Search Results (486)

Procedural physician-scientists have made significant contributions to medicine and science, with twelve proceduralists receiving a Nobel Prize. Unfortunately, several systemic challenges have jeopardized the existence, let alone the flourishing, of procedural physician-scientists: the widening gap in the National Institutes of Health salary cap, decreasing funding from nonfederal public and private agencies, and shifting priorities among U.S. hospitals, payers, and policymakers toward relative value unit productivity-based compensation and fee-for-service models. Additional pressures include prolonged training pathways and the need to maintain clinical continuity. Adopting a team science approach may offer a powerful strategy to mitigate these competing demands, support rigorous scientific inquiry, and address the growing complexity of biomedical research. Concerted efforts by the federal government, policymakers, corporations, institutions, and procedural departments will also be crucial to restoring the vitality of this diminishing workforce. Full article

This study examines the role of public–private partnerships in promoting the sustainable development of travel destinations through a comparative analysis of two emblematic heritage-based hospitality projects: Dar Tantora in Al Ula, Saudi Arabia, and Sextantio Le Grotte della Civita in Matera, Italy. These case studies were analysed through both architectural–urban and economic–legal perspectives to highlight how public–private partnership models can support heritage conservation, community engagement, and responsible tourism development. A mixed-methods approach was employed, combining quantitative indicators—such as projected profitability, tourist volume, and employment—with qualitative insights from interviews with key stakeholders. The analysis reveals that while both models prioritise cultural authenticity and adaptive reuse, they differ significantly in funding structures, legal frameworks, and governance dynamics. Dar Tantora exemplifies a top-down, publicly funded model integrated into Saudi Arabia’s Vision 2030 strategy, whereas Sextantio reflects a bottom-up, private initiative rooted in social enterprise. The findings offer insights into how different public–private partnership configurations can foster sustainable tourism development, depending on local context, institutional frameworks, and strategic goals. The study contributes to the broader discourse on regenerative tourism, architectural conservation, and policy-driven heritage reuse. Full article

This study conducts a comprehensive systematic review of the economic impact of Digital Twin (DT) technology within the Architecture, Engineering, and Construction (AEC) industry, following the PRISMA methodology. While DT adoption has been accelerated by advancements in Building Information Modelling (BIM), the Internet of Things (IoT), and data analytics, significant challenges persist—most notably, high initial investment costs and integration complexities. Synthesising the literature from 2016 onwards, this review identifies sector-specific barriers, regulatory burdens, and a lack of standardisation as key factors constituting DT implementation costs. Despite these hurdles, DTs demonstrate strong potential for enhancing construction productivity, optimising lifecycle asset management, and enabling predictive maintenance, ultimately reducing operational expenditures and improving long-term financial performance. Case studies reveal cost efficiencies achieved through DTs in modular construction, energy optimisation, and infrastructure management. However, limited financial resources and digital skills continue to constrain the uptake across the sector, with various extents of impact. This paper calls for the development of unified standards, innovative public–private funding mechanisms, and strategic collaborations to unlock and utilise DTs’ full economic value. It also recommends that future research explore theoretical frameworks addressing governance, data infrastructure, and digital equity—particularly through conceptualising DT-related data as public assets or collective goods in the context of smart cities and networked infrastructure systems. Full article

