Search Results (8,535)

Background: Supply chain management (SCM) research has expanded across the Middle East and North Africa (MENA), yet the field remains fragmented. Limited synthesis exists on how regional conditions shape research themes, theories, and methods. Methods: This study applies the PRISMA 2020 protocol to review SCM articles indexed in Scopus and Web of Science from January 2000 to March 2025. After screening and eligibility assessment, 512 peer-reviewed studies were retained. Bibliometric mapping and thematic coding were used to identify publication trends, research streams, theoretical lenses, and methodological patterns. Results: SCM research increased sharply after 2015, reflecting national diversification agendas, logistics reform, digitalization, and exposure to global supply chain disruptions. Three dominant streams were identified: resilience, sustainability, and digital transformation. Research output is concentrated in Saudi Arabia and the United Arab Emirates, while cross-country comparative studies remain scarce. Empirical studies rely mainly on cross-sectional surveys and SEM-based analysis, with limited longitudinal, qualitative, mixed-method, and comparative work across the region. Conclusions: The study develops an integrative SCM capability framework linking regional structural conditions, capability development, and supply chain outcomes. The findings support managers and policymakers seeking resilient, sustainable, and digitally enabled supply chains, and define clear future research priorities for the MENA region. Full article

The common root characteristic of CO₂ and air pollutants in the power industry, both derived from fossil fuel combustion, provides a natural basis for their synergistic emission reduction. However, existing studies suffer from the lack of a multi-pollutant synergistic evaluation system and an imperfect emission reduction technology database, which hinder their ability to support low-cost and high-efficiency emission reduction practices in the industry. Targeting the minimization of synergistic emission reduction costs and the maximization of emission reduction effects, this study integrated the process and economic parameters of 11 power generation technologies and 55 pollutant control technologies to establish a full-chain energy conservation and emission reduction technology database for the power industry, through literature research, industry surveys, and data mining. Based on the definition of pollution equivalent in the Environmental Protection Tax Law, we innovatively developed an air pollutant equivalent normalization evaluation method and constructed a two-dimensional coordinate system comprehensive evaluation system for CO₂ and air pollutants, enabling quantitative analysis and visual evaluation of the synergistic emission reduction effects of various technologies. The results show that new energy power generation technologies such as nuclear power and wind power, as well as O₂/CO₂ cycle combustion, ammonia-based desulfurization, and SNCR-SCR combined reduction technologies, exhibit excellent synergistic emission reduction performance for CO₂ and multiple pollutants. In contrast, some conventional pollutant control technologies, such as the limestone-gypsum method and traditional electrostatic precipitation, have significant CO₂ emission increase antagonistic effects. This study also completed the two-dimensional classification of 66 emission reduction technologies based on “emission reduction efficiency-economic cost”, identified application scenarios for different types of technologies, and proposed optimized paths for synergistic emission reduction adapted to the development of the power industry. The research findings fill the gap in quantitative standards for multi-pollutant synergistic emission reduction, provide theoretical support and detailed technical references for emission reduction technology selection and environmental policy formulation in the power industry, and help the industry achieve the dual development requirements of the “double carbon” goal and air quality improvement. Full article

Background/Objectives: There is growing interest among researchers in improved biological risk factor indices or combinations of indices, which have emerged as a major focus in evaluating the risk of cardiovascular disease (CVD). This study aimed to identify latent profiles based on the clustering of biological factors and to explore associations between lifestyle factors and CVD outcomes across the identified latent profiles. Methods: This epidemiological health survey was performed during 2023–2024. A random sample of Kaunas inhabitants aged 25–69 years, stratified by sex and age, was randomly selected from the Lithuanian population register. The 3426 individuals were screened. Latent profile analysis was performed using Latent Gold 6.1 and IBM SPSS Statistics 30. Multinomial logistic regression and multivariable binary logistic regression were used to evaluate the associations between biological risk factor profiles, lifestyle factors, and CVD outcome. Results: Three biological risk factor profiles were identified: low-risk profile (42.6%) was considered the healthiest, having the lowest levels of body mass index (BMI), fasting glucose, systolic blood pressure (SBP), and the highest level of high-density lipoprotein (HDL) cholesterol. Medium-risk profile (50.4%), having intermediate indicators of those factors. The high-risk profile (7.0%) was characterized by the lowest HDL cholesterol and the highest values of triglycerides, fasting glucose, SBP, and BMI. Conclusions: Compared to the low-risk profile, medium- and high-risk biological profiles were independently associated with higher odds of CVD, according to sociodemographic and lifestyle factors. The study suggests that integrating multiple biological risk factors rather than a single risk factor in clinical practice may enhance diagnostic accuracy. Full article

