PCI) rubric using category-specific weights, and the inter-reviewer reliability was quantified with weighted Cohen’s $\kappa$. We translated the evidence into compact decision maps for common deployment profiles (low-power rapid rollout; high-accuracy cost-flexible; and block-scale scouting). Across the corpus, vision/AI and well-engineered sensor systems more often reached deployment-leaning PCI (≥3.5: 32.0% and 33.3%, respectively) than spectroscopy (18.2%); the median PCI was 3.20 (AI), 3.17 (sensors), and 2.60 (spectroscopy). A Pareto analysis highlighted detector/attention models near $(P,C,I)\approx (4,5,4)$; sensor nodes spanning balanced $(4,4,4)$ and ultra-lean $(2,5,4)$ trade-offs; and the spectroscopy split between the early-warning strength $(5,4,3)$ and portability $(4,3,4)$. The inter-rater agreement was substantial for sensors and spectroscopy (pooled quadratic $\kappa$ = 0.73–0.83; up to 0.93 by dimension) and modest for imaging/AI (PA vs. Author 2: ${\kappa }_{\mathrm{quadratic}}=0.30$–$0.44$), supporting rubric stability with adjacency-dominated disagreements. The decision maps operationalize these findings, helping practitioners select a fit-for-purpose modality and encouraging a minimum PCI metadata set to enable reproducible, deployment-oriented comparisons. Full article

Sustainability is gaining relevance across organizations, yet significant challenges remain in how it is implemented and translated into daily operations. This paper examines how Lean Six Sigma can be used to address operational challenges while also supporting the integration of sustainability objectives in industrial contexts. The study is based on a project conducted in a fish processing plant, aiming to increase production capacity and reduce delays. Using the DMAIC framework, the team addressed key bottlenecks through demand-based workload leveling, earlier production planning, and targeted maintenance to improve equipment performance. These actions led to measurable gains in throughput, resource use, and schedule reliability. In parallel, they contributed to sustainability outcomes, including reduced rework, lower waste, and improved working conditions. The results suggest that Lean Six Sigma, typically focused on performance, can also act as a platform for embedding sustainability into existing routines. The findings offer insight into how performance-driven approaches can support sustainability transitions in process-intensive industries. Full article

Background: Elevated BMI in women is linked to metabolic and endocrine imbalances that impair fertility and increase pregnancy risks. While >10% weight loss before an Assisted reproductive technology (ART) treatment may improve outcomes, sustained results through conventional diets are challenging. A very-low calorie ketogenic diet (VLCKD) promotes rapid fat loss while preserving lean mass and may offer long-term benefits. This study evaluated the efficacy (≥10% weight loss without lean mass reduction), adherence, metabolic effects, and pregnancy outcomes of a meal replacement VLCKD in women with overweight or obesity scheduled for ART. Methods: This monocentric, prospective case-series was conducted at the Obesity and Work Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan (September 2019–September 2023). Eligible women underwent a three-phase dietary program: a 3-month VLCKD (<800 kcal/day), a 6-month transition with gradual carbohydrate reintroduction, and a Mediterranean-style maintenance diet. Participants were monitored for safety, body composition, adherence, and biochemical changes. Results: Of 52 women enrolled, 40 initiated the VLCKD; 27 (68%) achieved ≥10% weight loss while preserving lean mass. Eleven conceived naturally during or after the diet; 22 underwent ART, with 12 additional pregnancies. This corresponds to a 58% pregnancy rate among those who began the VLCKD. Significant improvements were observed in body mass index (BMI), fat mass, waist circumference, glucose metabolism, lipid profile, and liver function. No adverse events were reported. Conclusions: A meal replacement VLCKD protocol is feasible, well-tolerated, and associated with significant improvements in weight, especially in body composition, metabolic health, and potentially outcomes in women with overweight or obesity awaiting ART. Full article

Efficient utilization of low-calorific-value gases reduces emissions but remains challenging. Self-heat-maintained combustion uses fuel’s exothermic heat to sustain stability without external heat, yet the feed gas typically requires preheating (typically 573–673 K). This study innovatively proposes a compact regenerative catalytic reactor featuring an integrated helical heat-recovery structure and replaces empirical preheating with a user-defined function (UDF) programmed heat transfer efficiency model. This dual innovation enables self-sustained combustion at 0.16 vol.% methane, the lowest reported concentration for autonomous operation. Numerical results confirm stable operation under ultra-lean conditions, with significantly reduced preheating energy demand and accelerated thermal response. Transient analysis shows lower space velocities enable self-maintained combustion across a broader range of methane concentrations. However, higher methane concentrations require higher inlet temperatures for self-heat maintenance. This study provides significant insights for recovering energy from low-calorific-value gases and alleviating global energy pressures. Full article

