Search Results (752)

Seismic performance evaluation of existing buildings is essential for defining effective mitigation strategies in earthquake-prone regions. This study investigates the seismic performance of low-rise unreinforced masonry (URM) residential buildings located in several cities in the Albanian territory. Material properties were obtained from experimental tests conducted on representative samples and subsequently adopted in the development of analytical models. Three-dimensional finite element models were generated based on the collected geometric data and experimentally determined material characteristics. Nonlinear static (pushover) analyses were carried out to assess the seismic capacity and identify the potential failure mechanisms of the buildings. The numerical results showed significant variation in performance depending on the building typology, with some cases reaching the near-collapse limit state under design-level earthquakes. The capacity curves and performance points obtained from the models demonstrate the pronounced influence of construction techniques, boundary conditions, and material properties on the seismic response. The results indicated that URM residential buildings exhibit distinctive seismic performance characteristics influenced by their construction techniques and material properties. Based on the findings, recommendations for retrofit strategies are proposed to enhance the seismic resilience of such structures. Full article

This paper analyses the role of landscape as a fundamental dimension of post-earthquake recovery in the inland areas of Central Italy, arguing that reconstruction must be understood not only as the repair of damaged buildings but as a broader territorial process affecting identity, spatial organization, and long-term settlement trajectories. In this sense, post-earthquake recovery is also interpreted as a strategic opportunity to reinforce coast–inland relationships, acknowledging the structural interdependence between inland Apennine areas and coastal urban systems. Drawing on insights from applied research conducted in the L’Aquila 2009 crater and on the conceptual framework developed within the PRIN TRIALS project, the paper discusses how seismic events accelerate pre-existing territorial dynamics and produce enduring transformations, particularly in the proximity landscapes surrounding historic centres. Rather than presenting empirical findings, the contribution offers a theoretical and operational framework aimed at integrating landscape considerations into reconstruction processes. It outlines key concepts such as landscape quality, transformative resilience, and permanent temporariness; reviews critical normative aspects linked to emergency procedures; and proposes a set of landscape-oriented guidelines and criteria for the contextual integration of reconstruction projects. These include landscape quality objectives, multiscalar readings of identity values, and operational tools such as visual-impact assessment, Project Reference Context analysis, and principles for managing transformations in peri-urban and historic environments. Overall, the paper argues that adopting a landscape-based perspective can strengthen territorial cohesion, support the sustainable redevelopment of historic centres and their surroundings, and embed post-earthquake reconstruction within broader coast–inland territorial strategies aimed at long-term resilience and balanced regional development in Apennine communities. Full article

Following World Health Organization (WHO) validation of lymphatic filariasis (LF) elimination as a public health problem, countries are required to implement post-validation surveillance (PVS) to detect potential resurgence and ensure sustained elimination. WHO’s guidelines released in 2025 recommend implementation of at least two of four PVS strategies—targeted surveys, integration into standardised surveys, health facility-based screening, and molecular xenomonitoring (MX) of mosquitoes. This review synthesised global evidence on PVS activities from 2007 to 2025 in the 23 countries and territories validated as having eliminated LF. Studies were identified through PubMed, Scopus, Embase, Web of Science, and the WHO Institutional Repository for Information Sharing (IRIS). Data on publication information, surveillance strategies, priority populations, and operational challenges and enablers were extracted. Narrative synthesis using deductive content analysis was applied. Thirty documents from 17 countries were included. Targeted surveillance and integration of PVS with other health programmes were the most common approaches noted (reported in ten and nine countries, respectively), followed by MX (seven countries) and health facility-based screening (four countries). Surveillance often focused on migrants and previous hotspots, with operational challenges linked to limited funding, workforce, and supply chains. Documents indicated that Sri Lanka, Thailand, China, and South Korea developed sustained PVS through national policies and domestic funding. Findings highlight the need for clear, contextualised guidance to operationalise sustainable PVS in different settings. Full article

