Search Results (5,681)

Life Cycle Sustainability Assessment (LCSA) has been widely used to assess the environmental, economic, and social impacts of emerging technologies. However, its practical application in decision support remains limited due to incompatibility of units of measurement among sustainability dimensions and a lack of transparent integration mechanisms. This study constructs a monetized LCSA framework to examine how battery electric vehicles (BEVs) replacing gas-powered vehicles (GVs) in cold regions covered by carbon-intensive power systems affects overall sustainability performance. The results show that over a 15-year lifespan, BEVs reduce life cycle costs by 28.74% and carbon-related environmental costs by 25.27% compared to GVs, demonstrating significant economic and environmental advantages. However, BEVs show a 4.23% decrease in standardized socially perceived performance, primarily due to consumer concerns about transparency, privacy, and end-of-life liability. These findings suggest that incorporating social dimensions can significantly alter sustainability conclusions and reveal trade-offs that traditional single-dimensional assessments cannot capture. This study provides new empirical evidence for the comprehensive application of monetized life cycle sustainability assessment and offers valuable insights for vehicle design improvements, increased social acceptance, and low-carbon transportation policies in cold and carbon-intensive regions. Full article

The construction sector is undergoing a transformation and has established itself as an approach with the potential to improve the efficiency, quality, and sustainability of building projects. However, their contribution to sustainability is not fully reflected in the evaluation frameworks in use today. These were largely developed within traditional construction models and tend to prioritise the environmental dimension over social and economic ones. Previous studies have highlighted that significant shortcomings exist in the way industrialised construction is represented within the main sustainability assessment frameworks, in particular regarding the benefits associated with controlling the construction process, such as optimised timelines, cost certainty, decreases in unforeseen problems, improved workplace conditions, or the optimisation of logistics. These aspects, closely linked with social and economic sustainability, are seldom assessed explicitly by existing indicators. This article proposes a new set of indicators aimed at specifically assessing how industrialised construction contributes to sustainability in building projects. The proposed indicators are designed to complement the current assessment tools and focus on capturing the advantages gained from production in controlled environments, forward planning and a skilled workforce, paying special attention to economic and social dimensions and controlling the construction process. Full article

To address supply–demand dynamics and inter-provincial resource mismatches under high-penetration renewable integration, this study proposes a tri-level collaborative trading framework for provincial power grids in Northeast China. The system integrates intra-provincial baselines, intra-regional synergy, and inter-regional optimized export through multi-stage optimization models. An improved Shapley value method is further introduced to ensure fair benefit allocation based on electricity contribution and transmission support. Simulation results for the Northeast region show that this collaborative approach reduces generation costs by 13.88% and enhances social welfare by 7.58% compared to independent trading. This framework effectively breaks inter-provincial barriers and provides a theoretical foundation for regional power market planning and security of supply. Full article

Background/Objectives: In ketogenic therapy for children with refractory epilepsy—a special patient group—the quality of life of primary caregivers is often overlooked. This study aimed to explore the current state of primary caregivers’ quality of life and identify associated risk factors. Methods: A cross-sectional study was conducted from 21 January 2024 to 21 January 2025. A total of 117 primary caregivers of children with refractory epilepsy completed the World Health Organization Quality of Life (WHOQOL)-BREF (26 items) and Adherence questionnaire (6 items). Participants were divided into KD therapy groups (n = 51) and non-KD therapy groups (n = 66) according to the treatment. Factors associated with caregivers’ QoL in the ketogenic treatment were analyzed using the multifactor hierarchical regression. Results: There was no significant difference in QoL scores between the KD and non-KD caregiver groups (p > 0.05). KD adherence emerged as independently associated with caregivers’ QoL, particularly in the environmental domain (Model 1: β = −0.309, p = 0.022; Model 2: β = −0.306, p = 0.025). A higher KD cost was significantly associated with a lower social domain score in both models (Model 1: β = −0.285, p = 0.032; Model 2: β = −0.286, p = 0.034). Model 1 for the environmental domain demonstrated modest explanatory power (Adjusted R² = 0.246, p = 0.002). Conclusions: These findings underscore the need for clinical support systems to assess and address modifiable stressors early in treatment, including family structure, challenges with ketogenic diet therapy adherence, and financial burden. Such comprehensive evaluation is essential for developing effective and personalized interventions. Full article

