Search Results (175)

This study explored the relationship between safety leadership and project success in the construction industry, with a focus on the medium-sized Egyptian construction industry, and examined the mediating role of safety culture and the moderating role of team size. The research design was a cross-sectional survey, with 245 site engineers selected purposively. The data collection method used was a structured questionnaire. Data were analyzed using Hayes Process Macro (Model 4 and Model 1) with 5000 bootstrap resamples in SPSS to examine the mediation and moderation effects as hypothesized. The results show that safety leadership is positively related to both safety culture and project success. In addition, safety culture mediated the relationship between safety leadership and project success. Using the Johnson–Neyman technique, team size was found to moderate this relationship, with teams of fewer than 19 site engineers showing a greater moderation effect. These findings show that safety leadership and safety culture are crucial factors that increase key pillars of sustainable project delivery. This study offers practical recommendations for medium-sized construction firms to improve safety measures and team management, thereby enhancing safety and productivity. It also points out areas for future research, such as the moderating roles of other contextual factors on safety and project performance. Full article

Vaccination ranks among the most consequential interventions in medicine, yet cold-chain dependence, sharps hazards, needle phobia, and reliance on trained vaccinators limit coverage where vaccine-preventable mortality is highest. Microneedle patches deposit antigen into the antigen-presenting-cell-rich epidermis and upper dermis through projections that penetrate the stratum corneum without reaching dermal nociceptors. Such targeting yields immunogenicity matching or exceeding intramuscular injection at a fraction of the antigen mass, with dose-sparing up to six-fold recorded for influenza, polio, and SARS-CoV-2 antigens. Solid-state formulation converts that immunological advantage into a logistical one, since polymeric matrices preserve potency for as long as two years at ambient temperature, removing the refrigeration infrastructure that consumes significant delivery cost. Six microneedle types have reached preclinical or clinical maturity, with dissolving microneedle patches the most advanced. Two trials provide the clinical evidence: a Phase I influenza study showing non-inferior antibody responses and successful self-application, and a Phase I/II measles–rubella trial in The Gambia reaching 93% measles and 100% rubella seroconversion in infants without related serious adverse events. Engineering advances currently include an automated printer producing thermostable mRNA–lipid nanoparticle patches that retain bioactivity for six months at ambient temperature, the first intradermal self-amplifying RNA patch, and quantum-dot on-body immunization records. Sterility assurance, dose uniformity, nucleic acid integrity within solid matrices, and fragmented regulatory guidance remain the challenging obstacles, alongside a clinical pipeline concentrated on few antigens. This review integrates the mechanistic, materials, manufacturing, clinical, regulatory, and global health dimensions of the field to guide translation and equitable deployment. Full article

Background: Open-flap immediate loading full-arch rehabilitation of the atrophic edentulous maxilla remains clinically demanding because flap elevation modifies the soft-tissue anatomy and stable anatomical landmarks for digital registration are limited. The Impression Reference (IR) technique was developed as a workflow-oriented strategy to provide a recognizable spatial reference during dataset matching and prosthetic transfer. This case series evaluated the feasibility of completing an IR-assisted digital workflow in patients undergoing open-flap immediate full-arch rehabilitation of the atrophic maxilla. Methods: This feasibility case series included 26 completely edentulous patients with severe maxillary atrophy treated with immediate full-arch implant-supported rehabilitation using an Impression Reference-assisted digital workflow. No control group was included and no quantitative accuracy analysis was performed. Workflow-related and prosthetic-transfer outcomes were evaluated descriptively, including completion of dataset matching, prosthetic transfer, IR coupling within the predefined 0.2 mm tolerance, delivery of the immediate prosthesis, clinically acceptable passive fit, prosthetic congruence with the pre-surgical digital plan, and surgical complications. Results: The IR-assisted workflow, dataset matching, prosthetic transfer, and immediate prosthetic delivery were completed in all 26 patients. All patient-specific digital projects complied with the nominal 0.2 mm CAD coupling tolerance, and the associated components could be completely seated and remained clinically stable during use. Clinically acceptable prosthesis fit and prosthetic congruence with the pre-surgical project were recorded in all immediate restorations according to the predefined clinical criteria. No intraoperative surgical complications were documented in the available records. Conclusions: Within the limitations of this descriptive case series, the IR-assisted workflow was feasible in all the included patients undergoing open-flap immediate loading full-arch rehabilitation of the atrophic maxilla. Successful workflow completion should not be interpreted as quantitative evidence. Full article

