Search Results (601)

Background: Nutritional management has become an integral part of Inflammatory Bowel Disease (IBD) care, with growing evidence supporting specific dietary interventions alongside pharmacologic therapy. However, clinical guidance remains fragmented due to heterogeneous study designs and variable endpoints. Objectives: This review critically examines the current evidence on dietary strategies and oral nutritional supplementation (ONS) in both Crohn’s Disease (CD) and Ulcerative Colitis (UC), highlighting their clinical applications, mechanisms of action, and limitations. Methods: A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science databases, analyzing studies on various dietary approaches and ONS in IBD. Results: Exclusive Enteral Nutrition (EEN) is a first-line therapy in pediatric CD, while partial enteral nutrition (PEN) and the Crohn’s Disease Exclusion Diet (CDED) show promising efficacy and better adherence in both children and adults. Whole-food-based interventions, including the Mediterranean Diet, Specific Carbohydrate Diet, plant-based diets, and emerging strategies such as CD-TREAT and the Tasty & Healthy diet, have demonstrated varying levels of benefit in disease maintenance and symptom control. Targeted exclusion diets—such as low-FODMAP, low-emulsifier, and low-sulfur diets—may relieve functional symptoms and influence inflammatory activity, although evidence remains preliminary. ONS plays a pivotal role in addressing malnutrition and improving outcomes in perioperative and hospitalized patients. Conclusions: Dietary interventions and ONS represent valuable therapeutic tools in IBD management. Future research should prioritize standardized, well-powered clinical trials and personalized nutritional approaches to better define their role within integrated care pathways. Full article

Background/Objectives: Common femoral endarterectomy (CFE) is one of the most frequent open arterial surgical procedures. The ideal material to close the arteriotomy is equivocal. This study aims to evaluate the efficacy and safety of bovine pericardium patch (BPP) utilization in femoral artery bifurcation endarterectomy (FE). Methods: A single-center, retrospective study was conducted, involving 200 consecutive FE procedures performed between November 2019 and December 2022. Clinical data, including demographics, comorbidities, surgical details, and outcomes, were collected from institutional records. The primary endpoints were overall survival, reintervention-free survival, and amputation-free survival. Secondary endpoints included the incidence of surgical site infection (SSI) and its associated risk factors. Logistic regression models were used to identify predictors of SSI, adjusting for confounders such as age, smoking, comorbidities, and bacterial colonization. Results: The median age of the cohort was 68 (SD ± 9.70) years, and 66% were male. The median follow-up period was 1010 (SD ± 471.47) days. Thirty-day survival was 91%, and 2 year survival was 69.3%, with cardiovascular events and cancer being the leading causes of death. Reintervention-free survival was 94.7% at 30 days and 77.5% at 2 years, while amputation-free survival was 94.3% at 30 days and 87.4% at 2 years. SSI requiring surgery occurred in 16% of patients, with a higher risk observed in patients with critical limb ischemia (CLI) compared to those with claudication. The presence of pathogens such as MRSA, Escherichia coli, and Pseudomonas aeruginosa (OR 16.1, p < 0.001) was significantly associated with SSI. Previous groin surgery did not affect SSI incidence. Conclusions: BPP utilization in FE provides favorable patency and survival outcomes, even in a high-risk patient population with significant comorbidities. CLI and bacterial colonization increased the risk of SSI. Perioperative infection prevention strategies and management of systemic comorbidities are essential to improve patient outcomes. Full article

Farmer differentiation has led to significant differences in input behaviors, presenting new challenges for agricultural environmental governance. However, previous studies evaluating agricultural production systems often overlook the impact of farmer heterogeneity, and the relationship between farmer differentiation and environmental impacts remains unclear. This study takes the apple production system as a case and employs life cycle assessment (LCA) using the IMPACT2002+ model to establish environmental impact evaluation indicators for agricultural products. The environmental impacts of different types of farmers are analyzed. The findings are as follows: Overall, orchard systems under Type II part-time farmer (PTF(II)) management show the highest environmental impacts, whereas Type I part-time farmer (PTF(I)) systems exhibit the lowest, with pure farmer (PF) systems falling in between. Endpoint assessments reveal that human health is the most affected, with resource impacts being the least significant. Further analysis reveals that fertilizers are the primary environmental hotspot in the apple production system. For PFs and PTFs(I), the second-largest source of pollution in the orchard system is the purchase of storage services, whereas for PTFs(II), it is irrigation. Therefore, the government should strengthen the management of fertilizers and irrigation, and promote measures such as eco-friendly fertilizers and water-saving technologies, thereby reducing the environmental burden of production. Full article