This paper explores the effectiveness of an innovative FinTech risk-scoring model to predict the risk-appropriate return for short-term credit sales. The risk score serves to mitigate the information asymmetry between the seller of receivables (“Seller”) and the purchaser (“Funder”), at the same time providing an opportunity for the Funder to earn returns as well as to diversify its portfolio on a risk-appropriate basis. Selling receivables/credit to potential Funders at a risk-appropriate discount also helps Sellers to maintain their short-term financial liquidity and provide the necessary cash flow for operations and other immediate financial needs. We use 18,304 short-term credit-sale transactions between 23 April 2020 and 30 September 2022 from the private FinTech startup Crowdz and its Sustainability, Underwriting, Risk & Financial (SURF) risk-scoring system to analyze the risk/return relationship. The data includes risk scores for both Sellers of receivables (e.g., invoices) along with the Obligors (firms purchasing goods and services from the Seller) on those receivables and provides, as outputs, the mutual gains by the Sellers and the financial institutions or other investors funding the receivables (i.e., the Funders). Our analysis shows that the SURF Score is instrumental in mitigating the information asymmetry between the Sellers and the Funders and provides risk-appropriate periodic returns to the Funders across industries. A comparative analysis shows that the use of SURF technology generates higher risk-appropriate annualized internal rates of return (IRR) as compared to nonuse of the SURF Score risk-scoring system in these transactions. While Sellers and Funders enter into a win-win relationship (in the absence of a default), Sellers of credit instruments are not often scored based on the potential diversification by industry classification. Crowdz’s SURF technology does so and provides Funders with diversification opportunities through numerous invoices of differing amounts and SURF Scores in a wide range of industries. The analysis also shows that Sellers generally have lower financing stability as compared to the Obligors (payers on receivables), a fact captured in the SURF Scores. Full article

The development and implementation of microbial consortium-based biofertilizers represent a promising direction in sustainable agriculture, particularly in the context of the ongoing global ecological and agricultural crisis. This article examines the agroecological and economic impacts of applying microbial consortiums and explores the mechanisms of technology transfer using the example of two countries with differing levels of scientific and technological advancement–China and Kazakhstan. The analysis of the Chinese experience reveals that the successful integration of microbial biofertilizers into agricultural practice is made possible by a well-established institutional framework that includes strong governmental support for R&D, a robust scientific infrastructure, and effective coordination with the private sector. In contrast, Kazakhstan, despite its favorable agroecological conditions and growing interest among farmers in environmentally friendly technologies, faces several challenges from limited funding to a fragmented technology transfer system. The comparative study demonstrates that adapting Chinese models requires consideration of local specificities and the strengthening of intergovernmental cooperation. The article concludes by emphasizing the need to establish a multi-level innovation ecosystem encompassing the entire cycle of development and deployment of microbial biofertilizers, as a prerequisite for improving agricultural productivity and ensuring food security in countries at different stages of economic development. Full article

To promote the deepening of reform and the effective implementation of policies, the State Council launched the special supervision of the liquidation of local governments’ arrears in project funds in 2016, which supports the optimization of the government debt structure. Based on the quasi-natural experiment of the special supervision action, in this study, we use the difference-in-difference (DID) method to investigate the effect and mechanism of the optimization of the government debt structure on the financing constraints of private enterprises. This research is particularly relevant for private enterprises, which face acute financing challenges and are critical for promoting inclusive economic growth, employment, and innovation—key pillars of sustainable development. The results are as follows. Firstly, the special supervision significantly reduces the financing constraints of private enterprises. Secondly, it has heterogeneous effects on the financing constraints of different types of enterprises, and the alleviating effect is particularly significant for enterprises that rely on the funding support of local governments. This highlights the importance of institutional reforms in fostering equitable access to financial resources for vulnerable enterprise groups such as private enterprises. Thirdly, the optimization of the government debt structure eases enterprises’ financing constraints by improving their capital turnover and trade credit. By enhancing liquidity and creditworthiness, these changes create a more resilient financial environment for private enterprises, supporting their long-term development and contribution to sustainable economic systems. Full article

