Search Results (103)

Electric vehicle (EV) transport by ship is expanding beyond industrial logistics centred on automobile production, trade, and pure car and truck carriers (PCTCs) into daily transportation for island tourism, commuting, and essential mobility. According to Korea Maritime Transportation Safety Authority (KOMSA) vessel status data as of March 2026, 104 of 146 domestic passenger ships were car-ferry passenger ships, accounting for 71.2% of the fleet and operating on 75 of 99 designated routes nationwide. Korea Shipping Association (KSA) operational records show that the EV transport rate on these routes increased from 0.76% in 2024 to 1.21% in 2025, with some routes exceeding 2.0–4.7%. Unlike enclosed multi-deck PCTC vehicle spaces, Korean coastal car-ferry passenger ships generally have single-tier open vehicle decks and bow ramp gates. Crosswinds on open decks may reduce smoke detector activation probability by 60–75%. Although Article 97 of the Standard for Ship Fire-Fighting Appliance newly requires dedicated EV fire-fighting equipment for car-ferry ships, it remains primarily equipment-prescriptive and does not yet provide open-deck-specific performance requirements for wind-resistant detection, fixed EV-zone cooling, EV-designated stowage arrangements, or passenger–operator safety management obligations. This study applies the five-step International Maritime Organization (IMO) Formal Safety Assessment (FSA) procedure to support improvements to EV fire-fighting equipment standards for coastal car-ferry passenger ships. Hazard identification (HAZID) was conducted with a 15-member advisory panel, and probability elicitation was performed through a Delphi survey with 10 core experts, showing strong consensus (Kendall’s W = 0.74, p < 0.01). Fault tree analysis (FTA) and event tree analysis (ETA) probabilities were derived from the Delphi results and the international literature. H-07, representing wind-induced smoke dilution, was identified as the dominant single-point vulnerability within the detection-failure branch. Monte Carlo-based FTA–ETA analysis (n = 10,000) estimated annual fire frequencies of 5.9 × 10⁻², 1.8 × 10⁻¹, and 2.9 × 10⁻¹ yr⁻¹ at EV loading ratios of 10%, 30%, and 50%, respectively, with 2.47 expected fatalities per fire. Risk entered the IMO ALARP band above a 30% EV loading ratio and exceeded the maximum tolerable crew risk above 50%. The combined application of risk control options (RCOs) 2, 3, and 4 reduced annual expected fatalities by 85.6%. Based on these results, six RCOs and institutional recommendations are proposed, including strengthened safety management obligations for passenger ship operators. Full article

Fire safety in high-rise buildings represents a critical challenge in the United Arab Emirates (UAE), where intensive urbanization, extreme climatic conditions, and multilayered regulatory frameworks impose unique competency demands on architects and Fire Safety Engineering (FSE) consultants. Despite this, no empirically validated competency framework exists that simultaneously addresses both professional groups and is tailored to the specificities of the UAE context. This study aimed to construct and empirically validate such a framework. A three-phase sequential exploratory mixed-method design was employed. In the first phase, a systematic literature review yielded a preliminary set of 69 competency indicators organized within a Knowledge, Skills and Attitudes (KSA) structure. In the second phase, a three-round Delphi technique with an expert panel of 18 specialists validated the set to 62 final indicators. In the third phase, importance–performance analysis (IPA) was conducted on a sample of 250 professionals actively engaged in fire safety projects across four UAE. IPA identified 16 priority competency gaps, most pronounced in digital transformation (BIM, CFD, AI; gap = 1.23), proactive client advisory competencies (gap = 1.21), and regulatory navigation and Civil Defence coordination (gap = 1.00). A counterintuitive finding emerged whereby architects systematically rated competencies higher than FSE consultants across all dimensions (all p < 0.05). Psychometric validation confirmed excellent instrument reliability (Cronbach’s Alpha > 0.95) and a theoretically consistent three-factor KSA structure explaining 70.06% of variance. The developed framework of 62 empirically validated indicators represents the first competency model of its kind for architects and FSE consultants in the Gulf Cooperation Council (GCC) region. Its findings provide a direct empirical basis for curriculum reform, Continuing Professional Development (CPD) programmes, and professional licencing standards in the UAE and across the GCC region. The study makes three original contributions: the first empirically validated UAE-specific competency framework for these professional groups; a methodological combination of Delphi, IPA, EFA, Mann–Whitney, and Kruskal–Wallis not previously applied in fire safety competency research; and empirical confirmation that 74% of indicators required original development or adaptation, demonstrating the limitations of generic international competency models in the UAE context. Full article

