Search Results (535)

The modified Rankin Scale (mRS) is a widely used outcome measure for assessing disability in stroke care; however, its administration is often affected by subjectivity and variability, leading to poor inter-rater reliability and inconsistent scoring. Originally designed for hospital discharge evaluations, the mRS has evolved into an outcome tool for disability assessment and clinical decision-making. Inconsistencies persist due to a lack of standardization and cognitive biases during its use. This paper presents design principles for creating a standardized clinical assessment tool (CAT) for the mRS, grounded in human–computer interaction (HCI) and cognitive engineering principles. Design principles were informed in part by an anonymous online survey conducted with clinicians across Canada to gain insights into current administration practices, opinions, and challenges of the mRS. The proposed design principles aim to reduce cognitive load, improve inter-rater reliability, and streamline the administration process of the mRS. By focusing on usability and standardization, the design principles seek to enhance scoring consistency and improve the overall reliability of clinical outcomes in stroke care and research. Developing a standardized CAT for the mRS represents a significant step toward improving the accuracy and consistency of stroke disability assessments. Future work will focus on real-world validation with healthcare stakeholders and exploring self-completed mRS assessments to further refine the tool. Full article

The rapid evolution of Industry 4.0 technologies has resulted in a scenario in which collaborative networks are essential to overcome the challenges related to their implementation. However, the frameworks to guide such collaborations remain underexplored. This study addresses this gap by proposing Business Rules and Goals Models to operationalize Industry 4.0 solutions through enterprise collaboration. Using the For Enterprise Modeling (4EM) method, the research integrates qualitative insights from expert opinions, including interviews with 12 professionals (academics, industry professionals, and consultants) from Brazilian manufacturing sectors. The Goals Model identifies five main objectives—competitiveness, efficiency, flexibility, interoperability, and real-time collaboration—while the Business Rules Model outlines 18 actionable recommendations, such as investing in digital infrastructure, upskilling employees, and standardizing information technology systems. The results reveal that cultural resistance, limited resources, and knowledge gaps are critical barriers, while interoperability and stakeholder integration emerge as enablers of digital transformation. The study concludes that successfully adopting Industry 4.0 requires technological investments, organizational alignment, structured governance, and collaborative ecosystems. These models provide a practical roadmap for companies navigating the complexities of Industry 4.0, emphasizing adaptability and cross-functional synergy. The research contributes to the literature on collaborative networks by connecting theoretical frameworks with actionable enterprise-level strategies. Full article

Higher-education institutions are increasingly embracing digital transformation to meet the evolving expectations of students, academics, and administrators. The smart campus paradigm offers a strategic framework for this shift, yet most existing assessment models originate from high-income contexts and remain largely untested in the Global South, where infrastructural and technological conditions differ substantially. This study addresses this gap by evaluating the contextual relevance of a comprehensive smart campus assessment framework at the Papua New Guinea University of Technology (PNGUoT). A questionnaire survey of 278 participants—students and staff—was conducted using a 5-point Likert scale to assess the perceived importance of performance indicators across four key dimensions: Smart Economy, Smart Society, Smart Environment, and Smart Governance. A hybrid methodology combining the Best–Worst Method (BWM) and Public Opinion (PO) data was used to prioritise framework components. The research hypothesises that contextual factors predominantly influence the framework’s relevance in developing countries and asks: To what extent is the smart campus assessment framework relevant and adaptable in the Global South? The study aims to measure the framework’s relevance and identify contextual influences shaping its application. The findings confirm its overall applicability while revealing significant variations in stakeholder priorities, emphasising the need for context-sensitive and adaptable assessment tools. This research contributes to the refinement of smart campus frameworks and supports more inclusive and responsive digital transformation strategies in developing country higher education institutions. Full article

More and more sustainability data are being generated from green buildings and from urban and civil infrastructures. For decades, various systems have been developed, and their data have been collected and stored. More detailed, real-time, and cost-effective data, however, are still in short supply. To address this gap, one of the main objectives of the present study is to propose the GREEN method for opinion analysis to support the development of green infrastructure. Google Search was used to gather substantial amounts of information reflecting the views of both ordinary individuals and professionals regarding the benefits, drawbacks, challenges, and limitations of green infrastructure. Previously, however, such data have not been employed to improve green infrastructure by means of opinion analytics. The GREEN method was developed for the analysis of green infrastructure (GI) and its context, enabling multiple-criteria, neural network, correlation, and regression analyses across micro-, meso-, and macro-environmental scales. A total of 788 global regression (R² = 0.997) and neural network (R² = 0.596) GREEN models were developed and tested. In addition, 34 regression models for 12 (R² = 0.817) and 20 (R² = 0.511) cities were created for the world and separate cities (Munich (R^{2 aver} = 0.801) and London (R^{2 aver} = 0.817)). The GREEN method is a new way to analyze stakeholder opinions on sustainable green infrastructure and its context. With the objective of making green infrastructure more efficient and reducing carbon emissions, the Construction Material Reuse Optimization (SOLUTION) Portal was created as part of this research. The portal generates multiple options and proposes optimal alternatives for reused construction products. The results show that the GREEN method and SOLUTION Portal are reliable tools for evidence-based and rational green infrastructure development. Full article

