Search Results (216)

Small-scale inland fisheries in the Amazon are critical for food security, yet their sustainability is increasingly threatened by overexploitation and environmental degradation. In data-limited contexts such as the northern Ecuadorian Amazon, the absence of continuous monitoring constrains the development of adaptive management strategies. This study develops an integrated socio-ecological baseline to support the establishment of fisheries agreements in five Indigenous communities of the Napo and Aguarico rivers. Through a participatory monitoring approach, we generated reproductive parameters (gonadosomatic index, fecundity, size at first maturity), population structure metrics, and length–weight relationships for key subsistence species across three hydrological phases. Reproductive investment exhibited marked seasonality, with peak gonadosomatic indices during rising waters in most species, identifying a critical period for protection. Life-history strategies ranged from high-fecundity periodic strategists to low-fecundity equilibrium species, implying differentiated vulnerability to harvesting. Community perceptions prioritized large migratory catfish and floodplain habitats, aligning with biological indicators of vulnerability. High performance in technical training demonstrated the feasibility of long-term local monitoring systems. By linking biological indicators with local ecological knowledge, this study proposes a pathway from baseline assessment to adaptive co-management. The framework presented here provides a transferable model for strengthening sustainability, governance, and food security in tropical small-scale fisheries facing persistent data limitations. Full article

Micro-public space (MPS) regeneration is typically evaluated at the point of delivery, yet long-term performance depends on whether everyday stewardship can be sustained thereafter. This study reframes neighbourhood social capital as a governance–environment signal reflecting coordination capacity and examines whether residents’ willingness to participate in post-regeneration co-management is primarily appraisal-driven (perceived value, attitude, and perceived behavioural control) or coordination-driven via a residual direct channel consistent with routine governance. A cross-sectional survey of adults residing within walkable catchments of five regenerated MPS sites in Nan’an District, Chongqing, China ($N=477$), was conducted. An integrated Stimulus–Organism–Response × TPB model was estimated using WLSMV with ordered categorical indicators; indirect effects were assessed via bias-corrected bootstrap confidence intervals. Coordination capacity was strongly associated with perceived value, participation attitude, and perceived behavioural control. In the joint model, only perceived value retained a statistically reliable positive association with stewardship willingness, whereas the incremental contributions of attitude and perceived behavioural control were negligible once the stimulus was included. A residual direct association from coordination capacity to willingness persisted beyond the appraisal block, supporting a direct-dominant interpretation; bootstrap analyses yielded no robust evidence for mediation (BCa 95% CIs crossed zero). These findings suggest that sustaining regenerated micro-spaces requires low-friction governance designs that minimise coordination costs, reinforce soft accountability, and render institutional responsiveness visible to residents. Full article

Chronic hepatitis B (CHB) and Type 2 diabetes (T2DM) are major independent risk factors for Hepatocellular carcinoma (HCC). The bidirectional promotion between T2DM and CHB forms the biological basis for their synergistic carcinogenic effect. T2DM mainly accelerates the progression of CHB through mechanisms such as metabolic disorders, oxidative stress, chronic inflammation, and immunosuppression; CHB promotes the development of T2DM mainly through liver damage leading to dysfunction of the central glucose metabolism, HBx-driven gluconeogenesis, inhibition of the insulin signaling pathway, and potential β-cell damage. In comorbid conditions, these mechanisms intertwine to form a vicious cycle across four key aspects: metabolic and lipid disorders, activation of carcinogenic pathways, oxidative stress, and amplification of chronic inflammation, significantly accelerating the hepatocarcinogenesis. Regarding management strategies, we adopt the concept of three-level prevention, integrate various management plans and combine emerging drug therapies. We thus propose the establishment of a management strategy centered on “liver and glucose co-management” with multi-faceted joint control. This review aims to summarize the latest evidence on the mechanisms and management strategies by which the comorbidity of T2DM and CHB promotes the development of HCC, providing a theoretical basis for research on the mechanisms of this comorbidity and population-level HCC prevention strategies. Full article

