Search Results (7,406)

Antimicrobial resistance (AMR) constitutes a major global health challenge, driven significantly by inappropriate antibiotic use in human medicine. Despite the existence of evidence-based guidelines, variability in antibiotic prescribing persists, influenced by psychosocial factors, diagnostic uncertainty, patient expectations, and local prescribing cultures. Outpatient care, the setting in which most antibiotics are prescribed, is particularly affected by such challenges. Traditional top-down interventions, such as national guidelines, often fail to achieve sustained behavioral change among prescribers. In this comprehensive review, we provide an overview of the psychological and behavioral factors influencing antimicrobial stewardship (AMS) implementation, as well as describe a bottom-up project working to meet these challenges: the “Antibiotic Therapy in Bielefeld” (AnTiB) initiative. AnTiB employs a cross-sectoral strategy aimed at developing rational prescribing culture by means of locally developed consensus guidelines, interdisciplinary collaboration, and regularly held trainings. By addressing both the organizational and psychological aspects of prescribing practices, AnTiB has facilitated a harmonization of antibiotic use across specialties and care interfaces at the local level. The initiative’s success has led to its expansion within Germany, including through the creation of the AMS-Network Westphalia Lippe and the development of AnTiB-based national pediatric recommendations. These projects are all grounded in social structures designed to strengthen the long-term establishment of AMS measures. Our efforts underscore the importance of considering local social norms, professional network, and real-world practice conditions in AMS interventions. Integrating behavioral and social science approaches into outpatient antimicrobial stewardship—exemplified by the practitioner-led AnTiB model—improves acceptability and alignment with stewardship principles; wider adoption will require local adaptation, routine outpatient resistance surveillance, structured evaluation, and sustainable support. Full article

Using big data for risk analysis of construction projects is a largely unexplored area. In this traditional industry, risk identification is often based either on so-called domain expert knowledge, in other words on experience, or on different statistical and quantitative analysis of individual past projects. The motivation of this research is based on the implemented and evaluated data-driven and AI-based DARIA approach to identify financial risks in the execution phase of transportation infrastructure construction projects that shows exceptional results at an early stage of the project execution phase and has already been deployed into enterprise-wide production within the STRABAG group. Due to DARIA’s productive use, concern and doubts about the trustworthiness of its ML algorithm are certainly possible, especially when DARIA identifies risky projects while all conventional metrics within the STRABAG controlling system do not identify any problems. “If AI systems do not prove to be worthy of trust, their widespread acceptance and adoption will be hindered, and the potentially vast societal and economic benefits will not be fully realized”. Thus, and based on the results of a user study during DARIA’s successful deployment into enterprise-wide production, this paper focuses on the identification of suitable indicators to measure the trustworthiness of the DARIA ML algorithm in the interaction between individuals and systems as well as on the modeling of the reproducibility of the internal state of DARIA’s ML model. Full article

Addressing Artificial Intelligence (AI) faculty deficiencies in higher education, this paper develops the AI+ Dual-qualified Teacher Capability Ecology Model (AI-DTCEM) based on Capability Ecology Theory. The model is developed after a thorough analysis of the current state of new engineering talent cultivation in universities and the innovative practical abilities required in the AI+ environment. This paper proposes an implementation framework characterized by “three-dimensional collaboration, four-tier progression, and five-element drive.” Additionally, it uses the collaborative education project involving Hangzhou Normal University, Zhejiang University, and Hangzhou Ruishu Technology Co., Ltd. as a backdrop to introduce a deep collaborative education model, showcasing the theoretical and practical achievements of this project. Using NetLogo as the simulation platform, this paper designs a 96-month system dynamics experiment to compare and analyze the outcomes of four scenarios: the baseline experiment, the AI-enhanced experiment, the policy-driven experiment, and the comprehensive optimization experiment. This study reveals the following findings: (1) Policy-driven initiatives are crucial for the successful construction of dual-qualified teacher teams, with the policy-driven scenario achieving the highest overall skill level (9.332). (2) The application of AI technology significantly enhances teacher skill development, resulting in AI skill improvements ranging from 116.6% to 163.4%. (3) The comprehensive optimization scenario (utilizing a collaborative mechanism) achieves systemic advantages, realizing a 100% dual-qualified teacher ratio. However, this comes with diminishing marginal returns on investment. This research provides a theoretical foundation, quantitative analysis, and practical pathways for developing dual-qualified teacher teams in the AI+ era. Full article

