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Search Results (487)

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19 pages, 2573 KiB  
Review
A Review on Pipeline In-Line Inspection Technologies
by Qingmiao Ma, Weige Liang and Peiyi Zhou
Sensors 2025, 25(15), 4873; https://doi.org/10.3390/s25154873 (registering DOI) - 7 Aug 2025
Abstract
Pipelines, as critical infrastructure in energy transmission, municipal facilities, industrial production, and specialized equipment, are essential to national economic security and social stability. This paper systematically reviews the domestic and international research status of pipeline in-line inspection (ILI) technologies, with a focus on [...] Read more.
Pipelines, as critical infrastructure in energy transmission, municipal facilities, industrial production, and specialized equipment, are essential to national economic security and social stability. This paper systematically reviews the domestic and international research status of pipeline in-line inspection (ILI) technologies, with a focus on four major technological systems: electromagnetic, acoustic, optical, and robotic technologies. The operational principles, application scenarios, advantages, and limitations of each technology are analyzed in detail. Although existing technologies have achieved significant progress in defect detection accuracy and environmental adaptability, they still face challenges including insufficient adaptability to complex environments, the inherent trade-off between detection accuracy and efficiency, and high equipment costs. Future research directions are identified as follows: intelligent algorithm optimization for multi-physics collaborative detection, miniaturized and integrated design of inspection devices, and scenario-specific development for specialized environments. Through technological innovation and multidisciplinary integration, pipeline ILI technologies are expected to progressively realize efficient, precise, and low-cost lifecycle safety monitoring of pipelines. Full article
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20 pages, 1175 KiB  
Article
A Study on the Site Selection of Urban Logistics Centers Utilizing Public Infrastructure
by Jiarong Chen, Jungwook Lee and Hyangsook Lee
Sustainability 2025, 17(15), 6846; https://doi.org/10.3390/su17156846 - 28 Jul 2025
Viewed by 281
Abstract
The COVID-19 pandemic has highlighted critical vulnerabilities in urban logistics systems, particularly in last-mile delivery. To enhance logistics resilience and efficiency, the Korean government has initiated an innovative project that repurposes idle spaces in subway vehicle bases within the Seoul Metropolitan Area into [...] Read more.
The COVID-19 pandemic has highlighted critical vulnerabilities in urban logistics systems, particularly in last-mile delivery. To enhance logistics resilience and efficiency, the Korean government has initiated an innovative project that repurposes idle spaces in subway vehicle bases within the Seoul Metropolitan Area into logistics centers. This study proposes a comprehensive multi-criteria evaluation framework combining the Analytic Hierarchy Process (AHP) and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) to assess the suitability of ten candidate sites. The evaluation criteria span four dimensions, facility, geographical, environmental, and social factors, derived from the literature and expert consultations. AHP results indicate that geographical factors, especially proximity to urban centers and major logistics facilities, hold the highest weight. Based on the integrated analysis using TOPSIS, the most suitable locations identified are Sinnae, Godeok, and Cheonwang. The findings suggest the strategic importance of aligning infrastructure development with spatial accessibility and stakeholder cooperation. Policy implications include the need for targeted investment, public–private collaboration, and sustainable logistics planning. Future research is encouraged to incorporate dynamic data and consider social equity and environmental impact for long-term urban logistics planning. Full article
(This article belongs to the Section Sustainable Transportation)
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16 pages, 3781 KiB  
Article
Review of NFPA 780 Standard Compliance for Improved Lightning Protection in Indonesia’s Oil and Gas Industry
by Bryan Denov and Reynaldo Zoro
Energies 2025, 18(15), 4002; https://doi.org/10.3390/en18154002 - 28 Jul 2025
Viewed by 389
Abstract
Lightning represents a critical danger to facilities such as oil tank farms, with the potential to cause major explosive incidents. To address this risk, Indonesia’s oil and gas industry has adopted the NFPA 780 Standard for lightning protection systems. However, tank explosions and [...] Read more.
