Search Results (1,031)

Nowadays, the circular economy is driving the construction industry towards greater sustainability for both environmental and financial purposes. One prominent area of research with significant contributions to circular economy is the reuse of steel from decommissioned structures in new construction projects. This approach is deemed far more efficient than ordinary steel recycling, due to the fact that it contributes towards reducing both the cost of the new project and the associated carbon emissions. Along these lines, the feasibility of utilizing steel wind turbine towers (WTTs) as part of a new structure is investigated herein, considering that wind turbines are decommissioned after a nominal life of approximately 25 years due to fatigue limitations. General principles of structural steel reuse are first presented in a systematic manner, followed by two case studies. Realistic data about the geometry and cross-sections of previous generation models of WTTs were obtained from the Greek Center for Renewable Energy Sources and Savings (CRES), including drawings and photographic material from their demonstrative wind farm in the area of Keratea. A specific wind turbine was selected that is about to exceed its life expectancy and will soon be decommissioned. Two alternative applications for the reuse of the tower were proposed and analyzed, with emphasis on the structural aspects. One deals with the use of parts of the tower as a small-span pedestrian bridge, while the second addresses the transformation of a tower section into a water storage tank. Several decision factors have contributed to the selection of these two reuse scenarios, including, amongst others, the geometric compatibility of the decommissioned wind turbine tower with the proposed applications, engineering intuition about the tower having adequate strength for its new role, the potential to minimize fatigue loads in the reused state, the minimization of cutting and joining processes as much as possible to restrain further CO₂ emissions, reduction in waste material, the societal contribution of the potential reuse applications, etc. The two examples are briefly presented, aiming to demonstrate the concept and feasibility at the preliminary design level, highlighting the potential of decommissioned WTTs to find proper use for their future life. Full article

Background: Social and financial services are essential for the inclusion and well-being of people with disabilities (PWDs), who often rely on family caregivers to access these systems. In Saudi Arabia, where disability inclusion is a strategic goal under Vision 2030, understanding caregiver experiences is crucial to identifying service gaps and improving accessibility. Objectives: This study aimed to explore caregivers’ perspectives on awareness, perceived barriers, and accessibility of social and financial services for PWDs in Saudi Arabia. The analysis is grounded in Andersen’s Behavioural Model of Health Service Use and the WHO’s International Classification of Functioning, Disability and Health (ICF) framework. Methods: A cross-sectional survey was conducted with 3353 caregivers of PWDs attending specialised day schools. The survey collected data on demographic characteristics, service awareness, utilisation, and perceived obstacles. Exploratory Factor Analysis (EFA) identified latent constructs, and Structural Equation Modelling (SEM) was used to test relationships between awareness, barriers, and accessibility. Results: Findings reveal that over 70% of caregivers lacked awareness of available services, and only about 3% had accessed them. Key challenges included technological barriers, complex procedures, and non-functional or unclear service provider platforms. Both User Barriers and Service Barriers were negatively associated with Awareness and Accessibility. Awareness, in turn, significantly predicted perceived Accessibility. Caregiver demographics, such as age, education, gender, and geographic location, also influenced awareness and service use. Conclusions: There is a pressing need for targeted awareness campaigns, accessible digital service platforms, and simplified service processes tailored to diverse caregiver profiles. Inclusive communication, decentralised outreach, and policy reforms are necessary to enhance service access and promote the societal inclusion of PWDs in alignment with Saudi Arabia’s Vision 2030. Full article

Background: Brain health is a growing public health priority due to the high global burden of neurological and mental disorders. Promoting brain health across the lifespan supports individual and societal well-being, creativity, and productivity. Objective: To address the need for specialized education in this field, the University of Bern developed a Certificate of Advanced Studies (CAS) in Brain Health. This article outlines the program’s rationale, structure, and goals. Program Description: The one-year, 15 ECTS-credit program is primarily online and consists of four modules: (1) Introduction to Brain Health, (2) Brain Disorders, (3) Risk Factors, Protective Factors and Interventions, and (4) Brain Health Implementation. It offers a multidisciplinary, interprofessional, life-course approach, integrating theory with practice through case studies and interactive sessions. Designed for healthcare and allied professionals, the CAS equips participants with skills to promote brain health in clinical, research, and public health contexts. Given the shortage of trained professionals in Europe and globally, the program seeks to build a new generation of brain health advocates. It aims to inspire action and initiatives that support the prevention, early detection, and management of brain disorders. Conclusions: The CAS in Brain Health is an innovative educational response to a pressing global need. By fostering interdisciplinary expertise and practical skills, it enhances professional development and supports improved brain health outcomes at individual and population levels. Full article

