Search Results (1,297)

Container liner shipping companies operate within a complex environment where they must balance profitability and service reliability. Meanwhile, evolving regulatory policies, such as surcharges imposed on ships of a particular origin or type on specific trade lanes, introduce new operational challenges. This study addresses the heterogeneous ship routing and demand acceptance problem, aiming to maximize two conflicting objectives: weekly profit and total transport volume. We formulate the problem as a bi-objective mixed-integer programming model and prove that the ship chartering constraint matrix is totally unimodular, enabling the reformulation of the model into a partially relaxed MIP that preserves optimality while improving computational efficiency. We further analyze key mathematical properties showing that the Pareto frontier consists of a finite union of continuous, piecewise linear segments but is generally non-convex with discontinuities. A case study based on a realistic liner shipping network confirms the model’s effectiveness in capturing the trade-off between profit and transport volume. Sensitivity analyses show that increasing freight rates enables higher profits without large losses in volume. Notably, this paper provides a practical risk management framework for shipping companies to enhance their adaptability under shifting regulatory landscapes. Full article

Introduction: The optimal management of hallux sesamoid fracture nonunions remains a subject of ongoing debate, particularly in the context of personalized medicine. This systematic review aimed to synthesize current evidence regarding surgical strategies for this rare but disabling condition. Methods: A comprehensive literature search was conducted in accordance with the PRISMA guidelines. Results: Six studies met the inclusion criteria, encompassing a total of 80 patients. Surgical techniques varied and included open and arthroscopic sesamoidectomy, autologous bone grafting (alone or combined with screw fixation), and percutaneous screw fixation. When reported, outcomes were generally favorable, with union rates ranging from 90.5% to 100% and with consistent postoperative improvements in clinical function. Complication and reoperation rates were both 6.5%. The most frequent reoperation was sesamoidectomy for persistent pain or nonunion, followed by hardware removal. Conclusions: Despite the limited and low-quality evidence, available data suggest that individualized surgical planning can lead to favorable outcomes with low complication rates. Sesamoidectomy remains the most reliable salvage procedure in refractory cases. These findings support a personalized, stepwise approach to treatment—prioritizing sesamoid preservation, when feasible, while reserving excision for symptomatic nonunions. Further studies are needed to validate tailored algorithms and refine patient-specific decision-making in this challenging clinical scenario. Full article

Seafood contamination by heavy metals is a growing public health concern, particularly in regions like Tunisia where seafood is a major dietary component. This study assessed concentrations of cadmium (Cd), copper (Cu), lead (Pb), and zinc (Zn) in the muscle tissue of the red shrimp Parapenaeus longirostris, collected in 2023 from four coastal regions: Bizerte, Monastir, Kerkennah, and Gabes. Metal analysis was conducted using flame atomic absorption spectroscopy. This species was chosen due to its ecological and economic importance. The study sites were chosen based on their differing levels of industrial, urban, and agricultural influence, providing a representative overview of regional contamination patterns. Mean concentrations were 1.04 µg/g for Zn, 0.59 µg/g for Cu, 1.56 µg/g for Pb, and 0.21 µg/g for Cd (dry weight). Pb was the most prevalent metal across sites. Statistically significant variation was observed only for Cu (p = 0.0334). All metal concentrations were below international safety limits set by FAO/WHO and the European Union. Compared to similar studies, the levels reported were similar or slightly lower. Human health risk was evaluated using target hazard quotient (THQ), hazard index (HI), and cancer risk (CR) values. For adults, THQ ranged from 5.44 × 10⁻⁶ to 8.43 × 10⁻⁴, while for children it ranged from 2.40 × 10⁻⁵ to 3.72 × 10⁻³. HI values were also well below 1, indicating negligible non-carcinogenic risk. CR values for Cd and Pb in both adults and children fell within the acceptable risk range (10⁻⁶ to <10⁻⁴), suggesting no significant carcinogenic concern. This study provides the first field-based dataset on metal contamination in P. longirostris from Tunisia, contributing valuable insights for seafood safety monitoring and public health protection. Full article

