Search Results (6,428)

Corporate sustainability has emerged as a critical strategic imperative for organizations seeking to mitigate their environmental impacts amid escalating climate pressures and growing stakeholder demands. This study examines corporate strategies aimed at reducing environmental footprints—including circular economy models, energy efficiency measures, and digitalization—and investigates how young adults perceive and evaluate corporate sustainability commitments, with particular emphasis on greenwashing skepticism. A cross-sectional quantitative survey was administered to 150 university students and young professionals aged 18–25 years in Spain. Data were analyzed using descriptive statistics, analysis of variance (ANOVA), and linear regression to examine the influence of prior sustainability knowledge, academic background, age, and sectoral context on perceived corporate sustainability commitment, greenwashing perception, and willingness to consume sustainable products. The findings reveal that prior sustainability knowledge significantly and positively predicts higher evaluations of corporate environmental commitment, while age and academic background—particularly among students in Economics and Business—are associated with heightened greenwashing skepticism. Perceived corporate sustainability commitment is found to exert a significant positive influence on sustainable consumption intention, and production-intensive sectors are consistently perceived as more environmentally harmful than service-oriented industries. These findings underscore the importance of transparent, credible, and verifiable sustainability strategies in building legitimacy and trust among younger generations, and contribute to the growing literature on stakeholder perceptions of corporate environmental responsibility. Full article

Toxoplasmosis is a widely distributed zoonosis caused by the protozoan parasite Toxoplasma gondii. Infection during pregnancy is a major public health concern due to its potential impact on both maternal health and fetal development. Early detection of maternal infection is critical to prevent adverse outcomes; however, maternal signs are often subtle, non-specific or absent, complicating timely diagnosis. This scoping review aimed to map and synthesise existing evidence on early maternal signs, pregnancy and foetal outcomes, frequently assessed risk factors, and diagnostic approaches of toxoplasmosis in expectant mothers in Africa. The review was done in accordance with the PRISMA-ScR guidelines. A literature search of PubMed, Scopus, ResearchGate, and Google Scholar was performed to identify studies published between 2000 and 2025. Retrieved records were managed using Zotero (version 8.0.4) for deduplication and screening. Only English-language studies conducted in Africa and reporting relevant maternal or clinical data were included. A total of 28 cross-sectional studies were included. Lymphadenopathy (25.0%) was the most frequently reported maternal early sign, followed by flu-like illness, asymptomatic infection, low-grade or mild fever, and fatigue or malaise (each 10.7%). Congenital anomalies (50.0%) and miscarriage or spontaneous abortion (42.9%) were the most commonly reported foetal and pregnancy outcomes. Frequently reported risk factors were exposure to cat faeces (57.1%) and ingestion of undercooked or raw meat (42.9%). Diagnostic approaches were commonly enzyme-based immunoassays (78.6%), with limited use of RDTs and molecular methods. These findings suggest the need for improved early detection and prevention strategies in high-risk, low-resource African settings. Enhancing routine screening, health education, and access to appropriate diagnostics are considered. Future studies should consider adopting standardised reporting and integrating sensitive, affordable, rapid diagnostic approaches to enhance early detection and reduce the burden of congenital toxoplasmosis. Full article

Background/Objectives: This study aimed to explore the association between internet use and executive function among older adults and the mediating role of social participation and loneliness in internet use and executive function. Methods: A cross-sectional study was conducted among 439 community-dwelling older adults (≥60 years) in Nanjing, China, from September to December 2022. Participants were selected using simple random sampling and assessed with four standardized instruments: the Internet Use Questionnaire, the Social Participation Capacity Assessment, the six-item UCLA Loneliness Scale (ULS-6), and the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). Data were analyzed with the SPSS 21.0 software for descriptive statistics and correlation analysis and the AMOS 23.0 software for structural equation modeling to test the chain mediation effects. Model fit was evaluated using Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI), Tucker–Lewis Index (TLI), and Weighted Root Mean Square (WRMR), with bootstrap resampling for indirect effect estimation. Results: The results showed that internet use was positively correlated with loneliness (r = 0.203, p < 0.01), social participation impairment (r = 0.193, p < 0.01), and executive function (r = 0.420, p < 0.01). Structural equation modeling showed that greater internet use was significantly associated with poorer executive function (β = 0.306, p < 0.01). These associations were partially explained by pathways involving social participation and loneliness through three indirect pathways: internet use via social participation (indirect effect = 0.087, 18.3% of the total effect); internet use via loneliness (indirect effect = 0.049, 10.3%); and internet use via social participation and then loneliness in sequence (indirect effect = 0.035, 7.1%). Conclusions: In community-dwelling older adults, more frequent internet use was associated with greater executive function impairment through mechanisms involving reduced social participation and increased loneliness. Therefore, there is a need to limit excessive internet use while promoting social participation and reducing isolation, which can have the greatest benefits for executive functioning in older adults. Full article