Background: The dual nature of cannabis, as both a promising therapeutic tool and a widely used recreational substance with potential risks, raises important societal controversies, including its unclear impacts regarding mental health. This narrative review provides a comprehensive overview of cannabis, addressing (i) its historical context; (ii) its chemical composition and pharmacokinetics; (iii) its pharmacological effects; (iv) its negative impacts on physiological and mental health; (v) its potential use as a drug for the treatment of neurological and psychiatric disorders; (vi) its relationship with the gut microbiome and how this interaction might influence mental functioning; (vii) the pathophysiology, prevalence, comorbidities, and treatment strategies of cannabis use disorder; and (viii) social perspectives on its legalization. Results: Cannabis presents a complex chemical profile and pharmacokinetics that show promise in treating numerous neurological, psychiatric, and psychological conditions. However, its use carries risks, which depend on factors such as compound concentration, dosage, consumption method, frequency of use, and individual vulnerability. Cannabis use disorder seems to be less severe than other substance use disorders, but it still constitutes a significant concern, as its manifestation is not uniform across all users. Conclusions: Cannabis demands a thorough understanding that goes beyond simplistic explanations and prejudices, standing as a plant of substantial clinical significance and highlighting the importance of personalized approaches to its use and increased awareness of how individuals respond to its effects. Full article

In this study, we examine the impact of mergers and acquisitions (M&As) on firm environmental performance, aiming to address the gap in research and guide firms, investors, and policymakers toward more environmentally conscious decision-making in M&A. Using panel data from Chinese A-share listed firms (2008–2022), we estimate a two-way fixed effect model. The Propensity Score Matching and the instrumental variable method address potential endogeneity concerns, and robustness checks validate the findings. We found that M&As have a significantly positive effect on firm environmental performance, with heterogeneous impacts across regions, industries, and M&A types. The environmental benefits are most pronounced in heavily polluting industries and hybrid M&A deals. Eastern China shows more modest improvements. The results of mechanism tests revealed that M&As enhance environmental performance primarily by boosting total factor productivity and fostering innovation. This study offers a novel perspective by linking M&A activities to environmental sustainability, enriching the literature on both M&As and corporate environmental performance. We show that even conventional M&A deals (not sustainability-focused) can improve environmental performance through operational synergies. Expanding beyond polluting industries, we reveal how sector characteristics shape M&A’s environmental impacts. We identify practical mechanisms through which standard M&A activities can advance sustainability goals, helping firms balance economic and environmental objectives. It provides empirical evidence from China, an emerging market with distinct institutional and regulatory contexts. The findings offer guidance for firms engaging in M&A to strategically improve sustainability performance. Policymakers can leverage these insights to design incentives for M&A in pollution-intensive industries, aligning economic growth with environmental goals. By demonstrating that M&As can enhance environmental outcomes, this study supports the potential for market-driven mechanisms to contribute to broader societal sustainability objectives, such as reduced industrial pollution and greener production practices. Full article

Background/Objectives: Neurodegenerative proteinopathies, such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and dementia with Lewy bodies (DLB), are increasingly prevalent worldwide mainly due to population aging. These conditions are marked by complex etiologies, overlapping pathologies, and progressive clinical decline, with significant consequences for patients, caregivers, and healthcare systems. This review aims to synthesize evidence on the healthcare complexities of major neurodegenerative proteinopathies to highlight current knowledge gaps, and to inform future care models, policies, and research directions. Methods: We conducted a comprehensive literature search in PubMed/MEDLINE using combinations of MeSH terms and keywords related to neurodegenerative diseases, proteinopathies, diagnosis, sex, management, treatment, caregiver burden, and healthcare delivery. Studies were included if they addressed the clinical, pathophysiological, economic, or care-related complexities of aging-related neurodegenerative proteinopathies. Results: Key themes identified include the following: (1) multifactorial and unclear etiologies with frequent co-pathologies; (2) long prodromal phases with emerging biomarkers; (3) lack of effective disease-modifying therapies; (4) progressive nature requiring ongoing and individualized care; (5) high caregiver burden; (6) escalating healthcare and societal costs; and (7) the critical role of multidisciplinary and multi-domain care models involving specialists, primary care, and allied health professionals. Conclusions: The complexity and cost of neurodegenerative proteinopathies highlight the urgent need for prevention-focused strategies, innovative care models, early interventions, and integrated policies that support patients and caregivers. Prevention through the early identification of risk factors and prodromal signs is critical. Investing in research to develop effective disease-modifying therapies and improve early detection will be essential to reducing the long-term burden of these disorders. Full article

