Search Results (1,332)

Background: Inappropriate antibiotic use contributes to antimicrobial resistance. Evidence regarding the impact of antimicrobial stewardship programs (ASPs) in pediatric intensive care units (PICUs) remains limited. The study aims to evaluate the impact of a multidisciplinary prospective post-prescription review and feedback (PPRF) ASP in a European PICU on antimicrobial use and prescription quality (PQ). Methods: A prospective quasi-experimental study was conducted using interrupted time-series analysis to evaluate antimicrobial use trends before (July 2018–December 2020) and after (January 2021–March 2025) the implementation of a multifaceted ASP, integrated within a hospital-wide ASP, in a tertiary 24-bed medical–surgical PICU in Barcelona, Spain. Antimicrobial use was measured as days of therapy per 100 patient-days (DOT/100 PD) and per 100 discharges (DOT/100 D) and was analyzed by WHO AWaRe group and by individual drug. PQ was evaluated by means of cross-sectional point-prevalence surveys (PPSs). Results: During the study-period, median monthly activity in the PICU remained stable: 475 patient-days (IQR: 396–534) and 113 patients discharged (IQR: 102–124). Following ASP implementation, total antibiotic consumption significantly decreased, with an immediate reduction of 18.2 DOT/100 patient-days (p = 0.006) and a sustained monthly decline of 0.73 DOT/100 patient-days (p = 0.028). The COVID-19 pandemic did not significantly affect overall antibiotic consumption. Access and Reserve antibiotic use decreased significantly after ASP implementation, whereas Watch antibiotic use remained unchanged. Overall antifungal consumption was not significantly modified, although a transient increase was observed during the pandemic. At the individual drug level, several antibiotics demonstrated significant immediate decreases after ASP implementation. Prescription quality remained high (>88% optimal prescriptions), and PICU length of stay and mortality were unchanged. Conclusions: Implementation of a multidisciplinary PPRF-based ASP in a tertiary PICU was associated with a sustained reduction in antibiotic exposure without compromising prescription quality or clinical safety. These data support the effectiveness of collaborative stewardship in one of the most complex pediatric healthcare settings. Full article

Conventional air stripping for ammonia–nitrogen wastewater is often hampered by packing clogging and low mass transfer efficiency. To address these limitations, this study proposes a jet impact negative pressure reactor (JI-NPR) featuring an optimized scatter-pattern (D7) multi-orifice configuration. Computational Fluid Dynamics (CFD) simulations were employed to systematically investigate the effects of Reynolds number (Re = 5503.4~9651.0, corresponding to 2.76~4.84 m/s) on the hydrodynamic characteristics and deamination performance. Results indicate that increasing jet velocity significantly enhances the water volume fraction, resultant velocity, and pressure core intensity within the impact zone. Notably, these enhancements are maximized at the second row (z = 146 mm), attributed to reduced interference from the negative-pressure flash evaporation region. While a higher Re promotes interfacial renewal and vortex evolution, thereby enhancing mass transfer, it also intensifies energy dissipation and reduces the uniformity of the turbulent kinetic energy distribution. This work elucidates a critical trade-off between mass transfer enhancement and energy consumption, establishing a quantitative structure: the Re–flow field-performance relationship. The findings provide a theoretical foundation for the design and optimization of energy-efficient, high-performance wastewater treatment systems. Full article