Lightning represents a critical danger to facilities such as oil tank farms, with the potential to cause major explosive incidents. To address this risk, Indonesia’s oil and gas industry has adopted the NFPA 780 Standard for lightning protection systems. However, tank explosions and refinery disruptions caused by lightning strikes continue to occur annually, highlighting the need to reassess the standard’s self-protection criteria, particularly in Indonesia’s tropical climate. The NFPA 780 standard was primarily developed based on lightning characteristics in subtropical regions. This study evaluates its effectiveness in tropical environments, where lightning parameters such as peak currents, frequencies, and ground flash densities differ significantly. By analyzing specific incidents of tank explosions in Indonesia, the research reveals that compliance with the NFPA 780 standard alone may not be adequate to protect critical infrastructure. To address these challenges, this study proposes a novel approach to lightning protection by designing solutions tailored to the unique characteristics of tropical climates. By incorporating local lightning parameters, the proposed measures aim to enhance safety and resilience in oil and gas facilities. This research provides a framework for adapting international standards to regional needs, improving the effectiveness of lightning protection in tropical environments. Full article
(This article belongs to the Topic EMC and Reliability of Power Networks)
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14 pages, 487 KiB  
Article
Sex-Based Differences in Clinical Presentation, Management, and Outcomes in Patients Hospitalized with Pulmonary Embolism: A Retrospective Cohort Study
by Benjamin Troxler, Maria Boesing, Cedrine Kueng, Fabienne Jaun, Joerg Daniel Leuppi and Giorgia Lüthi-Corridori
J. Clin. Med. 2025, 14(15), 5287; https://doi.org/10.3390/jcm14155287 - 26 Jul 2025
Viewed by 273
Abstract
Background/Objectives: Pulmonary embolism (PE) remains a major cause of morbidity and mortality. Despite advances in care, its nonspecific symptoms pose diagnostic and therapeutic challenges. Emerging evidence suggests sex-based differences in PE presentation, management, and outcomes, yet real-world data from European settings remain [...] Read more.
Background/Objectives: Pulmonary embolism (PE) remains a major cause of morbidity and mortality. Despite advances in care, its nonspecific symptoms pose diagnostic and therapeutic challenges. Emerging evidence suggests sex-based differences in PE presentation, management, and outcomes, yet real-world data from European settings remain scarce. This study aimed to investigate sex differences in clinical presentation, diagnostic workup, therapeutic interventions, and outcomes among hospitalized PE patients. Methods: We conducted a retrospective cohort study including all adult patients (≥18 years) admitted with a main diagnosis of acute PE at the Cantonal Hospital Baselland between January 2018 and December 2020. Data were extracted from electronic medical records and included demographics, comorbidities, symptoms, diagnostics, treatments, and outcomes. Sex-based comparisons were performed using univariate analyses. Results: Among 197 patients, 54% were women. Compared to men, women were more often admitted by ambulance (42% n = 45 vs. 24% n = 22, p = 0.009), had more frequent tachycardia (38% n = 41 vs. 23% n = 21, p = 0.024), and received lysis therapy more often (10% n = 11 vs. 2% n = 2, p = 0.023). DVT was more frequently diagnosed in women when sonography was performed (82% n = 49 vs. 64% n = 34, p = 0.035). Men had higher rates of B symptoms, smoking, and family history of PE. Women had longer hospital stays and were more frequently discharged to rehabilitation facilities. No sex differences were found in in-hospital mortality, 6-month rehospitalization, or adherence to diagnostic guidelines. Conclusions: This study reveals sex-based differences in PE presentation and management, suggesting potential disparities in care pathways. Further research is needed to promote equitable, personalized treatment strategies. Full article
(This article belongs to the Special Issue Pulmonary Embolism: Clinical Advances and Future Opportunities)
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37 pages, 1895 KiB  
Review
A Review of Artificial Intelligence and Deep Learning Approaches for Resource Management in Smart Buildings
by Bibars Amangeldy, Timur Imankulov, Nurdaulet Tasmurzayev, Gulmira Dikhanbayeva and Yedil Nurakhov
Buildings 2025, 15(15), 2631; https://doi.org/10.3390/buildings15152631 - 25 Jul 2025
Viewed by 594
Abstract
This comprehensive review maps the fast-evolving landscape in which artificial intelligence (AI) and deep-learning (DL) techniques converge with the Internet of Things (IoT) to manage energy, comfort, and sustainability across smart environments. A PRISMA-guided search of four databases retrieved 1358 records; after applying [...] Read more.