On 20 April 2024, an extreme rainfall event occurred in Jiangwan Town Shaoguan City, Guangdong Province, China, where a historic 24 h precipitation of 206 mm was recorded. This triggered extensive landslides that destroyed residential buildings, severed roads, and drew significant societal attention. Rapid acquisition of landslide inventories, distribution patterns, and key controlling factors is critical for post-disaster emergency response and reconstruction. Based on high-resolution Planet satellite imagery, landslide areas in Jiangwan Town were automatically extracted using the Normalized Difference Vegetation Index (NDVI) differential method, and a detailed landslide inventory was compiled. Combined with terrain, rainfall, and geological environmental factors, the spatial distribution and causes of landslides were analyzed. Results indicate that the extreme rainfall induced 1426 landslides with a total area of 4.56 km², predominantly small-to-medium scale. Landslides exhibited pronounced clustering and linear distribution along river valleys in a NE–SW orientation. Spatial analysis revealed concentrations on slopes between 200–300 m elevation with gradients of 20–30°. Four machine learning models—Logistic Regression, Support Vector Machine (SVM), Random Forest (RF), and Extreme Gradient Boosting (XGBoost)—were employed to assess landslide susceptibility mapping (LSM) accuracy. RF and XGBoost demonstrated superior performance, identifying high-susceptibility zones primarily on valley-side slopes in Jiangwan Town. Shapley Additive Explanations (SHAP) value analysis quantified key drivers, highlighting elevation, rainfall intensity, profile curvature, and topographic wetness index as dominant controlling factors. This study provides an effective methodology and data support for rapid rainfall-induced landslide identification and deep learning-based susceptibility assessment. Full article

Traffic-related pollutants remain a challenging global issue, with significant policy implications. Within the European Union, Romania has the highest yearly societal cost per capita due to air pollution, which kills 29,000 Romanians every year, whereas the health and economic costs are also significant. In this context, municipal authorities in the country, particularly in high-density areas, should place a strong focus on mitigating air pollution. In particular, the capital city, Bucharest, ranks among the most congested cities in the world while registering the highest pollution index in Romania, with traffic pollution responsible for two-thirds of its air pollution. Consequently, studies that assess and model pollution trends are paramount to inform local policy-making processes and assist pollution-mitigation efforts. In this paper, a generalized additive modeling (GAM) framework is employed to model hourly concentrations of nitrogen dioxide (NO₂), i.e., a relevant traffic-pollution proxy, at a busy urban traffic location in central Bucharest, Romania. All models are developed on a wide, fine-granularity dataset spanning January 2017–December 2022 and include extensive meteorological covariates. Model robustness is assured by switching between the generalized additive model (GAM) framework and the generalized additive mixed model (GAMM) framework when the residual autoregressive process needs to be specifically acknowledged. Results indicate that trend GAMs explain a large amount of the hourly variation in traffic pollution. Furthermore, meteorological factors contribute to increasing the models’ explanation power, with wind direction, relative humidity, and the interaction between wind speed and the atmospheric pressure emerging as important mitigators for NO₂ concentrations in Bucharest. The results of this study can be valuable in assisting local authorities to take proactive measures for traffic pollution control in the capital city of Romania. Full article