Background: Monitoring antibiotic consumption represents an important objective for antimicrobial stewardship programs in hospitals. The aim of this study was to analyze antibiotic consumption patterns in three Romanian hospitals. Methods: A five-year retrospective study was conducted using monthly pharmacy consumption data from three Romanian hospitals for the years 2018, 2019, 2023, 2024, and 2025. Antibiotic consumption was quantified using defined daily doses (DDD) per 100 bed-days. Antibiotics were grouped using the World Health Organization AWaRe (Access, Watch, Reserve) classification. Results: The analysis revealed statistically significant differences in overall antibiotic consumption among the three hospitals (p < 0.001). A significant annual correlation between hospitalization days and antibiotic consumption was observed for some years in two of the facilities. Post hoc analysis confirmed statistically significant differences across all AWaRe category pairwise comparisons. Watch antibiotics had the highest consumption rates (over 60%). By therapeutic classes, the highest overall consumption was for cephalosporins, fluoroquinolones, penicillins, and carbapenems. Cefuroxime accounted for the highest cumulative consumption, followed by ceftriaxone, meropenem, vancomycin, ciprofloxacin, and metronidazole. Conclusions: Antibiotic consumption differed among the participating hospitals and study years. Monitoring antibiotic consumption provides valuable information on hospital antibiotic utilization patterns and can support evidence-based antimicrobial stewardship in hospitals. Full article

This study addresses the role of solar energy technologies in supporting sustainable and low-carbon residential energy systems through a comparative assessment of selected system configurations for a single-family house located in Lublin, Poland: photovoltaic–thermal (PVT) collectors, a hybrid system combining photovoltaic (PV) panels and solar thermal (ST) collectors, and a standalone PV installation. The analysis was carried out under the primary assumption of limited rooftop area available for renewable energy systems. The operational performance of each configuration was simulated using POLYSUN v. 2025.1 software, while the environmental impacts over a 25-year lifetime were evaluated using life cycle assessment (LCA) in SimaPro v. 10.3.0.1, including IPCC 2021 Global Warming Potential (GWP100) and ReCiPe 2016 Endpoint indicators. The results indicate that the PV + ST configuration achieved the best energy and environmental performance, providing the highest solar contribution (57.8%), the lowest total energy consumption (5136 kWh/year), and the lowest environmental impacts in both impact assessment methods (64.3 tCO₂ eq. and 3487 Pt). Under the adopted design assumptions, the PVT system exhibited intermediate overall performance between the PV + ST and standalone PV systems. The study demonstrates that combining energy performance analysis with LCA provides a more comprehensive basis for selecting sustainable solar technologies for low-carbon residential buildings than energy indicators alone. Full article

This study investigates the impact of alternative external wall systems on energy efficiency, cooling loads, and operational CO₂ emissions in a residential building in Hilla, Babylon, Iraq. An integrated assessment combining calibrated dynamic thermal simulation (DesignBuilder/EnergyPlus) and Life Cycle Assessment (LCA) was employed to evaluate thermal performance, operational energy demand, embodied carbon, and lifecycle emissions under consistent modeling conditions. The baseline model was calibrated against monthly electricity billing data, yielding an NMBE of +3.65% and a CV(RMSE) of 5.01%, indicating acceptable calibration performance for the investigated building and calibration period. Four wall systems were examined: conventional brick (BC), unstabilized rammed earth (RE-U), straw-stabilized rammed earth (RE-S), and fly-ash brick (FA). All four were evaluated using dynamic thermal simulation and operational-energy analysis, while the quantitative lifecycle environmental assessment was limited to BC, RE-S, and FA due to the lack of a sufficiently representative dataset for the unstabilized compacted-soil configuration (RE-U). The results highlight indicator-specific distinctions: RE-S achieved the greatest reductions in annual electricity consumption (20.6%), peak-summer cumulative cooling load (35.3%), and cooling-related operational CO₂ emissions (25.0%); RE-U provided the most favorable free-running operative-temperature response on 31 July under non-mechanical cooling conditions; and among the three configurations included in the quantitative LCA, FA exhibited the lowest embodied-carbon benchmark. The LCA findings for BC, RE-S, and FA further demonstrate that environmental impacts vary across lifecycle stages and indicators, underscoring the importance of interpreting embodied and operational carbon within clearly defined methodological boundaries. The study concludes that achieving low-carbon housing requires an integrated design approach combining low-carbon materials, improved envelope performance, and enhanced operational efficiency, with lifecycle assessment incorporated into early design decisions to support sustainable outcomes. Full article

