Search Results (8,244)

Purpose: Oral squamous cell carcinoma (OSCC) carries a substantial burden in low- and middle-income countries as well as underserved subpopulations within high-income settings, where structural barriers contribute to worse outcomes. While evidence supports targeted screening of high-risk groups, practical guidance for designing organized, quality-assured programs remains limited. This review proposes a framework to translate contemporary cancer-screening principles into operational criteria for OSCC. Methods: A review following the Scale for the Assessment of Narrative Review Articles principles was conducted. Conceptual papers, international evaluations, implementation studies, and programmatic guidance were included. The evidence was synthesized narratively, with emphasis on contemporary cancer-screening principles, implementation frameworks, and their applicability to OSCC. Results: Clinical oral examination can improve the detection of OSCC in early stages and reduce mortality among high-risk groups when embedded in coordinated care pathways. Effective programs require governance structures, screening policies, risk-stratified approaches, and robust information systems capable of call-recall, referral tracking, and quality monitoring. Dental schools and academic clinics may serve as feasible regional hubs for programs within mixed health systems. Conclusions: Aligning core OSCC-screening principles with operational enablers offers a practical pathway to develop context-appropriate programs that strengthen capacity, promote equity, and generate evidence for responsible scale-up. Full article

This study develops an Industry 5.0- and IoT-enabled roadmap for green transformation in manufacturing, with a particular focus on Turkish industry. The study combines a structured literature review, bibliometric keyword mapping based on Web of Science records, and interview-informed framework refinement drawing on the sustainability departments of five large-scale manufacturing firms operating in Türkiye. Rather than treating green transformation as a single initiative, the roadmap organizes it into five interrelated modules: emission reduction, clean and reliable energy, circular-economy mobilization, energy- and resource-efficient construction and renovation, and zero-pollution waste management. The main contribution is a five-level qualitative maturity model that shows how firms can move from compliance- and governance-based foundations to integrated, data-driven, and predictive sustainability practices. The framework clarifies which factors are foundational, enabling, or advanced at each level and is intended to be used as a practitioner checklist and strategic assessment tool rather than as a fixed quantitative scoring model. The interview insights were used to refine the sequencing of actions, identify implementation bottlenecks, and adapt the framework to the realities of Turkish manufacturing. By linking human-centric Industry 5.0 principles with operational sustainability priorities, this study offers both conceptual novelty and practical guidance for firms and policymakers seeking to align industrial upgrading with long-term environmental competitiveness. Full article

Coastal aquifers are essential freshwater sources for domestic, agricultural, and industrial use, particularly in regions where surface water is limited. However, these systems face growing stress from saltwater intrusion, climate-driven reductions in recharge, sea level rise, and intensified groundwater extraction. This review synthesizes recent research on coastal aquifer responses to these pressures, highlighting the interplay between natural hydrogeologic conditions and human-induced demand. Across deltaic and sedimentary systems, studies consistently show declining groundwater levels, the landward migration of saline interfaces, and reduced aquifer buffering capacity, especially in areas with high evaporation and limited recharge. The review also evaluates emerging strategies to preserve coastal groundwater security. Integrated hydrological models, managed aquifer recharge (MAR), optimized abstraction schemes, and remote sensing-based monitoring are advancing adaptive management capabilities. In parallel, policy and nature-based interventions—such as aquifer protection zoning, wetland rehabilitation, and dune system restoration—support long-term resilience by enhancing natural recharge and reducing vulnerability. The overall findings reveal the need for climate-informed and locally tailored groundwater management. Future efforts should prioritize coupling high-resolution climate projections with aquifer system models, evaluating MAR viability in saline-prone environments, and strengthening collaborative governance frameworks to ensure sustainable and equitable use of coastal aquifers. Full article

