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32 pages, 1625 KiB  
Article
Institutional, Resource-Based, Stakeholder and Legitimacy Drivers of Green Manufacturing Adoption in Industrial Enterprises
by Lukáš Juráček, Lukáš Jurík and Helena Makyšová
Adm. Sci. 2025, 15(8), 311; https://doi.org/10.3390/admsci15080311 (registering DOI) - 7 Aug 2025
Abstract
The present paper investigates the adoption of green manufacturing approaches among industrial enterprises in Slovakia, emphasizing the interplay between institutional pressures and enterprise-level resources. Based on a survey of 88 enterprises from energy- and material-intensive sectors, the study evaluates how regional context and [...] Read more.
The present paper investigates the adoption of green manufacturing approaches among industrial enterprises in Slovakia, emphasizing the interplay between institutional pressures and enterprise-level resources. Based on a survey of 88 enterprises from energy- and material-intensive sectors, the study evaluates how regional context and enterprise size influence the adoption of green practices. Using logistic regression and the chi-squared test, the findings reveal minimal regional variation, suggesting strong isomorphic effects of harmonised European Union environmental regulations. In contrast, enterprise size significantly correlates with the adoption of complex green practices, confirming the relevance of the resource-based view. These results highlight the dominance of internal capabilities over regional factors in green transition pathways within small post-transition economies. The study contributes to cross-national theorising by showing how resource asymmetries, rather than institutional diversity, shape environmental behaviour in uniform regulatory environments. Specifically, the paper examines how institutional pressures, enterprise-level resources, stakeholders, and legitimacy influence the adoption of green manufacturing practices in Slovak industrial enterprises. The study draws on institutional theory, the resource-based view, stakeholder theory, and legitimacy theory to explore the relationship between enterprise size, regional location, and the adoption levels of green manufacturing. Full article
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12 pages, 2150 KiB  
Article
First Survey on the Seroprevalence of Coxiella burnetii in Positive Human Patients from 2015 to 2024 in Sardinia, Italy
by Cinzia Santucciu, Maria Paola Giordo, Antonio Tanda, Giovanna Chessa, Matilde Senes, Gabriella Masu, Giovanna Masala and Valentina Chisu
Pathogens 2025, 14(8), 790; https://doi.org/10.3390/pathogens14080790 (registering DOI) - 7 Aug 2025
Abstract
Coxiella burnetii, the etiological agent of Q fever, is a globally distributed zoonotic pathogen affecting both animals and humans. Despite its known endemicity in various Mediterranean regions, data on human seroprevalence in Sardinia are still lacking. This study aimed to assess seroprevalence [...] Read more.
Coxiella burnetii, the etiological agent of Q fever, is a globally distributed zoonotic pathogen affecting both animals and humans. Despite its known endemicity in various Mediterranean regions, data on human seroprevalence in Sardinia are still lacking. This study aimed to assess seroprevalence in patients and to analyze the annual positivity rate related to the serum samples collected in Sardinia over a ten-year period (2015–2024). For this purpose, a total of 1792 patients were involved in the survey, and 4310 serum samples were analyzed using indirect immunofluorescence assay (IFI) to detect IgM and IgG antibodies against C. burnetii. The global seroprevalence rates relating to all the patients over a ten-year period were determined along with the annual positivity rate and trends from all sera. An overall seroprevalence of 27.0% and an average of annual positivity rate of 16.0% were determined, with the IFI detecting IgG antibodies in 15.2% of positive samples and IgM antibodies in 0.9%, suggesting significant prior exposure of the population evaluated. Annual positivity rates ranged from 24.8% in 2016 to 8.0% in 2020. These results confirmed the endemic circulation of C. burnetii in Sardinia and the ongoing risk of human exposure. A GIS-based map was built to evidence the spatial distribution of Q fever in Sardinia. Interestingly, areas with higher seroprevalence appear to coincide with the distribution of sheep and goat farms, indicating a link between livestock and human exposure. These findings confirm the circulation of C. burnetii in Sardinia and underscore the importance of epidemiological monitoring, public health interventions, and educational efforts in populations at increased risk. Full article
(This article belongs to the Section Bacterial Pathogens)
18 pages, 4314 KiB  
Article
Gender Differences: The Role of Built Environment and Commute in Subjective Well-Being
by Chen Gui, Yuze Cao, Fanyuan Yu, Yue Zhou and Chaoying Yin
Buildings 2025, 15(15), 2801; https://doi.org/10.3390/buildings15152801 (registering DOI) - 7 Aug 2025
Abstract
The literature has shown extensive interest in exploring the factors of subjective well-being (SWB). However, most research has conducted cross-sectional analysis of the built environment (BE), commute, and SWB, and little is known about gender differences in their connections. Based on two periods [...] Read more.