Background: Standard consumer theory treats preferences as fixed primitives and demand as the solution to an individual optimisation problem; we instead model consumption styles as heritable strategies whose prevalence is shaped by selection and experimentation, and ask when status competition produces an over-consumption trap. Methods: We embed a reference-dependent payoff—private utility concave in own consumption, a positional benefit proportional to consumption relative to the social mean, a financial-fragility cost, and a loss-averse relative-deprivation term—into replicator–mutator dynamics over three strategies (frugal, balanced, conspicuous). Results: Status concern induces strategic complementarity, so that a rising consumption norm penalises moderate consumers and makes imitation self-reinforcing. For intermediate status weight, the system is bistable: an efficient balanced equilibrium and a Pareto-inferior conspicuous trap are separated by a tipping threshold, and the width of the bistable window equals the deprivation weight, producing hysteresis in the consumption norm. The trap persists even though the positional benefit nets to zero in any monomorphic state. Mutation—behavioural experimentation—shrinks the bistable window and can dissolve the lock-in. Conclusions: Reference-dependent demand is better captured by evolutionary dynamics than by static equilibrium, and positional externalities can lock a population into self-defeating over-consumption that interventions on the deprivation or fragility channel may unlock. Full article

To address frequent street-level flooding, inadequate targeted management, and unbalanced cost-effectiveness in the old urban area, this study takes Yong’an Subdistrict in Quanshan District, Xuzhou, as a typical case, regards the street-level as its fundamental analytical unit and constructs a systematic “simulation–assessment–strategy” framework, focusing on evaluating and enhancing flood resilience in old urban districts. First, numerical simulation quantifies water depth under extreme rainfall to identify the flood risk spatial distribution. Second, a flood resilience assessment system is established based on the “exposure–vulnerability–adaptive capacity” framework, using the TOPSIS method to measure and grade street resilience. Finally, differentiated flood management strategies are proposed by integrating assessment results with regional characteristics. This study shows that high-risk flooding zones are clustered, with resilience results significantly correlated with the flood risk distribution. Low-resilience areas highly overlap with high-risk zones, mainly due to deficiencies in engineering, ecological, and social resilience. Accordingly, differentiated strategies—”pipe network upgrades + permeable paving”, “retention facilities + smart drainage”, and “micro-topography modifications”—are applied to old residential areas, core commercial districts, and new development peripheries. This approach balances management costs and effectiveness, providing theoretical and practical support for precise street-level flood management and spatial optimization in old urban districts. Full article

This study introduces a comprehensive framework for understanding sustainable online shopping preferences, validated using survey data collected in Serbia and Slovenia in 2025 (n = 572), thereby enhancing its generalizability. The primary aim of this research is to examine the extent to which specific environmental, social, and economic indicators influence decision-making processes for online purchasing and delivery. A detailed quantitative analysis was conducted using a structured questionnaire that included a wide range of variables related to online shopping behaviors and delivery preferences. The findings indicate that preferences for sustainability are inherently complex and multifaceted, shaped by critical factors such as environmental concerns, social responsibility, trust, skepticism towards sustainability claims, willingness to pay (WTP), and price sensitivity. Demographic variables, particularly gender and age, show consistent links to preferences for environmental considerations and corporate social responsibility (CSR), while income impacts trust-related behaviors and WTP. Furthermore, the analysis distinguishes between two distinct decision-making approaches: a value-driven sustainability cluster represented by EcoIndex, SocialIndex, and WTPIndex, and a cost-minimization strategy focused on price sensitivity (PriceIndex), with trust acting as a related yet separate factor (CredibilityIndex). Overall, this study emphasizes that a range of interconnected dimensions significantly shape sustainable online shopping preferences. The study was conducted in two developing European countries. Additionally, the findings highlight the need to address universal market barriers, such as price sensitivity, information asymmetry, and consumer skepticism. In a business context, they underscore the importance of adopting advanced analytical methods to enhance decision-making and optimize sustainable business strategies. Full article

