Search Results (301)

Multilayer packaging materials are extensively used in food packaging, particularly for powdered products. In alignment with sustainable development goals, packaging design should aim to minimize material usage while maintaining the protective properties necessary to preserve food quality and safety, thereby reducing environmental impact. A key strategy is to simplify multilayer structures to enhance recyclability. This study aims to evaluate the potential of sustainable alternative packaging materials with reduced metal and plastic content and improved recyclability for pudding powder packaging, as substitutes for conventional films. Four packaging structures were tested: a conventional three-layer laminate (polyethylene terephthalate (PET)/aluminum foil (Al-foil)/low-density polyethylene (LDPE)), two two-layer structures (AlO_x-coated PET/LDPE and Al-coated PET/LDPE), and a monolayer metallized biaxially oriented polypropylene (MetBOPP). Samples were stored under accelerated conditions (38 °C and 90% relative humidity) for 180 days, and changes in moisture content, water activity, caking degree, glass transition temperature, color, and sensory attributes were monitored. The experimental data were examined for their agreement with various sorption models by creating adsorption isotherms. The acceptable storage period was estimated using the constants calculated from these models. Statistically significant differences (p < 0.05) were observed among the packaging types, primarily associated with their water vapor permeability, affecting moisture content, water activity, caking degree, and color stability. In terms of moisture content, water activity, and caking degree, the conventional PET/Al-foil/LDPE (Polyethylene terephthalate/Aluminum foil/Low density polyethylene) structure demonstrated the best performance, followed by PET.AlO_x/LDPE (AlO_x-coated Polyethylene terephthalate/Low density polyethylene), MPET/LDPE (Metallized polyethylene terephthalate/Low density polyethylene), and MBOPP (Metallized biaxially oriented polypropylene), respectively. The sensory analysis scores followed the same ranking; however, all samples maintained scores above the threshold value of 3 throughout the storage period, indicating that they remained acceptable. Caking degree increased moderately (from 0.61% to 0.89%) and was negatively correlated with appearance scores (R² = −0.89, p < 0.01). Despite slight darkening (Browning Index increased from 18.16 to 20.37), sensory scores for appearance, odor, and taste remained above the acceptable threshold (score > 3.0). Based on the WVTR values of the packaging materials and the application of the GAB model, the estimated shelf lives were 800.32 days for PET/Al-foil/LDPE, 577.92 days for PET.AlO_x/LDPE, 407.58 days for MPET/LDPE, and 229.26 days for MBOPP. In conclusion, the longest shelf life was achieved with PET/Al-foil/LDPE, and it was observed that as the WVTR of the packaging materials increased, the shelf life of the cocoa-based pudding powder decreased; PET.AlO_x/LDPE and MPET/LDPE could be considered for medium-term storage (up to about 1–1.5 years), while MBOPP appeared suitable only for shorter durations (6–8 months). Full article

Cities around the world are facing growing challenges related to climate change, urban sprawl, infrastructure strain, and digital transformation. In response, smart and sustainable urban development has become a global focus, aiming to integrate technology and environmental stewardship to improve the quality of life. The smart and sustainable city concept is typically applied at the city scale; however, its impact is most tangible at the neighborhood level, where residents interact directly with infrastructure, services, and community spaces. A variety of global frameworks have been developed to assess sustainability and technological integration. However, these models often fall short in addressing localized needs, particularly in regions with distinct environmental and cultural contexts. In Saudi Arabia, Vision 2030 emphasizes livability, sustainability, and digital transformation, yet there remains a lack of tailored tools to evaluate smart and sustainable progress at the neighborhood scale. This study develops HayyScore, a localized evaluation framework and prototype digital platform developed to assess neighborhood performance across five core categories: (i) Environment and Urban Resilience, (ii) Smart Infrastructure and Governance, (iii) Mobility and Accessibility, (iv) Quality of Life and Social Inclusion, and (v) Economy and Innovation. The HayyScore platform operationalizes this framework through an interactive web-based tool that allows users to input data through structured forms, calculate scores, receive category-based and overall certification levels, and view results through visual dashboards. The methodology involved a comprehensive review of global frameworks, expert input to define localized indicators, and iterative prototyping of the platform using Python 3.13.5 and Streamlit 1.45.1. To demonstrate its practical application, the prototype was tested on two Saudi neighborhoods: King Abdullah Petroleum Studies and Research Center (KAPSARC) and King Fahd University of Petroleum and Minerals (KFUPM). Key platform features include automated scoring logic, category weighting, certification generation, dynamic performance charts, and a rankings page for comparing multiple neighborhoods. The platform is designed to be scalable, with the ability to add new indicators, support multilingual access, and integrate with real-time data systems in future iterations. Full article