Cardiorenal–metabolic (CKM) syndrome has emerged as a unifying condition describing the interplay between metabolic dysfunction, chronic kidney disease, and cardiovascular disease. To address this concept, the American Heart Association, in a 2023 Presidential Advisory, presented an official statement to capture the transition from metabolic risk and subtle cardiorenal dysfunction to overt cardiovascular and renal disease. Although this framework provides a structured representation of disease burden and facilitates risk stratification, emerging evidence suggests that it is primarily focused on the progressive nature, whereas high-risk patients may experience sudden cardiac or renal events. While staging systems provide important tools for risk stratification, they remain primarily descriptive and do not adequately reflect the dynamic and non-linear interactions underlying disease progression. Importantly, patients exhibit substantial heterogeneity in dominant pathophysiological drivers, related to various baseline risk factors and primitive cardio–kidney disorders, that is not fully captured by stage-based classifications. Notably, we propose a phenotype-oriented approach to CKM syndrome based on the recognition that its clinical expression reflects heterogeneous and evolving pathophysiological mechanisms rather than a uniform disease trajectory. According to this strategy, the paradigm of management shifts from an evolutive concept to a more appropriate use of disease modifying agents with cross-organ effects. Sodium–glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1a), and non-steroidal mineralocorticoid receptor antagonists (MRA) have demonstrated the ability to modulate key biological pathways across the cardiovascular, renal, and metabolic axes. Therefore, personalized management that identifies a specific strategy according to CKM phenotypes must be assessed. Full article

Innovative models of cancer care have emerged in response to advances in cancer treatment, expanding technologies that bring care closer to home and address COVID-19-related challenges and concerns about a shrinking healthcare workforce. Despite the advancements made, the psychosocial impact on people affected by cancer persists. The psychosocial burden of cancer underlines the need for patient access to evidence-based psychosocial oncology (PSO) and supportive care (SC) interventions. As models of care evolve, hiring practices of PSO professionals must also evolve for cancer patients to access properly staffed PSO programs that deliver high-quality and efficient services. In 2019, the Canadian Association of Psychosocial Oncology (CAPO)–Clinical Advisory Committee consulted administrators and clinicians across Canada to understand caseload volumes of PSO professionals with a goal to set staffing ratios. The engagement process revealed that there is no consistency in staffing PSO programs across Canada, let alone staffing ratios for PSO disciplines. In 2022, CAPO introduced a 10-point staffing framework and formula to calculate staffing ratios for hiring PSO professionals, beginning with the social work discipline. The goal of this paper is to provide updates to the existing framework and demonstrate how the formula can be adapted to other PSO disciplines. To our knowledge, this is the first published paper in Canada outlining the calculations for a PSO staff framework and formula. The authors advocate for greater transparency when reporting PSO staffing ratios across Canada, using this framework as a reference point. Organizations reporting on the cancer system performance are encouraged to develop PSO indicators, starting with tracking patient access to PSO services. Full article

Background: Agroecology is increasingly discussed as a strategic response to the combined challenges of drought, ecological degradation, and rural vulnerability. In Morocco, this debate has become particularly urgent because agriculture now operates under persistent hydro-climatic stress, declining water availability, and strong territorial disparities between rainfed, irrigated, mountain, and oasis systems. Methods: This article is based on a structured critical review combined with an interpretive bibliometric synthesis of Moroccan and North African literature on agroecology, water stress, agricultural transition, and food-system resilience. The review was organized through conceptual framing, targeted source selection, thematic screening, and integrative synthesis. Results: Morocco is not an agroecological blank slate. Practices compatible with agroecological transition already exist across the country, including crop diversification, legume rotations, crop–livestock integration, biological regulation, organic amendments, and multifunctional production systems. However, previous reviews have mainly documented practices, projects, or sustainability initiatives without fully explaining why these remain weakly connected, poorly scaled, and insufficiently institutionalized under Moroccan conditions. This review shows that the principal barrier is not the absence of relevant practices but the absence of a coherent transition architecture capable of aligning water governance, farm economics, advisory systems, public incentives, territorial differentiation, and market valorization. The Moroccan case reveals a central paradox: agroecology is most necessary precisely where the structural conditions for its adoption are most fragile. To capture this contradiction, the paper proposes the concept of a Hydro-Agroecological Transition Trap, defined as a condition in which worsening water stress simultaneously intensifies the need for agroecological redesign and reduces the ability of farms and institutions to implement it. Conclusions: The manuscript concludes by proposing a six-pillar transition framework for Morocco based on water-smart agroecology, territorially differentiated pathways, participatory innovation, transition finance and risk-sharing, market construction, and multidimensional assessment. The originality of the study lies in shifting the analysis from a shortage of practices to a shortage of transition architecture, thereby contributing to international debates on agroecological scaling under chronic hydro-climatic stress. Full article

