Search Results (20,731)

Water scarcity has become a significant constraint to agricultural development in China. In this study, we employed bibliometric methods to systematically review the current research on crop water use efficiency (WUE) and the development trends in the North China Plain (NCP) and Northwest China (NWC). We analyzed 1569 articles (NCP = 788; NWC = 781) from the Web of Science Core Collection (1995–2025) using visualization tools such as CiteSpace and VOSviewer to investigate annual numbers of publications, leading scholars and research institutions, and then to map keyword co-occurrence and co-citation structures. Our results showed that keyword clustering exhibited high structural quality (NCP: Q = 0.7345, S = 0.8634; NWC: Q = 0.758, S = 0.8912), supporting reliable thematic interpretation. The bibliometric analysis indicates a steady growth in annual publications since 1995, with the Chinese Academy of Sciences and China Agricultural University as leading contributors. From 1995 to 2005, studies centered on irrigation, yield and field-scale WUE, emphasizing the optimization of irrigation strategies and crop productivity. During 2006–2015, the thematic focus has broadened to encompass nitrogen use efficiency, crop quality and eco-environmental performance, thereby moving toward integrated evaluation frameworks that capture ecological synergies. Since 2016, the literature now emphasizes system integration, regional adaptability, climate-response mechanisms and the ecological co-benefits of agricultural practices. Future studies are expected to incorporate indicators such as crop quality, water footprint and carbon isotope indicators to support the sustainable development of agricultural water use. This study offers insights and recommendations for developing a comprehensive crop WUE evaluation framework in China, which will support sustainable agricultural water management and the realization of national “dual carbon” targets. Full article

Background: Neonatal sepsis (NS) is a life-threatening condition in newborns, which is an infectious process with a systemic inflammatory reaction to bacterial, viral, or fungal infection acquired in the first 28 days of life. Methods: This study examines the major pathogens causing neonatal sepsis in the Gulf Cooperation Council (GCC) and their resistance patterns to antimicrobial agents. We utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to develop this systematic review to follow a systematic and transparent process. The comprehensive literature review was done in several national and global databases, which include PubMed, Scopus, Google Scholar, Embase, and Cochrane Library. The key words inserted in the search strategy were “neonatal sepsis,” “late-onset sepsis,” “early-onset sepsis,” and “Gulf Cooperation Council (GCC),” and the keywords of antimicrobial resistance and pathogens were used: “antimicrobial drug resistance” and “pathogens.” Only articles published from January 1983 to January 2025 were included for screening. Results: The final count of the articles that fit the inclusion criteria is 54, and 5177 neonatal sepsis cases’ data have been identified. The most common pathogens were coagulase-negative staphylococci (CoNS) and Klebsiella spp., which caused 17.4 percent (901 cases) and 15.9 percent (825 cases) of neonatal sepsis, respectively. Coagulase-negative staphylococci (CoNS) were the most resistant, especially to oxacillin and erythromycin. The most isolated pathogens among Gram-negative spp. were Klebsiella spp., which showed a resistance to ampicillin, amoxicillin, and ceftriaxone. Conclusions: The bacterial isolates had a diversity of antimicrobial resistance, stressing the necessity of continuous hospital surveillance. Sophisticated diagnostic methods and well-designed research are necessary, especially in areas characterized by high rates of neonatal mortality, to determine the prevalence of neonatal sepsis, risk factors, and clinical outcomes. Full article

Pharmacist interventions (PIs) are central to optimising pharmacotherapy, preventing drug-related problems, and improving patient outcomes. In Portugal, the absence of a validated tool to consistently document and classify PIs limits data comparability and service development. Given these gaps, this study aimed to describe hospital pharmacists’ attitudes towards PI documentation and classification, following confirmatory factor analysis (CFA) of a survey instrument, and to provide a comprehensive overview of current practices and behaviours in hospital settings across Portugal. An online questionnaire, previously validated, was distributed online to all hospital pharmacists registered with the Portuguese Pharmaceutical Society (October–December 2024). Sociodemographic data and the cognitive and behavioural domains of pharmacists’ attitudinal model were analysed descriptively, and CFA tested the three-factor structure (Process, Outcome, Satisfaction) of the attitudinal affective domain. Of 1848 pharmacists, 260 responded (14%). Respondents reported performing a mean of 49 PIs/month (SD = 196), although many never recorded (28.8%), classified (56.2%), or analysed (52.3%) interventions. Only 2.7% declared to use a validated classification framework. The CFA supported the structural coherence of the Process factor but revealed some overlapping between Process and Outcome and instability in the Satisfaction factor. The nationwide scope and application of CFA provided partial support for the hypothesised model and highlighted areas for refinement, including revision of Satisfaction items and reconsideration of Process and Outcome as overlapping constructs. Findings highlight strong professional commitment to PIs but persistent barriers, including less clear procedures and satisfaction, underscoring the need for a unified, standardised national system to support consistent recording, classification, and evaluation. Full article