This comprehensive review maps the fast-evolving landscape in which artificial intelligence (AI) and deep-learning (DL) techniques converge with the Internet of Things (IoT) to manage energy, comfort, and sustainability across smart environments. A PRISMA-guided search of four databases retrieved 1358 records; after applying inclusion criteria, 143 peer-reviewed studies published between January 2019 and April 2025 were analyzed. This review shows that AI-driven controllers—especially deep-reinforcement-learning agents—deliver median energy savings of 18–35% for HVAC and other major loads, consistently outperforming rule-based and model-predictive baselines. The evidence further reveals a rapid diversification of methods: graph-neural-network models now capture spatial interdependencies in dense sensor grids, federated-learning pilots address data-privacy constraints, and early integrations of large language models hint at natural-language analytics and control interfaces for heterogeneous IoT devices. Yet large-scale deployment remains hindered by fragmented and proprietary datasets, unresolved privacy and cybersecurity risks associated with continuous IoT telemetry, the growing carbon and compute footprints of ever-larger models, and poor interoperability among legacy equipment and modern edge nodes. The authors of researches therefore converges on several priorities: open, high-fidelity benchmarks that marry multivariate IoT sensor data with standardized metadata and occupant feedback; energy-aware, edge-optimized architectures that lower latency and power draw; privacy-centric learning frameworks that satisfy tightening regulations; hybrid physics-informed and explainable models that shorten commissioning time; and digital-twin platforms enriched by language-model reasoning to translate raw telemetry into actionable insights for facility managers and end users. Addressing these gaps will be pivotal to transforming isolated pilots into ubiquitous, trustworthy, and human-centered IoT ecosystems capable of delivering measurable gains in efficiency, resilience, and occupant wellbeing at scale. Full article
(This article belongs to the Section Building Energy, Physics, Environment, and Systems)
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20 pages, 3122 KiB  
Article
Spatial Analysis of Medical Service Accessibility in the Context of Quality of Life and Sustainable Development: A Case Study of Olsztyn County, Poland
by Iwona Cieślak, Bartłomiej Eźlakowski, Andrzej Biłozor and Adam Senetra
Sustainability 2025, 17(15), 6687; https://doi.org/10.3390/su17156687 - 22 Jul 2025
Viewed by 205
Abstract
This study investigates the accessibility of public healthcare services in Olsztyn County, a major urban center in the Warmia and Mazury region of Poland. The aim was to develop a methodological framework using Geographic Information System (GIS) tools and spatial data to assess [...] Read more.
This study investigates the accessibility of public healthcare services in Olsztyn County, a major urban center in the Warmia and Mazury region of Poland. The aim was to develop a methodological framework using Geographic Information System (GIS) tools and spatial data to assess the local availability of healthcare infrastructure. The analysis included key facilities such as hospitals, clinics, pharmacies, and specialized outpatient services. A spatial accessibility indicator was constructed to evaluate and compare access levels across municipalities. The results show a clear disparity between urban and rural areas, with significantly better access in cities. Several rural municipalities were found to have limited or no access to essential healthcare services. These findings highlight the uneven spatial distribution of medical infrastructure and point to the need for targeted strategies to improve service availability in underserved areas. The proposed methodological approach may support future studies and inform local and regional planning aimed at reducing healthcare inequalities and improving access for all residents, regardless of their location. This research contributes to the growing body of evidence emphasizing the role of spatial analysis in assessing public service accessibility and supports the development of more equitable healthcare systems at the local level. Full article
(This article belongs to the Special Issue Quality of Life in the Context of Sustainable Development)
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15 pages, 2061 KiB  
Article
Comparison of Preservatives for the Prevention of Microbial Spoilage of Apple Pomace During Storage
by Ashley Harratt, Wenyuan Wu, Peyton Strube, Joseph Ceravolo, David Beattie, Tara Pukala, Marta Krasowska and Anton Blencowe
Foods 2025, 14(14), 2438; https://doi.org/10.3390/foods14142438 - 10 Jul 2025
Viewed by 401
Abstract
Apple pomace, a by-product from the production of concentrated juice, is a major contributor to global food waste. Despite its beneficial nutritional profile, apple pomace is predominantly disposed of in landfills. Rapid fermentation and spoilage caused by microorganisms are compounding factors in this [...] Read more.