Heart failure (HF) remains a global health burden with high morbidity and mortality, despite significant pharmacological advances. Vitamin D deficiency (VDD) is commonly observed in HF patients and may exacerbate disease progression through various pathophysiological mechanisms, including activation of the renin–angiotensin–aldosterone system, inflammation, oxidative stress, and impaired calcium homeostasis. While vitamin D (VD) supplementation may positively influence surrogate markers in selected patient groups—particularly those with reduced ejection fraction or severe vitamin D deficiency—its effect on primary endpoints such as mortality or HF-related hospitalization varies significantly across studies and patient populations. As a result, while VD supplementation may benefit VD-deficient HF patients, current evidence does not support routine administration across the whole HF population. It is still a matter of debate whether VDD belongs to prognostic markers of worse outcomes in HF or is instead their potential cause. Therefore, the clinical utility of VD in HF management remains underexplored. This review aims to assess the evidence regarding vitamin D status and its supplementation in the context of HF, with a focus on different HF phenotypes: reduced (HFrEF), mildly reduced (HFmrEF), and preserved ejection fraction (HFpEF). The aim is to synthesize findings from novel observational studies, randomized controlled trials, and meta-analyses that shed light onto this intricate relationship and may be valuable in everyday clinical practice. Full article

Background/Objectives: Anastomotic leakage is one of the most frightening and potentially fatal complications after esophagectomy. The collaboration between the surgical team, interventional gastroenterologists, and radiologists has the potential to improve the hospital stay, as well as morbidity and mortality. The aim of this study is to present our experience and evaluate the results of the multimodal management of anastomotic leak following esophagectomy in our unit. Methods: This is a retrospective study analyzing a single referral center’s prospectively maintained database of all patients diagnosed with anastomotic leak between March 2019 and March 2025 using the definition of the Esophageal Complications Consensus Group. The treatment pathways and the patient outcomes are presented. The primary endpoint was 90-day mortality and in-hospital mortality. Results: A total of 241 esophageal resections were performed between March 2019 and March 2025. Lymphadenectomy of the mediastinum was performed in 88.4% of the patients. Cervical and intrathoracic anastomosis were performed in 143 (59.3%) and 98 (40.7%) cases, respectively. Twenty-nine patients (12%) with a mean age of 59.1 years developed anastomotic leak. Anastomotic leak occurred in 14.3% of intrathoracic anastomoses and 10.5% of cervical anastomoses. The median day of leak diagnosis was the sixth postoperative day. Leak management involved conservative strategies, wound exploration, endoscopic stent placement or vacuum therapy, drainage of effusions under radiologic guidance, and reoperation. The 90-day and in-hospital mortality rate was 3.4%. No cases of conduit necrosis or mediastinitis were reported. Endoscopic management was employed in 18 patients (62.1%) as a first- or second-line treatment, while reoperation was required in 6 patients (20.7%). The median interval from diagnosis to anastomosis healing was 21 days and the median duration of hospital stay 32 days. The management was successful in 27 patients (93.1%) except for 1 who developed tracheoesophageal fistula and 1 who died due to hemorrhagic complication of anticoagulant treatment. Conclusions: Anastomotic leak after esophagectomy is considered a complex, diversified, and morbid clinical entity. The evolving potential of multidisciplinary management encompassing surgical and interventional radiological and endoscopic treatment addresses the mortality rates and heralds a new era of minimizing morbidity. Full article