Background/Objectives: Mitral regurgitation (MR) is the most common valvular defect worldwide, with an increasing incidence attributed to the aging population. Transcatheter edge-to-edge repair (TEER) is a viable treatment, but its long-term survival impact, particularly across sexes, remains underexplored. We aimed to assess relative survival (RS) and excess mortality (EM) in patients undergoing TEER for significant MR, with a focus on sex-based differences. Methods: We analyzed 253 patients treated with TEER between October 2015 and August 2024, stratified by sex. Observed survival (OS) was calculated using the actuarial life table method; expected survival (ES) was estimated via the Ederer II method using matched population data. Primary endpoints were RS and EM; secondary endpoints included mortality differences by MR subtype. Results: OS at 1, 2, and 3 years was 88.9%, 87.4%, and 78.9%, respectively. EM peaked in the first year (7.8%) and declined thereafter. RS was lower than in the general population, primarily due to persistently reduced RS and elevated EM in men. Women achieved RS comparable to matched peers from year one. Sex was not an independent predictor of mortality (HR 0.88, 95% CI 0.38–2.03, p = 0.771). Conclusions: In patients with significant MR undergoing TEER, EM was concentrated in the first year. Women reached RS comparable to the general population, while men showed persistent excess mortality. Sex was not independently associated with survival after adjustment. Full article

Background/Objectives: Over the past two decades, the incidence of breast cancer has been increasing in Korea, which is potentially attributable to longer life expectancies, Westernized lifestyles, and declining fertility rates. However, the contributions of modifiable metabolic and behavioral risk factors in Asian populations remain underexplored. This study aimed to assess the associations between health-related factors and incidence of breast cancer in a large Korean cohort. Methods: We analyzed data from the Korean National Health Insurance Service and included women who underwent health screening in 2009. Cases of breast cancer diagnosed between 2010 and 2021 were identified using medical claims and registration codes. The breast cancer cases were matched to controls in a 1:4 ratio based on age, income, and region of residence. Conditional logistic regression was used to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for key exposures. Results: In total, 52,869 breast cancer cases and 211,476 matched controls were included. The peak age group at diagnosis was 50–54 years. Dyslipidemia was associated with a 12% increase in the risk of breast cancer across all age groups (95% CI, 1.10–1.14). In women ≥ 50 years of age, a dose–response relationship was observed between body mass index (BMI) and breast cancer risk: aORs were 1.04 (95% CI, 1.01–1.08) for overweight, 1.14 (95% CI, 1.11–1.17) for obesity class I (BMI ≥ 25 to < 30 kg/m²), and 1.33 (95% CI, 1.26–1.41) for obesity class II (BMI ≥ 30 kg/m²). Conversely, being underweight was associated with a decreased risk (aOR, 0.81; 95% CI, 0.74–0.89). No consistent associations were observed with alcohol consumption, cigarette smoking, or the presence of diabetes mellitus. Conclusions: Postmenopausal obesity and dyslipidemia contribute to the risk of breast cancer among Korean women. Promoting healthy behaviors throughout life may support long-term risk reduction. Full article