The study uses a case study (Parliament House, Ghana) to identify a sustainable energy pathway for public institutions in emerging economies, from technical and economic viewpoints, towards the net-zero agenda. Technically, the study uses GIS (Google Earth Pro, v7.3.7) mapping and Python (Jupyter notebook from Anaconda, v4.20) simulation to assess rooftop/carport solar PV–grid integration and explore green hydrogen and ammonia productions. It combines a GIS rooftop solar resources assessment with a forward/backward sweep hosting-capacity analysis and a cascaded economic comparison of grid, hydrogen (H₂), and ammonia (NH₃) to inform decisions about RE investment scenarios in Ghana. The economic assessment uses net present value (NPV), internal rate of return (IRR), profitability index (PI), discounted payback period (DPP), and levelized cost of energy (LCOE, LCOH, and LCOA). A 6.3 MW (10,569 MWh) solar electricity system is proposed to meet the 2.56 MW (7554 MWh) demand with 3014 MWh excess. Hydrogen and ammonia production stood at 60.3 tons and 343,579 kg from excess electricity, respectively. The facility’s CO₂ contribution in 25 years period with the grid supply is 160,539 tons, while with PV deployment, it can save 211,611 tons. A total of GHS 58,558,962 (GHS 36,306,556 for local demand and GHS 22,252,405 for grid sales), GHS 12,328,785, and GHS 43,805,636 are required to set up the solar PV, hydrogen, and ammonia plants, respectively. Results from 100% local consumption and grid sales scenarios indicate an NPV of GHS 106.91, an IRR of 75%, a payback period of 3 years, a profitability index of 3.1, and an LCOE of GHS 0.68. An NPV of GHS 84.57 million, IRR of 56%, PI of 3.8, DPP of 4 years, and LCOE of GHS 1.06/kWh were recorded for the grid sales. Hydrogen sales had a negative NPV of GHS 16.78 million, a PI of 0.7, and an LCOH of GHS 87.2 per kg. Similarly, a negative NPV of GHS 70.72 million, a PI of 0.27, and an LCOA of GHS 29,419.55 per ton were recorded for the ammonia sales. The Parliament House can save 106.91 million GHS over 25 years if it chooses to go solar after meeting its local requirements. Results from the Python simulation show a 5.6% reduction in bus voltage for the system without PV, while the configuration with PV injections saw a voltage increase of up to 11.4%. The system loss increased 113.3 kW in case 1 to 1659.2 kW in case 2. Solar-to-grid is the recommended pathway, while H2/NH3 are not competitive under present costs. The sensitivity analysis shows that changes in key input variables (CAPEX, electricity input cost, and selling price) affect the prospective H₂/NH₃ sales under current market conditions in Ghana. Therefore, policymakers should make conscious efforts to lower these parameters (CAPEX and electricity input cost) to boost green hydrogen and ammonia penetration in the transition agenda. A new law is required to encourage consumers to sell to the grid rather than rely on the current net metering scheme, which limits prosumers’ generation to 500 kW and forbids grid sales. Full article

Cellulose nanofibrils (CNFs) are promising renewable materials, but high fibrillation energy remains a major barrier to industrial adoption. This narrative, mechanism-focused review examines CNF production from an engineering perspective, integrating the coupled roles of feedstock structure, interfacial chemistry, hydrodynamic stress transfer, and process boundary definition. This review examines energy consumption in CNF production by linking interfacial cohesion within cellulose fiber walls, hydrodynamic stress generation in fibrillation devices, and nonproductive energy-dissipation pathways. The principal mechanical routes—high-pressure homogenization, microfluidization, grinding and refining, and high-consistency extrusion—are compared with chemical, enzymatic, and interfacial pretreatments that reduce cohesive resistance or suppress re-agglomeration. Attention is given to feedstock composition, hornification history, solids content, and process boundary definitions, because these factors strongly influence both specific energy consumption and total process energy. Across the literature, meaningful energy reduction is achieved not by equipment choice alone but by co-optimizing feedstock design, pretreatment chemistry, and stress-transfer efficiency while limiting viscous losses, elastic recovery, and fibril reassociation. The review also highlights persistent comparability problems caused by inconsistent reporting of solids content, pass number, product quality, and system boundaries. A unified framework is proposed in which energy-efficient CNF production depends on three coupled objectives: lowering interfacial cohesion, improving productive stress localization, and reducing dissipation across the full process chain while evaluating energy demand against clearly defined process boundaries and product quality endpoints. Full article