The literature has shown extensive interest in exploring the factors of subjective well-being (SWB). However, most research has conducted cross-sectional analysis of the built environment (BE), commute, and SWB, and little is known about gender differences in their connections. Based on two periods of survey data of 4297 respondents from China, the study performs a cross-sectional and longitudinal examination of whether the BE and commute have effects on SWB, and how the effects differ between men and women. The results reveal that BE features, including destination accessibility and residential density, significantly affect SWB, with stronger impacts observed among men. Men benefit more from greater accessibility and are more negatively affected by higher residential density than women. In contrast, commute mode and duration influence SWB in similar ways for both genders. A shift from nonactive to active commuting improves well-being for men and women alike. Furthermore, certain life events produce gender-specific effects. For instance, childbirth increases SWB for men but decreases it for women. These findings highlight the importance of gender-sensitive planning in building inclusive urban and transportation environments that enhance population well-being. Full article
(This article belongs to the Special Issue New Trends in Built Environment and Mobility)
16 pages, 395 KiB  
Article
Radegund of Poitiers in Modern Scholarship: Recurrent Themes and Portrayals
by Giacomo Evangelisti
Humanities 2025, 14(8), 165; https://doi.org/10.3390/h14080165 (registering DOI) - 7 Aug 2025
Abstract
Radegund of Poitiers (520–587) was a princess of the Thuringian kingdom, wife to the Merovingian king Clothar I, and ultimately domina of the abbey of Sainte-Croix in Poitiers. The literary persona of Saint Radegund, as constructed by the poet-hagiographer Venantius Fortunatus and, a [...] Read more.
Radegund of Poitiers (520–587) was a princess of the Thuringian kingdom, wife to the Merovingian king Clothar I, and ultimately domina of the abbey of Sainte-Croix in Poitiers. The literary persona of Saint Radegund, as constructed by the poet-hagiographer Venantius Fortunatus and, a few years later, by the nun Baudonivia, underpins the historical figure. The saint exerted a significant cultural influence across Frankish territories, and over the ages her image has been continuously received, reinterpreted, and expanded. The purpose of this study is to provide a survey of the critical reception of Radegund’s character, in order to explore how modern scholarship has interpreted and reimagined her persona over time. Full article
18 pages, 7011 KiB  
Article
Monitoring Chrysanthemum Cultivation Areas Using Remote Sensing Technology
by Yin Ye, Meng-Ting Wu, Chun-Juan Pu, Jing-Mei Chen, Zhi-Xian Jing, Ting-Ting Shi, Xiao-Bo Zhang and Hui Yan
Horticulturae 2025, 11(8), 933; https://doi.org/10.3390/horticulturae11080933 (registering DOI) - 7 Aug 2025
Abstract
Chrysanthemum has a long history of medicinal use with rich germplasm resources and extensive cultivation. Traditional chrysanthemum cultivation involves complex patterns and long flowering periods, with the ongoing expansion of planting areas complicating statistical surveys. Currently, reliable, timely, and universally applicable standardized monitoring [...] Read more.