This article reviews the current scientific literature that relates to automated vehicles (AVs), vehicles controlled by a computer instead of a human driver, and people living with a disability (PLWD). The aim of this review is (1) to explore how AVs might improve mobility for PLWD, (2) to identify research gaps to guide future studies, and (3) to examine the real-world applicability of existing research. A structured search following PRISMA guidelines identified 66 relevant peer-reviewed publications. The findings suggest that AVs hold promise in reducing transport-related social exclusion by increasing autonomy, flexibility, and accessibility for PLWD, thereby supporting the transition toward more inclusive and environmentally sustainable transport systems. However, the potential benefits of AVs for the mobility of PLWD depend on the type of vehicle considered (e.g., private vs. public transport) as well as the potential challenges related to the legal framework, accessibility standards, and addressing PLWD concerns, opinions, and needs. To overcome the existing obstacles to the widespread adoption of AVs and make them a real opportunity for PLWD, collaboration between all stakeholders in the sector (i.e., governments, industries, and disability associations) is needed. This review supports cross-sector collaboration for inclusive AV implementation. Full article

The increasing development of coal mining subsidence wetland parks has led to a growing focus on assessing their ecological, economic, and social benefits following ecological restoration. This study establishes an assessment framework for the social landscape performance of coal mining subsidence wetland parks based on the landscape performance series (LPS), cultural ecosystem services (CES), and the unique characteristics of coal mining subsidence wetland parks. The framework integrates expert opinions and field research to select indicators, resulting in a comprehensive evaluation system comprising 28 indicators across five dimensions. Taking the Pan’an Lake National Wetland Park (PLNWP) in Xuzhou, China, as an example, we conducted empirical research by collecting data through questionnaires and on-site interviews. Using the fuzzy comprehensive evaluation method, the social landscape performance score of PLNWP was 3.511, which is rated as “good.” The importance–performance analysis (IPA) was applied to identify differences in the perceptions of visitors and local residents regarding the social landscape performance of the PLNWP. Local residents highlighted the need to enhance the amenity of waterside spaces, while visitors focused on the accessibility. Finally, based on the performance score and the perceptions from different stakeholders, optimization strategies were proposed in four aspects: enhancing waterside space amenity, optimizing accessibility, improving educational facilities, and addressing diverse user needs. This study could provide a feasible assessment framework and optimization guidance for other coal mining subsidence wetland parks. Full article

The evolving landscape of Health Technology Assessment (HTA) in Europe, shaped by the implementation of the new EU HTA Regulation (HTAR), places an emphasis on engaging all stakeholders, including patients, in collaborative evidence generation. Yet integrating patients’ perspectives into critical processes like PICO scoping remains a challenge, with concerns around subjectivity, representativeness, and methodological robustness. This opinion paper examines the complexities of patient engagement in HTA, highlighting both the opportunities for patients to make meaningful contributions and the barriers that stand in the way. We propose a framework that employes the Delphi panel methodology to (1) foster scientific validity and increase transparency in patient contributions, (2) establish a structured and consistent patient engagement framework, and (3) and understand European patients’ perspectives while promoting collaboration among EU countries. By facilitating iterative feedback and fostering agreement among diverse groups of patients and caregivers contributing with their expertise, consensus methods like Delphi panels can help refine PICO criteria, align diverse stakeholders’ expectations, and increase the relevance of HTA outcomes. A study is now underway to evaluate the feasibility and value of using the modified Delphi panel methodology for patient engagement in PICO scoping. The authors propose that embracing patient engagement through carefully designed consensus frameworks could enhance the legitimacy and completeness of HTA processes, driving more patient-centered decision making across Europe. Full article

The 2010 Haiti earthquake stands as one of the most catastrophic events in terms of loss of life and destruction. Following an earthquake, there is an urgent demand for information. Regrettably, few studies have tracked the progress of the post-disaster recovery, leaving this phase poorly understood. In previous years, data were exclusively collected through on-site missions, but today, social media (SM) has enhanced earthquake reconnaissance teams’ capacity to collect data beyond the emergency phase. However, text data from SM is unstructured, making it necessary to use natural language processing techniques to extract meaningful information. Sentiment analysis (SA), which classifies people’s opinions into positive, negative, or neutral polarity, is a promising tool for understanding earthquake recovery. For the purposes of this paper, we conduct SA at the tweet level on data collected around the tenth anniversary of the earthquake using human expertise to fine-tune automatic classification methods. We conclude that the anniversary date is the best time to collect data. In our sample, 56.3% of the tweets in the sample were classified as negative, followed by positive (27.3%), neutral (8.2%), and unrelated (8.1%). In our study, we conclude that the assessment of the recovery progress based on data collected from Twitter is negative. The automatic method for SA with the highest accuracy is ‘btweet’. The assessment result must be validated by stakeholders. Full article