Objective: To systematically evaluate the effectiveness and safety of radiofrequency ablation (RFA) for managing pain caused by spinal metastases. This review aimed to consolidate evidence on RFA’s analgesic efficacy and associated risks to inform clinical practice in palliative cancer care. Methods: A systematic review adhering to PRISMA guidelines was conducted. Databases were searched for studies evaluating RFA for spinal metastases pain. Inclusion criteria specified: randomized or non-randomized studies (prospective/retrospective); ≥3 adult patients; RFA used alone or combined with other treatments; reported pre- and post-RFA pain assessments; English language publication. Data extracted included patient demographics, primary tumor type, lesion location, pain scores (e.g., NRS/VAS), and complications. Pain response was assessed using definitions including the International Consensus Pain Response Endpoints (ICPRE) and definitions for moderate (≥2-point reduction) and high (≥4-point reduction) effectiveness. Results: This review included 33 studies, totaling 1336 patients (53.7% female) and 1787 treated lesions. The majority (85%) of studies reported highly effective pain management (≥4-point pain score reduction). The remaining 15% showed moderate effectiveness (≥2-point reduction). All studies reported achieving at least a partial pain response per ICPRE criteria. Mean pain scores decreased significantly from baseline (7.56/10) within 24–72 h (3.65) and remained low at 4 weeks (2.99), 12 weeks, and 24 weeks (both 2.70). Common primary cancers were lung (27.6%), breast (26.2%), and genitourinary (11.3%). Lesions were primarily in the thoracic (47.9%) and lumbar spine (47.3%). Crucially, no life-threatening (grade IV–V) complications occurred. The overall rate of grade I–III complications was low at 2.11%. Limitations: This systematic review is limited by its study-level nature, preventing detailed subgroup analyses regarding specific metastasis characteristics or the impact of complementary therapies. Conclusions: This systematic review suggests that RFA is a safe and effective treatment for pain control in patients with spinal metastases. It provides both rapid (within 24 h) and durable mid-term (up to 24 weeks) analgesia. The favorable safety profile, with a low complication rate, supports RFA as a valuable complimentary option within the multidisciplinary palliative management of painful spinal secondary tumors. Future randomized-controlled studies may help to further define its role when associated with other treatments. Full article

With the escalating frequency and intensity of global wildfires driven by climate change, fire retardants (FRs) have become essential tools in wildfire management. Despite their widespread use, the environmental safety of newer FR formulations—particularly in relation to aquatic ecosystems and developmental toxicity—remains insufficiently understood. In particular, their effects on fish embryos, which represent a sensitive and ecologically important life stage, are poorly characterized. This study investigated the acute toxicity of three commercially available FRs—N-Borate, N-Phosphate+, and N-Phosphate-—on early life stages of zebrafish (Danio rerio), based on an OECD 236 Fish Embryo Toxicity (FET) test. Notably, N-Phosphate- FR exhibited significant toxicity with a 96 h LC50 of 60 mg/L (0.0055%), while N-Borate (>432 mg/L, >0.032%) and N-Phosphate+ (>1181 mg/L, >0.08%) showed substantially lower toxicity. Sublethal effects, including reduced yolk sac absorption and yolk sac darkening, were observed across all FRs, highlighting potential developmental disruptions. The elevated toxicity of N-Phosphate- FR likely stems from its surfactant content. These findings reveal variations in the acute toxicity of different FR formulations, emphasizing the need for ecotoxicological assessments to guide the selection of safer FRs for wildfire management and to protect aquatic biodiversity. The results highlight the importance of incorporating developmental endpoints in FR risk assessments and provide foundational data for regulatory decisions regarding FR application near aquatic habitats. Further research is necessary to elucidate the mechanisms underlying observed effects and to evaluate cross-species toxicity at environmentally relevant concentrations. Full article

Background: Niraparib is an oral poly (adenosine diphosphate-ribose) polymerase inhibitor with promising activity for patients with advanced breast cancer harboring germline BRCA1/2 mutations. Methods: LUZERN (NCT04240106) was a multicenter, open-label, Simon’s two-stage, phase II clinical trial evaluating the efficacy and safety of niraparib with aromatase inhibitors (AIs) for patients with HR-positive/HER2-negative advanced breast cancer with either a germline BRCA1/2 mutation (cohort A) or germline BRCA1/2 wild-type and homologous recombination deficiency (exploratory cohort B). Eligible patients received ≤1 line of chemotherapy and 1–2 prior lines of endocrine therapy for advanced disease with secondary resistance to the last AI-based regimen. Patients received niraparib (300 mg or 200 mg) plus an AI. The primary endpoint was the clinical benefit rate (CBR) in cohort A. Results: Between June 2020 and November 2022, 14 patients were enrolled in cohort A (n = 6 for stage I, n = 8 for stage II) and no patients were enrolled in cohort B. One patient was excluded from the efficacy analysis due to no prior AI treatment. Nearly all patients (92.9%) previously received a cyclin-dependent kinase 4/6 inhibitor, but no patients had received prior platinum-based chemotherapy. Median follow-up was 16.7 months (range: 13.2–18.2). The CBR was 46.2% (95% CI: 19.2–74.9), meeting the primary endpoint. Median progression-free survival was 5.5 months (95% CI: 1.9–8.5), and median overall survival was 18.1 months (95% CI: 9.7–NE). The safety profile was consistent with the known toxicity of both drugs. Conclusions: Niraparib combined with an AI has encouraging antitumor activity and a manageable safety profile in patients with AI-resistant HR-positive/HER2-negative advanced breast cancer with germline BRCA1/2 mutations. Full article