Chrysanthemum has a long history of medicinal use with rich germplasm resources and extensive cultivation. Traditional chrysanthemum cultivation involves complex patterns and long flowering periods, with the ongoing expansion of planting areas complicating statistical surveys. Currently, reliable, timely, and universally applicable standardized monitoring methods for chrysanthemum cultivation areas remain underdeveloped. This research employed 16 m resolution satellite imagery spanning 2021 to 2023 alongside 2 m resolution data acquired in 2022 to quantify chrysanthemum cultivation extent across Sheyang County, Jiangsu Province, China. After evaluating multiple classifiers, Maximum Likelihood Classification was selected as the optimal method. Subsequently, time-series-based post-classification processing was implemented: initial cultivation information extraction was performed through feature comparison, supervised classification, and temporal analysis. Accuracy validation via Overall Accuracy, Kappa coefficient, Producer’s Accuracy, and User’s Accuracy identified critical issues, followed by targeted refinement of spectrally confused features to obtain precise area estimates. The chrysanthemum cultivation area in 2022 was quantified as 46,950,343 m2 for 2 m resolution and 46,332,538 m2 for 16 m resolution. Finally, the conversion ratio characteristics between resolutions were analyzed, yielding adjusted results of 38,466,192 m2 for 2021 and 47,546,718 m2 for 2023, respectively. These outcomes demonstrate strong alignment with local agricultural statistics, confirming method viability for chrysanthemum cultivation area computation. Full article
(This article belongs to the Section Medicinals, Herbs, and Specialty Crops)
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25 pages, 1429 KiB  
Review
Large Language Models for Structured and Semi-Structured Data, Recommender Systems and Knowledge Base Engineering: A Survey of Recent Techniques and Architectures
by Alma Smajić, Ratomir Karlović, Mieta Bobanović Dasko and Ivan Lorencin
Electronics 2025, 14(15), 3153; https://doi.org/10.3390/electronics14153153 (registering DOI) - 7 Aug 2025
Abstract
Large Language Models (LLMs) are reshaping recommendation systems through enhanced language understanding, reasoning, and integration with structured data. This systematic review analyzes 88 studies published between 2023 and 2025, categorized into three thematic areas: data processing, technical identification, and LLM-based recommendation architectures. Following [...] Read more.
Large Language Models (LLMs) are reshaping recommendation systems through enhanced language understanding, reasoning, and integration with structured data. This systematic review analyzes 88 studies published between 2023 and 2025, categorized into three thematic areas: data processing, technical identification, and LLM-based recommendation architectures. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review highlights key trends such as the use of knowledge graphs, Retrieval-Augmented Generation (RAG), domain-specific fine-tuning, and robustness improvements. Findings reveal that while LLMs significantly advance semantic reasoning and personalization, challenges remain in hallucination mitigation, fairness, and domain adaptation. Technical innovations, including graph-augmented retrieval methods and human-in-the-loop validation, show promise in addressing these limitations. The review also considers the broader macroeconomic implications associated with the deployment of LLM-based systems, particularly as they relate to scalability, labor dynamics, and resource-intensive implementation in real-world recommendation contexts, emphasizing both productivity gains and potential labor market shifts. This work provides a structured overview of current methods and outlines future directions for developing reliable and efficient LLM-based recommendation systems. Full article
(This article belongs to the Special Issue Advances in Algorithm Optimization and Computational Intelligence)
22 pages, 3869 KiB  
Article
On-Orbit Calibration Method for Rotation Axis Misalignment in Rotating Mirror-Based Wide-Field Space Cameras
by Guoxiu Zhang, Yishi Qiao, Zhenyuan Guo, Chen Wang, Yingming Zhao, Yuxin Zhang, Chunyu Liu and Xianren Kong
Remote Sens. 2025, 17(15), 2740; https://doi.org/10.3390/rs17152740 (registering DOI) - 7 Aug 2025
Abstract
Rotating mirror-based space cameras are susceptible to mirror misalignment due to the severe vibrations experienced during rocket launch and the harsh, variable conditions of the space environment, which can result in deviations of the camera’s line of sight. To mitigate this risk, this [...] Read more.
Rotating mirror-based space cameras are susceptible to mirror misalignment due to the severe vibrations experienced during rocket launch and the harsh, variable conditions of the space environment, which can result in deviations of the camera’s line of sight. To mitigate this risk, this study proposes a simulation-based on-orbit calibration method for quantifying rotating mirror misalignment using a system of pointing vector equations. The method employs star coordinates as a reference to establish the reference pointing vector for stars, while simultaneously developing a model of the rotating mirror imaging system. By incorporating a misalignment matrix, the actual pointing vector of star points is derived. Subsequently, the reference star pointing vector and the actual star point pointing vector are combined to formulate a system of pointing vector equations. Solving these equations enables precise measurement of the rotating mirror’s rotational misalignment without requiring additional spaceborne equipment. Through simulations, the three-axis misalignment of the rotating mirror is deduced from imaging pixel coordinates, given the known right ascension and declination of reference star points. The influence and patterns of three-axis misalignment on pointing accuracy are analyzed separately. Although validation based on real measurement data remains to be carried out in future work, this simulation-based method provides a theoretical foundation for the calibration of internal orientation elements of space cameras equipped with moving components. Full article
21 pages, 316 KiB  
Article
Associations Between Diverse Beverage Consumption Patterns and Oral Health: Evidence from a National Survey in Hungary
by Amr Sayed Ghanem, Zsuzsa Emma Hajzer, Vanessza Hadar, Eszter Vargáné Faludi, Tamari Shenheliia, Marianna Móré, Attila Csaba Nagy and Ágnes Tóth
Nutrients 2025, 17(15), 2572; https://doi.org/10.3390/nu17152572 (registering DOI) - 7 Aug 2025
Abstract
Background/Objectives: Oral diseases are highly prevalent in Hungary and driven in part by unhealthy beverage consumption, smoking, and other behaviors. No prior study has examined the impact of beverage consumption patterns on oral health in a representative Hungarian population. This study investigated [...] Read more.