Eight Pacific Island Countries and Territories (PICTs) have been validated by the World Health Organization (WHO) as having eliminated lymphatic filariasis (LF) as a public health problem. WHO recommends that these countries implement post-validation surveillance (PVS) to ensure resurgence has not occurred. Some PICTs proactively conducted LF PVS even in the absence of specific recommendations or best-practice guidelines at the time of implementation. We aimed to explore the barriers and facilitators to implementing LF PVS in PICTs, with a view to informing context-specific strategies and regional guidelines. Key informant interviews were held between March and September 2024 with 15 participants involved in LF and/or neglected tropical disease surveillance. Transcripts were analysed thematically using a generalised deductive approach. A conceptual framework was developed to summarise themes with two main streams of barriers identified. Stream One Barriers included limited awareness of, and guidelines for, PVS requirements and competing national health priorities. Stream Two Barriers included cost, resource, and logistical barriers to conducting PVS. Participants called for clearer, contextually tailored guidelines, improved communication from WHO, and integration within existing systems. This study highlights the urgent need for operational guidance, policy advocacy, and capacity strengthening to ensure sustainable LF PVS in PICTs. Incorporating local context and leveraging existing health structures will be essential to prevent disease resurgence and maintain gains achieved through elimination programmes. Full article

Background and Objectives: Access to anterior cruciate ligament reconstruction (ACLR) varies substantially across health systems, yet national-level data from Eastern Europe remain limited. This study provides the first nationwide, regionally stratified assessment of ACLR activity in Romania, examining geographic variation, socioeconomic and workforce determinants, and inequality. Materials and Methods: We conducted a retrospective cross-sectional analysis of all ACLRs reported in the national administrative hospital database (2017–2023), supplemented with demographic, GDP, and workforce statistics. Outomes included incidence per 100,000 population, private-sector share, and sex distribution. Regional differences were tested using Kruskal–Wallis and Dunn post hoc comparisons. Predictors of ACLR incidence and private-sector utilization were identified through multivariable Poisson and logistic models. Inequality metrics (Gini coefficients, P90/P10 ratios) and sensitivity analyses excluding Bucharest–Ilfov were also performed. Results: A total of 11, 080 ACLRs were recorded. Incidence varied markedly across regions, from a median of 40.0 per 100,000 in Bucharest–Ilfov to <1–3 per 100,000 in the South, South-East, and South-West (p < 0.001). Higher GDP per capita correlated with incidence (ρ = 0.36) and explained 45% of its variance. Private-sector involvement ranged from <5% in Bucharest–Ilfov and the South to 80–100% in the Centre, North-West, and South-East. In adjusted Poisson models, GDP, surgeon availability, and private-sector share were strong independent predictors of incidence (all p < 0.001). Private-sector access was primarily determined by the proportion of private orthopedic surgeons (OR 21.03). National inequality was extreme (Gini 0.842–0.752; P90/P10 > 10⁹), reflecting the concentration of procedures within a small number of counties. Results were consistent across sensitivity analyses. Conclusions: ACLR in Romania displays severe territorial inequities driven by socioeconomic development, workforce distribution, and uneven private-sector capacity. Targeted regional investment and coordinated workforce strategies are necessary to improve equitable access to surgical care. Full article

This study examines how territorial peripherality and regional entrepreneurial ecosystem quality shape the growth trajectories of Italian university spin-offs, with a specific focus on internal areas. Combining firm-level data from NETVAL and AIDA with territorial indicators from the Italian Strategy for Inner Areas (SNAI) and ISTAT, we construct a panel of 655 university spin-offs observed between 2018 and 2022. Two composite indicators capture provincial peripherality and regional ecosystem quality. Using mixed-effects models, we analyse their effects on revenue and employment growth. Results show that stronger regional ecosystems support employment growth overall and significantly amplify revenue growth for spin-offs located in internal areas, partially compensating for structural territorial disadvantages. The findings highlight the importance of place-based ecosystem policies and the strategic role of universities in fostering knowledge-based development and proxy indicators of territorial resilience in peripheral regions. Full article