This study explores the role of social media in raising awareness, fostering community engagement, and supporting efforts to reduce marine and coastal litter in Cyprus. Focusing on campaigns led by community-based organizations such as Yesil Baris Hareketi, Teneke Cocuk, and the Spot Turtle Project, the research highlights how digital platforms can mobilize public opinion and influence pro-environmental behaviors. Artificial intelligence (AI) algorithms particularly natural language processing (NLP) techniques were employed to analyze large volumes of social media data, enabling the detection of engagement patterns, sentiment dynamics, and thematic trends within environmental campaigns. A mixed-methods approach was adopted, combining social media content analysis, engagement metrics, and stakeholder interviews to provide a comprehensive view of the digital advocacy landscape. Findings suggest that social media plays a critical role in shaping public perceptions of marine litter; however, sustaining long-term behavioral change remains a significant challenge. The study offers practical recommendations for enhancing digital strategies, strengthening stakeholder collaboration, and integrating social media efforts with policy development and environmental education. Full article

This design-led research explored public awareness and opinions on air quality outside schools using an online survey with 310 parents and staff from 10 primary schools across Cork City. Twelve ethnographic interviews were also undertaken with school parents, staff and stakeholders. Air quality was found to be a concern for a minority of respondents (one-fifth of the sample), most seeing it as a concern for respiratory health. The majority indicated support for the installation of air quality sensors, with information from these communicated in an understandable and meaningful format. Initiatives tackling air quality including awareness-building actions and transport measures were identified as warranting consideration. The survey and interview findings underpin the need for multidimensional interventions incorporating Place-Making and design thinking. Tailored initiatives, meeting socio-economic community needs with a shift from individualistic thinking to collective action for air quality initiatives, are recommended from this research. Full article

The deficiency in competencies among built environment professionals (BEPs) in achieving sustainability goals presents a significant challenge, contributing substantially to the escalation of carbon emissions globally, with pronounced implications in Ghana. Addressing this issue is critical to bridging the existing knowledge gap concerning the role of key professional competencies in mitigating carbon emissions. This study, therefore, seeks to examine and synthesize the essential competencies required by BEPs to support the attainment of net-zero carbon emissions within the Ghanaian construction industry (GCI). A quantitative research approach was employed, utilizing a structured questionnaire survey to examine the opinions of 125 professionals, including architects, engineers, and construction managers. The questions were developed based on a review of the related literature. The data collected was analyzed using one-sample t-tests, multiple linear regression, and ANOVA to assess the significance and impact of the identified competencies on sustainability outcomes. The key competencies identified included “value engineering”, “stakeholder engagement for low-carbon development”, “circular impact assessment”, and “reverse logistics for sustainable material use”. This research also revealed the key competencies’ contributions to attaining environmental sustainability in the Ghanaian construction industry. Some key outcomes are “proper planning and provision of detailed net-zero carbon building specifications for contractors” and “promotion and implementation of net-zero carbon buildings”. It was identified that actions towards net-zero carbon emissions are the leading contributor to environmental sustainability, whereas the essential competencies have a greater impact on sustainable resource use. The findings highlight gaps in the current practices and underscore the need for improved professional training and development to meet sustainability goals. This study concludes that while professionals in the GCI are aware of sustainability objectives, significant improvements are needed in the application of sustainable practices. Full article