Background: Engaging diverse populations, including Muslims, in research activities is important to support patient-centered research and improve health equity. Objectives: The research aimed to describe the community engagement steps that informed conducting research with five distinctively diverse U.S. Muslim communities. Methods: This work provides methodological reflections on engaging diverse Muslim communities in the U.S. Researchers built trust-based partnerships with community healthcare organizations and engaged with administrative leaders, advisory members, and people from five diverse communities. Strategies to support sampling, recruitment, multi-language interpretation methods, and how to engage communities and address their concerns are discussed. Results: A total of 22 participants were included in the original study. The research team successfully engaged five of the six planned communities, utilizing multiple interpretation methods and participating in community events to support recruitment and relationship-building. Direct-to-participant recruitment efforts were strengthened by personal connections with trusted community members. Conclusions: Flexibility and adaptability are integral in recruitment and data collection, as diverse communities may respond differently to methods successfully used elsewhere. Attention to gender-related cultural norms, the inclusion of language-concordant researchers, and respect for communities’ autonomy in deciding whether and how to participate collectively contributed to more effective and culturally grounded engagement with Muslim communities. Full article

The application of AI in financial planning services has the potential to enhance universal access to financial services. However, AI still faces common consumer mistrust and resistance, hindering the long-term sustainability of AI-powered financial planning. This research aims to explain why consumers resist AI in financial planning and the mechanisms that lead to this resistance and negative customer behavior. This research developed a conceptual model by integrating the S-O-B-C framework with Innovation Resistance Theory, AI ethical risks, and social influence that influence AI mistrust and intention to resist, which lead to negative outcomes such as negative word-of-mouth and customer disloyalty in the context of digital financial planning services in Thailand. The research collected data from a sample of 420 persons and the data was analyzed using PLS-SEM. The research identified social influence and the risks associated with AI transparency and accountability as primary factors contributing to AI mistrust, whereas privacy risk serves as a more fundamental catalyst for resistance. This resistance contributes to negative word-of-mouth and leads to customer disloyalty. It emphasizes that developing sustainable AI financial advisors must go beyond technically secure design to transparent, accountable, and socially legitimate governance to maintain long-term relationships with customers in the digital financial system. Full article

The United Nations and the World Health Organization provide clear guidelines to ensure water security for urban and rural populations. Common contaminants include bacteria and a variety of organic contaminants, such as medications and agricultural runoff. The rapid advancement of point-of-use water treatment is crucial to align with these international recommendations. While some problems are chronic and require long-term solutions, others are transient contamination issues that occur without warning and frequently lead to boil water advisories that can last for extended periods. In these cases, providing reliable water security requires solutions that can be deployed rapidly, are affordable, and can be implemented at the point of use with minimal operator training. Our research explores the state of the art in photocatalysis as a method for purifying water from organic contaminants and bacteria. We present a comparative analysis of various catalysts, supports, and light sources, along with our perspective on the benefits of flow systems. Practical solutions require flow techniques that are portable and can address at least the recommended survival requirements of ~7.5 L per capita per day for small communities, schools, or small hospitals. In this perspective, we propose that flow-compatible modified TiO₂ catalysts can offer practical solutions implemented with either solar light or LED sources in the UVA or visible region. Full article

Bio-based fertilisers (BBFs), produced from various types of biological waste using different processing methods, have demonstrated encouraging levels of agronomic efficiency and environmental benefits, consistent with the principles of sustainable development (SD). Nevertheless, bringing these newly developed products to market remains difficult due to limited farmer awareness, perceived risks, and regulatory uncertainties. In this paper, we examine the attitudes, opinions, and awareness of farmers regarding the use of various BBFs in their fertilisation practices. We applied a survey research method, using the Paper and Pen Personal Interview (PAPI), and answers were collected by agricultural advisors. A questionnaire, consisting of open, closed, and Likert scale questions, focusing on general information about farmers, current practices regarding fertiliser use, and the determinants of fertiliser choice, was used. Descriptive statistics, cross-tabulations, chi-square tests, Cramer’s V coefficients, 95% confidence intervals, and McNemar’s test were used to analyse the data. This study was conducted in all 16 voivodeships in Poland, collecting a total of 800 responses. Factors influencing the negative or positive attitude of farmers toward this practice were identified. Currently, mineral fertilisers remain the dominant choice among Polish farmers due to their accessibility, cost-effectiveness, and agronomic performance. There is observed growing, albeit cautious, interest in alternative fertilisation strategies and the correct understanding of sustainable agriculture practices. About half of farmers expressed willingness to partially replace mineral fertilisers with organic options, but only a minority showed interest in adopting BBFs. The findings indicate that concerns about contaminants, heterogeneous quality, limited availability, and regulatory uncertainty continue to constrain interest in BBFs. Although respondents recognised potential environmental benefits, economic and agronomic considerations remained the primary drivers of decision-making. As the survey was conducted in late 2021, the results reflect pre-2022 market conditions and should be interpreted as a baseline rather than a direct indication of current attitudes. Overall, this study provides insights into behavioural and structural factors influencing fertiliser use in Poland and highlights areas where further policy, advisory, and market developments may help support more sustainable nutrient management. Full article