Healthcare cost acceleration and resource allocation issues have worsened across European health systems, where a small group of patients drives excessive healthcare spending. The prediction of high-cost utilization patterns is important for the sustainable management of healthcare and focused intervention measures. The aim of our study was to derive and validate machine learning algorithms for high-cost healthcare utilization prediction based on detailed administrative data and by comparing three algorithmic methods for the best risk stratification performance. The research analyzed extensive insurance beneficiary records which compile data from health group collective funds operated by non-life insurers across EU countries, across multiple service classes. The definition of high utilization was equivalent to the upper quintile of overall health expenditure using a moderate cost threshold. The research applied three machine learning algorithms, namely logistic regression using elastic net regularization, the random forest, and support vector machines. The models used a comprehensive set of predictor variables including demographics, policy profiles, and patterns of service utilization across multiple domains of healthcare. The performance of the models was evaluated using the standard train–test methodology and rigorous cross-validation procedures. All three models demonstrated outstanding discriminative ability by achieving area under the curve values at near-perfect levels. The random forest achieved the best test performance with exceptional metrics, closely followed by logistic regression with comparable exceptional performance. Service diversity proved to be the strongest predictor across all models, while dentistry services produced an extraordinarily high odds ratio with robust confidence intervals. The group of high utilizers comprised approximately one-fifth of the sample but demonstrated significantly higher utilization across all service classes. Machine learning algorithms are capable of classifying patients eligible for the high utilization of healthcare services with nearly perfect discriminative ability. The findings justify the application of predictive analytics for proactive case management, resource planning, and focused intervention measures across private group health insurance providers in EU countries. Full article

This article analyzes the revitalization process of the Kraków Fortress in the context of the amendment to the Revitalization Act of 29 July 2024, focusing on the legal, financial, social, and environmental effects of these changes. The aim of the work is to assess how the new regulations have affected the effectiveness of the revitalization of historic military facilities and the financial and participatory mechanisms that have enabled their effective implementation. The authors adopted an interdisciplinary approach, combining legal, urban, conservation, and social analysis, and applied the case study method of five forts: 52 “Borek”, 52a “Jugowice”, 2 “Kościuszko”, 49 “Krzesławice”, and 31 “Św. Benedict”. The selection of cases was based on different stages of implementation, financing models, and social functions. The research showed that the amendment to the Act accelerated decision-making processes and enabled more flexible management of space and better acquisition of financial resources, including from the EU and SKOZK. The use of a mixed financing model (local, European, private funds) and strong social participation contributed to the durability and acceptance of the projects. The effects of revitalization include, among others, an increase in the number of visitors (from 20,000 to 75,000 per year), the creation of approx. 120 jobs, and a reduction of energy consumption by over 30%. Revitalized facilities today perform cultural, educational, and recreational functions, supporting social integration and the development of a local identity. The article indicates that the Kraków model can be a model for other cities with military heritage. It also draws attention to the need to develop nationwide standards for the adaptation of historic buildings and recommends further research on the socio-economic durability of revitalization projects. Full article

High unemployment rates, inaccessible housing markets, and funding challenges create barriers to finding suitable housing for adults with Autism Spectrum Disorder (ASD) who have less obvious support needs, also known as autistic adults. While public and community housing services in Aotearoa New Zealand (AoNZ) may be an option, a lack of accessible designs leaves families uncertain about future care options. This paper, part of the MBIE-funded Public Housing and Urban Regeneration: Maximising Wellbeing research programme in partnership with registered Community Housing Provider, Te Toi Mahana (TTM), takes an exploratory approach to ask how public and community housing can support and help enable semi-independent living for autistic adults. It investigates how design elements—such as dwelling layouts, material choices, colour schemes, lighting, acoustics, shared and community spaces, and external environments—impact the wellbeing of autistic adults. By extension, insights may also inform private housing design. The study focuses on autistic adults who may be considered ‘mid-to-high’ functioning or those who have been previously diagnosed with Asperger’s Syndrome, whose housing needs are often overlooked. It develops guiding principles and detailed guidance points for public and community housing, informed by the literature, case studies, and data from a photo elicitation study and interviews undertaken with autistic adults in AoNZ. These guiding principles are tested through the speculative redesign of a large TTM site in Newtown, Wellington, AoNZ. Findings should be of interest to government agencies, housing providers, architects, stakeholders, and others involved in shaping the built environment, as well as autistic adults and their supporters, both in AoNZ and internationally. Full article