Public works projects are inherently complex, involving multiple stakeholders with distinct institutional roles and decision-making priorities. This study applies the multicriteria method Analytic Hierarchy Process (AHP) to evaluate and prioritize Critical Success Factors (CSFs) influencing the successful delivery of public construction projects, comparing the perspectives of Project Managers, Public Authorities, and Economists engaged in public works. The analysis is grounded in empirical evidence and institutional practice, reducing subjective bias. Results reveal systematic differences between operational and institutional actors: Project Managers prioritize project maturity, effective planning, technical supervision, and control mechanisms, while Public Authorities emphasize financial soundness, exposure to external risks (Force Majeure), and stakeholder communication. Economists, in turn, assign the highest importance to financial stability, risk exposure, and budgetary resilience, highlighting the central role of financial sustainability in public-project implementation. These findings highlight the role of administrative responsibilities and governance structures in shaping decision-making priorities within the public sector. By demonstrating how AHP can support transparent comparison of stakeholder perspectives, the study contributes to public administration and project governance literature, offering a decision-support framework that enhances institutional capacity and facilitates more aligned and effective public-sector decision-making. Full article

Background: Tobacco smoking remains one of the leading preventable causes of morbidity and mortality worldwide and is associated with cardiovascular, respiratory, oral, and psychological disorders. Although conventional smoking cessation interventions are effective, barriers related to accessibility, adherence, healthcare costs, and continuity of care frequently limit long-term success. Recent advances in technology may offer innovative opportunities to improve multidisciplinary smoking cessation pathways. Methodology: The Wear-Smile project is a non-profit, monocentric, randomized controlled trial registered in the Clinical Trial Protocol Registry and Results System (code No.: NCT07593742), designed to evaluate the effectiveness of a multidisciplinary telemedicine-based smoking cessation program assisted by wearable remote-monitoring devices. Adults who smoke combustible or heated tobacco or electronic nicotine delivery systems will be randomly allocated in a 1:1 ratio to either an experimental group receiving telemedicine-assisted rehabilitation integrated with wearable monitoring devices or a control group receiving standard in-person smoking cessation care. The intervention will include a multidisciplinary behavioral smoking cessation intervention involving cardiology, respiratory, dental, and psychology specialists. Primary outcomes will include Continuous Abstinence Rates and Point Prevalence Abstinence assessed at 6 and 12 months. Secondary outcomes will include cardiopulmonary and oral health parameters, smoking-related variables, health- and oral health-related quality of life (QoL), as well as adherence, usability, acceptability, and satisfaction with the rehabilitation program. Conclusions: The project may provide preliminary evidence regarding the potential feasibility, acceptability, and effectiveness of a multidisciplinary smoking cessation program integrating telemedicine and wearable monitoring technologies in improving abstinence outcomes, patient engagement, continuity of care, and QoL. Full article

Successful project delivery largely depends on effective progress management to ensure schedule reliability and resource efficiency. Conventional manual and paper-based approaches remain inefficient and error-prone, often causing fragmented data and poor collaboration among stakeholders. To overcome these limitations, this study proposes a computer vision–blockchain integrated framework for closed-loop construction progress management within the Plan–Do–Check–Act (PDCA) cycle. This system supports an automated, end-to-end workflow in which UAV-captured images are processed by a computer vision model, digitally signed, and verified on a blockchain ledger, triggering smart contract-based schedule deviation alerts to relevant stakeholders. An enhanced digital signature scheme ensures data integrity during off-chain and on-chain transitions, while self-executing smart contracts coordinate schedule submissions, progress reporting, and deviation detection. Implemented on Hyperledger Fabric and validated through a case study, the framework demonstrates transparent data flow and strong performance in detection accuracy, latency, and throughput. By shifting progress management from passive reporting toward proactive control, this study provides a replicable, transparent, and tamper-resistant solution for multi-stakeholder construction progress governance. Full article