Digital governance in higher education represents a complex systemic challenge, shaped by the intricate interplay of socio–economic–political contexts, technological infrastructures, and multiple stakeholders. Yet existing scholarship tends to examine these factors in isolation, lacking an integrated theoretical lens capable of capturing their systemic interdependencies and dynamic interactions. This study addresses this gap by drawing on the Social–Ecological Systems (SES) framework—a well-established systems theory for analyzing coupled social and ecological dynamics—to construct an integrated analytical framework for university digital governance. The framework organizes governance into three interconnected dimensions: external contexts, internal systems, and interaction effects. External contexts—including technological ecosystems and socio–economic–political factors—shape opportunities and constraints for universities. Internal systems, comprising resource systems, resource units, governance structures, and actors, form a complex network through information flows, resource flows, and institutional arrangements. Interaction effects emerge from these networks and are observed in both social outcomes and ecological outcomes, encompassing both positive and negative dimensions. The framework advances theory by extending the SES perspective to higher education, integrating multiple governance elements, and operationalizing core variables for measurement. Practically, it provides universities with a systematic tool for diagnosing digital governance performance, identifying gaps, and guiding optimization, while also supporting cross-institutional benchmarking and longitudinal monitoring. Future research should empirically test the framework, refine the operational indicators, and explore its applicability across diverse institutional and cultural contexts. Full article

Magnesium oxychloride cement (MOC), produced from reactive MgO and MgCl₂, has re-emerged as a promising low-carbon binder due to its rapid setting and high early-age strength. Yet its limited resistance to moisture and immersion remains the principal barrier to broader construction deployment. This review synthesizes the MOC evidence base using a structured approach that combines PRISMA-informed study identification and screening with bibliometric mapping to contextualize research evolution and thematic development. The review follows a structured data extraction of mix design, curing conditions, characterization methods, and performance outcomes. The synthesis confirms that MOC performance is strongly system-dependent. MgO reactivity, MgCl₂ concentration, mixture ratios, and curing regime govern hydration products, microstructure, and durability, accounting for the apparent variation across studies. Comparative assessment shows that improvements in water resistance are most consistently reported for phosphate-based modification, SCM incorporation, and polymer/hybrid strategies. However, benefits are frequently accompanied by trade-offs in workability, setting, strength development, and cost, and reinforcement compatibility and corrosion risk remain insufficiently resolved for structural applications. The review highlights gaps in reporting and durability testing that currently limit cross-study comparability and translation, and it consolidates priority research directions toward standardized protocols, mechanism-based durability design, scale-up validation, and robust sustainability assessment. Full article

Escherichia coli, a facultative anaerobic Gram-negative member of the Enterobacteriaceae, is an increasingly important opportunistic pathogen driven in part by rising resistance to clinically important antibiotics. Regulation of multidrug efflux systems by two-component signal transduction pathways, particularly the BaeSR system, plays a central role in this process. However, the functional residues governing signal transduction through the sensor kinase BaeS remain incompletely defined. In this study, we integrated domain prediction, homology-guided site-directed mutagenesis, in vitro protein purification, autophosphorylation assays, and reverse-transcription quantitative polymerase chain reaction (RT-qPCR)-based transcriptional analysis of selected BaeSR-regulated genes to delineate key residues required for BaeS function. Sequence analysis identified His250 as a candidate autophosphorylation site and Asn364 as a conserved residue within the catalytic domain. Biochemical characterization of purified wild-type BaeS and an H250A mutant demonstrated that His250 is indispensable for autophosphorylation. Consistently, RT-qPCR analysis showed that BaeS activation markedly induced the transcription of BaeSR-regulated efflux-associated genes, whereas genetic deletion of baeS or selective disruption of kinase activity by the N364A mutation abolished this response. Together, these findings establish His250 as a key residue for BaeS autophosphorylation and identify Asn364 as essential for inducible BaeSR signaling and activation of resistance-associated target genes, thereby establishing an experimental framework for elucidating BaeSR-mediated efflux regulation and informing future studies of resistance regulatory networks and potential intervention strategies centered on key signaling nodes. Full article