Background/Objectives: In late 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused a pandemic called the ‘coronavirus disease 2019’ (COVID-19). After the acute SARS-CoV-2 infection, many individuals (up to 33%) complained of unexplained symptoms involving multiple organ systems and were diagnosed as having Long COVID-19 (LC-19). Currently, LC-19 is inadequately defined, requiring the formation of consistent diagnostic parameters to provide a foundation for ongoing and future studies of epidemiology, risk factors, clinical characteristics, and therapy. LC-19 represents a significant burden on multiple levels. The reduced ability of workers to return to work or compromised work efficiency has led to consequences at national, economic, and societal levels by increasing dependence on community services. On a personal scale, the isolation and helplessness caused by the disease and its subsequent impact on the patient’s mental health and quality of life are incalculable. Methods: In this paper, we used Walker and Avants’ eight-step approach to perform a concept analysis of the term “Long COVID-19” and define its impact across these parameters. Results: Using this methodology, we provide an improved definition of LC-19 by connecting the clinical symptomology with previously under-addressed factors, such as mental, psychological, economic, and social effects. This definition of LC-19 features can help improve diagnostic procedures and help plan relevant healthcare services. Conclusions: LC-19 represents a complex and pressing public health challenge with diverse symptomology, an unpredictable timeline, and complex pathophysiology. This concept analysis serves as a tool for improving LC-19 definition, but it remains a dynamic disease with evolving diagnostic and therapeutic approaches, requiring deeper investigation and understanding of its long-term effects. Full article

Obstructive sleep apnea (OSA) is a prevalent and heterogeneous sleep disorder associated with significant health and societal burdens. While continuous positive airway pressure (CPAP) remains the gold standard treatment, its limitations in adherence and patient tolerance have highlighted the need for alternative therapies. Positional therapy (PT), which targets apneas that occur predominantly in the supine position, has emerged as a promising option for individuals with positional OSA (POSA). This narrative review synthesizes the current literature on PT, examining its clinical indications, typologies, comparative efficacy with CPAP, oral appliances, and hypoglossal nerve stimulation, as well as data on adherence and barriers to long-term use. Traditional methods such as the tennis ball technique have largely been replaced by modern vibrotactile devices, which demonstrate improved comfort, adherence, and comparable short-term outcomes in selected POSA subjects. While PT remains inferior to CPAP in reducing overall AHI and oxygen desaturation, it performs favorably in terms of mean disease alleviation (MDA) and sleep continuity. Importantly, treatment effectiveness is influenced by both anatomical and non-anatomical traits, underscoring the need for accurate phenotyping and individualized care. PT should be considered within a broader patient-centered model that incorporates preferences, lifestyle, and motivational factors. Further research is needed to validate long-term efficacy, optimize selection criteria, and integrate PT into personalized OSA management strategies. Full article

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, progressive form of pre-capillary pulmonary hypertension characterized by persistent, organized thromboemboli in the pulmonary vasculature, leading to vascular remodeling, elevated pulmonary artery pressures, right heart failure, and significant morbidity and mortality if untreated. Despite advances, CTEPH remains underdiagnosed due to nonspecific symptoms and overlapping features with other forms of pulmonary hypertension. Basic Methodology: This review synthesizes data from large international registries, epidemiologic studies, translational research, and multicenter clinical trials. Key methodologies include analysis of registry data to assess incidence and risk factors, histopathological examination of lung specimens, and molecular studies investigating endothelial dysfunction and inflammatory pathways. Diagnostic modalities and treatment outcomes are evaluated through observational studies and randomized controlled trials. Recent Advances and Affected Population: Research has elucidated that CTEPH arises from incomplete resolution of pulmonary emboli, with subsequent fibrotic transformation mediated by dysregulated TGF-β/TGFBI signaling, endothelial dysfunction, and chronic inflammation. Affected populations are typically older adults, often with prior venous thromboembolism, splenectomy, or prothrombotic conditions, though up to 25% have no history of acute PE. The disease burden is substantial, with delayed diagnosis contributing to worse outcomes and higher societal costs. Microvascular arteriopathy and PAH-like lesions in non-occluded vessels further complicate the clinical picture. Conclusions: CTEPH is now recognized as a treatable disease, with multimodal therapies—surgical endarterectomy, balloon pulmonary angioplasty, and targeted pharmacotherapy—significantly improving survival and quality of life. Ongoing research into molecular mechanisms and biomarker-driven diagnostics promises earlier identification and more personalized management. Multidisciplinary care and continued translational investigation are essential to further reduce mortality and optimize outcomes for this complex patient population. Full article