Background/Objectives: Oral diseases are highly prevalent in Hungary and driven in part by unhealthy beverage consumption, smoking, and other behaviors. No prior study has examined the impact of beverage consumption patterns on oral health in a representative Hungarian population. This study investigated the association between beverage intake, lifestyle factors, and oral health outcomes among Hungarian adults. Methods: Data were drawn from the 2019 Hungarian European Health Interview Survey, a nationally representative cross-sectional study. Oral health outcomes and key exposures, including beverage consumption, smoking, alcohol use, and sociodemographic variables, were self-reported. Associations were assessed using multiple logistic regression models. Results: Among 5425 adults, higher dairy intake was linked to less gum bleeding (odds ratio = 0.76; 95% confidence intervals [0.59–0.96]) and lower odds of teeth missing (0.63 [0.47–0.86]). Weekly juice intake reduced gum bleeding (0.62 [0.51–0.76]) and missing teeth (0.83 [0.71–0.96]). Daily soda was associated with more gum bleeding (1.94 [1.53–2.47]), caries (1.57 [1.27–1.94]), and poor self-perceived oral health (1.32 [1.10–1.59]). Alcohol (1–4 times/week) increased gum bleeding (1.38 [1.07–1.77]) and tooth mobility (1.47 [1.02–2.11]). Smoking raised odds for caries (1.42 [1.21–1.66]) and missing teeth (1.81 [1.55–2.10]). Conclusions: Increasing dairy and fresh juice intake while reducing sugar-sweetened and acidic beverages, alongside tobacco and alcohol control and routine oral health screening, are effective strategies for improving population oral health across all sociodemographic groups. Full article
(This article belongs to the Special Issue Diet and Oral Health)
24 pages, 2032 KiB  
Article
BCTDNet: Building Change-Type Detection Networks with the Segment Anything Model in Remote Sensing Images
by Wei Zhang, Jinsong Li, Shuaipeng Wang and Jianhua Wan
Remote Sens. 2025, 17(15), 2742; https://doi.org/10.3390/rs17152742 (registering DOI) - 7 Aug 2025
Abstract
Observing building changes in remote sensing images plays a crucial role in monitoring urban development and promoting sustainable urbanization. Mainstream change detection methods have demonstrated promising performance in identifying building changes. However, buildings have large intra-class variance and high similarity with other objects, [...] Read more.