Local and Indigenous knowledge (LIK) systems are recognised as a pertinent component of effective and equitable water governance, especially for building resilient, sustainable, and climate-resilient water management systems; however, their incorporation into water governance systems and processes remains limited, symbolic, and hindered by technocratic, legal, and power barriers. This study, through a systematic overview of existing work from Africa, aims to explore critically the role and contribution of LIK systems in water governance and climate adaptation, with the goal of establishing that LIK systems should be understood and operationalised as a water governance system, not as a supplementary knowledge system. Through systematic thematic analysis, four recurring themes are identified: (i) rhetorical recognition of LIK without substantive institutionalisation; (ii) evidence of contributions to local-scale climate adaptation, ecosystem management, and water resource allocation; (iii) inherent challenges of legal marginalisation, epistemic dominance, and power asymmetry; and (iv) transformative limitations of participatory or co-management frameworks that maintain state-led authority. SWOT analysis reveals LIK’s strengths in adaptive innovation, knowledge coproduction, and governance legitimacy, with potential threats of marginalisation, institutional fragmentation, and dominance by technocratic discourses. The results show that the failure of integration is governance-driven rather than knowledge-driven, emphasising the importance of institutional recognition, legal pluralism, vertical integration, and the sharing of power. Partnership with LIK as an equal in governance helps create policy environments that are inclusive, flexible, and socially legitimate. This approach to integration directly contributes to the achievement of SDG 6 (Clean Water and Sanitation), SDG 13 (Climate Action), SDG 10 (Reduced Inequalities), SDG 16 (Peace, Justice, and Strong Institutions), and SDG 17 (Partnerships for the Goals). This review establishes a conceptual, empirical, and practical basis for incorporating LIK into water governance, promoting adaptive, equitable, and resilient water resource management in a climate of uncertainty and complexity. Additionally, the review argues that climate-resilient water governance requires institutional recognition of legal pluralism, vertically integrated decision-making structures, and explicit power-sharing arrangements that treat LIK as coequal governance rather than consultative input. By reframing LIK integration as a question of authority and institutional design, this review contributes to debates on epistemic justice and adaptive water governance under climate change. While grounded in African case studies, the findings contribute to broader global debates on epistemic pluralism and inclusive water governance. Full article

Bacterial resistance on farms can be driven by antimicrobial use. Less is known about inter-farm transfer of resistance genes and their persistence under low antimicrobial pressure. Over two years and nine visits, we examined the shedding of resistant indicator bacteria (Escherichia coli) on one lower- and one higher-antimicrobial-usage pig farm. There was a unidirectional transfer of some less healthy pigs from the former to the latter. Faecal pools (180) were cultured on Chromagar ECC, with and without added cefotaxime or ciprofloxacin. Presumptive E. coli were phenotyped, and many ciprofloxacin-resistant isolates were whole-genome sequenced. Comparing farms, there was more (p < 0.0001) phenotypic resistance to the antimicrobial panel from the higher-usage unit, and markedly more (about ten-fold) multi-resistance. Significantly elevated individual drug resistances on this unit correlated with recently used antimicrobials. Ciprofloxacin and/or cefotaxime-resistant isolates were often present, although in low proportions. Neither of these antimicrobial classes had been administered recently, except for one fluoroquinolone course late in the study. AMR genes were more diverse from the higher-usage farm, but some resistant and multi-resistant isolates were closely related between farms. Thus, we demonstrated the maintenance of resistance genes in strains present on farms, even where selective pressure was low. Full article