This research examines stakeholders’ perspectives in Colombia and Switzerland on blockchain traceability systems in the coffee industry. Adopting the Unified Theory of Acceptance and Use of Technology (UTAUT) as an interpretive framework, the study analyzes these perceptions through the constructs of performance expectancy, effort expectancy, social influence, and facilitating conditions. Using a quantitative cross-sectional design with an exploratory scope, we survey 360 participants, comprising 60 coffee supply chain companies and 300 consumers. Results reveal that 78.3% of stakeholders consider traceability essential, yet only 46.7% are familiar with blockchain. Stakeholders identify three primary benefits: improved transparency (91.7%), fraud prevention (88.3%), and enhanced security (86.7%). However, significant barriers persist: high implementation costs (95%), limited expertise (91.7%), and lack of awareness (93.3%). Geographic differences emerge: Colombian stakeholders prioritize cost reduction and fraud prevention, while Swiss participants focus on data management and privacy protection. Among consumers, 62.7% express interest in provenance information, 56.7% are willing to pay for blockchain systems, and 59% are interested in tipping farmers. The study classifies benefits and drawbacks across nine dimensions, providing a comprehensive framework for understanding the multidimensional impacts of blockchain on the coffee supply chain. Full article

This study investigates the use of interpretable machine learning techniques to identify behavioral and demographic patterns associated with diabetes, based on structured population survey data from the Canadian Community Health Survey (CCHS). A decision tree classifier was applied to a dataset comprising $16,824$ respondents and 38 preprocessed features covering lifestyle, well-being, and sociodemographic factors. The model was optimized through grid search with five-fold stratified cross-validation, achieving a test accuracy of $61.3$% (mean $62.6$% ±$0.6$% across a $10\times 5$ repeated stratified cross-validation). Feature importance analysis revealed that age, alcohol consumption patterns, daily energy expenditure, and physical activity were the most influential factors associated with diabetes status, with the top three features exhibiting stable importance across all cross-validation folds. The model produced a set of 32 human-readable decision rules; a sensitivity analysis confirmed that these rules are stable across encoding choices and cross-validation folds. Several model variants were evaluated: a class-weighted decision tree, a logistic regression baseline, an age-only decision tree, and an age and sex logistic regression. The class-weighted model improved minority-class recall (from $0.25$ to $0.53$) at the cost of overall accuracy. A one-hot encoding sensitivity analysis showed that replacing ordinal label encoding of nominal variables with one-hot encoding produces virtually identical results (accuracy: $61.4$% vs. $61.3$%), confirming that the main rules are not artifacts of the encoding choice. Although the classification accuracy is moderate and not significantly better than a majority-class baseline (McNemar’s test, $p=0.455$), the extracted rules confirmed several known associations and revealed interactions between social and lifestyle variables. These rules are intended as hypothesis-generating population-level descriptors rather than validated clinical decision tools, and no causal inference is claimed. This approach demonstrates the value of rule-based models for exploratory public health research. Full article

Traditional olive groves are widely recognised as providers of landscape, environmental and cultural public goods in Mediterranean rural areas, but their long-term economic viability remains uncertain. This study assesses the income gap between traditional, intensive and super-high-density (SHD) olive-growing systems in a representative hill olive-growing area in Tuscany (central Italy), characterised by physical and structural conditions typical of traditional Mediterranean systems. Using a discounted cash-flow framework, the analysis compares long-term financial performance through standard investment appraisal indicators and uses the Equivalent Annual Value (EAV) as a policy-relevant benchmark for calibrating support. The results reveal a clear structural divergence: while intensive and SHD systems achieve higher profitability and faster capital recovery, the traditional system exhibits a persistent income disadvantage under market conditions. The estimated EAV gap amounts to approximately 950 €/ha relative to the intensive system and 3104 €/ha relative to the SHD system—values that represent the additional annual support required to preserve traditional olive groves and prevent abandonment. These values can also be interpreted as the annual private opportunity cost of maintaining traditional olive landscapes rather than converting them to more financially competitive systems. Break-even analysis further shows that the traditional system requires an oil price of at least 9.6 €/kg to achieve economic viability without public support, compared to 6.97 €/kg and 4.13 €/kg for the intensive and SHD systems, respectively. The findings highlight a structural misalignment between private profitability and social value, suggesting that the conservation of traditional olive landscapes cannot rely on market mechanisms alone and requires targeted, evidence-based policy instruments. Full article