Blended and virtual learning have become an integral part in international higher education, especially in the wake of the COVID-19 pandemic and the European Union’s Digital Education Action Plan. These modalities have enabled more inclusive, flexible, and sustainable forms of international collaboration, such as Collaborative Online International Learning (COIL) and Blended Intensive Programs (BIPs), reshaping the landscape of global academic mobility. This paper introduces the INVITE Learning Design Framework (LDF), developed to support higher education instructors in designing high-quality, internationalized blended and virtual learning experiences. The framework addresses the growing need for structured, theory-informed approaches to course design that foster student engagement, intercultural competence, and motivation in non-face-to-face settings. The INVITE LDF was developed through a rigorous scoping review of existing models and frameworks, complemented by needs-identification analysis and desk research. It integrates Self-Determination Theory, Active Learning principles, and the ADDIE instructional design model to provide a comprehensive, adaptable structure for course development. The framework was successfully implemented in a large-scale online training module for over 1000 educators across Europe. Results indicate that the INVITE LDF enhances educators’ ability to create engaging, inclusive, and pedagogically sound international learning environments. Its application supports institutional goals of internationalization by making global learning experiences more accessible and scalable. The findings suggest that the INVITE LDF can serve as a valuable tool for higher education institutions worldwide, offering a replicable model for fostering intercultural collaboration and innovation in digital education. This contributes to the broader transformation of international higher education, promoting equity, sustainability, and global citizenship through digital pedagogies. Full article

Background: Implantation of modularly built-up stems with a tapered and fluted design is currently state of the art in revision total hip arthroplasty (RTHA). Nevertheless, implant-specific major complications like breakage of taper junctions as well as periprosthetic fractures (PPFs) may lead to failure of reconstruction during follow-up. Methods: A cohort of 117 cases receiving femoral RTHA by a modular stem was investigated retrospectively with a mean follow-up of 5.7 (0.5–13.7) years. Cumulative risk and potential factors affecting the occurrence of PPFs were calculated with the Kaplan–Meier method. In addition, cases were presented to discuss operative treatment options. Results: A cumulative risk of PPF of 12.1% (95% CI: 0–24.6%) was calculated at 13.7 years. Female patients had significantly higher risk compared to male patients (0% after 13.5 years for male patients vs. 20.8% (95% CI: 0.5–41.2%) after 13.7 years for female patients; log-rank p = 0.0438) as all five patients sustaining a PPF during follow-up were women. Four fractures were treated by open reduction and internal fixation. Non-union and collapse of the fracture occurred in one patient after closed reduction and internal fixation. Conclusions: Postoperative PPF after femoral revision with a modular stem has shown to be a frequent complication within this mid-term follow-up. Female patients were at a significantly higher risk in this aged cohort, indicating osteoporosis as a risk factor. The surgical treatment of PPF with an integrated long-stemmed prosthesis is challenging and thorough considerations of adequate operative treatment of PPFs are strongly advised in order to limit complication rates. Full article

Improving the energy efficiency of residential buildings is essential for achieving global climate goals and reducing environmental impact. This study analyzes the Total Performance approach using the example of a modern semi-detached house built by a Polish developer, as an example. The building is designed with integrated systems that minimize energy consumption while maintaining resident comfort. The building is equipped with an air-to-water heat pump, underfloor heating, mechanical ventilation with heat recovery, and automatic temperature control systems. Energy efficiency was assessed using ArCADia–TERMOCAD 8.0 software in accordance with Polish Technical Specifications (TS) and verified by monitoring real-time electricity consumption during the heating season. The results show a PED from non-renewable sources of 54.05 kWh/(m²·year), representing a 23% reduction compared to the Polish regulatory limit of 70 kWh/(m²·year). Real-time monitoring conducted from December 2024 to April 2025 confirmed these results, indicating an actual energy demand of approximately 1771 kWh/year. Domestic hot water (DHW) preparation accounted for the largest share of energy consumption. Despite its dependence on grid electricity, the building has the infrastructure to enable future photovoltaic (PV) installation, offering further potential for emissions reduction. The results confirm that Total Performance strategies are not only compliant with applicable standards, but also economically and environmentally viable. They represent a scalable model for sustainable residential construction, in line with the European Union’s (EU’s) decarbonization policy and the goals of the European Green Deal. Full article