With the acceleration of urban renewal, directional blasting has become a common method for building demolition. Analyzing the time–frequency characteristics of blast-induced seismic waves allows for the assessment of risks to surrounding structures. However, the signals monitored are frequently tainted with noise, which undermines the precision of time–frequency analysis. To counteract the dangers posed by blast vibrations, effective signal denoising is crucial for accurate evaluation and safety management. To tackle this challenge, a dual denoising model is proposed. This model consists of two stages. Firstly, it applies endpoint processing (EP) to the signal, followed by complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN) to suppress low-frequency clutter. High-frequency noise is then handled by controlling the multi-scale permutation entropy (MPE) of the intrinsic mode functions (IMF) obtained from EP-CEEMDAN. The EP-CEEMDAN-MPE framework achieves the first stage of denoising while mitigating the influence of endpoint effects on the denoising performance. The second stage of denoising involves combining the IMF obtained from EP-CEEMDAN-MPE to generate multiple denoising models. An objective function is established considering both the smoothness of the denoising models and the standard deviation of the error between the denoised signal and the measured signal. The denoising model corresponding to the optimal solution of the objective function is identified as the dual denoising model for blasting seismic wave signals. To validate the denoising effectiveness of the denoising model, simulated blasting vibration signals with a given signal-to-noise ratio (SNR) are constructed. Finally, the model is applied to real engineering blasting seismic wave signals for denoising. The results demonstrate that the model successfully reduces noise interference in the signals, highlighting its practical significance for the prevention and control of blasting seismic wave hazards. Full article

Background/Objectives: Oral anticoagulation therapy (OAC) is crucial for reducing the risk of ischemic complications in patients with atrial fibrillation (AF). However, OAC also increases the risk of major bleeding events. The optimal management of OAC in patients with AF undergoing transaortic valve implantation (TAVI) is unclear. This study aimed to compare the efficacy and safety of OAC interruption vs. continuation in patients with AF scheduled for TAVI. Methods: PubMed, EMBASE, and Cochrane were searched to include all pertinent randomized and observational studies. The primary endpoint was the occurrence of net adverse clinical events (NACE), a composite of all-cause death, major vascular complications, and major bleeding at 30-day follow-up. Secondary endpoints included all-cause death, cardiovascular death, major vascular complications, major bleeding, any bleeding, stroke, non-fatal myocardial infarction, and the need for red-packed blood transfusion. Results: A total of three studies and 2773 patients were included in the analysis (1314 were allocated to continuation of OAC therapy and 1459 to interruption of OAC therapy during TAVI). The two study groups experienced a similar rate of NACE (OR = 0.89 [95% CI 0.61 to 1.31], I² = 77%, p = 0.56) compared to the OAC-interruption group. No significant differences were observed in the rate of all-cause death (p = 0.21), cardiovascular death (p = 0.35), major vascular complications (p = 0.84), major bleeding events (p = 0.47), total bleeding events (p = 0.62), or non-fatal MI (p = 0.55). Interestingly, the OAC-continuation group experienced a lower occurrence of stroke (OR = 0.62 [95% CI 0.39 to 0.97], I² = 0%, p = 0.04) and the need for red packed blood cells (OR = 0.66 [95% CI 0.50 to 0.86], I² = 20%, p < 0.01) compared to the OAC-interruption group. Conclusions: In patients with AF undergoing TAVI, there was no significant difference between interruption and continuation of OAC in terms of NACE, composite of all-cause death, major vascular complications, or major bleeding at 30-day follow-up. Of interest, the OAC-continuation group patients experienced lower rates of stroke and the need for blood transfusion. Full article