A rapid quasi-one-dimensional (quasi-1D) reacting-flow analysis code was developed for the preliminary assessment of rocket-based combined cycle engines over a broad flight envelope. The internal flow was modeled as steady and quasi-1D in a variable-area duct by solving the coupled conservation equations together with species transport, and finite-rate chemical kinetics were included to represent combustion-induced heat release and composition change. To incorporate configuration-dependent mixing effects that affect RBCC heat release evolution and thermal choking tendencies, a streamwise mixing efficiency distribution was extracted from non-reacting 3D CFD and prescribed as an input to the quasi-1D formulation to represent the progressive availability of reactable fuel along the flowpath. A mode-dependent solution strategy was established by separating the computation into scramjet mode and ramjet mode procedures with a switching criterion based on whether a sonic condition occurs within the combustor, allowing thermal choking and mode transition behavior to be addressed within a single framework. The numerical solver was implemented in Python 3.12.2 and integrated using a stiff ordinary differential equation (ODE) scheme to ensure robust convergence in the presence of reaction-induced stiffness. Verification against previously published hydrogen-fueled scramjet results reproduced the overall streamwise trends of key quantities including Mach number, pressure, temperature, and density. The developed code was then applied to an RBCC configuration under operating conditions representative of ERJ and ESJ regimes, and the quasi-1D predictions were compared with cross-section-averaged 3D RANS CFD results, showing consistent mode identification and comparable axial behavior at a level suitable for preliminary analysis with substantially reduced computational cost. Full article

Wind turbine blades are subjected to complex environmental conditions during long-term operation, which may lead to structural degradation and performance loss. To ensure structural integrity, fatigue testing prior to deployment is essential. This paper proposes a vision-based method for measuring the full-cycle breathing deformation of wind turbine blades during fatigue testing. The method captures dynamic image sequences of the blade’s hotspot cross-section using industrial cameras and employs a feature-based template matching approach to reconstruct the three-dimensional coordinates of target points. Through coordinate transformation, the deformation trajectories are obtained, enabling quantitative analysis of the blade’s dynamic responses in both flapwise and edgewise directions. A dedicated hardware–software system was developed and validated through full-scale fatigue experiments. Quantitative comparison with strain gage measurements shows that the proposed method achieves mean absolute deviations of 0.84 mm and 0.93 mm in two independent experiments, respectively, with closely matched deformation trends under typical loading conditions. These results demonstrate that the proposed method can reliably capture the global deformation behavior of the blade with millimeter-level accuracy, while significantly reducing instrumentation complexity compared to conventional contact-based approaches. The proposed method provides an effective and practical solution for full-field dynamic deformation measurement in blade fatigue testing, offering strong potential for structural health monitoring and early damage detection in wind turbine systems. Full article

Skeletal muscle activity, such as exercise, enhances mitochondrial function, a process critical for ATP production through oxidative phosphorylation. Mitochondrial dysfunction, often linked to mutations in the chchd10 gene, contributes to the pathogenesis of neurodegenerative and neuromuscular diseases. Although exercise is known to improve mitochondrial performance, its regulatory influence on chchd10 remains poorly defined. In this study, zebrafish (Danio rerio) at three different ages (4, 9, and 15 months) were divided into control and exercise groups, with the latter subjected to a swimming intervention. We observed that exercised male zebrafish exhibited improved muscle morphology across all age groups, marked by increased muscle fiber cross-sectional area and reduced inter-fiber spacing. Transcriptome sequencing via RNA-seq further identified chchd10 as a differentially expressed gene in three age group comparisons. Exercise may be associated with downward regulation of expression of chchd10, which was correlated with increased methylation levels in its promoter region. These results illuminate the epigenetic mechanisms induced by exercise, revealing a novel pathway through which physical activity, potentially via modulation of chchd10, promotes muscle and mitochondrial health. Full article