Background: The Canadian HIV Cure Enterprise (CanCURE) is a pan-Canadian research collaboratory, investigating approaches for achieving sustainable HIV remission. In preparation for the next research cycle, CanCURE researchers and the Community Advisory Board (CAB) co-designed a web-based survey to identify HIV research priorities from the perspective of people with HIV (PWH) in Canada. The current study examined gender-based differences in these priorities. Methods: From August to December 2024, we recruited PWH across Canada through community organizations and community members. We collected data using REDCap electronic data capture tools hosted at The Research Institute of the McGill University Health Centre. The survey included 36 demographic questions, 16 questions related to general knowledge about HIV and HIV cure-related concepts, and 21 questions ranking research priorities. Knowledge questions were multiple choice, while priorities could be ranked on a scale. We summarized participant characteristics via descriptive statistics, and the research priorities were further stratified according to gender. Results: Of 109 participants, 48.6% self-identified as men, 46.8% as women, and 4.6% as two-spirit, non-binary, agender, or other. The median age was 53 years old. Approximately one-third of participants had lived with HIV for ≤14 years, one-third for 15–24 years, and one-third for ≥25 years. Overall, the median knowledge score of respondents was 79%. Among the 78 participants with prior HIV research experience, three times as many men (61.1%) as women (19.0%) participated in interventional studies involving medication or medical procedures. Men ranked preventing HIV transmission to partners as a priority, studying where the virus hides as the second, and avoiding high comorbidity risks as the third. In contrast, women ranked not having to take pills daily as a priority and avoiding higher risks for comorbidities as the second priority. Both genders equally valued expanding community involvement in HIV cure research. However, men focused more on integrating social and behavioural research, while women emphasized the need for diverse ethnic representation in research. Conclusions: Although both men and women share some common priorities regarding HIV cure research, there are notable gender differences in their specific concerns. Furthermore, a significant gender gap in participation in interventional studies, essential for advancing HIV cure research, highlights the importance of aligning research priorities with concerns of both genders. Full article

Unprecedented quantities of pelagic sargassum since 2011 have demanded technical and management responses. Inappropriate measures might worsen environmental impacts, particularly in low-income regions and protected natural areas that also require low-cost, socio-ecologically integrated alternatives. This study aims to evaluate the effectiveness and local perception of sargassum clean-up treatments developed through a community–academic collaboration within a socio-ecological systems framework in the marine protected area Xcalak Reefs National Park (PNAX), at the southernmost Mexican Caribbean coast. In 2019 and 2021, clean-up efforts were implemented through the national PROREST program and a self-organized community group of 35–40 members supported by a multidisciplinary research advisory team. Monitoring in 2021 estimated sargassum removal at 4012 m² over 50–75 work hours. Although average shoreline retreat was obtained (δ_mean = −0.22 m), final accretion of ~0.96 m alleviated community concerns about erosion linked to clean-up activities. The most effective and socially accepted clean-up treatment involved sargassum spreading, collection, drying, and revetment-type beach protection, reducing odors and harmful fauna. However, treatments aimed at shoreline stabilization were impractical, raising doubts about their long-term efficacy. These findings highlight the relevance of integrating ecological performance and social perception in sargassum management, especially where co-management with local communities in marine protected areas is needed. Full article