The One Health approach offers an integrative framework to understand infectious threats, environmental factors, antimicrobial resistance (AMR) and how their interactions affect the human–animal–environment interface. This review examines the epidemiology, transmission pathways, and mechanisms of microorganisms of public health importance (bacteria, fungi, parasites, and viruses). It highlights the interconnectedness of ecosystems, where the environment plays a central role in the dissemination of pathogens, driven by climate change, globalization, agricultural intensification, and habitat degradation. AMR is a major concern, driven by the indiscriminate use of pharmaceuticals in human, veterinary, and agricultural settings, horizontal gene transfer through mobile genetic elements, and microbial evolution. The study of different pathogens is of great importance due to their high prevalence in different ecosystems, their virulence, clinical interest, and mortality rates produced. Some of them are ESKAPE bacteria, Candida auris, Plasmodium falciparum, and emerging viruses such as SARS-CoV-2, which present complex transmission dynamics influenced by ecological and health determinants. The review also addresses the effects of climate change on the persistence and geographic spread of pathogens. Successful implementation of the One Health program requires intersectoral policies, integrated surveillance systems, prudent use of antimicrobials and investment in translational science. Coordinating these strategies is essential to limit the spread of pathogens, protect biodiversity, and save global health in the face of the growing threat of infectious diseases. Full article

Constrained by fixed frame dimensions, conventional drones usually demonstrate insufficient capabilities to accommodate complex environments. However, the reconfigurable drone can address this limitation through its deformable frame equipped with actuators or passive interaction mechanisms. Nevertheless, these additional components may introduce an excessive weight burden, which conflicts with the lightweight objective in aircraft design. In this work, we propose a novel reconfigurable quadrotor inspired by the swimming morphology of jellyfish, with only one actuator placed at the centre of the frame to achieve significant morphological reconfiguration. In the design of the morphing mechanism, three telescopic sleeves are driven by the actuator, enabling arms’ rotation to achieve a maximum projected area reduction of 55%. The nested design of sleeves ensures a sufficient morphing range while maintaining structural compactness in the fully deployed mode. Furthermore, key structural dimensions are optimized, reducing the central motor load by up to 65% across configurations. After deriving parameter variations during morphing, Proportion–Integration–Differentiation (PID) controllers are implemented and flight simulations are conducted in MATLAB. Results confirm the drone’s sustained controllability during and after reconfiguration, with an “8”-shaped trajectory tracking root mean square error (RMSE) of 0.109 m and successful traversal through long narrow slits, reducing mission duration under certain conditions. Full article

HIV remains a significant public health challenge in sub-Saharan Africa (SSA), with vulnerable communities disproportionately affected and further marginalised by the COVID-19 pandemic. HIV self-testing (HIVST) has emerged as a transformative, empowering tool to bridge testing gaps and promote health equity. This study examined post-COVID-19 strategies for leveraging HIVST to empower vulnerable populations and advance health promotion in SSA. Analysis was performed using secondary Demographic and Health Survey (DHS) data (2015–2022) collected across 24 SSA countries. In addition, qualitative interviews were conducted with female sex workers in Port Harcourt, Nigeria (18–31 May 2023). The study adopted an explanatory sequential mixed-methods design. Quantitative analysis using complex sample logistic regression revealed low awareness (16.3%) and uptake (2.5%) of HIVST among the 594,639 respondents. Key predictors of uptake included higher education (aOR, 7.36; 95% CI, 6.62–8.18), wealth (richest quintile aOR, 3.28; 95% CI, 2.95–3.65), and knowledge of HIV transmission (aOR, 33.43; 95% CI, 11.03–101.24). Thematic analysis highlighted privacy, autonomy, and convenience as key benefits, while cost, stigma, and fear of testing alone were major barriers. The participants emphasised peer-led outreach and integration of HIVST into public health systems as effective strategies. The findings were integrated interpretively, linking macro-level testing disparities with community-level experiences to inform post-pandemic policy and programme design. The study concludes that HIVST holds strong potential to empower marginalised groups and strengthen community-driven HIV prevention post-COVID-19, but success will depend on equity-driven policies and sustainable implementation frameworks, guided by affordability and community participation. Full article