Operations management personnel emphasize the maintenance of workforce empowerment on the shop floor. This is made possible by implementing effective operations and human resource management practices. However, organizations are adept at controlling the workforce empowerment domain within operational scenarios. In the current industry revolution scenario, industry personnel often face failure due to a laggard mindset in the face of industry revolutions. There are higher possibilities of failure because of standardized operations controlling the shop floor. Organizations utilize well-established human resource concepts, including McClelland’s acquired needs theory, Herzberg’s two-factor theory, and Maslow’s hierarchy of needs, in order to enhance the workforce’s performance on the shop floor. Current SME individuals require fast-paced approaches for tracking the performance and idleness of a workforce in order to control them more efficiently in both flexible and transformational stages. The present study focuses on investigating the parameters and factors that contribute to workforce empowerment in an industrial revolution scenario. The present research is used to develop a framework utilizing operations and human resource management approaches in order to identify and address the issues responsible for deteriorating workforce contributions. The framework includes HRM and operations management practices, including Herzberg’s two-factor theory, Maslow’s theory, and lean and smart approaches. The developed framework contains four phases for achieving desired outcomes on the shop floor. The developed framework is validated by implementing it in a real-life electric vehicle manufacturing organization, where the human resources and operations team were exhausted and looking to resolve employee-related issues instantly and establish a sustainable work environment. The current industry is transforming from Industry 3.0 to Industry 4.0, and seeks future-ready innovations in operations, control, and monitoring of shop floor setups. The operations management and human resource management practices teams reviewed the results over the next three months after the implementation of the developed framework. The results revealed an improvement in workforce empowerment within the existing work environment, as evidenced by reductions in the number of absentees, resignations, transfer requests, and medical issues, by 30.35%, 94.44%, 95.65%, and 93.33%, respectively. A few studies have been conducted on workforce empowerment by controlling shop floor scenarios through modifications in operations and human resource management strategies. The results of this study can be used to fulfil manufacturers’ needs within confined constraints and provide guidelines for efficiently controlling workforce performance on the shop floor. Constraints refer to barriers that have been decided, including production time, working time, asset availability, resource availability, and organizational policy. The study proposes a decision-making plan for enhancing shop floor performance by providing suitable guidelines and an action plan, taking into account both workforce and operational performance. Full article

Background/Objectives: Total knee arthroplasty (TKA) is commonly associated with postoperative muscle atrophy and weakness, while traditional rehabilitation is often limited by pain and patient compliance. Passive blood flow restriction (pBFR) training may offer a safe, low-threshold method to attenuate muscle loss in this early phase. This pilot study examined the feasibility, safety, and early effects of pBFR initiated during hospitalization on muscle mass, swelling, and functional recovery after TKA. Methods: In a prospective, single-blinded trial, 26 patients undergoing primary or aseptic revision TKA were randomized to either a control group (CON: sham BFR at 20 mmHg) or intervention group (INT: pBFR at 80% limb occlusion pressure). Both groups received 50 min daily in-hospital rehabilitation sessions for five consecutive days. Outcomes, including lean muscle mass (DXA), thigh/knee circumference, 6 min walk test (6 MWT), handgrip strength, and patient-reported outcomes, were assessed preoperatively and at discharge, six weeks, and three months postoperatively. Linear mixed models with Bonferroni correction were applied. Results: The INT group showed significant preservation of thigh circumference (p = 0.002), reduced knee swelling (p < 0.001), and maintenance of lean muscle mass (p < 0.01), compared with CON, which exhibited significant declines. Functional performance improved faster in INT (e.g., 6 MWT increase at T3: +23.7%, p < 0.001; CON: −7.2%, n.s.). Quality of life improved in both groups, with greater gains in INT (p < 0.05). No adverse events were reported. Conclusions: Initiating pBFR training on the first postoperative day is feasible, safe, and effective in preserving muscle mass and reducing swelling after TKA. These findings extend prior BFR research by demonstrating its applicability in older, surgical populations. Further research is warranted to evaluate its integration with standard rehabilitation programs and long-term functional benefits. Full article