Biometric sensing systems enable accurate identity recognition using unique physiological traits. These systems can be unimodal (single trait) or multimodal (multiple traits, such as iris and fingerprint). Biometric templates, digital representations of these traits, enhance security over traditional methods but are vulnerable to attacks. Unlike passwords, compromised templates cannot be replaced, necessitating robust protection. Various security schemes exist, including cancellable biometrics, biometric cryptosystems, sensing technology, and biometrics in the encrypted domain. Cancellable biometrics apply transformations, such as biometric salting, to obscure the original data. Biometric cryptosystems integrate cryptographic techniques, including key generation and key binding, to enhance security. Biometrics in the encrypted domain, such as homomorphic encryption, ensures data remains encrypted during storage and computation. This survey focuses on the fuzzy vault method, a key-binding biometric cryptosystem. It analyses its applications, security performance, and associated challenges across different domains. By analysing advancements in fuzzy vault mechanisms, this paper provides insights into enhancing sensor-based biometric security. The study aims to serve as a reference for researchers exploring secure and efficient biometric authentication methods, ensuring robust protection against unauthorised access while maintaining the integrity and usability of biometric data in real-world applications. Full article

Background: Mucopolysaccharidosis type II (MPS II; Hunter syndrome) is a rare X-linked lysosomal storage disorder caused by pathogenic variants in the iduronate-2-sulfatase gene, leading to progressive multisystem involvement. Although international management guidelines exist, challenges in their implementation across different healthcare systems remain insufficiently addressed. This study aimed to establish a national expert consensus in Türkiye on the treatment and management of MPS II, aligning local practice with international standards. Methods: A modified Delphi methodology was conducted using two rounds of online surveys supported by three steering committee meetings. The process involved 10 experienced clinicians and a scientific committee of six professors. Based on international guidelines and country-specific clinical challenges, 72 consensus statements and 84 exploratory questions were developed. Statements achieving ≥ 80% agreement were accepted as consensus. Results: Consensus supported initiating enzyme replacement therapy (ERT) in both severe and attenuated MPS II, guided by functional and cognitive status. Severe cognitive impairment was not considered an exclusion criterion for ERT, given its somatic benefits. Experts agreed on continuing ERT into adulthood with individualized discontinuation decisions. Routine evaluations every 6–12 months, including respiratory, cardiac, and neurocognitive assessments, were recommended. Additional consensus areas included individualized premedication strategies, structured transition to adult care, selective home infusion, annual patient-reported outcome assessments, and the establishment of a national MPS II registry. Hematopoietic stem cell transplantation was not endorsed. Conclusions: This Delphi study demonstrates strong expert consensus on MPS II management in Türkiye, providing a practical framework to guide clinical practice, support alignment with international recommendations, and inform future policy and research priorities. Full article