Virtual reality (VR) has emerged as a promising tool for transforming science, technology, engineering, and mathematics (STEM) education, yet its adoption in K–12 classrooms remains uneven and often limited to short-term pilots. While prior studies highlight VR’s potential to increase engagement and support conceptual understanding, questions persist about scalability, sustainability, and equity in implementation. This paper addresses these gaps by synthesizing recent scholarship and proposing a structured framework of best practices for integrating VR into K–12 STEM education. Drawing on academic literature, U.S. policy reports, and case studies, we identify persistent challenges that include high costs, lack of teacher preparation, infrastructure disparities, and overlooked accessibility concerns. We use these findings to inform a phased implementation roadmap. Our framework emphasizes assessment and planning, technical integration, teacher preparation, student implementation, and iterative evaluation, providing actionable strategies for schools and districts. Results of this synthesis indicate that successful VR adoption requires coordinated attention to pedagogy, funding, professional development, and equity. We conclude that moving VR from isolated novelty projects to sustainable and equitable tools in STEM classrooms depends on aligning technology with curricular goals, investing in teacher pipelines, and embedding VR within long-term evaluation and improvement cycles. Full article

Background: Stakeholders’ perception plays a crucial role in shaping pharmaceutical strategies. Stakeholders are groups interested in pharmaceutical companies’ success and outcomes. Stakeholders’ perceptions are multifaceted and impact pharmaceutical strategies, from shaping research to enhancing market access, pricing, and corporate reputation. Understanding and actively managing stakeholders’ perceptions is vital for pharmaceutical companies to succeed in an increasingly complex and competitive industry. Methods: In this case study, knowledge contributions from stakeholders offered insights and strategies for application in the pharmaceutical sector. Results: Qualitative, exploratory research was conducted, which included the participation of sixteen stakeholders from different countries in Latin America, who responded to a semi-structured interview script, whose data were understood through lexical analysis in the Interface de R pour les Analyses Multimensionnelles de Texts et de Questionnaires (IRaMuTeQ). Conclusions: The results of this study underscore the importance of regulatory knowledge for professionals’ support and implementation of international strategies. Regulatory knowledge provides professionals with tools and insights to navigate complex regulatory environments, make informed decisions, and enhance organizational performance in global markets. Full article

Achieving sustainable pavement construction through high-content Reclaimed Asphalt Pavement (RAP) is a critical industry goal, but its implementation is frequently challenged by the reduced mechanical performance and durability inherent in such mixtures. This study evaluates the performance of semi-rigid pavements with RAP from 0% to 100%, a chemical rejuvenator, and four novel cementitious grout formulations (G1–G4). A comprehensive experimental program examined compressive strength, flexural strength, rutting resistance, fatigue life, and moisture sensitivity. Statistical analysis revealed that increasing RAP content significantly reduced all performance metrics. However, the primary innovation of this work lies in identifying strong interaction effects between key variables. The chemical rejuvenator effectively mitigated performance losses, with its benefits most pronounced at higher RAP contents (p ≤ 0.003). Among the Gi types, G3, containing a proprietary high-reactivity mineral additive, consistently achieved superior results; for instance, the R100-J-G3 regained over 70% strength of the virgin control mix (R0-NJ-G3). Notably, the interaction between RAP content and grout type (p ≤ 0.015) revealed that G3’s performance increased with RAP content, demonstrating its pivotal role in enabling technically viable 100% RAP mixtures. These findings underscore that the successful use of high-content RAP depends not just on individual components but on the optimized synergy between rejuvenator and grout selection, offering a validated pathway for technically viable pavements containing 100% RAP, reducing reliance on virgin materials and lowering environmental impact. Full article