Background: Alcohol use disorder (AUD) is a grave mental health condition that can result in significant health and social consequences. The medications Naltrexone and Nalmefene are indicated for the treatment of AUD, with Naltrexone having received the most extensive research attention. Methods: The majority of papers assessing universal measures of alcohol consumption employed two primary metrics: total alcohol consumption (TAC) and the number of days per month where individuals engaged in heavy drinking (HDD). Indicators pertaining to the maintenance of complete abstinence were excluded due to the absence of sufficient data. The safety of both substances was also assessed, as were the frequency of side effects and independent patient dropout. The study also incorporated practical factors of the therapy, such as the route of administration, dosage regimen, and the drug’s patient convenience, which can have a significant impact on adherence to therapy. Results: Nalmefene, administered in an “as needed” regimen, demonstrated statistically significant activity in reducing HDD and total alcohol consumption (TAC) among patients with AUD, particularly those with elevated World Health Organization (WHO) DRL risk. Preliminary findings from the ESENSE1 (Efficacy of Nalmefene in Alcohol Dependence; the first phase III study), ESENSE 2 (Efficacy of Nalmefene in Alcohol Dependence, the second phase III study), and SENSE (the final phase III long term-safety and cost-effectiveness study) studies indicate a substantial decrease in HDD and TAC following the initial month of treatment. These effects persist throughout the subsequent follow-up period. Several Japanese studies have corroborated the effectiveness of Nalmefene, demonstrating its efficacy across both short-term and long-term applications. Furthermore, these studies have substantiated its safety profile, indicating that there is no inherent risk of addiction or the emergence of withdrawal symptoms. The mild nature of adverse events (most commonly nausea and dizziness) led to a relatively low discontinuation rate of Nalmefene treatment. A subsequent study, employing a recognized methodology, corroborated the efficacy of psychosocial support in enhancing treatment outcomes. Meta-analyses demonstrate that Naltrexone exhibits comparable efficacy in reducing the frequency and severity of alcohol consumption. In select populations, the injectable form (LAI) of this pharmaceutical agent facilitates less frequent dosing, which is advantageous for the treatment process. A comparison of Nalmefene and Naltrexone reveals that the latter does not demonstrate a significant impact on the likelihood of individuals returning to heavy alcohol consumption. Conclusions: In the treatment of AUD, both naltrexone and nalmefene have been shown to yield positive outcomes, particularly in terms of reducing the HDD and TAC. According to the World Health Organization (WHO) classification, Nalmefene is indicated for individuals with a high risk of developing serious conditions. It has been demonstrated to produce rapid and sustained results while exhibiting a favorable safety profile, characterized by the absence of significant adverse effects. Naltrexone is a medication that has proven to be effective. LAI may have a positive impact on the efficacy of treatment. Full article