Small and Medium-sized Enterprises (SMEs) are central to the industrial fabric of Sub-Saharan Africa (SSA). Yet, they confront increasing demands to implement sustainability practices originating from institutional contexts markedly different from their own. Existing research has tended to neglect the cultural and institutional negotiations inherent in this process, often framing sustainability adoption as a technical or compliance-oriented exercise rather than as a multifaceted cultural adaptation. This study proposes and empirically examines the concept of sustainability acculturation—the process by which firms align global sustainability norms with local business cultures. Drawing on Institutional Theory, the Resource-Based View, and Berry’s Acculturation Model, we present a context-specific framework, tested using a sequential explanatory mixed-methods approach: survey data from 284 manufacturing SMEs across six SSA countries, followed by 24 semi-structured interviews. Structural equation modeling reveals that international market pressure and owner–manager values are direct drivers, whereas local regulatory pressure exhibits only a weak association with deep cultural integration. Managerial commitment and organizational learning mediate these relationships, while Ubuntu values enhance social sustainability integration, and institutional voids diminish regulatory effectiveness. The model accounts for 57% of the variance in sustainability acculturation. Findings show that SSA SMEs employ distinct acculturation strategies—Integration, Assimilation, Resilient Adaptation, and Decoupling—shaped by the interplay of external pressures, internal capabilities, and contextual conditions. The study underscores the importance of culturally attuned, context-specific interventions for sustainable industrial development in SSA. Full article

Background/Objectives: There is a limited body of research on evidence-based food literacy education for adolescents. The inquiry-based curriculum, Teens CAN: Comprehensive Food Literacy in Cooking, Agriculture, and Nutrition, was designed to improve food literacy among adolescents ages 14–18 years. This study aimed to assess the Teens CAN curriculum by examining changes in food literacy outcomes among high school–aged adolescents and explore the effectiveness of undergraduate facilitators in implementing the curriculum with fidelity. Methods: This quasi-experimental pilot study was conducted among high school students comprising intervention (n =14) and comparison groups (n = 16). All Teens CAN lessons were delivered by trained undergraduate facilitators, and lesson fidelity was measured by a trained observer. Baseline and follow-up survey measures assessed various components of food literacy, including adolescent nutrition knowledge, diet quality, and intrinsic motivation to prepare healthy food (cooking self-efficacy). Between-group differences were examined using t-tests, and ANCOVA regression models assessed associations between changes in baseline to follow-up nutrition knowledge, diet quality, and cooking self-efficacy, adjusting for baseline values. Results: The adolescents in the intervention group had a significant increase in nutrition knowledge scores compared to the comparison group (4.6 ± 2.3 vs. 1.1 ± 3.7, respectively; p = 0.01). High fidelity (≥80%) was achieved across lessons and lesson components. In ANCOVA regression analyses, participation in the intervention was positively associated with nutrition knowledge (β = 3.3, 95% CI [0.87–5.80]; p = 0.01), providing evidence for future investigation. Conclusions: The findings from this pilot study suggest that Teens CAN has the potential to positively influence food literacy and related behaviors among adolescents, therefore warranting further investigation in a larger population. Full article

Background: The Danish National Survey of Diet and Physical Activity (DANSDA) is Denmark’s national dietary surveillance system, providing population-level data to support evidence-based government advisory tasks and policymaking, research, and education. Methods: DANSDA 2021–2024 is a cross-sectional survey based on a simple random sample of citizens aged 4–80 years from the Danish Civil Registration System. Home visits included structured interviews covering socio-economic status, family composition, ethnicity, lifestyle behaviors and attitudes, health and non-communicable diseases, dietary supplement use, and measurements of anthropometrics and blood pressure. Dietary intake was recorded using a digital or paper-based seven-day food record and a food frequency questionnaire. Physical activity was measured with a pedometer and a seven-day step diary. Participants aged 40–70 years were offered blood sampling for glucose and lipid analyses. Results: A total of 4223 individuals participated, with 3824 providing valid food records (97.4% were digital). The response rate was 26.3%. The overall underreporting rate was 24%. The sample was skewed by age, education, income, household type, and region; these variables and sex were used to generate weighting factors. Nearly 1000 blood samples were analyzed for glucose and lipids, with surplus material stored in a biobank. Conclusions: DANSDA 2021–2024 provides comprehensive data on diet, physical activity, anthropometry, blood pressure, and blood glucose and lipids. Despite declining response rates and underrepresentation of individuals with lower education and income, weighting procedures support its continued use for national monitoring and research. Strengthening participation and representativeness should be a priority in future survey cycles. Full article