Europe is warming faster than the global average, making climate change adaptation a central concern for urban policy and planning. This article develops and applies an analytical framework to assess the maturity of multilevel adaptation governance across European Union Member States as of 2025. Governance is operationalised through eight dimensions: (i) National Adaptation Strategies/Plans; (ii) Regional Adaptation Plans; (iii) Local Adaptation Plans; (iv) Sectoral Adaptation Plans; (v) integration in National Urban Policies; (vi) adaptive content in Long-Term Strategies; (vii) adaptation relevance in climate laws; and (viii) participation in the Covenant of Mayors. The results reveal pronounced heterogeneity: many Member States have up-to-date national strategies but display incomplete territorial diffusion, weak legal anchoring, or limited urban policy standards. By linking auditable rules to urban-facing instruments, this study offers a practical tool for benchmarking governance capacities, prioritising reforms, and tracking progress towards integrated, multilevel adaptation systems that support resilient urban development across the European Union. Full article

Mountain Excavation and Land Creation Projects (MELCPs) have emerged as a critical strategy for expanding urban development space in mountainous regions facing land scarcity. Dynamic monitoring and risk management of these projects are essential for promoting sustainable urban development. This study develops an integrated monitoring framework for MELCPs by combining ascending and descending Sentinel-1 SAR data, Sentinel-2 optical imagery, SRTM digital elevation models (DEM), and field survey data. The framework incorporates multi-temporal change detection, random forest classification, and time-series InSAR analysis to systematically capture the spatiotemporal evolution and subsidence mechanisms associated with MELCPs. Key findings include: (1) The use of dual-orbit SAR data significantly improves the detection accuracy of excavation areas, achieving an overall accuracy of 87.1% (Kappa = 0.85) and effectively overcoming observation limitations imposed by complex terrain. (2) By optimizing the combination of spectral, texture, topographic, and polarimetric features using a random forest algorithm, the classification accuracy of MELCPs is enhanced to 91.2% (Kappa = 0.889). This enables precise annual identification of MELCP progression from 2017 to 2022, revealing a three-stage evolution pattern: concentrated expansion, peak activity, and restricted slowdown. Specifically, the reclaimed area increased from 2.66 km² (pre-2018) to a peak of 12.61 km² in 2021, accounting for 34.56% of the total area of the study region, before decreasing to 2.69 km² in 2022. (3) InSAR monitoring from 2017 to 2023 indicates that areas with only filling experience minor shallow subsidence (<50 mm), whereas subsequent building loads and underground engineering activities lead to continuous deep soil consolidation, with maximum cumulative subsidence reaching 333.8 mm. This study demonstrates that subsidence in MELCPs follows distinct spatiotemporal patterns and is predictable, offering important theoretical insights and practical tools for engineering safety management and territorial spatial optimization in mountainous cities. Full article

This paper addresses the problem of imbalance between coastal and inland areas and recognises the reuse of abandoned buildings as an evolutionary regeneration strategy which, through specific interventions linked by a system of routes for tourism and sport, can gradually trigger sustainable development on a regional scale. It presents research conducted in recent years on behalf of local administrations and continued in national and European projects. The reference context is the Abruzzo region, where coastal, hilly and mountainous areas are a short distance apart and include both densely built-up and populated urban centres and small depopulated towns surrounded by landscapes of high environmental value. The objective is to define, through the responsible use of built resources, viable and sustainable strategies for regeneration and rebalancing oriented towards the concept of transformative resilience. The methodology adopted is divided into phases and includes both theoretical developments and case study applications according to an approach that networks building restoration and reuse interventions in the region. The key results consist of defining a reuse logic that considers the regional territory as a whole, linking different resources, functions and environments. This logic, which envisages the organisation of new functions on a regional scale, emphasises the capacity of building reuse to produce positive effects on the territory and trigger socio-economic development dynamics. This research forms part of the experience underlying a project of significant national interest (PRIN 2022 TRIALs), which will provide guidelines for activating the transformative resilience capacities of inland areas of central Italy. Full article