Background: We recently reported that the transcutaneous bilirubinometer (TCB) tends to underestimate the severity of neonatal jaundice (NJ). We hypothesize that the cumulative ambient light exposure contributes to the discrepancy. Objectives: This study aimed to identify factors that affect the TCB underestimation. Methods: We analyzed prospectively collected data over a twenty-month period at a level III medical facility. Neonates at risk for NJ who couldn’t secure an appointment with the primary practitioner were followed by the nursery team. Neonates who had phototherapy or forehead bruises were excluded. Concurrently collected total serum bilirubin (TSB) was determined by the diazo method. The primary endpoint was the discrepancy between TCB and the corresponding TSB (TCB-TSB). A mixed-effects model was used to assess the correlation between (TCB-TSB) and potential contributors, including visit age (in hours), gestational age (GA), sex, TSB, season, birth weight, and race. Results: There were 795 visits for 559 neonates, including 341 males, 179 white, 235 black, 103 Hispanic, 41 Asian, and one unrecorded race. The TSB ranged between 1.8 and 33.9 mg/dL. The (TCB-TSB) ranged between −20.0 and 6.4 mg/dL. The median GA and birth weight were 38.7 weeks and 3214.5 g. The visits occurred between 48 and 381 h of age. 133, 148, 132, and 146 visits were in Spring, Summer, Autumn, and Winter, respectively. Fifty-four neonates (9.7%) were admitted for management. 500 sternum TCB readings were also collected from 350 neonates together with the corresponding forehead TCBs. We found that the forehead (TCB-TSB) was significantly less in winter than in spring and summer (p = 0.0014 and 0.0003, respectively). There was a negative correlation between forehead (TCB-TSB) and visit age in hours (p = 0.0006). After adjusting for visit age and season, the (TCB-TSB) is significantly correlated with TSB (p < 0.0001). Similar findings were also seen in the sternum (TCB-TSB) except for the season (p = 0.0808). Conclusions: Cumulative ambient light exposure and the severity of NJ may contribute to (TCB-TSB). Full article

Objectives: The objective of this study is to investigate the two-year continuous efficacy, risk factors, and safety profile of selective laser trabeculoplasty (SLT) in Japanese individuals diagnosed with normal-tension glaucoma (NTG) who underwent SLT as either a first-line or second-line treatment. Methods: A retrospective chart review was conducted of patients with NTG who underwent SLT as either an initial or secondary therapy at 26 medical institutions in Japan between January 2020 and December 2021 with a 2-year follow-up. The primary endpoint was a reduction in the rate of intraocular pressure (IOP) over 2 years after SLT. To estimate the time-varying effect of IOP reduction, a linear mixed-effects model was employed. The secondary endpoints were numerical IOP reduction, treatment success rates shown by a Kaplan–Meier analysis, and complications. Success was defined as an outflow pressure improvement rate (ΔOP) ≥ 20% (definition A) or an IOP reduction rate ≥ 20% (definition B) without further treatment. A Cox proportional hazards regression analysis was used to identify the risk factors to successful SLT treatment. The study was registered with UMIN-CTR (ID: UMIN R000064045). Results: A total of 230 eyes from 230 individuals participated in this study, with 148 eyes receiving SLT as an initial (first-line) therapy and 82 eyes undergoing SLT as a secondary (second-line) intervention. In the first-line group, the mean IOP dropped from 16.7 ± 2.3 mmHg to 13.7 ± 2.4 mmHg at two years post-treatment, reflecting a 16.8% reduction. In the second-line group, the average IOP declined from 15.9 ± 2.5 mmHg to 13.2 ± 2.0 mmHg, marking a 14.4% decrease over the same period. The treatment success rate according to definition A (ΔOP ≥ 20%) was 73.7% at 2 years. Analysis using a linear mixed-effects model identified time (p < 0.001), age (p = 0.044), baseline IOP (p < 0.001), and central corneal thickness (CCT) (p < 0.001) as statistically significant contributors to IOP reduction following SLT. However, neither the Group (first-line vs. second-line) variable (p = 0.386) nor the Time × Group interaction (p = 0.298) reached statistical significance. A lower baseline IOP and a thicker CCT were confirmed as significant predictors of SLT treatment failure. Conclusions: Both initial and secondary SLT treatments for NTG proved to be effective and safe over a two-year period, although the extent of IOP reduction was smaller in cases with a lower baseline IOP. Our findings indicate that the IOP-lowering effect of SLT in NTG is influenced by pretreatment IOP levels, aligning with previous studies on primary open-angle glaucoma and ocular hypertension. However, in contrast to those earlier findings, our research identified pretreatment central corneal thickness as a statistically significant factor influencing SLT efficacy in NTG. These results support the role of SLT as a reliable and safe therapeutic option for managing NTG. Full article