Specialized and special new “little giant” enterprises are characterized by specialization, refinement, uniqueness, and innovation. They have relatively strong innovation capabilities and enterprise vitality. However, they also face problems such as high innovation costs, long investment recovery cycles, and high risks of investment returns, which lead to information asymmetry and financing difficulties. Government venture capital is a policy fund provided by the government and established with the participation of local governments, financial institutions, and private capital. They can utilize fiscal policies to attract market funds and support the development of key industries. Therefore, in this study, the first through sixth batches of specialized and special new “little giant” enterprises listed on the A-share and New Third Board from 2013 to 2023 were taken as samples, and their investment behavior and investment effects were empirically studied using the multiple linear regression method. The investment behavior of government venture capital tends to target strategic emerging industries. The intervention of government venture capital can enhance the innovation of “little giant” enterprises and has an impact through the intermediary mechanism of R&D investment. This paper draws conclusions and puts forward relevant policy suggestions for supporting the development of “little giant” enterprises. Full article

This study is titled “Success Factors in Transport Interventions: A Mixed-Method Systematic Review (1990–2022)”. The purpose of the systematic review is to (1) identify effective interventions for transitioning individuals from private car reliance to sustainable transport, (2) summarise psychosocial theories shaping transportation choices and identify enablers and barriers influencing sustainable mode adoption, and (3) determine the success factors for interventions promoting sustainable transport choices. The last search was conducted on 18 November 2022. Five databases (Scopus, Web of Science, MEDLINE, APA PsycInfo, and ProQuest) were searched using customised Boolean search strings. The identified papers were included or excluded based on the following criteria: (a) reported a modal shift from car users or cars to less CO₂-emitting modes of transport, (b) covered the adoption of low-carbon transport alternatives, (c) comprised interventions to promote sustainable transport, (d) assessed or measured the effectiveness of interventions, or (e) proposed behavioural models related to mode choice and/or psychosocial barriers or drivers for car/no-car use. The identified papers eligible for inclusion were critically appraised using Sirriyeh’s Quality Assessment Tool for Studies with Diverse Designs. Inter-rater reliability was assessed using Cohen’s Kappa to evaluate the risk of bias throughout the review process, and low-quality studies identified by the quality assessment were excluded to prevent sample bias. Qualitative data were extracted in a contextually relevant manner, preserving context and meaning to avoid the author’s bias of misinterpretation. Data were extracted using a form derived from the Joanna Briggs Institute. Data transformation and synthesis followed the recommendations of the Joanna Briggs Institution for mixed-method systematic reviews using a convergent integrated approach. Of the 7999 studies, 4 qualitative, 2 mixed-method, and 30 quantitative studies successfully passed all three screening cycles and were included in the review. Many of these studies focused on modelling individuals’ mode choice decisions from a psychological perspective. In contrast, case studies explored various transport interventions to enhance sustainability in densely populated areas. Nevertheless, the current systematic reviews do not show how individuals’ inner dispositions, such as acceptance, intention, or attitude, have evolved from before to after the implementation of schemes. Of the 11 integrated findings, 9 concerned enablers and barriers to an individual’s sustainable mode choice behaviour. In addition, two integrated findings emerged based on the effectiveness of the interventions. Although numerous interventions target public acceptance of sustainable transport, this systematic review reveals a critical knowledge gap regarding their longitudinal impact on individuals and effectiveness in influencing behavioural change. However, the study may be affected by language bias as it only included peer-reviewed articles published in English. Due to methodological heterogeneity across the studies, a meta-analysis was not feasible. Further high-quality research is needed to strengthen the evidence. This systematic review is self-funded and has been registered on the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY; Registration Number INPLASY202420011). Full article