Environmental Impact Assessments (EIAs) are crucial for mitigating flood risks in vulnerable ecosystems, yet their effective application remains inconsistent. This study synthesises global literature to systematically map EIA methodologies, evaluate the extent of hydrological integration, and analyse the evolution of practices against policy frameworks for flood-prone areas. A scoping review of 144 peer-reviewed articles, conference papers, and one book chapter (2005–2025) was conducted using PRISMA protocols, complemented by bibliometric analysis. Quantitative findings reveal a significant gap where 72% of studies lacked specialised hydrological impact assessments (HIAs), with only 28% incorporating them. Post-2016, advanced tools like GIS, remote sensing, and hydrological modelling were used in less than 32% of studies, revealing reliance on outdated checklist methods. In South Africa, despite wetlands covering 7.7% of its territory, merely 12% of studies applied flood modelling. Furthermore, 40% of EIAs conducted after 2016 excluded climate adaptation strategies, undermining resilience. The literature is geographically skewed, with developed nations dominating publications at a 3:1 ratio over African contributions. The study’s novelty is its systematic global mapping of global EIA practices for flood-prone areas and its proposal for mandatory HIAs, predictive modelling, and strengthened policy enforcement. Practically, these reforms can transform EIAs from reactive compliance tools into proactive instruments for disaster risk reduction and climate resilience, directly supporting Sustainable Development Goals 11 (Sustainable Cities), 13 (Climate Action), and 15 (Life on Land). This is essential for guiding future policy and improving EIA efficacy in the face of rapid urbanisation and climate change. Full article

This study is situated at the critical stage of comprehensive implementation of China’s territorial spatial planning system, addressing the strategic need for planning evaluation and optimization. We innovatively construct a Computable General Equilibrium Model for China’s Territorial Spatial Planning (CTSPM-CHN) that integrates dual factors of construction land costs and energy consumption costs. Through designing two policy scenarios of rigid constraints and structural optimization, we systematically simulate and evaluate the dynamic impacts of different territorial spatial governance strategies on macroeconomic indicators, residents’ welfare, and carbon emissions, revealing the multidimensional effects and operational mechanisms of territorial spatial planning policies. The findings demonstrate the following: First, strict implementation of land use scale control from the National Territorial Planning Outline (2016–2030) could reduce carbon emission growth rate by 12.3% but would decrease annual GDP growth rate by 0.8%, reflecting the trade-off between environmental benefits and economic growth. Second, industrial land structure optimization generates significant synergistic effects, with simulation results showing that by 2035, total GDP under this scenario would increase by 4.8% compared to the rigid constraint scenario, while carbon emission intensity per unit GDP would decrease by 18.6%, confirming the crucial role of structural optimization in promoting high-quality development. Third, manufacturing land adjustment exhibits policy thresholds: moderate reduction could lower carbon emission peak by 9.5% without affecting economic stability, but excessive cuts would lead to a 2.3 percentage point decline in industrial added value. Based on systematic multi-scenario analysis, this study proposes optimized pathways for territorial spatial governance: the planning system should transition from scale control to a structural optimization paradigm, establishing a flexible governance mechanism incorporating anticipatory constraint indicators; simultaneously advance efficiency improvement in key sector land allocation and energy structure decarbonization, constructing a coordinated “space–energy” governance framework. These findings provide quantitative decision-making support for improving territorial spatial governance systems and advancing ecological civilization construction. Full article

The reproductive behavior and nest-building activity of the sand-dwelling goby Hazeus ammophilus were investigated to examine its nesting characteristics and to determine how and why this species builds radial structures around its nests. Field observations revealed that males spawned with multiple females in open muddy-sand bottoms, using bivalve shells or fallen leaves as spawning substrates. Males cared for eggs after spawning and repeatedly mated with multiple females, suggesting a male-territory-visiting polygamous mating system. A distinctive feature of this species was the presence of radial ditches extending from the nest. These ditches developed through repeated male behaviors of digging from the nest toward the surrounding area and sweeping accumulated sand out of the nest, resulting in a crater-like structure around the nest. These behaviors may contribute to cleaning and stabilizing the spawning substrate, and the resulting structures themselves may also be involved in female mate choice. Taken together, these findings indicate that H. ammophilus has evolved a flexible reproductive strategy, and nest-building behavior possibly adapted to unstable open sandy environments, highlighting the behavioral diversity and ecological plasticity within gobiid fishes. Full article