Protein-based APIs represent a big group of modern therapeutics. Their characterization involves complex analytical protocols which require special methods, especially in the case when the protein drug is included into tablet dosage forms. Although the fluorescence polarization assay (FPA) is not currently regulated by many national Pharmacopeias, it represents a promising approach for protein drug standardization, considering their rapid, sensitive, and automatable detection suitable for high-throughput analysis and real-time quality control. To evaluate the applicability of FPA for the analysis of protein drugs in tablets, the quantifying of lysozyme in tablet dosage forms was studied by this method with the use of a fluorescently labeled synthetic chitooligosaccharide tracer. It was shown that this approach overcomes the limitations of the conventional turbidimetric assay of lysozyme determination, which is labor-intensive and relies on unstable reagents. Measurements were performed with both portable and stationary fluorescence polarization readers. Commercial tablets from five manufacturers containing lysozyme (20 mg) and pyridoxine hydrochloride (10 mg) together with other excipients were analyzed. The FPIA method showed a linear range of 5.0–70 µg/mL, with specificity confirmed by the absence of interference from excipients. Accuracy, evaluated by standard addition (10–20 mg), yielded recoveries of 100.2–106.0%. Placebo spiked with lysozyme at 80–120% of nominal content demonstrated recoveries of 98.0–100.1%, with RSD (n = 6) not exceeding 13.7%, indicating good precision. The developed method enables reliable lysozyme quantification in tablets, offering speed, simplicity, and robustness, and shows its suitability for the routine quality control of protein-containing dosage forms including the enzyme ones. Full article

In this study, we present LizAI XT, an AI-powered platform designed to automate the structuring, anonymization, and semantic integration of large-scale healthcare data from diverse sources, into one comprehensive table or any designated forms, based on diseases, clinical variables, and/or other defined parameters, beyond the creation of a dashboard or visualization. We evaluate the platform’s performance on a cluster of 4x NVIDIA A30 GPU 24GB, with 16 diseases—from deathly cancer and COPD, to conventional ones—ear infections, including a total 16,000 patients, ∼115,000 medical files, and ∼800 clinical variables. LizAI XT structures data from thousands of files into sets of variables for each disease in one file, achieving > 95.0% overall accuracy, while providing exceptional outputs in complicated cases of cancers (99.1%), COPD (98.89%), and asthma (98.12%), without model-overfitting. Data retrieval is sub-second for a variable per patient with a minimal GPU power, which can significantly be improved on more powerful GPUs. LizAI XT uniquely enables fully client-controlled data, complying with strict data security and privacy regulations per region/nation. Our advances complement the existing EMR/EHR, AWS HealthLake, and Google Vertex AI platforms, for healthcare data management and AI development, with large-scalability and expansion at any levels of HMOs, clinics, pharma, and government. Full article

The global transition towards renewable energy production has increased the demand for new and more flexible hydropower operations. Although hydropower is generally considered environmentally friendly, it can cause environmental and social impacts. As the biggest and most representative hydropower project in Ecuador, the Coca Codo Sinclair hydropower project (CCSHP) provides a relevant case of water use competition between local communities and the country’s development. In this study, perspectives of four communities near the CCSHP were analyzed through a survey with 183 responses collected in 52 days through door-to-door household visits in two upstream and two downstream towns. The analysis highlights that limited community participation in project design and insufficient communication strategies have undermined public acceptance, despite government promotion of its national benefits. Survey results reveal that 79% of respondents expressed negative perceptions, primarily about environmental change, displacement, and lack of compensation, while only 15% expressed positive views. It is important to note that the communities had no role in selecting the project location, and their involvement was limited, particularly regarding transportation, environmental changes, and the loss of local species. These findings suggest that project managers should strengthen dialogue with local communities and design participatory mechanisms that can improve trust and long-term project acceptance. Full article