(1) Background: The management of ipsilateral breast cancer recurrence depends on the extent of the tumor, and staging results, and mastectomy is currently the standard of care for previously irradiated patients. Studies are increasingly investigating suitable candidates for the repeated use of breast-conserving approaches as an alternative to mastectomy. But this includes the crucial necessity for curative reirradiation (Re-RT). The therapeutic challenge in reirradiation involves finding a balance between tumor control and the risk of severe toxicity from cumulative radiation doses in previously irradiated organs. Re-RT options include the use of brachytherapy, intraoperative radiotherapy, or external beam RT with photons or electrons. The application of particle therapy using proton beam therapy represents an innovative radiotherapeutic technique for breast cancer patients that might offer advantageous physical properties, a superior dose reduction to adjacent organs-at-risk, and effective target volume coverage with lower integral doses to the patient’s whole body. In addition, this technique could potentially offer higher radiobiological effects and tumor responses. (2) Methods: The BREAST trial (NCT06954623) will be conducted as a prospective, single-arm, phase II study in 20 patients with histologically proven invasive breast cancer recurrences after repeat breast-conserving surgery and with an indication for local reirradiation. The patients will receive partial-breast re-RT with proton beam therapy in 15 once-daily fractions up to a total dose of 40.05 Gy(RBE), delivered with active raster scanning. The required time interval will be 1 year after previous RT to the ipsilateral breast. (3) Results: The following results will be reported: The primary endpoint is defined as the cumulative overall occurrence of (sub)acute skin toxicity of grade ≥ 3 within 6 months after the start of re-RT. Secondary outcome includes an analysis of the local, regional, and distant control, progression-free and overall survival, quality of life, and cosmesis. The explorative and translational objectives of this study include planning comparisons to other RT techniques and irradiation types, dosimetric evaluations, analyses of radiological imaging features, and translational assessments of cardiac toxicity biomarkers and tumor markers. (4) Conclusions: Overall, the aim of this study is to evaluate the potential of proton beam therapy for partial breast reirradiation and to establish the underlying data for a randomized trial. Full article

MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) is a growing global concern. Nutraceuticals offer an appealing approach by targeting key mechanisms, such as oxidative stress, inflammation, lipid metabolism, and insulin resistance. This narrative review examines the role of various nutraceuticals in MASLD treatment, including silymarin, vitamin E, omega-3, curcumin, berberine, and coenzyme Q10. Some of them show promising biochemical and metabolic changes, while others produce conflicting results due to relevant studies’ design and endpoints. To bridge the gap between research and reality, we summarize the data, create an interpretation heatmap, and develop a practical supplement guide. Regardless of their potential, nutraceuticals should be viewed as add-ons to lifestyle interventions rather than standalone treatments. Future research should focus on well-designed, long-term studies to prove efficacy, dosing, and combination strategies for personalized MASLD management. Full article

Given the relevance of sustainability, this study analyzed the impacts on water consumption in the production chain of ornamental stone pieces (marble and granite) and quartz-based composites. The goal was to compare the water demand throughout the process, from extraction to manufacturing, using 1 m³ blocks as the unit of analysis. This study was conducted in Bahia, a state with significant ornamental stone production, located in a semi-arid region with limited water availability. The methodology included data collection from participating companies, combined with sectorial information and the Ecoinvent version 3.3 database, modeled using the SimaPro 8.0 software. The impact assessment was carried out using the AWaRE (Water Scarcity Footprint) and ReCiPe Endpoint methods, following the guidelines of Life Cycle Assessment (LCA), as per ABNT NBR ISO 14040 standards. The results showed that marble and granite have lower water demand and environmental impact in the categories of particulate matter, human toxicity, ecotoxicity, eutrophication, and acidification when compared to quartz composites. The highest environmental impact occurred during the processing stage, which requires a large amount of water and generates effluents, losses, and particulate matter. The results indicate that marble and granite demand less water and exhibit lower environmental impacts—across categories like particulate matter, human toxicity, ecotoxicity, eutrophication, and acidification—than quartz composites. Notably, the processing stage incurred the highest environmental burden due to its intensive water use and consequent generation of effluents, losses, and particulate matter. These findings highlight the necessity of efficient water management and the adoption of circular economy principles—including water reuse and waste valorization—to promote long-term sustainability in the ornamental stone industry. Full article