Construction projects continue to experience persistent schedule delays that adversely affect cost efficiency, quality, productivity, and stakeholder satisfaction. Although prior studies have extensively examined the causes of delays, limited empirical evidence explains how integrated managerial success conditions proactively improve delay mitigation capability. This study investigates the structural relationships among Key Success Factors (KSF), Project Readiness (PR), and Delay Mitigation (DM) in construction projects. The analysis primarily focuses on delay mitigation during the construction execution phase, where managerial capability and project readiness directly influence schedule performance and disruption response. A quantitative research design was employed using questionnaire data collected from 308 construction professionals in Thailand. KSF was conceptualized as a higher-order construct reflected by Project Execution Capability, Managerial and Digital Support, and Supply Chain Capability. Data was analyzed using Exploratory Factor Analysis, Confirmatory Factor Analysis, and Structural Equation Modeling. The findings indicate that KSF significantly enhances both Project Readiness and Delay Mitigation, while Project Readiness positively contributes to delay mitigation performance and partially mediates the relationship between managerial capability and project delay mitigation outcomes. The study provides an integrated capability-based framework and practical guidance for improving project delivery performance in uncertain construction environments. Full article

Building Information Modeling (BIM) has changed the landscape of the architectural, engineering, and construction (AEC) industry in recent decades. However, BIM is not well researched in most developing countries; in particular, few studies have addressed its adoption in Malawi. A non-probability, purposive sampling approach was adopted. A total of 143 questionnaires were completed. This research reveals that, while construction experts are aware of BIM, the level of uptake remains quite low. Architects in Malawi are the most knowledgeable, followed by land surveyors and then engineers. This research shows that most experts in Malawi are at level 1 of BIM usage, which is the first stage of BIM adoption and is characterized by the use of 3D models and output representation. Furthermore, the study results have shown that the Malawian AEC sector is currently succeeding at the modelling stage of maturity but is stalled by lack of collaborative frameworks, such as Integrated Project Delivery (IPD). Therefore, unless the industry shifts toward a unified Common Data Environment (CDE), advanced capabilities like clash detection will remain underutilized and disconnected from broader project success metrics. Statistical analysis has shown that the correlation analysis demonstrates a strong link (r = 0.75) between Integrated Project Delivery (IPD) and high BIM maturity, whereas traditional Design-Bid-Build methods show a critical misalignment with digital workflows. The study identifies high software costs and a lack of national standards as the primary barriers to adoption. Therefore, there is a need for robust sensitization to the benefits of BIM and training to improve its uptake in the context of Malawi’s construction industry. In order to advance Malawi’s BIM maturity, the research recommends a strategic shift toward integrated procurement models, the establishment of national BIM mandates, and the modernization of technical education to bridge the existing knowledge gap. Full article

Background: Depression remains a major global health burden, yet fragmented care often leads to waiting times and unmet needs. Therefore, the Belgian collaborative Integrated Depression Care (IDECA) project strengthened primary care depression management by introducing a Reference Person Mental Wellbeing (RPMW) who functions as a case manager, supported by shared-care tools, structured psychoeducation modules, and targeted training for general practitioners (GPs). This study examines normalization in primary care practice. Methods: A single-arm, mixed-method study was implemented over 18 months in two Flemish Primary Care Zones (PCZ). Implementation outcomes were assessed every four months using the NoMAD questionnaire and analyzed using Wilcoxon signed-rank tests. Peer review sessions with professionals and interviews with patients were analyzed thematically. Caseload and service delivery were assessed using process evaluation logs. Results: Twenty-two professionals (17 GPs, two RPMWs, and three PCZ staff members) completed the NoMAD questionnaire. Intervention familiarity increased during the first eight months (T0–T1: p < 0.001; T1–T2: p = 0.022) and continued to rise thereafter (T3–T4: p = 0.008). Integration into daily practice and perceived impact on professional work improved progressively, reaching near-ceiling scores. Peer review sessions highlighted the RPMW’s central role in trust-building and care coordination. Over 12 months, one full-time equivalent RPMW supported 175 patients (mean age 40.7 years; 75% female), with an average of five consultations per patient. Patients reported high satisfaction, emphasizing accessibility, empathy, and practical support. Conclusions: Sustained results suggest successful normalization and support the potential of collaborative, low-threshold depression care. Future work will assess clinical and economic outcomes. Full article