Observing building changes in remote sensing images plays a crucial role in monitoring urban development and promoting sustainable urbanization. Mainstream change detection methods have demonstrated promising performance in identifying building changes. However, buildings have large intra-class variance and high similarity with other objects, limiting the generalization ability of models in diverse scenarios. Moreover, most existing methods only detect whether changes have occurred but ignore change types, such as new construction and demolition. To address these issues, we present a building change-type detection network (BCTDNet) based on the Segment Anything Model (SAM) to identify newly constructed and demolished buildings. We first construct a dual-feature interaction encoder that employs SAM to extract image features, which are then refined through trainable multi-scale adapters for learning architectural structures and semantic patterns. Moreover, an interactive attention module bridges SAM with a Convolutional Neural Network, enabling seamless interaction between fine-grained structural information and deep semantic features. Furthermore, we develop a change-aware attribute decoder that integrates building semantics into the change detection process via an extraction decoding network. Subsequently, an attribute-aware strategy is adopted to explicitly generate distinct maps for newly constructed and demolished buildings, thereby establishing clear temporal relationships among different change types. To evaluate BCTDNet’s performance, we construct the JINAN-MCD dataset, which covers Jinan’s urban core area over a six-year period, capturing diverse change scenarios. Moreover, we adapt the WHU-CD dataset into WHU-MCD to include multiple types of changing. Experimental results on both datasets demonstrate the superiority of BCTDNet. On JINAN-MCD, BCTDNet achieves improvements of 12.64% in IoU and 11.95% in F1 compared to suboptimal methods. Similarly, on WHU-MCD, it outperforms second-best approaches by 2.71% in IoU and 1.62% in F1. BCTDNet’s effectiveness and robustness in complex urban scenarios highlight its potential for applications in land-use analysis and urban planning. Full article
47 pages, 11661 KiB  
Article
Reintegrating Marginalized Rural Heritage: The Adaptive Potential of Barn Districts in Central Europe’s Cultural Landscapes
by Elżbieta Komarzyńska-Świeściak and Anna Alicja Wancel
Sustainability 2025, 17(15), 7166; https://doi.org/10.3390/su17157166 (registering DOI) - 7 Aug 2025
Abstract
Barn districts—ensembles of agricultural buildings situated at the edges of rural settlements—once played a key role in the spatial and economic organization of agrarian communities in Central Europe. Today, many of these structures remain marginalized and underexplored in contemporary landscape and heritage planning. [...] Read more.
Barn districts—ensembles of agricultural buildings situated at the edges of rural settlements—once played a key role in the spatial and economic organization of agrarian communities in Central Europe. Today, many of these structures remain marginalized and underexplored in contemporary landscape and heritage planning. This paper presents a comparative study of six barn districts in Poland’s Kraków-Częstochowa Upland, where vernacular construction, ecological adaptation, and local tradition shaped distinctive rural–urban interfaces. We applied a mixed-methods approach combining cartographic and archival analysis, field surveys, and interviews with residents and experts. The research reveals consistent patterns of landscape transformation, functional decline, and latent adaptive potential across varied morphological and material typologies. Despite differing levels of preservation, barn districts retain symbolic, spatial, and socio-cultural value for communities and local landscapes. The study emphasizes the importance of reintegrating these marginal heritage structures through adaptive reuse strategies rooted in the values of the New European Bauhaus—sustainability, aesthetics, and inclusion. The findings contribute to broader discussions on rural socio-ecological resilience and landscape-based development, highlighting how place-based strategies can bridge past identities with future-oriented spatial planning. Full article
23 pages, 307 KiB  
Article
How Do Government Subsidies Affect Innovation? Evidence from Chinese Hi-Tech SMEs
by Dong Xiang, Roman Matousek, Andrew C. Worthington and Yue Jiang
Sustainability 2025, 17(15), 7168; https://doi.org/10.3390/su17157168 (registering DOI) - 7 Aug 2025
Abstract
This paper examines the effectiveness of government subsidies in fostering innovation among small and medium-sized enterprises (SMEs), with a particular focus on additionality, crowding-out, and cherry-picking effects. Using the latest national survey data on Chinese high-tech SMEs, we apply robust econometric techniques—including the [...] Read more.
This paper examines the effectiveness of government subsidies in fostering innovation among small and medium-sized enterprises (SMEs), with a particular focus on additionality, crowding-out, and cherry-picking effects. Using the latest national survey data on Chinese high-tech SMEs, we apply robust econometric techniques—including the Heckman selection model, structural equation modeling (SEM), and propensity score matching (PSM)—to address potential selection bias and endogeneity. Our findings reveal that government subsidies positively influence both innovation inputs and outputs, suggesting a predominant additionality effect rather than a crowding-out effect, at least within high-tech SMEs. However, subsidies do not appear to alleviate the financial constraints faced by most SMEs, indicating that they are insufficient as a standalone solution to financing challenges. Furthermore, state ownership enhances input additionality but does not significantly impact output additionality. We also find evidence of cherry-picking in subsidy allocation, with loans exhibiting stronger additionality effects on innovation compared to grants and tax credits, which are more prone to selective intervention. These findings highlight the need for more targeted subsidy policies that prioritize financially constrained firms with high innovation potential while mitigating government selectivity. Our study offers valuable insights for policymakers seeking to design more effective innovation support mechanisms for high-tech SMEs. Full article
(This article belongs to the Section Economic and Business Aspects of Sustainability)
28 pages, 3313 KiB  
Article
Assessing Drivers, Barriers and Policy Interventions for Implementing Digitalization in the Construction Industry of Pakistan
by Waqas Arshad Tanoli
Buildings 2025, 15(15), 2798; https://doi.org/10.3390/buildings15152798 (registering DOI) - 7 Aug 2025
Abstract
Digitalization is rapidly reshaping the global construction industry; however, its adoption in developing countries, such as Pakistan, remains limited and uneven. Hence, this study investigates and evaluates the current status of digital technology integration in Pakistan’s construction industry, with a primary focus on [...] Read more.