With the in-depth advancement of the “Digital China” initiative, policies and research discourses related to the digital economy have continued evolved, making it necessary to systematically examine their stage-specific characteristics and underlying logic from a long-term perspective. Accordingly, this study adopts information society theory as the analytical framework and selects the annual series of reports on China’s digital economy development published by the China Academy of Information and Communications Technology (CAICT) from 2015 to 2024 as the research corpus. Using text mining techniques and Latent Dirichlet Allocation (LDA) topic modeling, this paper conducts a longitudinal examination of the stage-wise systemic evolution of key topics in China’s digital economy development. The findings indicate that over the past decade, the topic structure of China’s digital economy has followed a clear evolutionary trajectory, progressing from “informatization-driven development” to “platform expansion,” and subsequently to “data factors and institutional governance.” In the early stage, the focus was on information infrastructure development and industrial integration; the middle stage shifted toward the platform economy and enterprise growth; more recently, the emphasis has increasingly been placed on the construction of data factor markets and the improvement of governance frameworks. This process of topic evolution not only reflects changes in the practical forms of the digital economy but also reveals the ongoing adjustment of the state’s cognitive framework and governance logic regarding digital economy development. These findings provide empirical evidence for understanding the systemic evolution of China’s digital economy over time. By identifying the stage-specific pathways of China’s digital economy, this study extends the application of information society theory within this context and provides new empirical evidence for understanding the evolutionary logic underlying high-quality digital economy development. Full article

Purpose: Saudi Arabia’s Vision 2030 designates tourism as a non-oil diversification engine. This study tests Tourism-Led Growth Hypothesis (TLGH) predictions among tourism professionals across five regions of the Kingdom of Saudi Arabia (KSA), proposing the TLGH-GCC (Gulf Cooperation Council) Framework. Design/Methodology/Approach: Sequential explanatory mixed-methods design: Structural Equation Modelling (SEM; N = 612; five regions) as primary evidence, executive interviews (n = 24) explaining mechanisms, and exploratory ARDL (T = 9; non-inferential). Findings: Perceptual support was found for all four hypothesised structural pathways (all p < 0.001), with megaproject investment exhibiting the strongest association with employment generation (β = 0.63) and sustainability governance challenges inversely associated with diversification efficiency. All associations are directionally consistent with TLGH predictions but do not establish causation. Qualitative findings further identified Saudisation alignment and workforce competency development as critical boundary conditions for translating tourism employment growth into sustained economic diversification. Theoretical Contribution: The TLGH-GCC Framework extends TLGH with institutional acceleration, Dutch Disease boundary conditions, and sustainability governance as a diversification determinant. The SGS-6 scale is validated for GCC megaproject contexts. Practical Implications: Regional decentralisation of gigaproject investment, occupational upgrading, and proactive sustainability governance are the highest-leverage Vision 2030 policy interventions. The findings further inform human capital development priorities under Vision 2030, including sector-specific tourism competency frameworks and Saudisation alignment in megaproject workforce planning. Originality/Value: The study addresses a methodological gap in the TLGH literature by combining five-region stratified SEM, executive interviews, and the validated SGS-6 sustainability governance scale within a single GCC-contextualised framework. Full article

Sub-Saharan African health systems face critical funding challenges due to declining foreign aid, mounting debt and increasing disease burdens. Traditional financing mechanisms have proven inadequate, necessitating the exploration of innovative domestic revenue mobilization (DRM) strategies. This paper contributes to the health economics literature by examining the use of innovative tax models as DRM strategies for sustainable health financing in Sub-Saharan Africa, using the fiscal space for health framework. This narrative review synthesizes peer-reviewed articles, policy documents, and grey literature published between 2010 and 2025. The review identifies four promising innovative models: health taxes (tobacco, alcohol, sugar-sweetened beverages), environmental levies (pollution, carbon, plastic), digital taxation (digital services taxes, mobile money taxes, Value Added Tax (VAT) on digital services) and resource extraction taxes. The evidence demonstrates significant revenue generation potential while achieving public health and environmental co-benefits. However, critical implementation challenges persist: weak administrative capacity, poor governance quality, equity concerns and extensive informality and economic diversity. The paper recommends strengthening tax administration through digital infrastructure investment and capacity building, implementing progressive tax design with targeted exemptions, enhancing transparency and linking tax revenue to health service delivery, and tailoring reforms to country-specific contexts while learning from regional experience. Full article