Apple pomace, a by-product from the production of concentrated juice, is a major contributor to global food waste. Despite its beneficial nutritional profile, apple pomace is predominantly disposed of in landfills. Rapid fermentation and spoilage caused by microorganisms are compounding factors in this demise, despite significant research into upcycling strategies. Thus, there is an unmet need for economical approaches that allow for the preservation of pomace during storage and transportation to centralized processing facilities from regional hubs. To address this challenge, we investigated the potential of different preservatives for preventing microbial growth and the spoilage of apple pomace, including antimicrobials (natamycin and iodine), polysaccharides (chitosan and fucoidan), and acetic acid. Spread plates for total microbial and fungal counts were employed to assess the effectiveness of the treatments. High concentrations (10,000 ppm) of chitosan were effective at reducing the microbial load and inhibiting growth, and in combination with antimicrobials, eliminated all microbes below detectable levels. Nevertheless, acetic acid at an equivalent concentration to commercial vinegar displayed the highest economic potential. Apple pomace submerged in 0.8 M acetic acid (3 kg pomace per liter) resulted in a five-log reduction in the microbial colony-forming units (CFUs) out to 14 days and prevented fermentation and ethanol production. These results provide a foundation for the short-term storage and preservation of apple pomace that could contribute to its upcycling. Full article
(This article belongs to the Section Food Microbiology)
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30 pages, 7940 KiB  
Article
Research on the Performance Evaluation of Urban Innovation Spaces: A Case Study in Harbin
by Songtao Wu, Bowen Li and Daming Xu
Buildings 2025, 15(13), 2258; https://doi.org/10.3390/buildings15132258 - 27 Jun 2025
Viewed by 380
Abstract
Innovation has become a pivotal factor in driving economic growth for cities and regions. Urban innovation spaces are urban spaces where innovative economic and industrial activities, such as research, teaching, and high-tech manufacturing, are clustered. They have become hot research topics in recent [...] Read more.
Innovation has become a pivotal factor in driving economic growth for cities and regions. Urban innovation spaces are urban spaces where innovative economic and industrial activities, such as research, teaching, and high-tech manufacturing, are clustered. They have become hot research topics in recent years. Evaluating the performance of urban innovation spaces to promote rational resource allocation and enhance land development potential has become a critical task in urban planning. However, existing studies suffer from insufficient depth of research scales and a lack of quantitative indicators and data analysis. In response to the above gaps, this study constructed a framework for evaluating the performance of urban innovation spaces from 25 indicators of five major types, including core elements of innovation, entrepreneurship support institutions, service facilities, external environments, and diversities, aiming to quantify the performance heterogeneity of innovation spaces at the micro scale. This study took Harbin as an example and employed the entropy, kernel density estimation, and entropy-weighted TOPSIS methods, identifying four high-scoring areas of innovation spaces—the Science and Technology Innovation City area, the High-tech Industrial Development area, the core area of the old city, and the Harbin Veterinary Research Institute area—which were divided into three types: the Entrepreneurial leading area, Environmental Support area, and Balanced Development area. Finally, this study analyzed the interaction between each indicator. It was found that the correlation between the core elements of innovation and the indicators of entrepreneurship support institutions was strong and had a high degree of importance. The correlation of different types of service facility indicators is quite different, and the external environment indicators and diversity indicators are mainly affected by other indicators, especially the core elements of innovation and entrepreneurship support institutions. This paper provides a valuable tool for the performance evaluation of urban innovation spaces for researchers and urban planning decision makers. Full article
(This article belongs to the Collection Strategies for Sustainable Urban Development)
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26 pages, 3971 KiB  
Article
Investigating Holiday Subway Travel Flows with Spatial Correlations Using Mobile Payment Data: A Case Study of Hangzhou
by Yiwei Zhou, Haozhe Wang, Shiyu Chen, Jiakai Jiang, Ziyuan Wang and Weiwei Liu
Sustainability 2025, 17(13), 5873; https://doi.org/10.3390/su17135873 - 26 Jun 2025
Viewed by 364
Abstract
The subway is crucial for urban operations, especially during holidays. Unlike traditional studies using smart card data, this research analyzes National Day holiday subway travel patterns with Hangzhou’s 2021 mobile payment data, covering 42 days from 6 September to 17 October for comprehensive [...] Read more.