Dynamic wind-induced vibrations of structures will cause cyclic stresses in structural elements, potentially leading to fatigue damage accumulation or structural failure. Existing research on wind-induced fatigue mainly focuses on tower and large-span steel structures, such as chimneys, signal towers, transmission towers, long-span bridges, and wind turbines. However, existing studies on wind-induced fatigue damage in tall steel buildings remain limited. To determine whether and under what conditions wind-induced fatigue damage needs to be considered in tall steel structures, this study investigates wind-induced fatigue failure through wind tunnel tests and numerical simulations. Specifically, six real tall steel buildings were examined to assess their fatigue life under dynamic wind loads. First, wind tunnel tests using synchronous pressure models were conducted to obtain wind load time histories of these six buildings. Subsequently, time histories of wind-induced displacements and component stresses were calculated. The wind-induced fatigue life of each building was evaluated using the rain-flow counting method and the Palmgren–Miner rule, revealing that the fatigue life generally exceeds 400 years. The results demonstrate that tall steel structures designed according to current standards perform well in resisting wind-induced fatigue damage. Furthermore, when the ratio of the wind-induced root mean square (RMS) stress to the ultimate strength of a structural element reaches 0.125–0.164, the fatigue life of components may fall below the design life, indicating the necessity of considering potential fatigue damage. The RMS stress ratio can be preliminarily compared with the RMS stress ratio threshold proposed in this study to determine whether wind-induced fatigue damage needs to be considered in tall steel buildings. Finally, a simplified fatigue life prediction formula is established to provide approximate estimates for the fatigue life of tall steel buildings. Full article

A pilot-scale reactor prototype was designed to produce hydrocarbons through the catalytic pyrolysis process of low-density polyethylene, thereby extending its life cycle and contributing to energy efficiency and sustainability. The reactor consists of a stainless-steel tank encased in a ceramic jacket with refractory cement and clay bricks. The tank, made of 304 stainless steel, ensures mechanical strength and efficient heat transfer to the reactor core. A spiral condenser was incorporated into a water tank to cool the vapors and recover the liquid oil. The insulating materials, ceramic, refractory cement and clay brick, demonstrated a high combined thermal resistance of 0.159 m²·K/W. Simulations and energy flow calculations demonstrated that heat is efficiently directed to the reactor core, reaching 350 °C with only 3000–3800 W, while the outside of the jacket remained close to 32 °C. These results confirm that the proposed design improves thermal efficiency and optimizes energy use for catalytic pyrolysis. The novelty of this design lies in its energy-efficient configuration, which can be replicated in rural regions worldwide due to the accessibility of its construction materials. This reactor was developed based on a smaller-scale model that previously yielded excellent results. Full article

Urban park green spaces (UPGSs) play a critical role in enhancing residents’ quality of life, particularly for older adults. However, inequities in accessibility and resource distribution remain persistent challenges in aging urban areas. To address this issue, this study takes Gulou District, Nanjing City, as an example and proposes a comprehensive framework to evaluate the overall quality of UPGSs. Furthermore, an enhanced Gaussian two-step floating catchment area (2SFCA) method is introduced that incorporates (1) a multidimensional park quality score derived from an objective evaluation system encompassing ecological conditions, service quality, age-friendly facilities, and basic infrastructure; and (2) a Gaussian distance decay function calibrated to reflect the walking and public transit mobility patterns of the older adults in the study area. The improved method calculates the accessibility values of UPGSs for older adults living in residential communities under the walking and public transportation scenarios. Finally, factors influencing the social equity of UPGSs are analyzed using Pearson correlation coefficients. The experimental results demonstrate that (1) high-accessibility service areas exhibit clustered distributions, with significant differences in accessibility levels across the transportation modes and clear spatial gradient disparities. Specifically, traditional residential neighborhoods often present accessibility blind spots under the walking scenario, accounting for 50.8%, which leads to insufficient accessibility to public green spaces. (2) Structural imbalance and inequities in public service provision have resulted in barriers to UPGS utilization for older adults in certain communities. On this basis, targeted improvement strategies based on accessibility characteristics under different transportation modes are proposed, including the establishment of multi-tiered networked UPGSs and the upgrading of slow-moving transportation infrastructure. The research findings can enhance service efficiency through evidence-based spatial resource reallocation, offering actionable insights for optimizing the spatial layout of UPGSs and advancing the equitable distribution of public services in urban core areas. Full article