Community land management plays an important role in wildfire-prone landscapes in Mediterranean Europe. However, in Portugal, information on the spatial extent and boundaries of community land remains fragmented across multiple institutions. This study addresses a critical but often overlooked issue in wildfire management: the fragmentation of institutional data on community land boundaries in mainland Portugal and its direct implications for forest fire risk management, planning, and accountability. We harmonized georeferenced datasets from various government and public institutions, applying multi-institutional spatial integration supported by legal land use criteria using the Land Use Land Cover map 2018 (LULC2018). The resulting national map represents the first fully harmonized spatial assessment of community land (baldios) in mainland Portugal. Our results show that baldios currently occupy approximately 595 thousand hectares, significantly exceeding official estimates. Of this total, around 74% are under partial forest regime law, and approximately 76% are classified as having a high or very high wildfire hazard. This means that three out of every four hectares of baldios in mainland Portugal are structurally susceptible to extreme wildfire conditions. Beyond improving cartographic data, the study’s findings demonstrate how the lack of land registry weakens the institutional foundations for community-based wildfire management. Without a functional, legally validated national map of community land boundaries, responsibilities, co-management mechanisms, and prevention measures remain spatially inconsistent. Full article

Background and Objectives: Patients admitted to plastic surgery units increasingly present with multimorbidity, advanced age, diabetes, cardiovascular disease, chronic wounds, and complex metabolic requirements. In several surgical specialties, internal medicine specialist (IMS) co-management has been associated with improved clinical outcomes, yet its potential role in plastic surgery remains unexplored. Materials and Methods: A narrative scoping review conducted using systematic search principles was conducted using MEDLINE, Web of Science, Scopus, and Google Scholar from inception to 1 December 2025. Search terms combined “internal medicine,” “co-management,” and “surgery.” Studies assessing outcomes of IMS involvement in surgical inpatient care were included. Data on population, intervention characteristics, and outcomes were extracted and summarized. PRISMA recommendations were used to report the study selection process. The review focuses on adult and elderly surgical inpatients, as the available evidence is not applicable for pediatric populations. Results: Twenty-two articles met the inclusion criteria. IMS co-management demonstrated consistent benefits across multiple surgical specialties, including reduced length of stay, lower complication rates, improved metabolic and cardiovascular stabilization, enhanced perioperative optimization, and decreased costs. Despite the growing complexity of plastic surgery inpatients, no studies specifically evaluated IMS co-management in this field. Conclusions: Evidence from other surgical specialties suggests that structured IMS co-management may offer substantial benefits for plastic surgery patients, particularly those with multimorbidity, diabetes, severe burns, chronic wounds, or undergoing microsurgical reconstruction. Prospective studies are needed to determine its impact on patient outcomes, resource utilization, and clinical workflows within plastic surgery. Full article

Efforts to build a sociobiodiversity-based bioeconomy increasingly depend on recognizing and rewarding the stewardship practices carried out by Indigenous Peoples and Local Communities, and smallholder farmers. Yet, such practices, rooted in collective governance, traditional knowledge, and care for ecosystems, remain largely invisible in market and policy frameworks. This study compares recognition mechanisms for stewardship practices worldwide (38 case studies) and in Brazilian projects supporting sociobiodiversity chains (384 projects) using an inductive typology of material and non-material recognition and Arnstein’s Ladder of Citizen Participation. Results show that 70% of cases combine multiple recognition forms, but their distribution and empowerment outcomes diverge. Globally, recognition mechanisms are more balanced, often codified in laws, participatory councils, and payment-for-ecosystem-service schemes that place communities on the upper rungs of Arnstein’s ladder, with co-management authority. In Brazilian projects, recognition remains predominantly material and focused on short-term interventions–capacity-building, equipment, and market access, corresponding to lower rungs of citizen participation. Overcoming this condition requires policies that couple economic incentives with institutionalized participation. Markets alone will not value the non-material elements that sustain sociobiodiversity. Implementing Brazil’s National Bioeconomy Strategy will therefore depend on public policies that reward both the products and the collective stewardship behind them. Full article