Rugby Union is a high-impact sport with considerable injury risk, especially in emerging rugby settings where structured physical preparation may be limited. This study aimed to assess the epidemiological profile and injury incidence among Rugby Union players in Brazil, providing insights to inform strength and conditioning strategies. A cross-sectional observational study was conducted between October 2023 and February 2024 using a digital questionnaire that captured demographic data, sports participation history, and detailed information about injuries sustained in 2022 and 2023. A total of 236 players participated (58.9% male; mean age = 29.4 ± 7.5 years), with males averaging 29.6 ± 7.7 years and females 29.1 ± 7.5 years. Overall, 183 injuries were reported. Most injuries occurred during matches (73.3%) and were contact-related (82.1%), with the shoulder/clavicle and knee being the most affected regions. Ligament injuries (27.3%), dislocations (15.3%), and fractures (16.4%) were the most prevalent types. Female players had a distinct injury pattern, with a greater proportion of non-contact mechanisms. Significant associations were found between injury occurrence and sex (p = 0.012), playing modality (p < 0.001), injury type (p = 0.013), and recovery time (p = 0.006). These findings highlight the urgent need for tailored strength and conditioning interventions focused on injury prevention and athletic preparedness. Such programs should address sport-specific demands, promote neuromuscular resilience, and be accessible across competitive levels to improve performance and minimize injury-related setbacks. Full article

Global resource consumption continues to grow each year, exerting increasing pressure on their availability. This trend could lead to a shortage of raw materials in the coming years. Aware of the risks associated with this situation, the European Union has implemented policies and strategies aimed at diversifying its supply sources, including waste recycling. In this context, the present study was conducted with the objective of developing innovative processes to concentrate valuable metals present in the non-recovered fractions of waste electrical and electronic equipment (WEEE). Three types of samples were studied: washing table residues (WTRs), printed circuit boards (PCBs), and powders from cathode-ray tube screens (CRT powders). Several separation techniques, based on the physical properties of the elements, were implemented, including electrostatic separation, magnetic separation, and density and gravity-based separations. The results obtained are promising. For WTRs and PCBs, the recovery rates of targeted metals (Cu, Al, Pb, Zn, Sn) reached approximately 91% and 80%, respectively. In addition to these metals, other valuable metals, present in significant quantities, deserve further exploration. Regarding CRT powders, the performances are also encouraging, with recovery rates of 54.7% for zinc, 57.1% for yttrium, and approximately 71% for europium. Although these results are satisfactory, optimizations are possible to maximize the recovery of these critical elements. The techniques implemented have demonstrated their effectiveness in concentrating target metals in the treated fractions. These results confirm that recycling constitutes a viable alternative to address resource shortages and secure part of the supplies needed for the European Union’s industry. Full article

The United Kingdom (UK) is a key market for puppy importation from the European Union (EU), as demand for puppies exceeds domestic supply. Many are illegally imported. Potential welfare risks to the puppies and negative impacts of these on their prospective owners are well documented, but UK residents’ perspectives on the trade are not. This study aimed to use an online survey to capture UK residents’ understanding of the benefits and risks to imported puppies of being imported from Romania for sale in the UK, and the benefits and risks of buying an imported puppy for their prospective owners. Eligible responses were collected from n = 7184 participants; 4000 randomly selected free-text comments underwent content analysis. Respondents displayed a limited understanding of the nature and range of risks potentially associated with puppy importation. Worryingly, many viewed an EU-born puppy as equivalent to one bred in the UK; others considered them as “rescued”. Synonyms used for non-endemic diseases that might be carried by the puppies varied widely, suggesting substantial confusion may exist on this topic. The UK public may underestimate the potential risks associated with buying a puppy bred in the EU, which plays into the hands of illegal puppy traders. Full article