Background: Lumbar foraminal stenosis (LFS) is a prevalent degenerative condition associated with significant radicular pain and impaired quality of life. Advances in minimally invasive and fusion-based surgical techniques have introduced new strategies for decompressing the neural elements. However, comparative data correlating volumetric foraminal expansion with functional outcomes remain limited. Methods: This retrospective cohort study analyzed 256 patients treated surgically for symptomatic LFS between December 2017 and December 2023. Patients were categorized into four surgical subgroups: endoscopic decompression, anterior lumbar interbody fusion (ALIF), microsurgical decompression, and transforaminal lumbar interbody fusion (TLIF). Preoperative and postoperative assessments included magnetic resonance imaging (MRI) to calculate foraminal volume and standardized clinical scales: the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for back and leg pain, and SF-36 health-related quality-of-life scores. Statistical significance was determined using p-values, and inter-observer agreement was evaluated via κ-statistics. Results: Postoperative imaging demonstrated a significant increase in foraminal canal volume across all surgical groups: endoscopy (29.9%), ALIF (71.8%), microsurgery (48.06%), and TLIF (67.0%). ODI scores improved from a preoperative mean of 55.25 to 18.27 at 24 months post-surgery (p < 0.001). VAS scores for back pain decreased from 6.37 to 2.1 (p < 0.001), while leg pain scores declined from 6.85 to 2.05 (p < 0.001). Functional improvement reached or exceeded the minimal clinically important difference (MCID) threshold in over 66% of patients. Conclusions: Modern surgical strategies for LFS, particularly fusion-based techniques, yield significant volumetric decompression and durable clinical improvement. Volumetric gain in the foraminal canal is closely associated with pain reduction and enhanced functional outcomes. These findings support a tailored surgical approach based on anatomical pathology and segmental stability. Full article

Background/Objectives: Facial palsy causes both functional and aesthetic impairments, with asymmetry significantly affecting quality of life. Botulinum toxin injections are increasingly used to restore facial balance by reducing contralateral hyperactivity, but outcome assessments remain largely subjective. The objective of this study was to evaluate the ability of three-dimensional (3D) stereophotogrammetry coupled with root mean square (RMS) surface analysis to objectively quantify improvements in facial symmetry following botulinum toxin treatment and to support clinicians in patient care. Methods: Sixteen adults with long-standing unilateral peripheral facial palsy underwent individualized botulinum toxin injections. Three-dimensional images were acquired using the Vectra H2 system before and 2–3 weeks after injection at peak efficacy. Five facial expressions (neutral, surprise, frown, Mona Lisa smile, and forced smile) were analyzed. RMS values were calculated for the whole face and facial thirds. Clinical assessment included House–Brackmann and Sunnybrook scores. Results: Whole-face RMS values decreased significantly after injection (1.51 ± 0.42 vs. 1.35 ± 0.43, p < 0.001). Improvements were observed across all thirds, most notably in the middle third. During expression, symmetry improved for all movements, with the strongest effects for surprise (d = 1.270), Mona Lisa smile (d = 0.870), and frown (d = 0.832). Conclusions: Three-dimensional stereophotogrammetry with RMS analysis provides an objective and reproducible method to quantify changes in facial symmetry after botulinum toxin treatment. This technique may complement clinical scoring systems and support personalized treatment planning in facial palsy patients. Full article