The giant panda holds a critical position in global biodiversity conservation, yet the ongoing fragmentation of its habitat poses a severe threat to the long-term viability of its survival. This study focused on the giant panda habitat in the Xiangling region and systematically analyzed the mechanisms through which human socioeconomic activities drive habitat fragmentation. The analysis was based on data from 2000 to 2023, encompassing land use, population density, transportation networks, mining activities, and nighttime light emissions, utilizing a methodology that integrated Principal Component Analysis, the Moving Window method, trend analysis, and the Geodetector model. The findings reveal the following: First, the degree of habitat fragmentation has intensified over time with significant spatial heterogeneity, exhibiting a pattern of “low fragmentation in the core areas and high fragmentation in the periphery,” where areas of very high fragmentation have expanded markedly along the habitat edges. Second, the trend in fragmentation demonstrates an overall improvement in the core zones, particularly within the Giant Panda National Park, where over 70% of the area shows reduced fragmentation; conversely, nearly 30% of the peripheral areas continue to degrade. Third, the driving factors of habitat fragmentation exhibit bi-factor enhancement and nonlinear enhancement effects, with land use identified as the dominant factor. The study recommends enhancing the overall connectivity and ecological functionality of the habitat through measures such as refining land-use planning, constructing ecological corridors, implementing hierarchical management, and promoting community co-management. Full article

The enclave villages of Lake Malawi National Park (LMNP) are human settlements within a World Natural Heritage landscape. While social heterogeneity has been widely discussed in social–ecological systems (SES) scholarship, ethnic diversity has often remained analytically implicit. This study makes ethnic diversity central to analysis by examining how it shapes livelihoods, resource use, and governance across enclave villages. Drawing on an integrated household survey, key informant interviews, and extended field observations, and informed by collaboration theory, the SES framework, and scholarship on social differentiation, the analysis shows that ethnic diversity facilitates exchanges of fishing techniques, farming skills, ecological knowledge, and market linkages, producing plural and seasonally adaptive livelihood portfolios. Households routinely combine fishing, agriculture, tourism, petty trade, and forest use, contributing to diversified resource use. However, pressures on fish stocks, forest resources, and agricultural land highlight the need for more inclusive co-management. Emerging community-based institutions and collaborative initiatives increasingly facilitate coordination, rule-making, and shared stewardship. Overall, the findings identify practical and conceptual entry points through which ethnic diversity, ecological knowledge, and adaptive livelihoods can jointly support more resilient and inclusive pathways for sustainability at the crossroads of resource-dependent livelihoods and conservation, offering insights for socially diverse human–nature landscapes. Full article

At the beginning of life, there are no sex differences in fetal kidney growth, nephron endowment nor in the prevalence of low birth weight. In chronic kidney disease (CKD) in adults, however, significant sex- and gender-specific differences exist in diagnosis, progression, and management of CKD. In adult individuals, CKD is more prevalent in women, but CKD progression is faster in men; nevertheless, women have a higher life expectancy than men. A possible explanation for the enigmatic higher CKD prevalence in women may derive from the Brenner–Luyckx concept of hyperfiltration. Diseases that lead to hyperfiltration will lead to premature nephron loss and to a faster decline in glomerular filtration rate (GFR). This condition is predominantly seen in middle-aged men with a higher GFR, larger hypertrophied kidneys, and a higher prevalence of arterial hypertension, diabetes mellitus, smoking, and hypercholesterolemia compared to women. Thus, a high GFR may not be a good sign if it reflects hyperfiltration. Any GFR must be interpreted against the comorbidities of an individual. An individual may end up with a realistic GFR far below normal once hyperfiltration is stopped, for example, by a Sodium Glucose-Linked Transporter 2 (SGLT2) inhibitor. With regard to the management of CKD, women with CKD receive poorer healthcare compared to men with CKD. Women less frequently receive a CKD diagnosis, are less frequently referred to nephrology for co-management, less frequently undergo eGFR and albuminuria assessments, and are less likely to receive guideline-recommended treatments for CKD, such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, and statins. Cardiovascular risk factors are less rigorously controlled in women with CKD compared to men with CKD. The causes for the poorer CKD care among women are to be found in gender rather than in sex. It is crucial to integrate assessments of sex and gender into both clinical routines and scientific reports. All studies should incorporate sex- and gender-specific analyses, and the evaluation of pre- and postmenopausal women should be conducted separately. The utilization of Gender Scores can help identify the impact of cultural, societal, and psychological factors on observed gender differences in ambulatory healthcare for those with CKD. Guidelines need to be sensitive to gender and emphasize the existing knowledge gaps regarding sex and gender differences in CKD healthcare. Urgent attention is required to substantially improve and ensure equitable healthcare for CKD across sexes and genders. Full article