The growing concentration of innovation-driven economic activity in core metropolitan areas threatens the sustainable development of peripheral regions. Conventional aid programs are giving way to place-based strategies that harness endogenous regional resources. Yet most computable general-equilibrium (CGE) models—the standard tools for policy appraisal—operate at the national scale and generally treat regions as passive recipients. This study adopts the regional system (RS) approach and contributes a step towards its practical implementation with the introduction of a Regional Economic Development (RED) model—a CGE framework that embeds the region as an explicit behavioral block inside a national system. The model comprises four interlinked modules and makes a key distinction, often overlooked in the RS literature, between a region’s domestic product (output generated within the territory) and its regional product (income earned by resident labor and capital, irrespective of where those factors are employed). This distinction captures income leakages and interregional spill-overs—factors that are critical for peripheral economies. Scenario analysis couples exogenous policy levers—tax incentives, infrastructure upgrades, human-capital investment—with endogenous outcomes such as employment, income, and structural change. By disentangling internal production capacity from external income opportunities, the RED model lets policymakers compare strategies that prioritize local output with those that maximize household welfare. Iterative simulations reveal feasible development targets, the policy mixes required to achieve them, and the structural implications of each trajectory. Full article

This study examines the determinants of talent retention in the hotel sector of Extremadura, a peripheral European region facing depopulation, labour scarcity and structural limitations that threaten the sustainability of its human capital base. Grounded in the Job Demands–Resources (JD-R) theory, the research analyses how a set of key labour resources, specifically professional training, organisational trust, job satisfaction and sustainability commitment, influence employees’ intention to remain in their organisations. These resources are conceptualised as organisational and motivational mechanisms that enhance employees’ capacity to cope with job demands and reinforce their attachment to the organisation. A quantitative survey was conducted with hotel-sector employees in Extremadura; 255 questionnaires were validated, and the proposed structural model was tested using SEM. The findings show that organisational trust is the strongest predictor of retention, followed by professional training and sustainability commitment, while job satisfaction also exerts a significant, though more moderate, effect. These results indicate that enhancing fairness perceptions, strengthening continuous training pathways and integrating sustainability-oriented values are essential strategies for retaining qualified personnel in territories with limited external opportunities. Rather than measuring human capital sustainability directly, the study shows that talent retention operates as a central empirical mechanism through which the sustainability of human capital can be supported in peripheral tourism economies. It concludes by highlighting the need for managerial practices that support transparent leadership, structured professional development and participatory sustainability initiatives, and encourages future research to incorporate longitudinal designs and direct measures of human capital sustainability. Full article

Total Coronary Revascularization via left Anterior Thoracotomy (TCRAT) represents a modern evolution of sternum-sparing, on-pump multivessel coronary artery bypass grafting. In this review, we will summarize the historical development, detail the surgical principles, and provide a comprehensive overview of the clinical outcomes of TCRAT. The technique combines cardiopulmonary bypass using peripheral arterial as well as venous cannulation and cardioplegic cardiac arrest using transthoracic aortic cross-clamping with surgical access through a left anterior minithoracotomy. By applying special slinging and rotational maneuvers, both a stable exposition of all coronary territories—in particular those of the right and the circumflex coronary artery—and a quiet, bloodless operating field enable complete anatomical revascularization and complex coronary surgery procedures, including all variations in multiarterial grafting in unselected patients. Data from all published clinical series were integrated, and a weighted analysis of a total of 2282 patients was performed. TCRAT proved to be very effective with regard to complete anatomical revascularization and modern grafting strategies, and it showed excellent perioperative safety in an all-comers population. Both the 30-day mortality and perioperative stroke incidence were distinctly below 1.0%. Data from mid-term follow-up, although rare so far, are promising and compare well to those of the important RCTs. The TCRAT approach eliminates sternal complications completely and accelerates recovery. As an on-pump arrested-heart surgery, TCRAT inherently permits the combination of minimally invasive multivessel CABG with a variety of other cardiac operations, mainly the combination with valve procedures. The integration of robotic and endoscopic assistance represents the next evolutionary step. With its reproducibility and broad applicability, TCRAT holds strong potential to become a standard routine technique in the field of minimally invasive cardiac surgery. Full article