Understanding human–nature–animal relationships is central to conservation and visitor management, yet these relationships are commonly studied through language-based surveys that may exclude participants across age groups and diverse cultural or educational backgrounds. This limitation highlights the need for more inclusive and experience-sensitive approaches capable of capturing relational meanings beyond verbal expression. This study adopts a visual participatory approach in which volunteer tourists were invited to draw circles representing themselves in relation to images of a giant panda, nature, and a pet. Extending the visual idea of Schultz’s Inclusion of Nature in Self in the Connection to Nature Index, more than 1000 tourists at the Chengdu Research Base of Giant Panda Breeding produced over 3000 drawings. These drawings were systematically coded along three dimensions—circle size, orientation, and spatial relationship—and analyzed using multinomial logistic regression and non-parametric tests. The results reveal consistent yet differentiated patterns of visual representation. Participants most frequently expressed relationships with nature and pets through enclosing circles, suggesting spatial inclusion, whereas relationships with the giant panda were more often represented through separate but proximal positioning, indicating a more mediated or observational mode of connection. Demographic factors, including age, residence, and visitation stage, significantly influenced drawing configurations, supporting the interpretation of connection as a context-sensitive and dynamic process rather than a fixed individual trait. Associations between drawing dimensions and self-reported pro-environmental orientation and momentary well-being were observed, although these relationships should be interpreted cautiously given the use of brief, context-specific indicators. Overall, the findings demonstrate that participatory drawing can function as both a research instrument and an engagement tool, enabling diverse visitor groups—including children—to express relational understandings of nature and wildlife. For conservation practice, such visual methods offer a scalable and low-barrier approach to visitor engagement, with potential applications in environmental education, interpretation design, and the assessment of human–animal relationships in situ. Full article

This sequential mixed-methods study examines when sustainability becomes a meaningful criterion in everyday consumption versus a widely endorsed discourse enacted selectively in Spain. Informed by research on the attitude–behavior gap in sustainable consumption, including work using TPB- and norm-based perspectives, the study explores how feasibility constraints and credibility concerns shape the translation of sustainability commitment into practice in a non-student adult sample. It addresses a recurring pattern in sustainable consumption research: strong normative endorsement often coexists with partial behavioral uptake, particularly when feasibility constraints (cost, convenience, perceived impact) and credibility concerns (skepticism/greenwashing perceptions) intervene. A focus group (n = 9) explored how participants define sustainability, justify conditional enactment, and interpret sustainability communication; these insights informed and refined an online survey (N = 317) capturing awareness, conceptual knowledge, concern, self-perceived behavior, practice adoption, willingness to change, and perceptions of sustainability as marketing/politics. Self-reported awareness was high (83.91%) and mean concern was 7.40/10, whereas mean self-assessed sustainable behavior was lower (6.20/10), indicating a commitment–practice gap. Most respondents reported at least one sustainable practice (98.42%) and expressed willingness to change habits (96.21%), yet intentions appeared stronger than current uptake for higher-effort changes. Associations between attitudinal endorsement and enactment were modest to moderate: concern was positively related to self-assessed sustainable behavior (Spearman’s ρ = 0.445) and to reported practice adoption (practice count; ρ ≈ 0.34), while self-assessed behavior was moderately related to practice adoption (ρ ≈ 0.48). Qualitative findings emphasized feasibility trade-offs and credibility discounting of sustainability claims. By combining interpretive evidence with survey patterns, the study shows that sustainability is widely endorsed in this sample but enacted unevenly, with feasibility and credibility helping to explain why commitment does not consistently translate into practice in the Spanish context. Full article