Background and Clinical significance: This case describes a patient with a complex medical history who develops an active Mycobacterium tuberculosis (MTB) infection. The complex multidrug regimen has led to significant drug–drug interactions (DDIs) and adverse effects. This case highlights an urgent need for standardized guidelines on dose adjustment and therapeutic monitoring for opioid substitution therapy (OST) and antiretroviral therapy (ART) during MTB treatment to prevent adverse health outcomes and ensure clinical success. Case Presentation: A 43-year-old man with medical history including human immunodeficiency virus (HIV), chronic hepatitis C virus (HCV), psychotic disorder, and opioid dependence maintained on buprenorphine (24 mg/day) presented with acute psychosis and respiratory symptoms. During hospitalization, he was diagnosed with MTB infection and was started on an empirical rifampicin-based anti-MTB regimen. His clinical course was complicated by reduced buprenorphine efficacy caused by rifampicin, which precipitated opioid withdrawal symptoms. Conclusions: The successful clinical stabilization with resolution of withdrawal syndrome, reduced agitation, and normalization of vital signs, including heart rate and blood pressure of this patient, was achieved through targeted management of pervasive DDIs. A strategic ART switch and careful buprenorphine dose titration during rifampicin therapy was the key factor. This case highlights that co-managing HIV, MTB, and opioid use disorder presents a significant challenge where unaddressed DDIs directly threaten treatment efficacy, a patient’s safety, and adherence, and may result in increased toxicity. The case underscores the critical need for proactive DDI assessment, interdisciplinary collaboration, and guideline development for medication optimization in people living with HIV receiving OST. Full article

This grounded theory study examines how 40 married couples (N = 80) successfully maintained sexual abstinence until marriage, focusing on the strategies, relational processes, and spiritual commitments that sustained this non-normative practice. Because premarital abstinence is statistically uncommon among African Americans, this sample functions as a critical case context—offering a high-contrast environment in which grounded theory can clearly illuminate the relational and spiritual mechanisms that support abstinence maintenance. Using in-depth individual and dyadic interviews, the study explores how couples upheld abstinence in contexts where it was often encouraged within religious settings yet rarely modeled by parents, mentors, or peers. Findings revealed four interrelated processes: (a) a shared spiritual “why” grounded in sacred meaning, (b) mutual commitment and accountability, (c) proactive boundary-setting and trigger management, and (d) grace-based resilience and recommitment after lapses. Together, these processes illustrate the Premarital Sexual Abstinence Sustainability Model through which couples co-manage temptation and align their behaviors with shared spiritual values. Despite limited examples in their communities, many participants reported becoming perceived role models within their families and faith settings, demonstrating how new behavioral templates emerge when social models are absent. Overall, as the first study of its kind to document how abstaining couples sustain their commitment and experience success, this work offers new implications for research, relationship education, counseling, and faith-based program development. Full article