Background/Objectives: Recurrent laryngeal nerve injury (RLNI) is a major complication of thyroidectomy, affecting voice, airway protection, and quality of life. Intraoperative nerve monitoring (IONM) has been introduced to complement direct nerve visualization and reduce RLNI risk, but its efficacy remains controversial. This systematic review and meta-analysis aimed to determine RLNI prevalence with IONM, compare rates with historical no-IONM cohorts, perform head-to-head comparisons, and assess the influence of IONM characteristics. Methods: PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar were searched for studies reporting RLNI rates in thyroidectomy with and without IONM. Pooled prevalence estimates were calculated for transient and permanent unilateral and bilateral RLNI in IONM studies and historical controls. Direct meta-analysis estimated pooled odds ratios (ORs) for RLNI risk reduction. Subgroup analyses examined IONM type, monitoring model, stimulation amplitude, voltage, and neuromuscular blockade use; meta-regression identified influential parameters. Results: A total of 103 studies involving 132,212 patients met the criteria. Unilateral transient RLNI was lower with IONM (4%, 95% CI: 4–5%) than in historical controls (5%, 95% CI: 4–6%), while unilateral permanent RLNI was 1% in both groups. Bilateral RLNI was rare. Direct comparison showed a 38% reduction in transient unilateral RLNI (OR: 0.62, 95% CI: 0.42–0.79) and a 51% reduction in permanent unilateral RLNI (OR: 0.49, 95% CI: 0.34–0.70) with IONM. Continuous IONM, lower stimulation amplitudes (≤2 mA), and avoidance of neuromuscular blockade were protective. Conclusions: IONM significantly reduces RLNI risk, particularly for unilateral injuries, with optimal protection achieved through continuous monitoring, low stimulation amplitudes, and avoidance of neuromuscular blockade. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) and climate change are major global health challenges. Aim: Our aim was to assess the relationship between intrahepatic fat content (IFC) and diet-related environmental impact in a Mediterranean diet (MD)-based intervention. Design: The design included a six-month longitudinal analysis within the frame of a FLIPAN randomized controlled trial, including 60 participants aged 40–60 years with MASLD, metabolic syndrome and obesity. Methods: IFC expressed as a percentage (%IFC) was measured by magnetic resonance imaging, and dietary intake was assessed via a validated food frequency questionnaire (FFQ). Environmental impacts of diets were estimated using life cycle assessment data from the Agribalyse^® database, focusing on greenhouse gas (GHG) emissions, water use, energy use and land use. A composite sustainability score was also calculated. Changes in liver fat and environmental footprints were analyzed using a general linear model (GLM) adjusted for within-subject variability and partial correlation analysis adjusted for energy intake, MD adherence and body weight. Results: The participants with the highest %IFC reduction group in the GLM showed the highest decreases in GHG emissions and land use. Water use increased in this same group. Energy use and the composite sustainability score did not differ significantly between groups. Higher %IFC reductions were also associated with higher MD adherence and lower visceral fat. When the adjusted partial correlation analysis for the environmental parameters was performed, only water use remained significant. Conclusions: Higher reductions in %IFC were linked to dietary patterns with lower GHG emissions and land use and higher water use. However, when adjusted by energy intake, MD adherence and body weight in continuous modeling, only higher water use was related to lower %IFC. These findings highlight the complexity of achieving environmentally sustainable and health-promoting diets. Full article

Background/Objectives: Therapeutic exercises during hospitalization may provide important benefits for onco-hematological patients. However, the most effective protocols and outcomes for evaluation remain unclear. The objective of this study was to evaluate the effects of a structured exercise program during hospitalization. Methods: We conducted a randomized clinical trial with hospitalized onco-hematological patients. The control group performed conventional exercises, while the intervention group received a combined program of aerobic and resistance training. Outcomes included functional capacity, muscle strength, quality of life, and fatigue, assessed at admission and discharge. The sample size was calculated for a moderate effect size (Cohen’s d = 0.50; α = 0.05; power = 80%), yielding a target of 35 participants per group. Data were analyzed using repeated measures analysis of variance, followed by Bonferroni post hoc tests. The significance level was set at 5%. Results: The intervention group showed significant improvements in dyspnea (p = 0.017) and pain (p = 0.024) compared with the control group. In addition, reductions in insomnia (p = 0.021) and improvements in emotional functioning (p = 0.024) were observed. No significant between-group differences were found for fatigue, muscle strength, or functional capacity. Conclusions: A short-term program of aerobic and resistance exercises was safe and improved pain and dyspnea in hospitalized onco-hematological patients, with additional favorable effects on insomnia and emotional function. However, no significant effects were detected in fatigue, muscle strength, or functional capacity, likely due to the short hospitalization period and limited number of sessions. Future studies should consider longer interventions and post-discharge follow-up to clarify the sustainability of these benefits. Full article