Digitalization is rapidly reshaping the global construction industry; however, its adoption in developing countries, such as Pakistan, remains limited and uneven. Hence, this study investigates and evaluates the current status of digital technology integration in Pakistan’s construction industry, with a primary focus on key tools, implementation challenges, and necessary policy interventions. Using a three-phase mixed-method approach involving a literature review, expert interviews, and a nationwide survey, this research identifies Building Information Modeling, Geographic Information Systems, and E-Procurement as essential technologies with strong potential to improve transparency, efficiency, and collaboration. However, adoption is hindered by a lack of awareness, limited technical expertise, and the absence of a cohesive national policy. This study also highlights that the private sector shows greater readiness compared to the public sector; however, systemic barriers persist across both sectors. Based on stakeholder insights, a three-part policy strategy was also proposed. This includes establishing a national regulatory framework, investing in capacity-building programs, and providing financial or institutional incentives to encourage the adoption of these measures. The findings emphasize that digitalization is not just a technical upgrade; it represents a pathway to improved governance and more efficient infrastructure delivery. With timely and coordinated policy action, the construction industry in Pakistan can align itself with global innovation trends and move toward a more sustainable and digitally empowered future. Full article
(This article belongs to the Section Construction Management, and Computers & Digitization)
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29 pages, 1884 KiB  
Article
Modeling Ontology-Based Decay Analysis and HBIM for the Conservation of Architectural Heritage: The Big Gate and Adjacent Curtain Walls in Ibb, Yemen
by Basema Qasim Derhem Dammag, Dai Jian, Abdulkarem Qasem Dammag, Yahya Alshawabkeh, Sultan Almutery, Amer Habibullah and Ahmad Baik
Buildings 2025, 15(15), 2795; https://doi.org/10.3390/buildings15152795 (registering DOI) - 7 Aug 2025
Abstract
The conservation of architectural heritage (AH) in regions threatened by natural and human-induced factors requires interdisciplinary approaches that integrate physical documentation with semantic modeling. This study introduces a comprehensive framework combining Historic Building Information Modeling (HBIM) with ontology-based modeling aligned with the CIDOC [...] Read more.
The conservation of architectural heritage (AH) in regions threatened by natural and human-induced factors requires interdisciplinary approaches that integrate physical documentation with semantic modeling. This study introduces a comprehensive framework combining Historic Building Information Modeling (HBIM) with ontology-based modeling aligned with the CIDOC Conceptual Reference Model (CIDOC CRM). Focusing on the Big Gate and adjacent curtain walls in Ibb, Yemen, where the gate is entirely lost, the study reconstructs the structure using historical photographs, eyewitness accounts, and analogical references. The methodology incorporates UAV and terrestrial photogrammetry surveys, point cloud generation, and semantic enrichment using Autodesk Revit V. 2024 and Protégé V. 5.5. Decay phenomena such as cracks, efflorescence, and disintegration were ontologically classified and spatially linked to the HBIM model, revealing deterioration patterns concerning historical phases and environmental exposure. The resulting system enables dynamic documentation, facilitates strategic conservation planning, and enhances data interoperability across heritage platforms. The proposed framework is transferable to other heritage sites, supporting both the conservation of extant structures and the reconstruction of lost ones. Full article
(This article belongs to the Special Issue BIM Methodology and Tools Development/Implementation)
14 pages, 514 KiB  
Case Report
Thallium Exposure Secondary to Commercial Kale Chip Consumption: California Case Highlights Opportunities for Improved Surveillance and Toxicological Understanding
by Asha Choudhury, Jefferson Fowles, Russell Bartlett, Mark D. Miller, Timur Durrani, Robert Harrison and Tracy Barreau
Int. J. Environ. Res. Public Health 2025, 22(8), 1235; https://doi.org/10.3390/ijerph22081235 (registering DOI) - 7 Aug 2025
Abstract
Background: Thallium is a metal that is ubiquitous in our natural environment. Despite its potential for high toxicity, thallium is understudied and not regulated in food. The California Department of Public Health was alerted to a household cluster of elevated urine thallium levels [...] Read more.