Background: In the Philippines, studies have shown that availability and access to healthcare varies widely. Although the shortage of psychiatrists in the country has been recognized for many years, no published study to date has described their distribution across the regions. This study aimed to describe the distribution of psychiatrists in the country using publicly available data on the Internet. Methods: This was a cross-sectional study, analyzing publicly available data from the Philippine Psychiatric Association (PPA) web directory, the Philippine Health Insurance Corporation (PhilHealth) web database of accredited psychiatrists, and the Philippine Statistics Authority. Information on location of practice, sex, PPA membership, PhilHealth accreditation, regional gross domestic product (GDP), and regional population were collated. Results: Information on 409 psychiatrists was available online, with 68% being female and 53% holding PhilHealth accreditation. There were a total of 417 declared locations of practice, with six psychiatrists practicing in more than one location. The National Capital Region accounted for 53.5% of the declared practice locations, while no psychiatrist declared practicing in the Bangsamoro region. Conclusions: This study highlights the maldistribution of psychiatrists across the Philippines. Policies to incentivize and encourage practice in low-access regions and investment in technology, such as telemedicine, may help reduce the access gap. Full article

Background: Upper limb functional performance depends on the interaction of strength, mobility, and neuromuscular control, while inter-limb asymmetries may increase injury risk. However, comprehensive analyses integrating these factors remain limited. This study aimed to evaluate sex differences and identify functional phenotypes in young adults using a multidimensional assessment approach. Methods: Forty-six healthy young adults (23 women, 23 men) underwent a comprehensive battery of upper limb assessments, including anthropometric measurements, maximal handgrip strength, isometric elbow flexion and extension torque, postural stability via the Fall Risk Index (FRI), and functional reach using the Upper Quarter Y-Balance Test (YBT-UQ). Inter-limb symmetry was calculated using the Limb Symmetry Index (LSI). K-means clustering was applied to standardized variables to identify latent functional phenotypes. Results: Men demonstrated significantly greater body mass, height, limb length, and absolute strength (p < 0.01), while functional performance (YBT-UQ composite scores) and inter-limb symmetry were similar between sexes. Strength asymmetry was most prevalent for elbow flexion and handgrip strength (up to 89%), whereas stability asymmetry was less frequent (≈54%). Three functional clusters were identified: Cluster 1—high strength and moderate stability, Cluster 2—lower anthropometry and strength, Cluster 3—high strength but reduced stability and increased asymmetry. Despite phenotypic differences, composite functional performance was comparable across clusters. Conclusions: Upper limb function reflects the interaction of morphological and neuromuscular factors rather than strength alone. Observed asymmetries should be interpreted within a functional context, as moderate asymmetries may represent normal variation in motor control, while larger asymmetries may indicate potential functional imbalance; however, due to the cross-sectional design of this study, no causal inferences regarding injury risk can be made. Functional phenotyping provides a framework for individualized training, screening, and rehabilitation strategies. Full article