Any risks arising during the construction phase of nuclear power projects become permanently embedded in the power station’s lifecycle, evolving into inherent and difficult-to-alter potential hazards. Consequently, identifying behavioral risks in this phase is critical to the successful delivery of nuclear power engineering projects. This paper proposes a behavior risk identification and early warning methodology for nuclear power construction operations based on artificial intelligence algorithms. The research employs text mining techniques to construct a risk indicator system for nuclear power construction operations; based on the You Only Look Once (YOLOv8) algorithm, it incorporates modules such as Deformable Convolutional Network (DCN), Generalized Lightweight Attention Network (GELAN), Efficient Channel Attention (ECA), and Atrous Spatial Pyramid Pooling (ASPP) to develop the DCN -GELAN-ECA- ASPP-YOLO for Nuclear Power Engineering (DGEAYoLo-NPE) model, and designs and develops a supporting behavior risk identification and early warning methodology. Results show that the precision of nuclear power construction behavioral risk detection reaches 94.3%, with a 2.2% improvement in precision. This study confirms that artificial intelligence technology can effectively enhance the behavior risk prevention and control capabilities of nuclear power construction operations. Full article

Background/Objectives: Antimicrobial peptides (AMPs) represent a promising class of therapeutics with diverse biological functions, including antibacterial, anti-fungal, anti-parasitic and anti-tumoral activities. Previous works demonstrated the successful repurposing of the two synthetic AMPs 19-2.5 and 19-4LF for cutaneous leishmaniasis, when the compounds were administered in solution on skin lesions caused by Leishmania major in a BALB/c mouse model. In this research project, we assessed the activity of 19-4LF, 19-2.5, and their hybrid 19-2.5LF derivative when formulated as a cream for topical administration in the same animal model. Methods: The peptides were formulated in DAC cream and applied to the wound of BALB/C mice for 30 days. Lesion progression was monitored using a digital caliper. Parasite burden was measured by qPCR. Parasite viability was assessed using MTT and microscopy imaging assays. Results: The three peptides in cream formulation succeeded in reducing the skin lesion. Peptide 19-4LF was the most potent, followed by 19-2.5LF and then 19-2.5. In addition, 19-4LF was able to significantly reduce the parasite burden in the skin lesions of infected mice, as measured by quantifying L. major Lm18S ribosomal gene mRNA levels using qPCR. Moreover, when combined, the peptides exhibited synergistic effects on L. major promastigotes and significantly reduced the number of amastigotes in infected macrophages. Conclusions: These studies support the approach of repurposing these AMPs as antileishmanial drugs and identify 19-4LF as a lead candidate for further studies. While historical barriers to peptide therapeutics included high production costs, recent advancements in biological fermentation and synthesis strategies have significantly improved their economic viability. Furthermore, the use of nanotechnology delivery systems can reduce the required dosage, further making peptide therapy a sustainable option for neglected diseases, including leishmaniasis. Full article

Extensive research has been developed on the success factors and benefits of Digital Transformation projects for both public and private sectors. In this spectrum, the parameters that drive company administrations to proceed with such projects have been the subject of research as distinct attributes, with scholars analyzing whether the parameters were sufficiently evaluated and to what extent digital transformation project delivery met initial expectations. In this study we present a scoping review of 61 peer-reviewed academic journal articles published between 2013 and 2024, retrieved from the Scopus and Web of Science databases, to assess which are the most crucial evaluation parameters that could support corporate administrations in taking calculated decisions on initiating new digital transformation projects. We selected eligible articles based on predefined inclusion and exclusion criteria related to publication type, language, publication period, and scientific rigor. We analyzed the selected articles using thematic and content analysis, enabling the identification and synthesis of recurring evaluation dimensions. The findings indicate that key parameters—vision, scope, duration, and budget—consistently emerge as critical determinants of project success. Moreover, we propose the integration of these parameters into a digital transformation plan, which organizations could use in future as a control method to support a digital transformation project’s successful delivery. Full article