Additively manufactured lattice structures have become a staple of optimized structural parts and are increasingly common in biomedical and chemical applications that require consideration of flow through porous architectures. However, design principles governing transport performance trail those established for mechanical optimization. Here, we introduce two complementary design frameworks that modify symmetry at both the unit cell and part scales to systematically tune internal transport. These approaches are further extended into patterned lattice structures, where multiple unit cell designs can be combined in one, two, or three dimensions to further regulate the internal flow. We find that identical global lattice geometries can arise from different unit cell basis and voxel plane orientations, with minimal changes in bulk geometric properties. Yet in parts with diameters of 12–35 mm, hydraulic diameters of 1–4 mm, and porosities ~80%, these design selections significantly affect the hydraulic tortuosity and fluid transport behavior. We further demonstrate performance from select designs that yield a new class of anisotropic lattices with strong sensitivity to flow direction that is tuned by the projected area perpendicular to flow. Collectively, these symmetry-informed, multi-order combinatorial design approaches enable predictable, direction-dependent transport design and expand the functional potential of lattice architectures across disciplines. Full article

Urban fires are highly destructive with high casualty rates, often causing significant casualties and property losses. The obstruction of the Community Emergency Corridor System is a critical factor exacerbating fire casualties, directly related to residents’ life safety and public security governance effectiveness. Currently, community emergency corridors face severe systemic bottlenecks in the coordinated development of triadic space (physical, social, and information spaces), and the lag of information space has become a fatal shortcoming restricting emergency response efficiency, highlighting the urgent need for a comprehensive evaluation framework. However, existing studies mostly focus on a single spatial dimension, lacking a systematic framework for the coordinated patency of triadic space. Based on this, this study adopts the triadic space perspective, takes 77 typical communities in China as research objects, and uses the Entropy Weighted TOPSIS method to construct an evaluation index system for the accessibility of the Community Emergency Corridor System and systematically measure its level. The results show that the patency of triadic space is unbalanced overall; social space outperforms physical and information spaces (with the latter being the lowest), reflecting deficiencies in emergency information release and acquisition. Regionally, accessibility in Northeast China is significantly higher than in other regions (Northeast > West > Central > East), and eastern China has the lowest scores in physical and information spaces due to high urbanization, dense buildings, and land scarcity. Corresponding countermeasures are proposed to address regional disparities. The triadic space evaluation framework and methodological path provide a replicable analytical tool for urban fire-oriented community emergency management and references for fire resilience governance in other countries or high-density communities. Full article

Rainfed agriculture is the most common type of agriculture in South Africa among smallholder farmers, accounting for the majority of the arable land. In a country with so much potential, only about 8% of the arable land is under irrigation. In response, the South African post-apartheid government has invested in the establishment of irrigation schemes in rural provinces such as the Eastern Cape to promote the sustainability of smallholder farming systems. Despite these efforts, the participation of farmers in these schemes remains low. This study investigated socioeconomic and environmental factors that affect farming households’ level of participation in irrigation schemes and intensity. Cross sectional data was collected from 209 households using a multi-stage sampling procedure. Descriptive statistics was used to analyse the socio-economic and environmental factors. A double hurdle model was used to analyse both participation in irrigation and the intensity of participation. The study results reveal that agriculture is largely practised by elderly farmers with an average age of 54 years and largely female-dominated (58%). On average, farmers have 7.5 years of schooling and 12 years of farming experience. Econometric findings demonstrate that participation is significantly influenced by market access, whereas participation intensity is driven by market access, market information and the level of education. The study recommends strengthening gender-targeted agricultural support systems, improved water access through expanded and well-maintained irrigation infrastructure and improving market access. In addition, enhanced extension training support and youth-focused agricultural programmes are required to build productive capacity and ensure the long-term sustainability of irrigation schemes. Full article