Background: Dysphagia and malnutrition are common among head and neck squamous cell carcinoma (HNSCC) patients. Evidence and guidelines emphasize treatment and prevention of these conditions before surgery. In this context, multimodal prehabilitation (MP) is an essential part of a holistic treatment approach. However, the specific components and their relative importance remain debated. This study aimed to evaluate the impact of nutritional, logopedic and psychological MP. Methods: Adult HNSCC patients who completed the German version of the Functional Assessment of Cancer Therapy—Head and Neck (FACT-H&N) quality-of-life (QOL) questionnaire after undergoing curative resection and reconstructive surgery were included in this cross-sectional study. Clinical data on psychological, logopedic and nutritional MP and possible confounders was collected. To evaluate the nutritional status, bodyweight loss, the body mass index (BMI) and the Graz Malnutrition Screening (GMS) score were recorded. We determined the length of stay (LOS), the QOL, the Clavien–Dindo type III and IV complication rate (CR) as the outcome parameters for MP. Results: In total, 102 patients were included. Of those, 68 were male, while the other 34 were female. The mean age was 59.82 ± 12.27 years. The average GMS was 3.11 ± 1.45. Simultaneously, 62.75% of patients were at risk or malnourished. Malnutrition was significantly associated with adverse outcomes in the univariate, but only with decreased QOL in the multivariate model. On the other hand, MP was significantly associated with reduced LOS and improved QOL. These findings remained robust even after adjustment for possible confounders. Neither had a significant effect on the CR. Conclusions: Our findings suggest that malnutrition is a potential risk factor for adverse outcomes in curative HNSCC therapy. The GMS is a sensitive tool for identifying patients at risk of malnutrition in HNSCC surgery prehabilitation. Our multimodal protocol was associated with improved postoperative outcomes following curative surgical resection and free flap reconstruction. The observed associations may reflect potential synergistic interactions within the multimodal framework. Full article

Background: The consumption of meat and high-fat foods is constantly discussed, with attention to their health and environmental consequences, as well as the barriers to changing current behaviors. Objective: The study aimed to examine how pro-environmental behavior, perceived food insecurity, and financial constraints correlate with intentions to limit meat and fat consumption among older adults. Methods: A cross-sectional study was conducted in 2025 among 475 individuals aged 60 to 92 years. The questionnaire includes scales that enable the calculation of four scores: Meat Reduction, Low Fat, Perceived Food Insecurity, and Lack of Financial Support. Additionally, questions about involvement in pro-ecological behaviors and sociodemographic characteristics were included. Logistic regression analysis was used to examine associations between perceived food insecurity, lack of financial support, and pro-environmental behaviors (independent variables) and intentions to reduce meat (Model 1) and fat (Model 2) (dependent variables). Results: Intentions to limit meat correlated positively with buying food produced in an environmentally friendly way (adjusted OR = 2.05; 95% CI: 1.56, 2.69), not wasting food (adjusted OR = 1.26; 95% CI: 1.05, 1.51), and buying local food (adjusted OR = 1.48; 95% CI: 1.21, 1.82). Intentions to limit fat correlated positively with buying food produced in an environmentally friendly way (adjusted OR = 1.66; 95% CI: 1.27, 2.18) and not wasting food (adjusted OR = 1.45; 95% CI: 1.20, 1.76). No relationships were found between the lack of financial support and intentions to limit meat (p = 0.069) and fat (p = 0.600). The perceived food insecurity decreased the likelihood of intentions to restrict fat (adjusted OR = 0.45; 95% CI: 0.24, 0.83), but not meat (p = 0.387). Conclusions: To better understand why experienced financial constraints did not influence the intention to reduce consumption of meat and high-fat products, further research is needed that focuses on motivation to change and the ability to change behavior among older people. Nevertheless, the results suggest that enhancing pro-environmental behaviors beyond those directly related to meat and fat consumption may facilitate reductions in meat and fat consumption through pro-environmental behavioral spillover. Full article

Swimming and water safety education can reduce drowning risk, yet research among the Turkish population is limited. This study examined differences in water safety attitude and knowledge scores by self-reported participation in swimming and lifeguard education, including any differences seen by participant gender. A cross-sectional survey collected data on demographics, swimming experience, perceived ability, aquatic location use, swimming and lifeguard education participation, water safety knowledge and self-reported attitudes. Among 255 participants (51.4% female; mean age 22), 83.9% reported being able to swim. Females were significantly less likely than males to self-report swimming ability (χ² = 5.99; p = 0.018) or prior lessons with a qualified teacher (χ² = 4.10; p = 0.043). Swimming or lifeguard education did not significantly affect attitude scores overall or by gender. However, both forms of education were significantly associated with knowledge scores overall and by gender, with males showing significant differences in knowledge levels after swimming (χ² = 16.46; p < 0.001) and lifeguard education (χ² = 11.93; p = 0.003). Findings indicate that swimming and lifeguard education were significantly associated with greater water safety knowledge but not with positive attitudes. Gender disparities persist, with females reporting lower self-reported swimming ability and males showing higher water safety knowledge after education. Expanding swimming and lifeguard education in Türkiye could enhance water safety knowledge. Full article