Nowadays, the urban population is steadily increasing worldwide and, as a result, global construction output is expected to grow to more than 16 trillion EUR by 2030. This rapid urbanization has created a strong need for the successful selection and delivery of urban development projects to meet the challenges related to the provision of sustainable and resilient infrastructure, together with affordable residence solutions. Meanwhile, the dominance of the traditional capital budgeting discounted cash flow (DCF) technique has long been questioned for its inability to be effectively applied to the complex, uncertain, and turbulent current environment. The main cause of this stems from its deficiencies in recognizing and incorporating the value of managerial interventions through strategic decisions to delay, expand, or even abandon an investment. A real options analysis (ROA) is proposed in this paper as a dynamic “wait and see” alternative to the static “now or never” DCF methodology, which is based entirely on a positive net present value (NPV) output. Thus, the aim of the research is to explore whether the practical application of ROA for the assessment of the financial viability of urban development capital investment projects can be improved from the obtained managerial flexibility in the decision-making process. Spreadsheet-based mathematical models are developed for the analysis and implementation of both the Black–Scholes formula and the binomial lattice method. The results are discussed and compared with a classic DCF analysis. The main advantages of using ROA, i.e., determining alternative paths of urban development and providing a practical and flexible means to adapt to changing external conditions, are highlighted through the application of a common type of real option to an actual new multistorey office building project. Based on the DCF model and its negative NPV, the investment under study is not viable. However, when simply considering the delay strategic option, the project turns out to be highly valuable. For comparison reasons, future work is recommended on alternative types of real options, like the compound staging option, and towards the use of alternative ROA tools, like the Monte Carlo Simulation technique, non-recombining binomial lattices, and the dividend-based version of the Black–Scholes model. Full article

Construction disputes remain a major barrier to project success, particularly in international contexts characterized by diverse stakeholder expectations and high uncertainty. Although numerous studies have examined dispute causes, existing research is frequently limited by regional focus, phase-specific analysis, or delivery-method constraints. This study addresses these limitations by developing a lifecycle-based understanding of dispute causation through a semi-automated systematic literature review. A total of 6603 records were retrieved from Scopus and Web of Science, and after applying PRISMA-aligned screening and citation tracking, 52 peer-reviewed articles published between 2000 and 2024 were included. Bibliometric analysis was used to map publication trends, geographic distribution, journal contribution, and keyword networks, while content analysis supported the identification and consolidation of dispute causes across lifecycle phases. The results show that early project stages are dominated by unfair risk allocation, ambiguous contract documents, design errors, and unclear technical specifications, whereas the Execution phase is driven by variation orders, payment delays, ineffective communication, and unforeseen site conditions. Disputes in the Close-out phase remain underexplored, indicating a clear research gap. By linking dispute causes to specific lifecycle stages, the study provides a structured foundation for proactive dispute-prevention strategies and supports more effective management of construction projects worldwide. Full article

Introduction: Maintaining adherence and access to antiretroviral treatment is basic for good management of people with HIV (PWH), while enhancing patient satisfaction. With the aim of shifting from drug-centered into patient-centered care and integrating care interventions into community settings, here we share an outpatient hospital pharmaceutical care implementation model for PWH. This model involves the delivery of medication through a community center, BCN-Checkpoint, using a proprietary app and coordinated with automated locker systems. Methods: During the pre-implementation phase the circuit was defined and seven steps were considered critical for successful implementation: (1) assignation of teams and roles; (2) adaptation of the self-developed app; (3) development of a patient journey map; (4) locker installation and system integration with data from the electronic records; (5) staff training; (6) review of data protection regulations; (7) simulation tests. A two-phase simulation—with fictitious users and with real ones—validated the system. The implementation phase included an initial pilot study, in which 46 patients were included in the project. Results: System uptake was high, with strong adherence to the dispensing pathway; only five discontinuations due to personal preferences or availability of alternative dispensing pathways. Several barriers to implementation emerged, primarily categorized into technical issues, process and operational challenges, coordination, and user-related difficulties. However, a communitarian setting, flexible attention times and protocols, and the strong intersectoral collaboration between specialists are believed to increase patient retention and overall satisfaction. Conclusions: The implementation of an outpatient dispensing hospital medication model using an app and automated locker systems is feasible, considering detail to procedures, timely adaptations, and staff training. Full article