Modern architectural heritage is increasingly threatened by rapid urban transformation, yet documentation practices often remain descriptive and insufficiently aligned with governance decision-making processes. This article addresses the gap between heritage documentation and regulatory readiness by proposing the Modern Heritage Documentation Protocol (MHDP), a governance-oriented framework that transforms documentation into decision-grade evidence. The protocol integrates a structured evidence taxonomy and a staged documentation workflow that links architectural documentation to heritage governance requirements, including designation review, conservation planning, and adaptive reuse decisions. The framework was tested through demonstrator applications across three modern architectural heritage cases to evaluate its operational applicability within real documentation workflows. The results show that structured evidence capture and synthesis can convert fragmented heritage information into coherent documentation that supports governance decisions in rapidly transforming urban environments. By reframing documentation as a governance-oriented process, the proposed framework contributes to more effective heritage management and supports the integration of modern architectural heritage within sustainable urban development strategies. Full article

Background: Governments increasingly seek whole-system, public-health approaches to prevent serious youth violence. However, there is limited empirical evidence on how such approaches are implemented and sustained in complex, post-conflict settings characterised by coercive control, political instability, and fragmented system ownership. Aim: This study examines the Executive Programme on Paramilitarism and Organised Crime (EPPOC) in Northern Ireland as a system-level implementation architecture for addressing serious youth violence, with a focus on how coordinated action was enabled, constrained, and adapted over time. Methods: We conducted an embedded qualitative case study of EPPOC using systematic analysis of programme documentation, independent evaluations, oversight reports, and population-level data spanning nine years of delivery. Implementation science frameworks (ERIC, Proctor’s implementation outcomes, and CFIR) were applied retrospectively as analytic lenses to examine implementation strategies, outcomes, and contextual determinants. Results: EPPOC demonstrated strong implementation outcomes in acceptability and adoption across statutory and community sectors, supported by cross-government governance, trauma-informed workforce development, and shared learning systems. Penetration and sustainability were more variable and constrained by political instability, short-term funding cycles, uneven departmental ownership, and coercive community conditions. Conclusions: The findings suggest that the most transferable element of EPPOC is not individual interventions but the implementation architecture that enabled coordinated, trauma-responsive action across government in a highly complex environment. This architecture represents a potentially replicable design pattern for jurisdictions seeking to address serious youth violence where traditional programme models struggle to operate. Full article

Airborne microplastics (MPs) are increasingly recognized as a pervasive pollutant with potential implications for environmental and human health. Despite growing concern, the influence of seasonal dynamics and environmental conditions on MP distribution remains poorly understood. This study investigates the temporal variability and environmental drivers of MPs across outdoor settings, highlighting how factors such as temperature, wind speeds, and precipitation modulate their behaviors. Using a combination of shielded gravitational deposition sampling (Sigma-2) and bulk deposition sampling over four seasons, coupled with μ-FTIR single particle analysis, we quantified MP abundance, size distribution, morphology, and polymer composition across contrasting environments. Deposition fluxes differed between samplers, with bulk samplers yielding 131–1589 MP/m²/d and Sigma-2 samplers yielding 4208–39,126 MP/m²/d. Multivariate analyses indicate that temperature was significantly correlated with MP loading in the Sigma-2 sampler, whereas precipitation effects were not detectable within the temporal resolution of our dataset. Polymer profiles differed between samplers, with Sigma-2 samples enriched in polyamide (PA) and resin-type particles, and bulk samples containing higher proportions of rubber and acrylate. Spherical and irregular particles were the predominant morphologies across both samplers. Together, these findings provide new insights into the environmental controls governing airborne MP deposition and underscore the need for long-term, meteorology-integrated, and methodologically standardized monitoring strategies to improve exposure assessment and inform mitigation efforts. Full article