Background/Objectives: Systemic Lupus Erythematosus (SLE) is a multifactorial disease that significantly affects patients’ quality of life (QoL) and poses management challenges. This project combined a nationwide patient listening initiative with an Advisory Board (AB) to identify unmet needs and perceptions, aiming to integrate patient perspectives into decision-making and enhance SLE care. Methods: The “PaLESiamoci!” project, conducted by IQVIA with two patient organizations (Gruppo LES Italiano and APMARR), included both qualitative and quantitative phases. Ten patients completed disease diaries and one-hour interviews, while 151 others voluntarily filled a PO-administered survey including the validated 12-item Medical Outcome Short Form (SF-12) and items on physical, emotional, and daily life impact. Insights from these phases informed the AB discussion involving clinicians and patient representatives on six key topics. Results: Patients with SLE showed lower Physical (−13.4) and Mental (−14.0) Component Summary scores than the Italian population, indicating reduced social and work functioning. Despite EULAR recommendations to minimize corticosteroid use, 64% of patients remained on corticosteroids. The AB discussions revealed key unmet needs, including differing awareness of organ damage risks, corticosteroid-related adverse events, and adherence challenges, as well as the need for non-pharmacological and multidisciplinary support. Conclusions: The project highlighted major gaps and opportunities in SLE management. Patient organizations and rheumatologists emphasized developing tailored educational materials, strengthening rheumatologist–patient communication, and promoting multidisciplinary, patient-centered approaches to improve overall care. Full article

Since the World Health Organization (WHO) launched its global network for age-friendly cities (AFC) movement in 2010, the number of participating cities and towns, as well as the body of literature focusing on this initiative has grown steadily. Nevertheless, few studies have directly examined how older adult volunteers are involved in AFC planning and initiatives for their municipalities. This study explores the experience of citizen volunteers, mostly older adults, engaging in local municipal-level age-friendly (AF) advisory committees as a part of the Age-Friendly Niagara (AFN) movement in Ontario, Canada. Since its conception as a grassroots movement in 2013, the AFN Network (AFNN) has expanded across the entire region, as each municipal government has appointed its local AF advisory committee or an equivalent, which consists of citizen volunteers, at least one councilor and one municipal staff member. Employing a qualitative multisite case study approach, we conducted focus groups with eight municipal AF advisory committees (or their equivalent) (n = 48, average age 69) to explore their roles, achievements and challenges. Our findings highlight the crucial role older adult volunteers play in their local AFC initiatives as they strive to co-produce and co-create sustainable age-friendly communities in collaboration with their municipal government. Full article

Hispanic, Asian, and African Americans are disproportionately affected by liver cancer, viral hepatitis B (HBV), and viral hepatitis C (HCV), in part because of barriers to liver cancer awareness and prevention. We implemented a community-based, culturally tailored initiative to raise awareness and promote uptake of behaviors for liver cancer prevention, early diagnosis, monitoring, and treatment. Guided by community-based participatory research (CBPR) principles and built on well-established collaboration with community-based organizations, we actively engaged the community advisory board (CAB), community health workers, and community members in multiple phases of (1) a community-based educational initiative, (2) a city-wide bus campaign, and (3) community health fairs. This multilevel initiative saw notable changes in community members’ knowledge of liver cancer, viral hepatitis, lifestyle behaviors like dietary patterns, and uptake of screening tests for HBV/HCV. Additionally, the comprehensive engagement of CAB, healthcare workers, and community members significantly benefited community capacity building on cancer research and health promotion. These CBPR-guided community initiatives had remarkable positive impacts on promoting liver cancer awareness and prevention among underserved racial/ethnic minorities. The academic–community relationships built on and strengthened through shared power, mutual respect, and trust serve as the foundation for sustainable community growth and empowerment. Full article

Sustainable Weed Management Practices (SWMPs) are currently underrepresented in European cropping systems despite considerable attention from the research and policymaking communities. In public discourse, their adoption is associated with low yields, high initial investment costs, additional machinery requirements, elevated labor demands and limited or uncertain profitability. Nevertheless, little is known regarding their economic effects when implemented under real-life conditions at the farm level. This study aims to determine the impact of SWMPs against broomrape parasitism on the organization, management and economic performance of industrial tomato farms, considering that broomrapes (Orobanche and Phelipanche species) are a major impediment to the expansion of key crops in the Mediterranean basin due to their resistance toward commonly applied herbicides. For the purpose of economic appraisal, detailed technical and economic data were collected in 2022 from 76 arable farms cultivating industrial tomato in the Region of Thessaly in Central Greece. By combining Principal Component Analysis (PCA) with Two-Step Cluster Analysis (TSCA), a farm typology according to the implementation level of different SWMPs was developed. Based on this typology, a comparative technical and economic analysis revealed important differences in terms of structure, resource utilization and economic performance across the various farm types. “Holistic” farms, which exhibited the highest adoption levels of SWMPs, implemented an effective broomrape management strategy and achieved superior economic outcomes, evidenced by a remarkable net profit of 488.5 €/ha. Conversely, this was either negative or nearly negligible in farm types characterized by low adoption rates, indicating a lack of economic viability in the long run. The findings of this study offer useful recommendations for farm-level decision making, advisory support and policy design toward the promotion of SWMPs. Full article