Background: Frailty is known to elevate the risk of all-cause mortality and shorten life expectancy. Although the effects of diet on health are well documented, the specific interaction between diet quality and frailty remains unexplored. This research aims to examine the combined effects of various diet quality scores and frailty on all-cause mortality and life expectancy among middle-aged and older adults. Methods: A total of 151,628 participants were sourced from the UK Biobank for analysis. Frailty phenotype (FP) and frailty index (FI), as two different approaches, were used to assess frailty status. Diet quality was evaluated through seven diet quality scores: the Alternate Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension (DASH) score, Mediterranean diet (MED) score, Dietary Inflammatory Index (DII), and three plant-based diet indices (overall PDI, healthful PDI, and unhealthful PDI). Cox proportional hazards models were applied to calculate adjusted hazard ratios (HRs) for overall mortality and predict life expectancy differences. Results: Over a median follow-up period of 12.2 years, 8231 deaths were identified. After accounting for potential confounding factors, frail individuals in the unhealthier tertile of diet scores exhibited markedly elevated mortality risks, ranging from 1.99 to 2.07 based on the frailty index and 2.79 to 3.06 based on the frailty phenotype, compared to their robust counterparts in the healthier tertile. Regardless of frailty categories, a healthier diet was associated with longer life expectancy and with lower mortality risk in a dose–response relationship. Conclusions: The healthier tertile of diet scores was found to mitigate the detrimental effects of frailty, emphasizing diet quality as a modifiable factor in promoting healthier aging. Evidence suggests that it is never too late to adopt healthier dietary habits for significant health benefits. Full article

Objective: This study examines the effects of non-standard (lactose-reduced, hydrolyzed), cow-milk-based infant formulas on early childhood growth outcomes compared to standard formulas and breastfeeding. Methods: This retrospective cohort study included full-term infants with a birth weight >2500 g. Exposure and control data, including the type of infant formula [non-standard vs. standard] and breastfeeding status, were obtained at 2-month well visits. Growth outcomes (weight-for-age, length-for-age, BMI (Body Mass Index), and weight-for-length z-scores] were calculated using WHO (World Health Organization) growth standards at 1- and 2-year well visits. Generalized linear mixed models were used to evaluate associations between formula type and growth outcomes, adjusting for maternal, infant, and socioeconomic factors. Results: A total of 5515 infants were included in the final analysis. Feeding practices included exclusive breastfeeding (35%), standard formula (42%), and non-standard formula (23%). Infants fed non-standard formulas had significantly higher weight-for-age, BMI, and weight-for-length z-scores at 12 months than those fed standard formulas, and after controlling for other covariates, weight-for-age and BMI z-scores remained significantly higher in the non-standard formula infants. At 24 months, only weight-for-age z-scores remained significantly higher for non-standard formula users compared to standard formula users. Both non-standard and standard formula groups showed significantly higher weight-for-age, BMI, weight-for-length, and length-for-age z-scores compared to breastfed infants at 12 and 24 months. Conclusions: Non-standard infant formula may have a differential effect on growth during the first year of life compared to standard infant formula and breastfeeding. Future research should explore the long-term health effects of non-standard infant formula use and the risk of obesity. Full article

To address the challenge of reduced prediction accuracy caused by capacity regeneration during the use of lithium-ion batteries, this study proposes an RUL (remaining useful life) prediction method based on mode decomposition and an enhanced Informer-LSTM hybrid model. The capacity is selected as the health indicator, and the CEEMDAN (complete ensemble empirical mode decomposition with adaptive noise) algorithm is employed to decompose the capacity sequence into high-frequency and low-frequency components. The high-frequency components are further decomposed and predicted using the Informer model, while the low-frequency components are predicted with an LSTM (long short-term memory) network. Pearson correlation coefficients between each component and the original sequence are calculated to determine fusion weights. The final RUL prediction is obtained through weighted integration of the individual predictions. Experimental validation on publicly available NASA and CALCE (Center for Advanced Life Cycle Engineering) battery datasets demonstrates that the proposed method achieves an average fitting accuracy of approximately 99%, with MAE (mean absolute error) below 0.02. Additionally, both MAPE (mean absolute percentage error) and RMSE (root-mean-square error) remain at low levels, indicating improvements in prediction precision. Full article