Background/Objectives: Antimicrobial stewardship programs (ASPs) play a vital role in combating antimicrobial resistance (AMR). However, their implementation in Zambia remains variable despite some notable progress. This study assessed healthcare professionals’ awareness of the Multisectoral National Action Plan (NAP) on AMR, alongside their perceptions, barriers, and implementation practices related to ASPs. Methods: A cross-sectional survey conducted between August and December 2024 included 364 healthcare professionals (HCPs) in 58 randomly selected public healthcare facilities in Zambia. Data were analysed using IBM SPSS 25.0. Results: Findings revealed that while 75.3% of respondents were aware of the Zambian NAP on AMS, only 68.1% of the respondents reported that their hospitals had established AMS committees. Conversely only 41.2% of the respondents stated that their hospitals possessed hospital-specific treatment guidelines. Encouragingly, 97.5% believed ASPs could enhance clinical outcomes and reduce AMR. Key barriers included limited funding (75.9%), inadequate IT infrastructure (64.1%), limited access to essential data (64%), and healthcare workforce shortages (53.8%). Conclusions: Whilst HCPs in Zambia demonstrated high awareness of the NAP and supported ASP implementation, systemic challenges hindered their consistent execution across health facilities. Gaps in treatment guideline development, AMR data usage, and the integration of antimicrobial susceptibility recording systems into clinical activities must be addressed to strengthen ASP efforts nationwide. Full article

Background: Zambia, like many low- and middle-income countries, faces a growing burden of antimicrobial resistance (AMR), driven by the misuse of antimicrobials in both human and animal health, a limited diagnostic capacity, and weak regulatory enforcement. To address this challenge, Standard Treatment Guidelines (STGs) were developed for the veterinary sector, which represents a major milestone in the country’s AMR containment strategy. STGs are evidence-based protocols that guide veterinary professionals in consistently and appropriately diagnosing and treating animal diseases. They promote the rational use of veterinary medicines, and can mitigate AMR and improve animal health outcomes. By translating the best evidence into best practices, STGs also provide a practical foundation for antimicrobial stewardship (AMS) programs. Until 2023, Zambia lacked nationally adopted STGs for the veterinary sector. The introduction and standardization of these guidelines are expected to promote prudent antimicrobial use and raise the standard of care delivered to animal patients across the country. Objective: The aim of this paper is to provide a practical reference for future revisions of STGs and outline the successful methodology used to create STGs in the Zambian animal sector. Methods: A situational analysis was conducted to identify priority animal health conditions and existing treatment gaps within the veterinary sector. A multidisciplinary expert committee was then formed, comprising veterinarians, veterinary paraprofessionals, academics, regulatory authorities, and private sector stakeholders, to lead the development of the STGs. The process was guided by the WHO methodology for developing treatment guidelines, including a comprehensive review of the clinical evidence, local disease patterns, antimicrobial resistance data, and existing treatment practices. Draft STGs were developed with clearly defined, species-specific treatment protocols tailored to the Zambian context. For the validation process, the AGREE II instrument was used to assess the quality, clarity, and applicability of the guidelines. Structured stakeholder consultations with practitioners, policy-makers, and technical experts were held to ensure that the guidelines were practical, evidence-based, and aligned with national priorities. The validated drafts were then disseminated and piloted in selected districts. Conclusions: The development of the species-specific STGs represents an essential turning point in the country’s efforts to promote responsible veterinary care and contain AMR. STGs have become a prominent key support in the delivery of quality animal care. Further, the guidelines will assist in the optimization of antimicrobial use in animal health in Zambia. Full article