Background/Objectives: Dieting is a widespread behavior that is associated with psychological distress, body dissatisfaction, and eating disorders. Recent research suggests that a body-positive attitude and mindful approach to eating may influence individuals’ experiences with dieting; however, their combined role has been insufficiently explored. Methods: A two-phase study was conducted among voluntary adults using online data collection. In Phase 1, a cross-sectional survey was completed by 180 participants (71.7% women), assessing dieting behavior, body appreciation, nutritional awareness, psychological distress, well-being, and eating disorders. Correlation analyses, group comparisons, and regression models were performed. In Phase 2, 90 participants entered the pilot and received a brief psychoeducational digital material promoting mindful eating and positive body image. The follow-up assessment was completed by 59, after one month of engagement. Results: Body appreciation and nutritional awareness were positively associated with mental well-being and inversely related to psychological distress (p < 0.001 for all) and to eating disorder screening scores (p < 0.001 and p = 0.046, respectively). More frequent dieting was associated with lower body appreciation (p < 0.001). According to the observed pattern of correlations, body appreciation may play a role in the relationship between dieting and psychological distress. In the intervention phase, greater engagement with the psychoeducational material was associated with higher reported levels of nutritional awareness (p = 0.003) and greater perceived body awareness (p = 0.026) at follow-up; however, due to the exploratory design, findings are preliminary. Conclusions: The results suggest that dieting, as a behavior, may be embedded in broader psychological processes that include body-related attitudes and nutritional awareness. Taking these factors into account may have potential implications for preventive measures aimed at promoting healthier dietary habits, a more positive relationship with one’s body, and mental well-being. Full article

The employment and labor market landscape has undergone significant transformations globally, including the three Central European countries examined in this study. Over the past decades, organizations in this region have transitioned from a state of full employment to labor shortages, raising the question: What factors have driven these changes? Our study aims to present a theoretical framework highlighting key macro-level factors, such as demographic trends, economic development, labor market dynamics, the impact of the COVID-19 pandemic, and the role of robotization and artificial intelligence. Based on two empirical studies conducted in 2019 and 2022 among Czech, Hungarian, and Slovak organizations, we analyzed the extent and causes of labor shortages, as well as the labor market effects of robotization. Using descriptive and non-parametric statistical methods, including frequency analysis and Mann–Whitney U tests, the study examined key trends and compared the two periods to identify significant shifts. The analytical approach of this study primarily aims to compare perceptions across occupational groups and between the two survey waves (2019 and 2022). Because most variables were measured on ordinal Likert-type scales and the datasets represent independent cross-sectional samples rather than a panel dataset, non-parametric methods were considered the most appropriate. More advanced causal modeling techniques, such as regression or factor analysis, were not applied because the objective of the research was exploratory and comparative rather than to establish causal relationships between variables. The findings reveal significant shifts in the perceived causes of labor shortages across occupational groups in the surveyed Central European organizations. In particular, increasing labor shortages were observed in specific job categories, alongside changes in the relative importance of the underlying drivers of labor shortages. While adopting robotization and artificial intelligence has been positively received, demographic decline and emigration remain critical challenges. The study provides practical insights for policymakers and corporate leaders regarding labor market challenges, workforce planning, and the potential role of robotization and artificial intelligence in addressing labor shortages. Although the research is based on a non-representative sample, it offers valuable insights into the Central European region’s employment and labor market trends. Future research could examine whether, in hard-to-fill positions, robotization and AI primarily provide indirect support by augmenting and reallocating human work, or whether they may serve as direct substitutes. Full article