Public concern about environmental issues has led to growing interest in sustainability across various sectors, including entrepreneurship. However, beyond the concern for environmental protection and the presseration of natural resources for future generations, additional conditions are necessary to foster the development of sustainable entrepreneurship. While developed countries provide examples and evidence of the successful implementation of this concept, its application in developing countries presents challenges due to a range of limiting factors. In addition to essential financial support, the literature often highlights the lack and/or complexity of sustainability reporting, the absence of standards and clearly defined sustainability metrics, insufficient regulation, and the lack of support from higher education institutions as barriers to the transition toward sustainable entrepreneurship. This paper aims to examine the feasibility of applying the concept of sustainable entrepreneurship in Western Balkan countries, taking into account the aforementioned constraints. For the purpose of the empirical research, potential limitations were evaluated by managers and business owners in Albania, Bosnia and Herzegovina, North Macedonia, and Serbia. The results of the study answer the question of whether developing countries have the potential to foster sustainable entrepreneurship, given the analyzed constraints, or whether the implementation of this concept is reserved solely for large enterprises and economically advanced countries. Full article

This study identifies twelve critical factors influencing the successful implementation of Blockchain Technology (BCT) in supply chain processes, addressing the significant gap in understanding the practical and theoretical complexities of blockchain implementation. Through semi-structured interviews and grounded theory analysis, the concept of Decentralized Coordination and Sustainability was derived in addition to themes such as Strategic Alignment and Leadership Commitment, Organizational Adaptability and Resilience, Data Security and Integrity, User Preparedness and Engagement. These themes provide a novel theoretical lens to explore blockchain’s role in enhancing supply chain transparency, traceability, and collaboration. The study bridges strategic frameworks with decentralized technologies, providing actionable insights for successful implementation in the supply chain discipline. This research advances the application of grounded theory in blockchain research, encouraging qualitative methods to explore emerging technologies within complex organizational systems. This study establishes a foundation for future research to enhance our understanding of blockchain’s transformative impact in supply chain contexts. Full article

The escalating frequency and complexity of cyber threats have made cybersecurity education a national priority, yet a practical gap persists between theoretical instruction and workforce readiness. This study presents a comprehensive, modular framework for designing and implementing cybersecurity laboratories in academic institutions, environments that foster hands-on learning, skill mastery, and curricular innovation. Using a mixed-methods, multi-stage case study approach, the research combined qualitative analysis of institutional practices and instructional methods with quantitative evaluation of learning outcomes to comprehensively examine technical and pedagogical considerations impacting lab development. Data sources included literature analysis, direct observation, document review, and semi-structured interviews. The study synthesized best practices across these domains into a scalable lab design model grounded in experiential learning theory. Results demonstrate that the framework supports enhanced student performance, instructional adaptability, and simulation fidelity. Case study data revealed measurable gains in participant competency, with all participants achieving at least a 20% improvement in post-training test scores, high engagement levels demonstrated through consistent session attendance and active participation in hands-on exercises, and successful adaptation to logistical and technological barriers, including facility relocations and system downtime incidents. The lab’s modularity enabled curricular alignment, resource efficiency, and expansion to serve workforce training initiatives beyond the classroom. By integrating pedagogical (structured, teacher-guided instructional approaches) and andragogical (adult learning) design with technological scalability, this research contributes an actionable roadmap for institutions seeking to modernize cybersecurity education and respond effectively to evolving digital threats. The findings offer broad implications for future curriculum development, facilitator training, and sustainable program implementation. Full article