The subway is crucial for urban operations, especially during holidays. Unlike traditional studies using smart card data, this research analyzes National Day holiday subway travel patterns with Hangzhou’s 2021 mobile payment data, covering 42 days from 6 September to 17 October for comprehensive comparison. Considering spatial passenger flow correlations, a Composite Weight (CW) matrix integrating network distance and time is defined and integrated into a Spatial Error Model (SEM), Spatial autoregressive model (SAR), and Spatial Durbin Model (SDM) to create CW-SEM, CW-SAR, and CW-SDM. The CW matrix innovatively considers network distance and time, overcoming traditional spatial weight matrix limitations to accurately and dynamically capture passenger flow spatial correlations. The results show the following: (1) Hangzhou saw 37% and 49% increases in average daily passenger flow during the extended holiday versus workdays and weekends, with holiday peak hour flow declining 16% compared to workdays but increasing 18% versus weekends, likely due to shifted travel purposes from commuting to tourism; (2) strong spatial passenger flow correlations existed in both workdays and weekends, attributed to urban functional zoning and transport network connectivity; (3) key factors such as population, social media activity, commercial facilities and transportation hubs show significant positive correlations with holiday passenger flow. Medical facility reveals significant negative correlations with holiday passenger flow. These findings highlight the need to incorporate spatial variations into major holiday subway travel studies for urban planning and traffic management insights. Full article
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21 pages, 575 KiB  
Article
Mechanisms of Resident Satisfaction Enhancement Through Waterfront Sports Buildings: A Synergistic Perspective of Blue Space and Built Environment—Empirical Evidence from Nine Chinese Cases
by Zhihao Zhang, Wenyue Liu, Jia Zhang, Linkang Du and Jianhua Pan
Buildings 2025, 15(13), 2233; https://doi.org/10.3390/buildings15132233 - 25 Jun 2025
Viewed by 542
Abstract
While the existing research has extensively explored the impact of urban green spaces on residents’ well-being, studies specifically focusing on waterfront sports buildings remain scarce. This study examines how the combined effects of built environment characteristics in waterfront sports facilities enhance user satisfaction [...] Read more.
While the existing research has extensively explored the impact of urban green spaces on residents’ well-being, studies specifically focusing on waterfront sports buildings remain scarce. This study examines how the combined effects of built environment characteristics in waterfront sports facilities enhance user satisfaction through psychological mechanisms. Based on survey data from 721 users across nine major waterfront sports complexes in China, we find that (1) four social function dimensions (social interaction, accessibility, safety, and multifunctionality) show significant positive correlations with satisfaction; (2) place attachment mediates these relationships. These findings validate the importance of integrating water-oriented design principles with community needs, offering both theoretical contributions to human–water interaction studies and practical implications for urban blue space (defined as visible water features including rivers, lakes, and coastal areas) development. Full article
(This article belongs to the Section Architectural Design, Urban Science, and Real Estate)
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18 pages, 1903 KiB  
Review
Application of Remote Sensing and Machine Learning in Sustainable Agriculture
by Claudiu Coman, Ecaterina Coman, Vasile Gherheș, Anna Bucs and Dana Rad
Sustainability 2025, 17(12), 5601; https://doi.org/10.3390/su17125601 - 18 Jun 2025
Viewed by 766
Abstract
The growing demand for sustainable food production has driven significant advancements in modern agriculture, including increasing interest in Controlled Environment Agriculture (CEA), a high-tech solution designed to provide fresh, local, and organic products. Although the integration of various technologies in agriculture continues to [...] Read more.