Remote sensing is widely used in archaeological prospection to detect surface anomalies (crop marks) indicating buried remains, typically through recognition of visual patterns in high- or very high-resolution imagery acquired by means of satellite, airborne, or drone sensors. In contrast, spectroscopic approaches focusing on variations in spectral signatures still remain rarely applied in archaeological research. This study proposes a technological barrier-free method addressed to archaeologists which is based on pixel-level analysis of the Reflectance Values (RV) and spectral shape variations in the visible, near-infrared and short-wave infrared (VIS-NIR-SWIR) range derived from Sentinel-2 imagery. Spectral signatures are extracted through sampling polygons designed to account for the spatial resolution of the different Sentinel-2 bands and their spatial relationship with the location and size of the archaeological features. The RV method is tested on two Roman archaeological contexts: the ancient city of Telesia Vetere (San Salvatore Telesino, Benevento) and a Roman villa at Podere Colle Agnano (Labro, Rieti) using the full Sentinel-2 archive since 2017. While Telesia has previously been investigated through aerial photo interpretation and archaeological fieldwork, the Roman villa at Labro is documented here for the first time. Results show consistent seasonal repeated spectral separability between areas corresponding to known buried archaeological features and surrounding areas. Similar anomalies were also detected in areas without previously documented remains, thus suggesting the possible presence of buried structures and highlighting the predictive potential of the RV method. Owing to its easiness to use beyond image processing specialism and reliance on open-access data, the method can support archaeological decision-making and guide further investigation with higher-resolution remote sensing data or targeted field surveys, particularly in the framework of preventive archaeology. Full article

Background/Objectives: Patient understanding during healthcare appointments is essential for positive health outcomes and effective healthcare delivery. There is limited research exploring patient understanding for patients with swallowing difficulties (dysphagia) and voice disorders, where treatment engagement is often low. Dysphagia and voice disorders can affect communication, nutrition, and quality of life; therefore, it is essential to understand how to support this population effectively. This exploratory study aimed to identify barriers and facilitators to perceived patient understanding in clinical settings. Methods: A survey was administered to adults receiving assessment results for dysphagia or voice disorders from a speech–language pathologist or laryngologist at outpatient clinics in Ontario, Canada. The survey included demographics, health literacy levels (HLS19) and facilitators and barriers to comprehension. Descriptive statistics and content analysis were used to summarize responses. Results: Twenty-nine participants completed the survey (mean age of 64; 38% identifying as women). Facilitators to perceived understanding included the use of clear language (83%), being encouraged to ask questions (76%), and prior knowledge of their condition (59%). Reported barriers included rushing (28%), using a fast rate of speech (21%), and receiving short explanations (17%). Additionally, emotional and environmental factors such as the clinic atmosphere (55%) and the nature of assessment results (45%) influenced perceived patient comprehension. Conclusions: These findings suggest the need for consistent use of patient-centered communication strategies. Recommendations for clinicians include slowing speech, avoiding medical jargon, encouraging patient questions, incorporating visual aids, and creating a supportive environment. Implementing these strategies may improve understanding and health outcomes for patients with dysphagia and voice disorders. Full article

Background/Objectives: Micronutrient malnutrition, particularly deficiencies in calcium, vitamin D, iron, zinc, and iodine, remains a significant public health issue among school-aged children in Morocco. Processed cheese, such as “The Laughing Cow” (TLC), has potential as a vehicle for fortification due to its widespread consumption and accessibility. This study aimed to evaluate the impact of fortified TLC on micronutrient intake and adequacy relative to the Recommended Dietary Allowances (RDA), among Moroccan children aged 6–12 years, and to explore differences in effects by socioeconomic status (SES). Methods: Data from the Moroccan Household Budget Survey (2013–2014) included 9266 children (39.4% TLC consumers). Dietary intake was assessed using 24 h recalls, and nutrient composition was analyzed using Ciqual 2020 tables and specialized software. Fortification scenarios were modelled to estimate potential impacts on micronutrient intake and compliance with RDAs. Results: Under the modelling scenarios, consumption of one portion/day of fortified TLC significantly improved RDAs compliance for iron, iodine, and zinc (p < 0.05). There was also an increase in RDA compliance for calcium and vitamin D, but differences were not significant. The impact of fortification on micronutrient intake and RDA compliance increased with socioeconomic status. Consumers of more than one portion/day showed the highest compliance with RDAs (p < 0.001). Fortification effects were consistent across age subgroups. Conclusions: Fortifying processed cheese represents a feasible strategy to address micronutrient deficiencies among Moroccan schoolchildren. This study highlights the potential of targeted fortification programmes to improve public health outcomes, particularly in vulnerable populations. Further research is needed to optimize fortification approaches and ensure sustainability. Full article