As has repeatedly been pointed out in recent years, the categories ESL/Outer Circle and EFL/Expanding Circle should not be considered as clear-cut as traditionally assumed. Consequently, recent research has made first attempts for an integrative approach to Englishes traditionally ascribed to one of these categories. The paper at hand introduces the Extra- and Intra-territorial Forces Model (EIF Model) as a successful attempt to bridge the traditional gap between the two categories and shows how the model works in practice by implementation to the cases of Greece and Cyprus. These two countries are particularly interesting for the application of this framework since their linguistic ecologies, with Greek and English in contact, are essentially similar. From a historical perspective, however, they are fundamentally different; Cyprus is a former colony of the British Empire, whereas Greece has never experienced British colonization. Therefore, the two countries offer the perfect basis for putting the traditional categories of EFL and ESL to the test and for illustrating how more recent models of World Englishes, such as the EIF Model, might offer more flexible theoretical alternatives to earlier, often more rigid theoretical approaches. Full article

The increasing demand for sustainable substrates in agriculture and urban greening calls for alternatives to peat, whose extraction poses significant environmental risks. This study assesses the potential of olive pomace biochar (OB), wood biochar (WB), and green compost (GC), alone or in combination, to partially replace peat in growing media and improve substrate properties and plant development. Ten different substrates were formulated by substituting 10–20% of a commercial peat-based substrate with these organic amendments, using the commercial substrate alone as a control. The effects of such replacements were evaluated in the following experiments: a germination test conducted in Petri dishes using four forage species (Medicago polymorpha, Lolium perenne, Festuca arundinacea, and Lolium rigidum); and two parallel pot experiments lasting 100 days each (one with M. polymorpha and L. perenne, and another with young Olea Europaea var. Arbequina saplings). This study evaluated the impact on plant development, as well as the physical properties and composition of the substrates during the incubation process. Germination and survival of forage species were comparable or improved in most treatments, except those including 20% OB, which consistently reduced germination—likely due to high electrical conductivity (>10dS/m). In the pot experiments, substrate pH and total carbon content increased significantly with biochar addition, particularly with 20% WB, which doubled total C relative to control. Both forage species (Medicago polymorpha and Lolium perenne) and the olive saplings (Olea Europaea) exhibited normal growth, with no significant differences in biomass, water content, or physiological stress indicators when compared to the control group. Nutrient uptake was found to be stable across treatments, although magnesium levels were below sufficiency thresholds without triggering visible deficiency symptoms. Overall, combining compost and biochar—particularly WB and GC—proved to be a viable strategy to reduce peat use while maintaining substrate quality and supporting robust plant growth. This approach proved effective across the different plant varieties tested, including Medicago polymorpha, Lolium perenne, and young olive plants, which together encompass a wide spectrum of agronomic and horticultural applications as well as contrasting growth and nutrient requirements. Adverse effects on early plant development can be avoided by carefully selecting and characterizing biochars, with specific attention to salinity and C/N ratio. This finding is crucial for the successful large-scale implementation of sustainable alternatives to peat. Full article

Cost is a key performance indicator for evaluating the success of architectural construction projects. While previous studies have relied on quantitative data and statistical models to evaluate cost performance, recent advancements in methods have enabled analysis using unstructured data. Unstructured data, particularly in construction supervision reports, can be considered the significant variables for performance evaluation, as they represent independent third-party monitoring of the construction project’s execution. This study aims to present a framework that supports cost performance evaluation using unstructured data and random forests (RFs), a representative method of machine learning. Specifically, association rule analysis and social network analysis were used to identify the main keywords, and an RF model was applied to these data to evaluate cost performance. The tuning of hyper-parameters in the RF was implemented by the Bayesian optimization technique with the augmentation of the original dataset. The accuracy of cost performance evaluation was 59% for the traditional logistic regression (LR), 74% for the regularization-based logistic regression (BLR) designed to prevent overfitting, and 76% for the RF model utilizing augmented data. The complementary utility of the models consisting of the proposed framework can be useful for deriving various evaluation explanations about cost performance. The applicability is expected to increase as more data become available in the future. Full article