Sustainable urban freight logistics requires routing decisions that jointly account for operating cost, vehicle technology, low-emission-zone (LEZ) access, terrain-sensitive energy use, and battery feasibility. This study develops a policy–terrain-coupled mixed-fleet routing framework integrating LEZ exposure, system-level carbon settlement, terrain-sensitive energy consumption, electric-vehicle (EV) battery feasibility, and route-level EV/internal-combustion-engine vehicle reassignment within a unified daily total operational cost (DTOC) evaluator. An adaptive large-neighborhood search (ALNS) procedure reconstructs feasible routes, while vehicle type is re-evaluated through counterfactual comparison of the complete system objective. The main experiments use 60 enhanced Gehring–Homberger benchmark-derived scenarios and 20 independent seeds, supplemented by ablation, carbon-price, EV-fixed-cost, heuristic-weight, convergence, and customer-scale scalability analyses. The ALNS-based framework achieves the lowest mean DTOC among the tested procedures, albeit with higher runtime. Policy and terrain information alter modeled fleet composition, with topology-dependent cost effects. Lower EV fixed costs consistently increase EV share, whereas carbon-price effects vary across network structures. All runs in the additional 200–1000-customer tests were feasible, although runtime increased with problem size. London- and Madrid-informed cases are treated as archetypes rather than as real-world validation cases. These results provide a basis for scenario screening and comparative planning of policy–terrain interactions before city-specific calibration and deployment. Full article

The global interest in utilizing waste from agro–industrial processes through the implementation of clean technologies is rapidly increasing. This study evaluates the technical, economic, and environmental feasibility of valorizing regional agro–industrial residues in Santander, Colombia, specifically coffee mucilage, cocoa mucilage, and pig manure, using integrated biorefinery scenarios. Modernizing these processes is essential given a theoretical energy potential of 75,000 TJ/year, which could generate up to 20,833 GWh/year. Three biorefinery scenarios were designed and simulated using Aspen Plus^® to produce bio-hydrogen, methane, and methanol. The total plant capacity was established at 31.7 t/day, distributed according to regional biomass availability: 4.62 t/day of cocoa mucilage, 1.83 t/day of coffee mucilage, and 25.25 t/day of pig manure. The technical results for Scenario 1 indicated a reformed H₂ production of 0.15 t/day with an associated preheating energy requirement of 193,365 kJ/h. Environmental impact assessment using the ReCiPe 2015 Midpoint methodology identified Scenario 3 as having the lowest direct CO₂ mass flow (9.28 t/day) due to carbon consumption during methanol synthesis. However, Scenario 1 reported a CO₂ equivalent (CO₂e) of 194.37 t/day, reflecting indirect emissions from thermal and energy requirements. Economic analysis, validated through engineering cost references, demonstrated that while Scenario 3 offers a diverse product portfolio, it is currently not cost-effective as the production costs exceed the total expected income. Consequently, Scenario 2 is identified as the most balanced alternative for the Santander context, offering a sustainable compromise between technical efficiency, environmental mitigation, and economic viability. Full article