Introduction: Sub-Saharan Africa in general, and the Democratic Republic of the Congo (DRC) in particular, is undergoing an epidemiological transition characterized by a more rapid increase in the number of non-communicable diseases (NCDs). However, the level of readiness of the DRC’s healthcare facilities (HFs) to manage these diseases is unknown. Thus, our study aimed to assess these HFs’ level of readiness to manage cardiovascular disease (CVD) and diabetes. Methodology: This cross-sectional study involved 1412 HFs in the DRC, selected by stratified random sampling. They are representative of the country’s 26 provinces. The World Health Organization (WHO) Service Availability and Readiness Survey (SARA) was used. The “readiness” outcome was a composite measure of the capacity of HFs to manage CVD and diabetes. The readiness indicator comprised four domains, and a score of ≥70% indicated “readiness” to manage CVD and diabetes. Informed consent was obtained from the stakeholders, and the ethics committee held a positive opinion. Statistical analyses were performed using STATA 17 software. Results: The average readiness scores of the DRC’s HFs to manage CVD and diabetes are less than 50%, being 38.3% (37.3–39.3) and 39.8% (38.7–40.9), respectively. These scores were less than 40% for CVD and diabetes in rural HFs. They were less than 30% for CVD and diabetes in primary-level HF. No province possesses over 50% of health facilities equipped to address cardiovascular illnesses, and only four provinces (Haut Uele, Kinshasa, Nord Kivu, and Sud Kivu) possess over 50% of health facilities equipped to address diabetes. The provinces with health facilities exhibiting the least preparedness in managing cardiovascular illnesses and diabetes are Nord Ubangi and Sankuru. Only 0.07% (0.01–0.5) of HFs obtained a score ≥ 70% for CVD management, and 5.9% (4.8–7.3) obtained this score for diabetes management. Conclusions: Significant deficiencies must be rectified to enhance service delivery in the management of cardiovascular disease (CVD) and diabetes. Most primary-level and rural facilities demonstrated inadequate preparedness for CVD and diabetes screening and management, exhibiting low readiness scores and limited-service availability in the assessed domains. While secondary-level services are relatively accessible, critical gaps persist that must be addressed to improve readiness for CVD and diabetes care. Healthcare facilities should possess the capacity to deliver recommended services across various tiers, ensuring both service readiness and availability. Full article

Transitioning to sustainable systems often faces significant challenges. People from different backgrounds often have different views on sustainability, which may lead to group polarisation. To promote collective participation in the transition to sustainability, it is critical to understand the drivers of polarisation and promote inclusiveness in decision-making. We developed a Dialogue Tool based on the HUMAT framework to explore opinion dynamics such as polarisation in the community and find potential pathways to reconcile when division occurs. By simulating dissatisfaction, division, and reconciliation in the community, we studied how individual characteristics (such as openness to change and assertiveness) affect collective decisions. Furthermore, the Dialogue Tool can be used to test possible interventions to reduce polarisation and increase community satisfaction. Visual representations of community dynamics under different scenarios within the Dialogue Tool have the potential to foster meaningful dialogues among stakeholders, which may promote a deeper reflection on community collaboration. While limitations such as simplifications and lack of empirical calibration limit the predictive accuracy of the Dialogue Tool (although this is not its goal), it still shows strong potential for educational and policy applications. It offers insights into social influences, conformity, and polarisation in community settings, making it a promising tool for fostering inclusive, informed decision-making and strengthening community participation in sustainable development transitions. Full article

The international seabed area (“the Area”) harbors abundant metal mineral resources that are critical to address global metal supply–demand and sustainable development. However, exploitation of mineral resources in the Area faces complex risks spanning politics, economy, technology, science, environment, society, industry, and law. No commercial-scale deep-sea mining operations have been conducted to date. Systematic risk identification and prioritization can inform strategic planning for stakeholders. This study employs literature analysis and an 80-expert questionnaire to identify key risk factors affecting mineral exploitation in the Area. Using the Analytic Hierarchy Process (AHP), we quantitatively assess the relative importance and weightings of these risks. Our results indicate that Level 1 risk groups prioritize (1) policy and public opinion risk, (2) extended continental shelf (ECS) delineation risk, (3) high sea marine protected areas (HSMPAs) establishment risk, and (4) mining area economic value risk. The five most critical Level 2 risk factors are (i) policy changes in contractor states, (ii) ECS-mining area boundary conflicts, (iii) environmental provisions in exploitation regulations at the international seabed (ER), (iv) ER implementation delays, and (v) mineral resource uncertainty. These findings provide actionable insights for contractors, policymakers, and stakeholders to optimize decision making in deep-sea mining projects. Full article

A high-speed rail (HSR) system is directly related to people’s daily travel and safety. To make HSR systems work better for society, it is necessary to improve their resilience. Based on an in-depth literature review, six HSR system ontology-related variables and four resilience attribute-related variables were identified. Then, a questionnaire was designed and distributed to targeted respondents after a pilot survey, aiming to collect experts’ opinions on these driving variables. Subsequently, multiple regression analysis was conducted to check the relationship between driving variables and HSR system resilience. Finally, a fuzzy set qualitative comparative analysis (fsQCA) was carried out to identify the potential configurations of driving variables from a holistic perspective. The results show that all driving variables are significantly correlated to HSR system resilience. Moreover, seven variable configurations were identified and divided into three categories, i.e., strong HSR system ontology–weak resilience attributes, weak HSR system ontology–strong resilience attributes, and strong HSR system ontology–strong resilience attributes. This paper explores the effect of configuration of the driving variables on HSR system resilience, providing a holistic perspective for system resilience literature. The results can also help HSR system-related stakeholders understand the effect of variable combinations on resilience improvement. Full article