The growing demand for sustainable food production has driven significant advancements in modern agriculture, including increasing interest in Controlled Environment Agriculture (CEA), a high-tech solution designed to provide fresh, local, and organic products. Although the integration of various technologies in agriculture continues to expand, many opportunities remain to improve environmental performance and operational efficiency. Recent advancements in Remote Sensing (RS) and Machine Learning (ML) offer promising tools for enhancing resource efficiency, improving sustainability, and optimizing processes across various agricultural settings. This study presents a bibliometric analysis of the application of Remote Sensing and Machine Learning in agriculture, highlighting publication trends, influential research contributions, and emerging themes in this interdisciplinary field. While the majority of the analyzed literature addresses general agricultural modernization, the growing relevance of RS and ML in artificial climate facilities and controlled environments has been evident in more recent research. Furthermore, we explore how RS and ML technologies contribute to real-time monitoring, precision agriculture, and decision-making in agriculture. Full article
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11 pages, 2009 KiB  
Article
Different Approaches to Extracting Proximally Migrated or Broken and Retained Pancreatic Stents
by Navkiran Randhawa, Ahamed Khalyfa, Raahi Patel, Rahil Desai, Mahnoor Inamullah, Haoran Peng, Varshita Goduguchinta, Subbaramiah Sridhar and Kamran Ayub
J. Clin. Med. 2025, 14(12), 4298; https://doi.org/10.3390/jcm14124298 - 17 Jun 2025
Viewed by 460
Abstract
Background: Pancreatic stents (PSs) play a crucial role in the management of pancreatic duct obstructions, particularly in the context of endoscopic retrograde cholangiopancreatography (ERCP). However, stent migration remains a significant complication, leading to risks such as pancreatitis, pancreatic duct stenosis, and abscess formation. [...] Read more.
Background: Pancreatic stents (PSs) play a crucial role in the management of pancreatic duct obstructions, particularly in the context of endoscopic retrograde cholangiopancreatography (ERCP). However, stent migration remains a significant complication, leading to risks such as pancreatitis, pancreatic duct stenosis, and abscess formation. This study aims to evaluate the efficacy of various endoscopic techniques for retrieving proximally migrated or broken pancreatic stents, highlighting optimal strategies for improving patient outcomes. Methods: A retrospective multicenter review was conducted across six hospitals from 2016 to 2024. Patients with proximally migrated or broken pancreatic stents referred for endoscopic retrieval after failed attempts at other facilities were included. Demographic data, stent characteristics, and retrieval techniques were analyzed. Endoscopic methods included SpyGlass forceps, SpyGlass baskets, Soehendra retriever stents, balloon sweeps, flower baskets, and extension pancreatic sphincterotomy. Procedural success, retrieval times, and post-procedural outcomes were assessed. Results: Twelve patients underwent endoscopic retrieval, including two with broken stents. All procedures were successful, with retrieval times averaging 30 to 45 min. Two patients developed pancreatic duct narrowing, requiring balloon dilation. All patients had new stents placed to maintain duct patency, and no major complications were observed. Follow-up evaluations confirmed complete resolution of migration-related issues, with all stents removed. Conclusions: Endoscopic retrieval of migrated pancreatic stents is highly effective, with specialized techniques ensuring a 100% success rate in this study. Early intervention and the selection of appropriate retrieval methods are critical in minimizing complications. Further research is needed to refine retrieval strategies and standardize protocols to enhance clinical outcomes. Full article
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19 pages, 583 KiB  
Review
Analyzing Patterns and Predictive Models of Energy and Water Consumption in Schools
by Hana Begić Juričić and Hrvoje Krstić
Sustainability 2025, 17(12), 5514; https://doi.org/10.3390/su17125514 - 15 Jun 2025
Viewed by 475
Abstract
Schools are major consumers of energy and water, significantly influencing environmental sustainability and operational budgets. This study presents a comprehensive review of global trends in energy and water consumption in school buildings, identifying key factors that shape usage patterns, such as the geographic [...] Read more.
Schools are major consumers of energy and water, significantly influencing environmental sustainability and operational budgets. This study presents a comprehensive review of global trends in energy and water consumption in school buildings, identifying key factors that shape usage patterns, such as the geographic location, climate, building characteristics, and occupancy levels. A particular focus is placed on the role of predictive models in enhancing resource efficiency. The review found that energy consumption in schools varies widely, with heating, lighting, and cooling systems being the primary contributors. In contrast, research on water consumption—especially predictive modeling—is notably scarce, with no studies found that focused specifically on school buildings. This highlights a critical gap in the literature. This study evaluated the existing predictive approaches, including regression analyses, machine learning algorithms, and statistical models, which offer valuable tools for forecasting consumption and guiding targeted efficiency interventions. The findings underscore the urgent need for data-driven strategies to support sustainable resource management in educational facilities. Full article
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13 pages, 497 KiB  
Article
Hospital-Based Emergency and Trauma Care—The Expanding Epicenter of the US Healthcare Delivery System
by Glenn Melnick
Healthcare 2025, 13(12), 1424; https://doi.org/10.3390/healthcare13121424 - 13 Jun 2025
Viewed by 486
Abstract
Background/Objectives: This study investigates the evolution of hospital capacity and utilization in California between 2003 and 2023, focusing on emergency departments (EDs) and trauma centers (TCs). We seek to document structural changes in the healthcare delivery system with respect to hospital-based emergency and [...] Read more.