Achieving carbon-neutral cities requires innovative strategies that integrate technological carbon capture, sustainable urban infrastructure, and proactive public engagement. While microalgae-based systems have shown promise for CO₂ sequestration and resource recovery, their scalability remains constrained by high costs and energy-intensive photobioreactor (PBR) designs. Here, we propose the retrofit of existing urban fountains into high-efficiency microalgae cultivation systems—microalgae-enhanced fountain landscapes—as an integrated solution that bridges ecological function and social outreach. This approach capitalizes on ubiquitous fountain infrastructure to minimize deployment costs, employs advanced fountain-style cultivation technology to enhance biomass productivity, and leverages strategic locations in high-footfall urban zones to actively elevate public carbon literacy and motivate low-carbon behavioral shifts through immersive engagement—a vital step toward city-wide participatory climate action. We critically analyze the feasibility of this system, highlighting its potential for multi-stakeholder value creation across developers, municipalities, and citizens. Furthermore, we synthesize recent advances in suspended microalgae cultivation, building-integrated PBRs, and microalgae-informed landscape design to contextualize the development pathway of fountain-based systems. By uniting technical efficiency with civic education, this work establishes a replicable framework for scalable urban deployment—simultaneously advancing carbon mitigation, public awareness, and circular resource flows in the transition toward climate-resilient cities. Full article

Oral health problems among older adults represent a growing public health concern due to increasing life expectancy and treatment needs. This study aimed to assess dental treatment needs and cost burden within the context of oral health policies. This retrospective study included anonymized data from 250 patients aged ≥65 years (F/M: 121/129; 65–89 years). Sociodemographic characteristics, treatment needs, and costs were obtained from the Hospital Information Management System (HIMS). Costs were adjusted to 2025 Turkish lira values using the Consumer Price Index and converted to international dollars using purchasing power parity (PPP). Patients were classified by total treatment costs using K-means cluster analysis. Periodontal (61.2%), restorative (36.0%), and endodontic (41.2%) treatment needs, which are largely preventable through oral hygiene practices, were more frequent among patients with a lower mean age, whereas tooth loss and prosthodontic treatment needs (89.6%) increased with mean age. Cluster analysis identified two groups: a low-cost group (67.6%) and a high-cost group (32.4%). The high-cost group had a lower mean age (68.84 ± 4.27 years) compared to the low-cost group (70.73 ± 5.18 years), indicating that relatively younger patients needed more complex and costly treatments. Out-of-pocket payments were notable for prosthodontic and surgical treatments, although Social Security Institution (SSI) payments constituted most of the costs. Preventive and early dental care strategies are essential to reduce treatment complexity and cost burden among older adults within the framework of oral health policy. Full article

Aquatic environments that support tourism, including coasts, lakes, reservoirs, and estuaries, are experiencing accelerating eutrophication worldwide. This trend increases the frequency and intensity of algal blooms. These blooms undermine ecosystem services and weaken the socio-economic performance of destination areas. Despite these challenges, existing research remains fragmented. Aquatic sciences mainly examine nutrient enrichment and bloom dynamics. In contrast, tourism studies often treat blooms as episodic disturbances and rarely integrate exposure pathways, risk communication, or feedback to destination governance. This review synthesizes evidence across freshwater and marine systems to develop a coupled tourism–water ecosystem perspective. We link eutrophication drivers and bloom typologies to three dimensions. These are the degradation of tourism-supporting ecosystem services, compound health stressors, and communication filters. The first includes losses of water clarity and aesthetic value. The second involves multi-route exposure through contact, inhalation, and seafood ingestion. The third shapes perceived safety, trust, and behavioral adaptation. We further connect perceived health risks to observable tourist behaviors, including cancellation, destination substitution, and activity avoidance. These micro-level responses can aggregate into market-level demand contractions and consumption reallocation. They can also trigger regional economic cascades, including public management costs, employment impacts, and long-term reputational damage. Crucially, tourism is not merely a victim of blooms. It can also act as a reinforcing anthropogenic driver through wastewater burdens, infrastructure expansion, and pulse pressures. These pressures lower ecological resilience, especially under warming and hydrological stabilization. Finally, we identify governance leverage points. These include early-warning systems, threshold-based graded interventions, transparent risk communication, and integrated social–ecological modeling. These strategies can reduce uncertainty-driven losses and support adaptive destination management. Overall, this review reframes algal blooms as systemic social–ecological risks. It provides a structured basis for future empirical attribution and policy design in tourism-dependent waters under climate stress. Full article