Search Results (582)

This paper presents a comprehensive economic comparison between renewable and fossil-fuel-based heating systems for a newly constructed residential building in Kraków, Poland, over the period 2022–2030. The analysis introduces the concept of Corrected Final Energy Consumption (CFEC) as a harmonized measure for comparing various energy sources and applies the Present Value of Total Lifecycle Cost (PVTLC) as an appropriate financial metric for non-commercial residential investments. Four heating options were examined: district heating system (DHS), gas boiler, air-to-water heat pump, and heat pump combined with photovoltaic (PV) panels. Based on real tariffs and standardized data from the Energy Performance Certificate (EPC), the DHS option demonstrated the lowest lifecycle cost, while the air-to-water heat pump—despite environmental advantages—proved the most expensive without substantial subsidies. Sensitivity analyses confirmed the strong influence of investment subsidies and fuel price fluctuations on the competitiveness of alternative systems. The findings highlight the methodological shortcomings of conventional annual-cost approaches and propose PVTLC as a more reliable decision-making tool for residential energy planning. The study also discusses regulatory, climatic, and behavioral factors affecting investment outcomes and emphasizes the need to integrate financial, environmental, and social criteria when evaluating household-level energy solutions. Full article

The concept of carbon-neutral buildings encompasses not only carbon emission reductions but also sustainability. Building sustainability includes the physical durability of the structure, the health and safety of its tenants, and harmony with the surrounding environment. The achievement of these goals requires alignment among diverse stakeholders associated with buildings; however, such alignment is limited by economic (cost), environmental (global warming), and social (institutions and policies) factors. This study proposes an operation model that integrates buildings, the carbon permit market, and deep reinforcement learning (DRL) to address these limitations. The DRL model reduces energy consumption while maintaining indoor comfort, generates carbon permits equivalent to the amount of energy saved, and creates a new revenue stream by selling them. To achieve more precise comfort management, the model incorporates a policy that combines predicted mean vote (PMV) and Humidex. In the context of a privately owned commercial office building, the DRL model achieved indoor comfort levels of 98.51% for PMV and 97.22% for Humidex, while reducing energy consumption by 34,376 kWh, lowering carbon emissions by 26,607 kgCO₂eq, and generating USD 176 in carbon permit revenue. These results translated into a total reduction in operating costs of 7.5%, amounting to USD 2951. Consequently, the proposed approach provides cost reductions for building owners, comfort for tenants, efficiency for managers, and carbon emission reductions that contribute to carbon neutrality. Full article

Background: Scoliosis is a common musculoskeletal disorder that remains underrecognized in Saudi Arabia, where limited public awareness may delay early detection and treatment. This study assessed public knowledge, support for school-based screening, and attitudes toward treatment. Methods: A nationwide cross-sectional survey was conducted during the 2025 Saudi National Scoliosis Awareness Campaign through public venues and online platforms. A culturally adapted questionnaire assessed demographics, knowledge, symptom recognition, treatment preferences, barriers, and information sources. A total of 2055 responses were analyzed using descriptive statistics and chi-square tests. Results: While 70.9% of participants had heard of scoliosis, only 18.1% reported good understanding. Symptom recognition was limited, with spinal curvature, back pain, and uneven shoulders most often identified. Most respondents supported school-based screening (88.2%) and early detection (92.1%), with a mean preferred screening age of 8 years. Bracing (64.3%) and surgery (53.5%) were more accepted than observation (30.5%), though concerns about pain, effectiveness, and appearance were frequent. Social media was the most common initial information source (34.6%), while healthcare professionals were the preferred future source (79.2%). Reported barriers included lack of awareness (68.2%), difficulty accessing specialists (19.9%), and cost (8.9%). Conclusions: Public support for school-based screening is strong, but baseline knowledge remains limited, and treatment perceptions are shaped by psychosocial and cultural concerns. National campaigns, school curricula, and healthcare-led education, combined with accessible, low-cost screening, may enhance early detection and improve scoliosis management in Saudi Arabia. Full article