Green steel transitions in emerging economies are currently planned around large integrated plants, while the small and medium enterprise (SME) segment that dominates finished steel output remains poorly characterized. This review consolidates the environmental evidence on India’s secondary steel sector, which supplies nearly 65% of national finished steel through more than 8500 units spanning coal-based direct reduced iron (DRI), induction furnace, electric arc furnace, steel re-rolling, foundry, and forging operations. Using an integrative scoping design that combines the peer-reviewed literature, government publications, industrial energy audits, and cluster assessments, the review maps process routes, regional clusters, product flows, and energy and carbon footprints, identifying the source, reference year, system boundary, and confidence level of each principal value. The sector consumed approximately 11.8 Mtoe (137,234 GWh) and emitted an estimated 58.2 Mt CO₂ in 2019–2020, with coal-based DRI contributing about 52% of sector emissions, 60% of steelmaking-route emissions, and roughly twice the specific energy consumption of international benchmarks. Water use remains a critical evidence gap. The resulting route- and cluster-resolved baseline provides the foundation from which green production pathways for SME steel systems can be identified and the plant-level measurement priorities that credible net-zero planning requires can be specified. Full article

Understanding the relationship between economic growth, energy use, and environmental degradation remains a key challenge for resource-dependent economies undergoing energy transition. This study re-examines the effects of economic growth, energy consumption, renewable energy, and capital formation on CO₂ emissions in Kazakhstan using annual data for 1992–2024. To account for structural changes and ensure robust inference, the analysis employs the Bai–Perron structural break test, the Autoregressive Distributed Lag (ARDL) approach, and alternative cointegration estimators including Fully Modified Ordinary Least Squares (FMOLS), Dynamic Ordinary Least Squares (DOLS), and Canonical Cointegrating Regression (CCR). The results reveal a stable long-run relationship among the variables. Economic growth and energy consumption significantly increase CO₂ emissions, indicating the persistence of a carbon-intensive growth pattern in Kazakhstan. The effect of renewable energy is not robust across estimation techniques and does not provide consistent evidence of an emissions-reducing impact. Capital formation also shows limited explanatory power for long-run environmental outcomes. Overall, the findings suggest that Kazakhstan has not yet achieved a decoupling between economic growth and environmental degradation. The study contributes to the literature by jointly incorporating structural breaks, multiple cointegration estimators, and an extended sample period within a country-specific framework. The results imply that expanding renewable energy capacity alone may be insufficient to improve environmental quality, highlighting the need for broader structural transformation and low-carbon development strategies. Full article

This study aims to demonstrate that, in the context of the energy transition and with solar generation playing a dominant role in the energy mix, key technical parameters of energy infrastructure should be re-evaluated and taken into account, as changes in these parameters affect operational processes and energy-loss calculation mechanisms. Data from newly installed battery energy storage systems (BESSs) connected to the power grid and photovoltaic power plants (PVPPs) in Bulgaria are used to establish a portfolio-level baseline for installed capacity, storage duration, geographic distribution, and preliminary economic indicators. By analyzing annual consumption and generation for 2024, 2025, and the first three months of 2026, the seasonal and cyclical nature of these variables and their dynamics of change are observed. The monthly data distribution allows for an in-depth study of load dynamics and the identification of key factors. The analysis identifies three typical seasonal cycles—winter, summer, and transitional—each of them differing in terms of specific consumption and generation profiles; the operation of PVPPs, BESS, and power transformers exhibits specific characteristics. The results show how changes in power quality indicators, specific technical parameters, and operational values directly or indirectly affect losses during power generation and distribution, and consequently also impact operating, maintenance, and repair costs. Full article