The documentation of cultural heritage, particularly built heritage, represents a critical component in ensuring its preservation, sustainable management, and effective transmission to future generations. As the field increasingly undergoes a digital transformation, there is a growing need for structured, standardised approaches that can guide professionals and stakeholders through the complexities of documentation practices. Despite the availability of numerous standards and charters, a clear synthesis of consolidated methodologies and recent technological shifts remains limited. This study addresses this gap by conducting a Systematic Literature Review (SLR) to assess current documentation practices. The research is part of a larger initiative funded by the FSE REACT-EU programme under the Italian PON Ricerca e Innovazione 2014–2020, specifically aiming to support public and private stakeholders in developing practical documentation strategies. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, over 266 publications were analysed to reconstruct the state of the art. The findings confirm widely adopted practices among research groups while also highlighting emerging trends driven by technological advancements in geomatics. These insights will contribute to the formulation of practical guidelines to support operators in the field and reinforce the integration of innovative tools in Cultural Heritage documentation workflows. Full article

This paper analyzes “Umbrella Agreements,” a policy tool implemented by the Israeli government across 32 municipalities over the past decade. Introduced in response to a deepening housing crisis, these agreements offered funding for local infrastructure in exchange for municipal consent to large-scale residential development on (mostly) state- managed land. We argue that umbrella agreements rescale the neoliberal mechanism of “planning deals” from the urban to the state (national) scale, expanding their logic to new contexts, and fundamentally transforming the Israeli planning regime. While prevailing theories of neoliberalism emphasize decentralization and privatization through “free market” mechanisms, the Israeli process is characterized by strong state control over land and a concentration of planning powers at the national level as a pre-condition for private housing development. Our analysis yields three main findings. First, upscaling planning deals erodes the state’s regulatory powers while increasing its interest as a direct beneficiary of the capitalist order. Second, these agreements subject market logic to greater political control. Third, this transformation has seriously undermined the democratic and professional characters of the planning system, leading to regressive social consequences. Full article

School food policy (SFP) that promotes nutritional behaviour is a national priority. Despite the role of school principals, teachers, and food service staff (FSS) in implementing SFP, their contribution to the current state of school food policy remains unexplored. The study aims to explore the perspective of these stakeholders on the effectiveness of SFP, barriers, and future recommendations for effective implementation. A qualitative study using 24 key informants interviews including principals (n = 6), teachers (n = 12), and FSS (n = 6) was conducted. From the list of private secondary schools, six schools were randomly selected. Principals, teachers, and FSS were selected through purposive sampling. A thematic approach was adopted for the data analysis. Interview data were categorised into three broad themes: (1) availability of school food policy, (2) barriers to enforcement, and (3) recommendations. Most participants stated that policy implementation is not enforced. The barriers are non-prioritised funding, resistance to change, and time constraints. The recommendations include regular training, activity manual development, seasonal food promotion, nutrition education, and leadership support. The study provides a deeper understanding of the role of key stakeholders in the current state of the effectiveness of SFP implementation. The inclusion of stakeholders is essential for a successful school food policy. Full article

Background: Reproductive, maternal, neonatal, and child health (RMNCH) remains a key priority for official development assistance and private voluntary assistance (ODA+) in low-income countries. In Guinea-Bissau, maternal and child mortality rates remain high, with the healthcare system heavily dependent on foreign aid. This study analyzes ODA+ trends for RMNCH in Guinea-Bissau from 2002 to 2018 and assesses its impact on maternal, neonatal, infsupplent, and under-five mortality rates. Methods: We used data from the OECD Creditor Reporting System and applied the Muskoka2 methodology to estimate RMNCH-related disbursements. Funding trends were categorized by donor type and RMNCH subsectors. A longitudinal analysis used regression models to assess the relationship between aid categories and mortality outcomes. Results: RMNCH funding accounted for 8.9% of total ODA+ to Guinea-Bissau, with most aid directed toward child health. Models revealed a negative association between child health funding and under-five and infant mortality, while reproductive health funding showed no significant correlation with maternal or neonatal mortality. Conclusions: Although variable, ODA+ for RMNCH in Guinea-Bissau has helped reduce child mortality. However, maternal and neonatal mortality require targeted interventions and improved coordination. Fluctuating aid disbursements emphasize the need for sustainable health financing and stronger donor alignment with national priorities. Full article