Background/Objectives: This study investigates the evolution of hospital capacity and utilization in California between 2003 and 2023, focusing on emergency departments (EDs) and trauma centers (TCs). We seek to document structural changes in the healthcare delivery system with respect to hospital-based emergency and trauma services. Methods: This analysis examines changes in population demographics, hospital resources, and patient utilization patterns across facility types. Given the significant increase in the proportion of the population aged 65+ and the documented higher use of emergency and trauma services by this population, we expected to observe an expansion in ED and trauma service capacity and utilization. Results: Utilizing a comprehensive dataset of California general acute care hospitals over this 20+ year period, our descriptive analysis reveals major shifts in the healthcare delivery system, notably the increased prominence of hospitals with EDs, particularly those designated as trauma centers. Findings indicate that, while the overall number of hospitals and licensed beds has slightly decreased, facilities with EDs, especially trauma centers, have increased their capacity and manage a greater proportion of inpatient admissions and ED visits. Conclusions: The increase in ED visits and inpatient admissions at trauma centers, contrasted with decreases in both capacity and utilization at non-trauma hospitals, indicates a significant restructuring of the health delivery system with significant implications for healthcare policy, financing, operations, and affordability. The high and increasing percentage of inpatient admissions originating from hospital EDs and from hospitals with trauma centers suggests a need for policies that foster integration between ED and inpatient care and the broader healthcare delivery system, while at the same time managing the increase in prices and costs associated with growing emergency services utilization. Further research is needed to explore the implications of these trends, particularly concerning their impact on the affordability of healthcare in the US. Full article
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17 pages, 1345 KiB  
Article
Level of Service Criteria for Urban Arterials with Heterogeneous and Undisciplined Traffic Streams
by Afzal Ahmed, Farah Khan, Syed Faraz Abbas Rizvi, Fatma Outay, Muhammad Faiq Ahmed and Muhammad Adnan
Sustainability 2025, 17(11), 5126; https://doi.org/10.3390/su17115126 - 3 Jun 2025
Viewed by 816
Abstract
Accurate evaluation of the prevailing traffic operations plays an important part in developing sustainable transport systems. This research examines the suitability of the level of service (LOS) criteria developed by the Indian and United States (US) Highway Capacity Manuals (HCM) for heterogeneous and [...] Read more.
Accurate evaluation of the prevailing traffic operations plays an important part in developing sustainable transport systems. This research examines the suitability of the level of service (LOS) criteria developed by the Indian and United States (US) Highway Capacity Manuals (HCM) for heterogeneous and undisciplined traffic streams and proposes new criteria using a data-driven approach. Traffic data were collected from a selected major arterial in Karachi, and fundamental diagrams were developed using these data. These fundamental diagrams and field-collected data were analyzed using the K-mean clustering approach to examine the actual traffic states at various LOS bands used in practice. Associating the field-measured volume-to-capacity ratio with the speed bands used for LOS analysis gives insights into actual traffic conditions at various LOS categories. The research shows that the volume-to-capacity ratio corresponding to the speed range for LOS A is about 0.45, which implies that the heterogeneous traffic moves with comparatively higher speeds despite an increase in traffic volume. The criteria for LOS were developed using the K-mean cluster analysis technique. The proposed values of LOS criteria for speed percentages are significantly higher than those reported in both the HCMs. This research highlights the need to develop separate LOS criteria for heterogeneous and undisciplined traffic for all transportation facilities. The development of such new criteria can provide researchers and engineers with a schematic for the effective and realistic evaluation of local traffic regimes. Full article
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