Cancer-related pain remains one of the most frequent and burdensome symptoms in oncology, significantly impairing patients’ quality of life and functional status. Despite advances in treatment and the availability of evidence-based guidelines, pain continues to be undertreated worldwide. In Italy, legislative efforts such as Law 38/2010 have not fully translated into consistent clinical practice. On 28 March 2025, a national roundtable held in Rome, Italy, brought together experts from medical oncology, radiation oncology, palliative care, anesthesiology, and pain medicine, representing the main Italian scientific societies involved in oncology and supportive care, to examine the current status of cancer pain management and develop a consensus on actionable priorities. Four key gaps were identified: insufficient education and training of healthcare providers in pain management; fragmented care pathways and limited interdisciplinary integration; lack of clarity regarding professional roles; and challenges in implementing shared diagnostic and therapeutic care pathways (Percorsi Diagnostico Terapeutici Assistenziali). The roundtable proposed coordinated strategies to address these gaps, including expanding interdisciplinary educational initiatives and integrating pain management into undergraduate and specialty curricula; establishing local oncology orientation centers to provide joint, patient-centered assessments; promoting cross-specialty collaboration through congress sessions, educational activities, and practical workshops; and developing adaptable therapeutic frameworks to ensure standardized yet context-sensitive care delivery. This congress report formalizes a joint framework aimed at embedding pain management within comprehensive cancer care. Its implementation will require sustained advocacy, structured education, and alignment of clinical practice with policy support. By addressing these barriers through pragmatic, evidence-informed actions, the proposed strategies aim to optimize timely, integrated, and effective pain care, ultimately improving outcomes for patients with cancer. Full article

Mosquito-borne viruses like West Nile virus (WNV) and Usutu virus (USUV) present growing public health concerns, especially with climate change and expanding vector ranges. This study describes the development and validation of a duplex Real-Time RT-PCR assay targeting β-actin (ACTB) mRNA as an endogenous control and a conserved 92 bp region shared by WNV and USUV genomes. Degenerate primers for ACTB ensure RNA extraction quality and PCR performance while enabling simultaneous detection of both viruses. A total of 1002 mosquito pools collected in Piedmont, Italy, during the 2024 vector season under the National Surveillance Plan for Arboviruses (PNA), were tested. The assay showed 100% accuracy—ACTB mRNA was detected in all pools, and six pools tested positive for WNV or USUV (three each). Diagnostic specificity was confirmed on 40 horse and bovine serum samples. Sanger sequencing confirmed ACTB identity across multiple mosquito species. The assay also demonstrated reproducibility across different operators and thermocyclers. The limit of detection (LOD) evaluation showed that the assay is capable of detecting viral RNA at very low concentrations, confirming its high analytical sensitivity. The duplex RT-PCR here developed is a reliable, sensitive, and specific tool for arbovirus surveillance, combining pathogen detection with internal quality control of RNA extraction and amplification, thus improving early warning and rapid response to mosquito-borne disease threats. Full article

Maintaining social adaptation in later life has become a key challenge amid China’s rapidly aging population. Using nationally representative data from the China Longitudinal Aging Social Survey (CLASS 2023), this study examined the relationship between physical exercise and social adaptation among 8913 older adults. Ordinary least squares regression and the Karlson–Holm–Breen decomposition method were applied to test both direct and mediating effects. The results showed that physical exercise significantly improved social adaptation (β = 0.452, p < 0.001), while aging identity played a partial mediating role, accounting for approximately 11.0% of the total effect. The association was stronger among those aged 80 and above, with lower education and income, without chronic diseases, and covered by social security. These findings suggest that physical exercise enhances social adaptation not only through physical benefits but also by strengthening psychological resilience and fostering a positive sense of aging, providing valuable evidence for developing inclusive aging policies and targeted exercise interventions. Full article

The application of Artificial Intelligence (AI) in river basin pollution control shows great potential to improve governance efficiency through real-time monitoring, pollution prediction, and intelligent decision-making. However, its rapid development also brings regulatory challenges, including data privacy, algorithmic bias, responsibility definition, and cross-regional coordination. Based on the SETO loop framework (Scoping, Existing Regulation Assessment, Tool Selection, and Organizational Design), this paper systematically analyzes the regulatory needs and pathways for AI in watershed water pollution control through typical case studies from countries such as China and the United States. The study first defines the regulatory scope, focusing on protecting the ecological environment, public health, and data security. It then assesses the shortcomings of existing environmental regulations in governing AI, such as their inability to adapt to dynamic pollution sources. Subsequently, it explores suitable regulatory tools, including information disclosure requirements, algorithmic transparency standards, and hybrid regulatory models. Finally, it proposes a multi-tiered organizational scheme that integrates international norms, national legislation, and local practices to achieve flexible and effective regulation. This study demonstrates that the SETO loop provides a viable framework for balancing technological innovation with risk prevention and control. It offers a scientific basis for policymakers and calls for establishing a dynamic, layered regulatory system to address the complex challenges of AI in environmental governance. Full article