Background: Thallium is a metal that is ubiquitous in our natural environment. Despite its potential for high toxicity, thallium is understudied and not regulated in food. The California Department of Public Health was alerted to a household cluster of elevated urine thallium levels noted among a mother (peak 5.6 µg/g creatinine; adult reference: ≤0.4 µg/g creatinine) and her three young children (peak 10.5 µg/g creatinine; child reference: ≤0.8 µg/g creatinine). Objectives: This case report identifies questions raised after a public health investigation linked a household’s thallium exposure to a commercially available food product. We provide an overview of the public health investigation. We then explore concerns, such as gaps in toxicological data and limited surveillance of thallium in the food supply, which make management of individual and population exposure risks challenging. Methods: We highlight findings from a cross-agency investigation, including a household exposure survey, sampling of possible environmental and dietary exposures (ICP-MS analysis measured thallium in kale chips at 1.98 mg/kg and 2.15 mg/kg), and monitoring of symptoms and urine thallium levels after the source was removed. We use regulatory and research findings to describe the challenges and opportunities in characterizing the scale of thallium in our food supply and effects of dietary exposures on health. Discussion: Thallium can bioaccumulate in our food system, particularly in brassica vegetables like kale. Thallium concentration in foods can also be affected by manufacturing processes, such as dehydration. We have limited surveillance data nationally regarding this metal in our food supply. Dietary reviews internationally show increased thallium intake in toddlers. Limited information is available about low-dose or chronic exposures, particularly among children, although emerging evidence shows that there might be risks associated at lower levels than previously thought. Improved toxicological studies are needed to guide reference doses and food safety standards. Promising action towards enhanced monitoring of thallium is being pursued by food safety agencies internationally, and research is underway to deepen our understanding of thallium toxicity. Full article
(This article belongs to the Section Environmental Health)
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14 pages, 702 KiB  
Article
Patient Safety Culture of Hospitals in Southern Laos: A Cross-Sectional Study Using the Hospital Survey on Patient Safety Culture
by Miho Sodeno, Moe Moe Thandar, Somchanh Thounsavath, Olaphim Phouthavong, Masahiko Hachiya and Yasunori Ichimura
Healthcare 2025, 13(15), 1934; https://doi.org/10.3390/healthcare13151934 - 7 Aug 2025
Abstract
Background: Patient safety culture is critical for enhancing the quality and safety of healthcare. Studies in low- and middle-income countries have reported challenges in developing patient safety culture, especially in implementing nonpunitive responses to errors and event reporting. However, evidence from Laos remains [...] Read more.
Background: Patient safety culture is critical for enhancing the quality and safety of healthcare. Studies in low- and middle-income countries have reported challenges in developing patient safety culture, especially in implementing nonpunitive responses to errors and event reporting. However, evidence from Laos remains limited. Objectives: This study aimed to assess patient safety culture in hospitals in southern Laos, using a validated survey tool to identify strengths and areas of improvement. Methods: A cross-sectional study using purposive sampling was conducted in four provincial and twenty-three district hospitals in southern Laos. Healthcare workers on patient safety committees responded to the Hospital Survey on Patient Safety Culture. The positive response rate was analyzed. Bivariate tests (chi-square/Fisher’s exact) were applied to compare positive response rates between hospital types and professions. Results: A total of 253 valid responses (75.5%) were analyzed. “Organizational Learning–Continuous Improvement” scored over 75% in both provincial and district hospitals. In contrast, “Nonpunitive Response to Error” and “Frequency of Events Reported” were scored <20% on average. Provincial hospitals scored significantly higher than district hospitals in supervisory support and handoffs. Conclusions: This study illustrated strengths in organizational learning while identifying nonpunitive responses and event reporting as critical areas of improvement for hospitals in Laos. To improve patient safety, hospitals in Laos must promote a culture in which errors can be reported without fear of blame. Strengthening leadership support and reporting systems is essential. These findings can inform strategies to enhance patient safety in other low-resource healthcare settings. Full article
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