Artificial reefs are an important tool for marine ecological restoration and fishery resource proliferation, and are widely used around the world. Among them, Japan, the United States, China, South Korea, Australia, and the Mediterranean coastal countries have particularly invested in scientific research and practice in this field, and the reefs’ material selection, structural performance, and ecological benefits have attracted much attention. The purpose of this paper is to summarize the preparation methods, characterization methods (such as microstructure analysis and mechanical tests) and mechanical properties (such as compressive strength and durability) of new concrete materials (steel slag-blast furnace slag concrete, oyster shell concrete, sulfoaluminate cement concrete, recycled brick concrete, silica fume concrete, and banana peel filler concrete) that artificial reefs and ceramic artificial reefs developed in recent years, and to explore the resource utilization potential of different waste materials. At the same time, the biostatistical methods (such as species abundance and community diversity) of wood, shipwreck, steel, rock, waste tire, and ordinary concrete artificial reefs and their effects on the marine environment were compared and analyzed. In addition, the potential impact of artificial reef deployment on local fishermen’s income was also assessed. It is found that the use of steel slag, blast furnace slag, sulfoaluminate cement, and silica fume instead of traditional Portland cement can better improve the mechanical properties of concrete artificial reefs (compressive strength can be increased by up to 20%) and reduce the surface pH to neutral, which is more conducive to the adhesion and growth of marine organisms. The compressive strength of oyster shell concrete and banana peel filler concrete artificial reef is not as good as that of traditional Portland cement concrete artificial reef, but it still avoids the waste of a large amount of solid waste resources, provides necessary nutritional support for aquatic organisms, and also improves its chemical erosion resistance. The deployment of artificial reefs of timber, wrecks, steel, rock, waste tires, and ordinary concrete has significantly increased the species richness and biomass in the adjacent waters and effectively promoted the development of fisheries. Cases show that artificial reefs can significantly increase fishermen’s income (such as an increase of about EUR 13 in the value of a unit effort in a certain area), but the long-term benefits depend on effective supervision and community co-management mechanisms. This paper provides a scientific basis for the research and development of artificial reef materials and the optimization of ecological benefits, and promotes the sustainable development of marine ecological restoration technology and fishery economy. Full article

Urban resilience has emerged as a critical paradigm for addressing the intertwined challenges of climate change, rapid urbanization, and social inequality, positioning green public spaces as catalysts for social, ecological, and institutional transformation. This article presents a systematic review conducted under the PRISMA 2020 guidelines, examining how collaborative and community participation influenced transformative urban resilience in green public spaces between 2021 and 2025. A total of 6179 records were initially identified across ScienceDirect and MDPI (last search: July 2025), of which 26 empirical studies met the inclusion criteria (peer-reviewed, empirical, published 2021–2025). Methodological rigor was strengthened through the application of the Mixed Methods Appraisal Tool (MMAT, 2018) and confidence in qualitative evidence was assessed using the GRADE-CERQual approach, enhancing transparency and reliability. Data extraction and synthesis followed a theoretical-methodological coding framework, allowing for the comparison of participatory strategies, typologies of green spaces, resilience dimensions, and applied instruments. The results show that multi-actor co-management, co-design, and community self-organization are the most frequent participatory strategies, while urban green infrastructure, pocket parks, and urban gardens constitute the predominant spatial contexts. Socio-ecological and social-participatory resilience emerged as dominant theoretical perspectives, with qualitative and mixed-methods designs prevailing across studies. Evidence synthesis through GRADE-CERQual identified seven key pathways—multi-actor co-management, Nature-based Solutions, community-based actions, social equity, cultural identity, institutional innovation, and planned densification—each contributing differently to resilience dimensions. Overall, the findings highlight that transformative resilience depends on deep, inclusive participatory processes, multi-level governance, and the integration of social, ecological, and cultural dimensions. Despite the heterogeneity of designs and unequal data adequacy, this review confirms that transformative urban resilience is a co-produced process grounded in community action, ecological sustainability, and collaborative governance. Strengthening underexplored areas—technological innovation, cultural resilience, and standardized methodological instruments—is essential for advancing comparative research and practice. Full article