Background/Objectives: Sarcomas are rare, highly heterogeneous malignancies comprising more than 100 subtypes. Their nonspecific clinical presentations, frequent misdiagnosis, and limited access to specialized expertise contribute to prolonged routes to diagnosis. Prolonged diagnostic intervals are associated with worse clinical outcomes, yet determinants of time to diagnosis remain insufficiently characterized. Therefore, the aim of this study was to examine clinical, health system, and socioeconomic determinants of time to diagnosis among patients with sarcoma. Methods: We conducted a global cross-sectional survey through the Sarcoma Patient Advocacy Global Network (SPAGN), including 1803 patients and caregivers across 19 languages. Collected data included sociodemographic characteristics, tumor-related factors, healthcare access, and diagnostic timelines. Associations between patient-, tumor-, and system-level variables and time to diagnosis were assessed using multivariable linear regression. Missing data were handled using multiple imputation. Results: The median time to diagnosis was 92 days (interquartile range (IQR): 31–245). Patient-reported barriers to care were strongly associated with prolonged diagnostic intervals. Female gender was independently associated with longer care intervals, while patients from low/lower-middle-income countries reported shorter diagnostic times. Tumor characteristics, age, and stage at diagnosis were not independently associated with time to diagnosis. Conclusions: Timely and accurate sarcoma diagnosis remains a global challenge. Prolonged routes to diagnosis appear to be driven by modifiable structural and socioeconomic factors, including misdiagnosis, limited specialist expertise, and unclear referral pathways, rather than tumor-related characteristics. These findings highlight the need to enhance awareness, streamline referral processes, and expand access to specialized care to reduce avoidable prolonged routes to diagnosis and improve patient outcomes worldwide. Full article

The condition assessment of alkali-silica reaction (ASR)-damaged concrete structures necessitates accurate reproduction of ASR expansion progression and its induced load effects across time and spatial dimensions. To address this challenge, a time-dependent free ASR expansion model was developed based on experimental measurements. A user subroutine incorporating stress-dependent behavior for restrained ASR expansion evolution was implemented on the ABAQUS platform and validated through simulation of ASR expansion in specimens under external loading and internal reinforcement restraint. Finite element analyses of the reinforced concrete specimens revealed distinct variations in ASR expansion between the surface and interior zones of concrete members. The assumption that surface ASR expansion strain equals steel rebar strain leads to significant overestimation of actual rebar stress and strain conditions. Additionally, based on the validated finite element model, the influence of elastic modulus, creep, stress-dependent function, steel plate thickness, and reinforcement ratio on the ASR expansion was investigated. For the reinforced concrete specimens, the stress variation over the cross-section is considerably reduced when creep is considered, while the concrete strain at the surface is only slightly influenced by creep. Full article

Objectives: This study aimed to evaluate the relationship between quiet quitting and burnout among nurses, considering the influence of sociodemographic and occupational factors in healthcare settings. Methods: This cross-sectional, observational, and quantitative study was conducted from April to July 2025 in health services in northern Portugal, involving 1097 nurses who completed a questionnaire, the Silent Employment Abandonment Scale, and the Shirom–Melamed Burnout Scale. Descriptive and inferential analyses examined associations between sociodemographic variables, work context, and outcomes. Results: The 1097 participating nurses showed a positive correlation between overall quiet quitting and total burnout across all domains. Burnout remained significantly associated with overall quiet quitting after adjustment, and physical and cognitive fatigue showed the most consistent independent associations across models. The strongest coefficients were observed for the ‘lack of motivation’ dimension. Conclusions: Quiet quitting was consistently associated with burnout among nurses after adjustment for sociodemographic and occupational factors. The pattern of results was stronger for physical and cognitive fatigue and for lack of motivation, supporting the interpretation of quiet quitting as an important correlation of occupational strain in nursing and reinforcing the need for organizational and leadership strategies that reduce fatigue and sustain professional engagement. Full article