The spatial configuration of Waste-to-Energy infrastructure plays a decisive role in determining the environmental and economic performance of municipal solid waste (MSW) management systems. This study applies a Life Cycle Assessment methodology to evaluate the environmental implications of centralized and decentralized siting strategies for Refuse-Derived Fuel utilization in Greece. Two alternative scenarios were modeled: (i) a centralized approach based on six large WtE plants as proposed by the Greek Ministry of Environment and Energy (gr. YPEN), and (ii) a decentralized approach involving smaller, regionally distributed units located closer to Recycling and Recovery Facilities. Using the SimaPro software and the ReCiPe method, environmental impacts were quantified across categories including global warming potential, acidification, eutrophication, and particulate matter formation. The results indicate that the decentralized scenario yields substantial environmental advantages, with reductions ranging from 33% to 45% across all impact categories and displaying a 35% decrease in CO₂-equivalent emissions compared to the centralized scenario. Economic analysis confirms these findings, showing a 31% reduction in total transport and emissions-related costs due primarily to minimized long-distance and maritime transport. The study concludes that decentralized RDF-to-energy systems offer a more balanced and sustainable pathway, enhancing operational flexibility, lowering environmental burdens, and improving social acceptance. These results underscore the importance of integrating spatial and logistical parameters in national WtE planning to align with EU waste hierarchy principles and circular economy objectives. Full article

Background/Objectives: Neck pain is a complex biopsychosocial condition that affects a significant proportion of the global population. Projections indicate that over the next 30 years, cervical pain will impact approximately 269 million individuals, positioning it as one of the primary drivers of healthcare expenditure and system burden worldwide. While exercise is a key approach for neck pain, the effectiveness and cost-effectiveness of treatments delivered remotely remain underexplored. The aim of this study is to analyse the cost-effectiveness and cost-utility of the treatment of non-specific neck pain through a telerehabilitation programme based on cervical exercise and analgesic electrotherapy. Methods: This is a study protocol for an economic evaluation based on a randomised controlled trial (RCT) with a sample size of 210 participants (N = 210). The sample will be evenly divided into two groups to perform the same cervical exercise programme combined with electroanalgesia: one group will receive the intervention via telerehabilitation, and the other will receive the intervention face-to-face. Three sessions will be held per week for eight weeks for a total of 24 sessions. Demographic and clinical data of the participants, healthcare resource utilisation, and associated costs will be collected. Assessments will be carried out throughout the study: before the first session (baseline), at 8 weeks (post-intervention), and 6 months after completion of the treatment (follow-up). Discussion: This study will make a significant contribution to reducing costs and improving the treatment of patients with non-specific chronic neck pain. The social perspective associated with economic evaluation will enable the investigation of indirect costs such as work absenteeism or expenses borne by the patient, providing useful data to optimise planning and decision-making in the healthcare sector. Full article

The first extensive Bus Rapid Transit (BRT) system in the Philippines, the EDSA Busway, was put into place as a result of Metro Manila’s ongoing traffic congestion. This study uses an integrated framework that combines cost–benefit analysis (CBA), commuter perception survey, and traffic simulation to assess its economic, social, and environmental implications. The operational viability and traffic impact of the planned Magallanes BRT station were evaluated through simulation using PTV VISSIM. A total of 385 commuters participated in a survey measuring their impressions of safety, accessibility, and satisfaction using a four-point Likert scale. The Busway’s excellent economic feasibility was confirmed by the CBA results, which showed a Benefit–Cost Ratio (BCR) of 15.38 and a Net Present Value (NPV) of ₱778.64 billion. Results from the simulation showed a 24% decrease in PM₂ emissions, a 75% increase in throughput, and a 64% reduction in bus trip time. According to survey results, 61% of commuters said accessibility had improved and 62% said travel satisfaction had increased. The study supports the EDSA Busway’s status as a feasible model for future BRT expansion in Metro Manila and other emerging metropolitan regions by showing how it greatly improves environmental sustainability and mobility efficiency. Full article