This study examines the psychological and social processes through which high-involvement sports fandom is associated with the subjective well-being of female spectators in South Korea’s professional KBO baseball league. Utilizing a secondary qualitative analysis informed by grounded-theory coding procedures, we investigate the dynamic processes, interaction strategies, and sociopsychological factors through which female spectators experience high-involvement fandom and how this engagement relates to their well-being. Data originally collected through in-depth semi-structured interviews with nine highly involved, long-term female KBO spectators for a prior study on fandom formation were reanalyzed through systematic coding, employing the frameworks of bottom-up, hedonic, social, and eudaimonic well-being as structural guides. Results reveal a multidimensional paradigm of well-being generation: immediate hedonic well-being appears to be associated with dramatic game narratives and collective crowd dynamics, and relationships expand to foster social well-being through regional belonging and community solidarity. These dimensions shape the phenomenon of “fandom as an emotional sanctuary,” marked by collective identity integration and daily behavioral immersion. Despite threats to their well-being, fans employ active restoration strategies to re-engage. This pattern, observed within the bounded context of nine long-term KBO fans, points toward a possible pathway linking sustained fandom involvement to subjective well-being, characterized by emotional maturity and the assimilation of sports fandom into life’s meaning. These findings offer exploratory theoretical insights into the feminization of sports fandom and suggest that sports consumption may be relevant for modern psychological and social well-being. Full article

Contaminated soil remediation is of increasing importance due to the environmental and health risks associated with hazardous pollutants. Solidification/stabilization (S/S) is a widely adopted remediation technique; however, its environmental performance is often limited by the high demand for Portland cement. This study evaluates the environmental impacts of a conventional cement-based S/S system and an alternative formulation incorporating ground granulated blast furnace slag (GGBFS), washed fly ash (W-FA), and marble sludge (MS) using a comparative Life Cycle Assessment (LCA). The assessment was performed using SimaPro 9.3, the Ecoinvent v3.9 database, and the ReCiPe 2016 Midpoint (H) method, within a cradle-to-gate system boundary. Particular attention was given to developing a transparent and reproducible life cycle inventory, integrating primary operational data with background datasets for all material and energy flows associated with the remediation process. The results show that replacing a substantial portion of Portland cement with industrial by-products reduces Global Warming Potential by approximately 27%, while smaller reductions of approximately 20% are observed for ozone formation, human health and ozone formation, and terrestrial ecosystems, respectively. Conversely, the Green S/S formulation shows higher impacts across most of the remaining midpoint categories, including ionizing radiation; terrestrial, freshwater, and marine ecotoxicity; human toxicity; eutrophication; resource scarcity and water consumption. These increases reflect upstream elementary flows and processing requirements associated with the alternative binder constituents included within the adopted cradle-to-gate system boundary. Overall, the results demonstrate that the environmental performance of the alternative formulation is characterized by clear category-specific trade-offs rather than a uniform reduction across impact categories. The findings highlight the potential of industrial by-products to reduce cement-related climate impacts while emphasizing the need for a multi-impact life-cycle perspective when evaluating alternative S/S formulations for contaminated soil remediation. Full article

This study presents a life cycle assessment (LCA) of drip and flood irrigation systems for wheat production in the semi-arid Central Mashhad Plain, northeastern Iran, following the ISO 14040/14044 framework. The functional unit is defined as 1 ton of wheat grain at the farm gate. Environmental impacts were assessed using the ReCiPe 2016 Midpoint (H) method. Inventory data were sourced from field surveys, the Ecoinvent database, and regional statistics. The results indicate that while drip irrigation reduces water consumption by approximately 35.3% compared with flood irrigation, it is associated with higher environmental burdens in a range of impact categories, notably marine ecotoxicity (+62%), freshwater ecotoxicity (+58%), freshwater eutrophication (+42%), fossil resource scarcity (+41%), human non-carcinogenic toxicity (+38%), and global warming potential (+19%), along with substantial increases in mineral resource scarcity, human carcinogenic toxicity, and terrestrial ecotoxicity. These trade-offs are mainly linked to the material and energy demands of the pressurized irrigation infrastructure (pipes, pumps, and filters). Sensitivity and uncertainty analyses confirm the robustness of the comparative rankings. However, the analysis is limited by the gate-to-gate system boundary and the use of background databases that may not fully reflect region-specific emission factors. These findings highlight the importance of integrated irrigation policies that address both water conservation and the broader environmental implications of irrigation modernization in semi-arid, groundwater-dependent regions. Full article