Under the dual pressures of global climate warming and rapid urbanization, the Yangtze River Basin, as the world’s largest urban agglomeration, is facing intensifying thermal environmental stress. Although river ecosystems demonstrate significant thermal regulation functions, their spatial thresholds of cooling effects and multiscale driving mechanisms have remained to be systematically elucidated. This study retrieved land surface temperature (LST) using the split window algorithm and quantitatively analyzed the changes in the river cold island effect and its driving mechanisms in the Yangtze River Basin by combining multi-ring buffer analysis and the optimal parameter-based geographical detector model. The results showed that (1) forest land is the main land use type in the Yangtze River Basin, with built-up land having the largest area increase. Affected by natural, socioeconomic, and meteorological factors, the summer temperatures displayed a spatial pattern of “higher in the east than the west, warmer in the south than the north”. (2) There are significant differences in the cooling magnitude among different land types. Forest land has the maximum daytime cooling distance (589 m), while construction land has the strongest cooling magnitude (1.72 °C). The cooling effect magnitude is most pronounced in upstream areas of the basin, reaching 0.96 °C. At the urban agglomeration scale, the Chengdu–Chongqing urban agglomeration shows the greatest temperature reduction of 0.90 °C. (3) Elevation consistently demonstrates the highest explanatory power for LST spatial variability. Interaction analysis shows that the interaction between socioeconomic factors and elevation is generally the strongest. This study provides important spatial decision support for formulating basin-scale ecological thermal regulation strategies based on refined spatial layout optimization, hierarchical management and control, and a “natural–societal” dual-dimensional synergistic regulation system. Full article

Background: Since the introduction of Pasteur’s rabies vaccine in 1885, rabies prophylaxis and post-exposure prophylaxis (PEP) have been widely administered globally under the recommendation of the World Health Organization (WHO). However, 124 documented cases of PEP failure had been reported worldwide between 1980 and 2023. Additionally, sporadic media reports from China showed occasional PEP failures between 2017 and 2024. Rabies remains a serious public health problem in over 150 countries and regions. Methods: In this review, we summarize PEP procedures recommended by the Advisory Committee on Immunization Practices (ACIP) and the WHO. We also analyze potential contributing factors to PEP failure, propose a concept of circulating antibodies, and discuss their roles in PEP. Furthermore, we summarize key guidelines for clinical trial design from the U.S. Food and Drug Administration (FDA) and China’s Center for Drug Evaluation (CDE), as well as the latest developments in monoclonal antibody (cocktail) therapies. Results: Adherence to core PEP practices, such as wound cleansing, infiltration of wounds with immunoglobulin (mAbs), and administration of vaccines, and broader societal involvement are crucial for preventing rabies infection in most cases. For high-risk exposures or immunocompromised individuals, the provision of circulating antibodies through high-dose human rabies immune globulin (HRIG) or mAbs is of utmost importance for preventing PEP failure. Conclusions: Early, high-concentration circulating antibodies are important for preventing PEP failure. Addressing the global issue of rabies requires involvement of the entire society. Only through collective efforts can we tackle this neglected disease and achieve WHO’s goal of “zero by 30”. Full article

Chemical, biological, radiological, and nuclear (CBRN) incidents pose significant challenges requiring swift, coordinated responses to safeguard public health. This is especially the case in densely populated urban areas, where the public is not only at risk but can also be of assistance. Public cooperation is critical to the success of mass decontamination efforts, yet prior research has primarily focused on technical and procedural aspects, neglecting the psychological and social factors driving casualty behaviour. This paper addresses this gap through a narrative literature review, chosen for its flexibility in synthesising fragmented and interdisciplinary research across psychology, sociology, and emergency management. The review identified two primary pathways influencing casualty decision making: rational and affective. Rational pathways rely on deliberate decisions supported by clear communication and trust in responders’ competence, while affective pathways are shaped by emotional responses like fear and anxiety, exacerbated by uncertainty. Trust emerged as a critical factor, with effective —i.e., transparent, empathetic, and culturally sensitive— communication being proven to enhance public cooperation. Cultural and societal norms further shape individual and group responses during emergencies. This paper demonstrates the value of narrative reviews in addressing a complex, multifaceted topic such as casualty behaviour, enabling the integration of diverse insights. By emphasising behavioural, psychological, and social dimensions, the results of this paper offer actionable strategies for emergency responders to enhance public cooperation and improve outcomes during CBRN incidents. Full article