Background/Objectives: Oral health is a critical component of public health, yet disparities in access and financing remain significant. In Bulgaria, dental services are financed through the National Health Insurance Fund and patient co-payments, with coverage differing between children and adults. The aim of this study was to analyze the dynamics of health insurance payments and expenditures for dental care in Bulgaria over the period 2019–2025, with a focus on differences between age groups and the balance between public funding and patient contributions. Methods: A retrospective descriptive–analytical study was conducted using aggregated data from NHIF annual reports, national legislation, and secondary literature. Absolute expenditures (BGN) and relative shares (%) of dental services within total health insurance payments were examined for the period 2019–2025 (actual data). Key dental procedures analyzed included examinations, restorations, extractions, and treatment of pulpitis/periodontitis in children, as well as prosthetic rehabilitation in older adults. Descriptive statistics, trend analysis, and simple linear regression were applied to assess expenditure growth and predictability. Results: Total health insurance payments in Bulgaria nearly doubled between 2019 and 2025, increasing from 4.12 to 8.87 million BGN. Dental expenditures rose from 167,000 to 416,000 BGN, with the share of dental care rising modestly from 4.05% to 4.69%. For children, NHIF covered nearly all costs, with minimal or absent co-payments. Among adults, a co-financing model prevailed, with fixed patient contributions for basic services but full NHIF coverage for prosthetic rehabilitation in edentulous patients aged 65–69 years. Conclusions: Bulgaria’s dental care financing reflects a socially oriented model, with full coverage for children and mixed financing for adults. Strategic policy adjustments are needed to ensure sustainability, equity, and alignment with universal health coverage goals. Full article

To date, exploration of Gracilaria and Gelidiella’s bioactive compounds has been conducted using conventional methods that require a long time, high costs, and significant effort. Currently, metabolomic profiling and molecular networking have emerged as methods of exploring bioactive compounds. This study aimed to perform bioactive compound profiling through a metabolomic LC-HRMS-based and molecular networking approach in Gelidiella acerosa, Gracilaria arcuata, and Gracilaria verrucosa. All chromatograms and MS/MS spectra obtained for three crude extracts were digitally converted into an mzXML file using MSConvert, submitted to the Global Natural Product Social (GNPS), and visualized in Cytoscape 3.9.1. In total, nine dereplicated compounds were identified: 11-Deoxyprostaglandin (m/z 324.214), Diacylglyceryl trimethylhomoserines (DGTS) (m/z 684.575), Glycochenodeoxy acid (m/z 448.369), Lysophosphatidylcholine (m/z 522.350), Diacylglyceryl trimethylhomoserines (DGTS) (m/z 656.557), Pheophorbide A (m/z 593.266), Pyropheophorbide A (m/z 593.266), (2R,3R)-2-(3,4-dihydroxyphenyl)-3,5,7-trihydroxy-2,3-dihydro-4H-chromen-4-one (m/z 303.15), and Polyporic acid (m/z 293.156). These compounds are typically classified as fatty acids, lipids, terpenoids, alkaloids, shikimates, and phenylpropanoids. The molecular networking and metabolite clustering showed an interesting pattern where some compounds were produced only by one species, some by two species, and some by all three. These compounds may have pharmaceutical potential based on their chemical properties and reported activities. Full article

Mixed-use development (MXD) is crucial for urban planning and travel. The COVID-19 outbreak had a significant impact on travel behaviour and MXD projects worldwide, particularly in high-income countries. However, limited studies have explored the predictors of MXD usage and travel patterns in low- and middle-income countries, including Malaysia, and how these events were affected by COVID-19. Using the Rowley and extended Hopenbrouwer and Louw models, this study investigates the travel patterns within MXD premises, their associated factors, and residents’ perspectives of internal and external trips before and during COVID-19 in Klang Valley, Malaysia. A mixed-method study was conducted by using a validated survey and performing a structured interview with MXD residents. A total of 134 and 52 respondents participated in the survey and qualitative interviews, respectively. Data were analysed using descriptive statistics, logistic regression models, and thematic analysis. A significantly higher proportion of MXD respondents engaged in external travel compared to internal travel before and during COVID-19. Before COVID-19, external travel was significantly higher among younger residents, government servants, higher-income earners, and those who owned a car and had recently moved to MXD areas. The odds of internal travel were significantly higher among private-sector employees, students, and low-income earners. During the pandemic, external travel frequency was significantly higher among male residents, older residents, government servants, high-income earners, and those with multiple vehicles. Residents with more parking lots tended to travel less internally compared to those with fewer parking lots allocated. Qualitative analyses revealed that cost-saving, convenience and comfort, social lifestyle, health and well-being, and green environment were the factors that shaped MXD residents’ perceived benefits of trip internalisation. Meanwhile, the barriers to internal trips included the lack of infrastructure, poor management, lifestyle activities/individual factors, and environmental factors. The recommended strategies to reduce external trips were to ensure diversified services and accessibility, inclusiveness in planning activities, promoting social interaction, and work-from-home policies. These findings reflect the strategies that can be incorporated to reduce external trips generated by MXD and enhance effective traffic management. Full article