This study investigates the health impacts of air pollution in the Greater Athens Area (GAA), Greece, by estimating the Relative Risk (RR) of hospital admissions (HA) for cardiovascular (CVD) and respiratory diseases (RD) from 2018 to 2020. The analysis focuses on daily exceedances of key air pollutants—PM₁₀, O₃, and NO₂—based on the “Fair” threshold and above, as defined by the European Union Air Quality Index (EU AQI). Data from ten monitoring stations operated by the Ministry of Environment and Energy were spatially matched with six hospitals across the GAA. A Distributed Lag Non-linear Model (DLNM) was employed to capture both the delayed and non-linear exposure–response (ER) relationships between pollutant exceedances and daily HA. Additionally, the synergistic effects of pollutant interactions were assessed to provide a more comprehensive understanding of cumulative health risks. The combined exposure term showed a peak RR of 1.49 (95% CI: 0.79–2.78), indicating a notable amplification of risk when multiple pollutants exceed thresholds simultaneously. The study utilizes R for data processing and statistical modeling. Findings aim to inform public health strategies by identifying critical exposure thresholds and time-lagged effects, ultimately supporting targeted interventions in urban environments experiencing air quality challenges. Full article

This article explores the role of the European Union (EU) as a normative gender actor promoting women’s participation in STEM (Science, Technology, Engineering, and Mathematics) within the Eastern Partnership (EaP) region. In a context marked by global inequality and overlapping international efforts, this paper assesses the extent to which EU-driven Europeanisation influences national gender policies in non-EU states. Using a postfunctionalist lens, this research draws on a qualitative analysis of EU-funded programmes, strategic documents, and a detailed case study encompassing Armenia, Georgia, Moldova, Ukraine, Belarus, and Azerbaijan. This study highlights both the opportunities created by EU initiatives such as Horizon Europe, Erasmus+, and regional programmes like EU4Digital and the challenges presented by political resistance, institutional inertia, and socio-cultural norms. The findings reveal that although EU interventions have fostered significant progress, structural barriers and limited national commitment hinder the long-term sustainability of gender equality in STEM. Moreover, the withdrawal of other global actors increases pressure on the EU to maintain leadership in this area. This paper concludes that without stronger national alignment and global cooperation, EU gender policies risk becoming symbolic rather than transformative. Full article

Background: Surgical neck nonunions of the proximal humerus present a complex clinical challenge, especially in elderly patients with pre-existing glenohumeral arthritis. Reverse total shoulder arthroplasty (RTSA) offers a reliable treatment option in these cases; however, resection of the tuberosities may compromise joint stability, increase the risk of postoperative dislocation and compromise postoperative function. This article describes a reproducible RTSA technique that preserves and repairs the greater and lesser tuberosities, aiming to enhance construct stability and optimize outcomes. Methods: We present a 74-year-old female with underlying glenohumeral arthritis who underwent RTSA for a symptomatic surgical neck nonunion via an extended deltopectoral approach. The nonunion is first mobilized, and tuberosity osteotomies are performed. After implant placement, the tuberosities are secured to the implant, to each other, and to the humeral shaft. A cerclage suture is also passed circumferentially to reinforce the repair and prevent posterior gapping. Results: The patient regained her pre-injury level of function by her last follow-up. She had pain-free, active forward elevation to 110 degrees and radiographic evidence of maintained tuberosity reduction and healing. There was no evidence of instability. Conclusions: In conclusion, incorporating tuberosity preservation and repair into RTSA for proximal humerus nonunion may reduce dislocation risk and improve functional recovery in elderly, low-demand patients. Full article

This article examines the theological trajectories of Watchman Nee (1903–1972) and Witness Lee (1905–1997) on sanctification, union with Christ, and deification, situating their contributions within recent reappraisals of the doctrine of theosis in the academy. Though deification was universally affirmed by the early church and retained in various forms in medieval and early Protestant theology, post-Reformation Western Christianity marginalized this theme in favor of juridical and forensic soteriological categories. Against this backdrop, Nee and Lee offer a theologically rich, biblically grounded, and experientially oriented articulation of deification that warrants greater scholarly attention. Drawing from the Keswick Holiness tradition, patristic sources, and Christian mysticism, Nee developed a soteriology that integrates justification, sanctification, and glorification within an organic model of progressive union with God. Though he does not explicitly use the term “deification”, the language he employs regarding union and participation closely mirrors classical expressions of Christian theosis. For Nee, sanctification is not merely moral improvement but the transformative increase of the divine life, culminating in conformity to Christ’s image. Lee builds upon and expands Nee’s participatory soteriology into a comprehensive theology of deification, explicitly referring to it as “the high peak of the divine revelation” in the Holy Scriptures. For Lee, humans become God “in life and nature but not in the Godhead”. By employing the phrase “not in the Godhead”, Lee upholds the Creator–creature distinction—i.e., humans never participate in the ontological Trinity or God’s incommunicable attributes. Yet, in the first portion of his description, he affirms that human beings undergo an organic, transformative process by which they become God in deeply significant ways. His framework structures sanctification as a seven-stage process, culminating in the believer’s transformation and incorporation into the Body of Christ to become a constituent of a corporate God-man. This corporate dimension—often overlooked in Western accounts—lies at the heart of Lee’s ecclesiology, which he sees as being consummated in the eschatological New Jerusalem. Ultimately, this study argues that Nee and Lee provide a coherent, non-speculative model of deification that integrates biblical exegesis, theological tradition, and practical spirituality, and thus, present a compelling alternative to individualistic and forensic soteriologies while also highlighting the need for deeper engagement across global theological discourse on sanctification, union with Christ, and the Triune God. Full article