The forest bioeconomy is an emerging global sector that uses forest material to make value-added bioproducts that range from pharmaceuticals to biofuels. Notwithstanding their capacity to advance various United Nations Sustainable Development Goals, forest bioproducts face considerable sustainability challenges in global supply chains associated with harvesting, processing, and transportation. Using a systematic literature review focused on challenges and solutions to sustainability in forest bioeconomy supply chains, we analyze 81 peer-reviewed studies to identify the primary sustainability challenges and their attendant solutions. We find that economic barriers to scaling the forest bioeconomy are the most commonly studied challenge, while social and environmental challenges are often marginalized. Increasing stakeholder engagement is the most commonly mentioned solution, but the limitations of stakeholder engagement are largely absent from scholarly discourse. Lastly, we identify significant gaps in the literature related to coverage of non-European countries and analysis of key sectors like mass timber construction. The results gesture to the need for more research on under-represented regions and sectors, greater attention to social and environmental supply chain challenges, and deeper engagement with adjacent literatures on the intersection of public policy with sustainable supply chain governance. Full article

This study examines how mindful consumption contributes to sustainable marketing and consumer engagement by influencing green purchase intention and life satisfaction among Generation Z, while also assessing the moderating role of social influence. Grounded in Self-Determination Theory, a survey of 1541 Thai consumers aged 18–24 was analyzed using a structural equation model and path analysis to test the mediation framework. The results show that mindful consumption significantly enhances sustainability values and purchase intentions, with sustainability values mediating the relationship between mindful consumption and both behavioral and psychological outcomes. Moreover, social influence strengthens the impact of sustainable consumption on purchase intentions, highlighting the role of peers, networks, and societal norms in promoting ethical and environmentally responsible consumer behavior. The findings extend sustainable marketing theory by highlighting mindful consumption as a driver of both behavioral (green purchase intention) and psychological (life satisfaction) outcomes. Beyond its theoretical contribution, the study offers practical insights for businesses, educators, and policymakers on fostering value-driven relationships with young consumers through mindful and socially reinforced sustainability initiatives. Promoting mindful consumption and leveraging social influence provides a pathway to engage Generation Z in sustainability-oriented lifestyles, supporting long-term consumer loyalty and achieving the United Nations’ Sustainable Development Goals. Full article

This paper examines how sustainable leadership and strategic sustainability integration are framed and supported for SMEs in the EU. We apply comparative document analysis (CDA) to 35 policy, industry, and NGO reports published in 2020–2025 for Germany, Sweden, Poland, and Spain. Multi-level materials (EU, national, industry/NGO) were thematically coded, and the synthesis is presented in a multi-level conceptual framework linking policies, leadership, strategy, barriers, and transferable practices. The analysis indicates systematic differences in institutional maturity: Sweden and Germany display denser, more navigable support ecosystems and clearer leadership narratives, whereas Poland and Spain exhibit greater fragmentation and a more compliance-oriented framing. Instrument menus are broadly similar (grants/co-funding, concessional finance, advisory vouchers, training, standards/toolkits, green public procurement), yet accessibility and measurement strength diverge; outcome tracking (e.g., energy savings, CO₂e avoided) is more consistent in Sweden/Germany than in Poland/Spain. Green–digital coupling is pivotal: sequencing “on-ramps” (advisory/vouchers) into innovation finance accelerates adoption; where such on-ramps are thin, uptake concentrates among already prepared firms. Implications follow for policy design and practice: prioritize simple entry points for micro- and small enterprises, strengthen monitoring with meaningful KPIs, and ensure regional parity in access to finance and advisory. For SME leaders, role-modeling, employee development, and experimentation help embed sustainability when formal structures are lean. Beyond mapping patterns, this study provides an auditable operationalization of sustainable leadership for document analysis and a transferable framework to compare policy mixes and ecosystem readiness across countries. Full article