Background/Objectives: Cancer is the second most common cause of death in Poland, responsible for 26.7% of deaths in 2023. Our aim was to estimate total direct and indirect costs of cancer in Poland. Methods: We acquired epidemiological data from the System Analysis and Implementation Database provided Polish Ministry of Health. For estimating the direct costs of medical procedures and chemotherapy, we used statistics of homogeneous groups of patients provided by the Polish National Health Fund. For analyzing the indirect costs in the field of absenteeism we acquired data from Statistical Portal of Polish Social Insurance Institution. Results: The total direct costs of treatment for cancer in the adult population in the period 2021–2023 to be equal to USD 192,935,858, taking purchasing power parity of Polish currency into account. This was equal to 0.00394% of General Domestic Product. The costs associated with absenteeism were equal to USD 3,103,526,321, which was equal to 0.063% of GDP. The sum of Years of Potential Life Lost was equal to 930,962 and the sum of Years of Potential Productive Life Lost was equal to 363,511. Cancer morbidity and incidence in the period 2021–2023 increased by 1.3%. Mortality increased by 2.1%. The total cost of medical services relative to GDP in 2022 was lower than in 2021; in 2023, however, it was higher than both in 2021 and 2022. The cost of chemotherapy, both in absolute numbers and relative to GDP, was significantly lower in 2022 than in 2021. Conclusions: In 2023, the cost was higher than in 2021 and in 2022. The costs of absenteeism in three consecutive years increased. Years of Potential Life Lost and Years of Potential Productive Life Lost due to cancer increased substantially in the period 2021–2023, both for males and for females, in all three age groups. Full article

Background/Objectives: Diabetes is Mexico’s second-leading cause of death, primary cause of disability, and diabetic retinopathy (DR) associated with this disease is the leading cause of vision loss among the working population. Limited healthcare funding and inequitable access hinder diagnosis and treatment, leaving 32% undiagnosed and at risk of developing serious complications such as DR. With screening rates declining, nonprofits like the Association to Prevent Blindness in Mexico (APEC) play a crucial role in detecting diabetes and DR, reducing healthcare costs, and improving patient outcomes. Methods: This study analyzes data from over 25,000 first-time patients screened at APEC in 2023, providing a unique empirical resource on diabetes and DR in Mexico. Using the Social Return on Investment (SROI) approach, it evaluates program costs (medical resources, equipment, and personnel) against patient benefits. These benefits are quantified as the probability that newly diagnosed or uncontrolled diabetes patients begin treatment, thus preventing DR, weighted by the Value of Statistical Life (VSL). Results: Of the total screened patients, 17.2% had diabetes. Among them, 20.0% were unaware of their condition, while the remaining 80.0% knew their diagnosis. Notably, 25.8% of those who were aware of their diagnosis did not have diabetes under control. Considering all costs associated with the first-time ophthalmology patients screening program and assuming only a portion of patients would seek treatment, every peso invested by APEC has the potential to generate the equivalent to 542 pesos in patient well-being. When factoring in the subsequent costs of diabetes control treatment borne by the patients, the potential Benefit–Cost Ratio is estimated at 9:1. These results proved consistent to sensitivity analysis for key assumptions affecting the estimated benefits and costs. Conclusions: The study demonstrates that integrating routine diabetes screening into specialized ophthalmologic care can generate substantial social value through timely intervention, as early detection promotes better diabetes management and helps prevent complications beyond diabetic retinopathy. Full article