Guaranteeing food safety in the European Union (EU) is a continuing issue affected by diverse national traditions, regulatory power, and consumer culture. Despite the presence of a harmonized regulatory context, there continues to be variability in performance among the 27 member states. This study gives an extensive comparative evaluation of EU food safety based on three indicators: Rapid Alert System for Food and Feed (RASFF) alerts, pesticide maximum-residue-limit (MRL) violation, and per capita food loss. Fuzzy TOPSIS, K-means clustering, and scenario-based sensitivity tests are used to give an extensive appraisal of the performance of member states. Alarming differences are quoted as findings of significance. The highest number of RASFF notifications (212) and percentage of pesticide MRL non-compliance (1.5%) were reported in 2022 by Bulgaria, whereas the lowest values were reported by Estonia and Lithuania—15–20 RASFF notifications and less than 0.6% MRL violation rates. A statistically significant correlation (r = 0.72, p < 0.001) between pesticide MRL violation and food safety warnings was confirmed in favor of pesticide regulation as the optimal predictor of food safety warnings. On the other hand, food loss did not significantly affect safety measures but indicated very high variation (from 76 kg/capita per year in Croatia to 142 kg/capita per year in Greece). These findings suggest that while food loss remains an environmental problem, pesticide control is more central to the protection of food safety. Targeted policy is what the research necessitates: intervention and stricter enforcement in low-income countries, and diffusion of best practice from successful states. The composite approach adds to EU food safety policy discourse through the combination of performance indicators and targeted regulatory emphasis. Full article

Background: Atypical subtrochanteric femoral fractures (ASFs), frequently linked to long-term bisphosphonate use, present significant fixation challenges due to impaired bone healing. While intramedullary (IM) nailing is the standard treatment, delayed union or nonunion remains common. This study aimed to evaluate whether supplementing IM nailing with lateral plate augmentation improves radiographic healing in patients with ASFs. Methods: This retrospective comparative study included 12 elderly female patients with ASFs treated between October 2013 and October 2023. Five patients underwent IM nailing alone (IM group), while seven received IM nailing with additional lateral plate fixation (Plate + IM group). Fracture healing was assessed using the modified Radiographic Union Score for Tibial fractures (mRUST) at 3, 6, and 12 months postoperatively. Intergroup comparisons were performed using the Mann–Whitney U test. Results: The median mRUST scores in the IM group were 4 (IQR 3.5–4), 6 (IQR 4.5–6.5), and 8 (IQR 7–9) at 3, 6, and 12 months, respectively. In the Plate + IM group, the scores were 5 (IQR 4–6), 8 (IQR 8–8), and 10 (IQR 10–11), respectively. The Plate + IM group demonstrated significantly higher mRUST scores at all assessed time points (3 months: p = 0.018; 6 months: p = 0.003; 12 months: p = 0.006). No implant failures or postoperative infections occurred in either group during the 12-month follow-up period. One patient (20%) in the IM group developed fracture nonunion, while no nonunion cases were observed in the Plate + IM group. Conclusions: Lateral plate augmentation as an adjunct to IM nailing may promote faster and more consistent radiographic healing in atypical subtrochanteric femoral fractures. This dual-fixation strategy may offer a biomechanically more robust option for patients at risk of delayed union, potentially contributing to a lower risk of nonunion, though further prospective studies are required to confirm this finding. Full article