Background/Objectives: Rheumatic fever is preventable and can be treated successfully; however, a lack of understanding of the disease and barriers to timely healthcare can impact outcomes. Pacific people in Aotearoa New Zealand experience inequitable burdens, and a Pacific community group and health professional network are working together to co-design education initiatives. This descriptive, mixed-methods study aimed to (1) explore Pacific people’s awareness and understanding of rheumatic fever, (2) describe where Pacific people access health information. Methods: An online survey co-developed with Pacific community members was run from December 2024 to February 2025. Questions related to sore throats, rheumatic fever, medication adherence, long-term outcomes and where Pacific people access health information. Quantitative data was analyzed descriptively using SPSS version 28 and open-ended qualitative responses were analyzed using an inductive content analysis approach. Results: A total of 400 Pacific respondents were included: 34% were aged 16–24 years and 66% were female. Based on the analysis, 71% of Pacific participants knew that a sore throat should always be checked by a health professional and 65.3% had heard of rheumatic fever. Fever and sore throats were commonly identified as symptoms of rheumatic fever, with joint pain, body aches and chest pain mentioned less. Barriers to health services such as cost, long waiting times and cultural factors were discussed as reasons why many Pacific people often utilize social media and online forums for health information. Conclusions: This study highlights gaps in rheumatic fever knowledge and thus opportunities for health education initiatives for Pacific communities, potentially utilizing social media and online platforms. Full article

This study investigates the adoption and utilisation of hidden roof construction as an innovative alternative to traditional roofing systems in Ghana’s urban housing. Although hidden roofs offer advantages in climate adaptability, aesthetics, and cost efficiency, their adoption remains limited. Using a survey-based partial least squares structural equation modelling approach, this study identifies the factors influencing their acceptance and use. Quantitative data were collected through field surveys from residents and construction professionals within the Kumasi Metropolitan Area. A structured questionnaire was administered using purposive and convenience sampling, yielding 175 valid responses from a total of 220 distributed questionnaires (79.5% response rate). Findings indicate that hidden roof systems are valued for their climatic suitability, particularly their resistance to water leakage and reduced heat absorption, alongside their efficient drainage design. Aesthetic appeal, cultural relevance, and ease of maintenance also emerged as key determinants of positive perception and adoption. Structural analysis confirmed significant positive relationships between design concept, aesthetic and social values, sustainability, functionality, and overall acceptance. The study provides practical guidance for architects, engineers, developers, and policymakers seeking to promote sustainable, user-centred roof design in tropical urban contexts. Findings are, however, limited to Kumasi and may not fully generalise to other Ghanaian cities. Full article

This study presents the initial validation of the IMPACT model, a psychometric tool developed to evaluate how university faculty adopt ChatGPT in higher education. It specifically addresses the existing gap in validated instruments designed for educators, as most prior research has focused on student-based adoption models. A total of 206 professors completed a 39-item Likert-scale questionnaire. Exploratory factor analysis using principal axis factoring with oblimin rotation identified the underlying structure of the instrument. Reliability and internal consistency were examined through Cronbach’s alpha and McDonald’s omega. The analysis revealed a five-factor structure comprising functional appropriation, ethical and academic concerns, cost and accessibility, facilitating conditions, and perceived reliability and trustworthiness. Intention to use and performance expectancy merged into a single factor, and social influence did not emerge as a determinant. The model demonstrated strong reliability and internal consistency across all dimensions. The IMPACT model offers a validated framework for understanding faculty adoption of ChatGPT, emphasizing functional, ethical, and infrastructural factors over social influence. These findings provide a foundation for confirmatory analyses and contribute to advancing theoretical and practical insights into AI integration in higher education teaching. Full article

The unequal status between manufacturers and live-streamers often undermines supply chain profitability and social welfare. However, the “volume guarantee” commission mode, designed to mitigate this issue, has proven ineffective in practice. This paper adopts a Nash bargaining fairness framework to analyze this paradox, incorporating two defining features of live-streaming commerce: the social network effect and the streamer’s cost of purchasing public domain traffic. We develop a dynamic game model involving the platform, manufacturer, streamer, and consumers to examine commission mode selection and supply chain decision-making. Our analysis yields four key findings: (1) Under Nash bargaining fairness, the “volume guarantee” mode is invariably redundant, regardless of who sets the sales threshold. Bargaining power only influences profit distribution via commission rates without distorting optimal product pricing or traffic acquisition decisions. (2) The social network effect boosts product prices, traffic purchases, total profit, and social welfare, with its impact amplified by the streamer’s fanbase size. Thus, collaborating with top-streamers is advantageous for manufacturers. (3) While higher platform traffic costs do not affect the optimal product price, they reduce traffic purchase volume, thereby decreasing supply chain profits and social welfare. (4) To enhance social welfare, platforms can implement differentiated traffic pricing, offering discounts to top-streamers. This study provides critical managerial insights for designing fair contracts and fostering equitable cooperation in live-streaming ecosystems. Full article