Search Results (333)

Sectoral vulnerability to distinct crisis types in small, open, and geopolitically exposed markets—such as Jordan—remains insufficiently quantified, constraining targeted policy design and portfolio allocation. This study’s primary purpose is to establish a transparent, comparable metric of sector-level market resilience that reveals how crisis typology reorders vulnerabilities and shapes recovery speed. Applying this framework, we assess Jordan’s equity market across three archetypal episodes—the Global Financial Crisis, the Arab Spring, and COVID-19—to clarify how shock channels reconfigure sectoral risk. Using daily Amman Stock Exchange sector indices (2001–2025), we estimate $GARCH\left(\mathrm{1,1}\right)$ models for each sector–crisis window and summarize volatility dynamics by persistence $(\alpha +\beta )$, interpreted as an inverse proxy for resilience; complementary diagnostics include maximum drawdown and days-to-recovery, with nonparametric (Kruskal–Wallis) and rank-based (Spearman, Friedman) tests to evaluate within-crisis differences and cross-crisis reordering. Results show pronounced heterogeneity in every crisis and shifting sectoral rankings: financials—especially banking—display the highest persistence during the GFC; tourism and transportation dominate during COVID-19; and tourism/electric-related industries are most persistent around the Arab Spring. Meanwhile, food & beverages, pharmaceuticals/medical, and education recurrently exhibit lower persistence. Higher persistence aligns with slower post-shock normalization. We conclude that resilience is sector-specific and contingent on crisis characteristics, implying targeted policy and portfolio responses; regulators should prioritize liquidity backstops, timely disclosure, and contingency planning for fragile sectors, while investors can mitigate crisis risk via dynamic sector allocation and volatility-aware risk management in emerging markets. Full article

Background: Although most amputations caused by diabetes and peripheral artery disease (PAD) are preventable, current limb preservation efforts in the United States remain poorly understood. This study aims to identify key barriers and facilitators to limb preservation from the primary care provider (PCP) perspective. We plan to use the insights from this work to promote targeted intervention strategies. Methods: Using a mixed-methods design, an online 5–10 min survey was distributed to Oklahoma primary care providers who could elect to participate further in a semi-structured, audio-recorded interview. Descriptive analysis was used to summarize survey results. Interviews were transcribed and qualitatively analyzed using grounded theory. Donabedian’s structure, process, and outcome framework was used to categorize how each identified barrier and facilitator increases or reduces the risk of limb loss for at-risk patients at the practice level. Finally, we compared and contrasted survey and interview findings. Results: Thirty surveys were completed (approximately 14% response rate), and seven interviews were conducted with PCPs geographically dispersed across Oklahoma. Most clinicians reported in the survey that they see at-risk limbs at least once every 1–2 months (n = 29, 96.7%). Half of clinicians were satisfied or very satisfied with access to vascular surgery (n = 15, 50.0%), interventional specialists (n = 13, 43.3%), and endocrinologists (n = 12, 40.0%). Finally, survey respondents reported that social needs most often affecting their patients with a limb at risk of amputation include income, health education, transportation, and health insurance. Interviews confirmed PCPs frequently see at-risk limbs. We identified thematic barriers to limb preservation that included limited access to specialty care, limited PCP and patient amputation prevention education, and patient social struggles surrounding transportation, finances, and insurance. Patient advocates (community, clinical, or personal), affordable medications, and more time with patients were reported as facilitators in amputation prevention. Conclusions: Oklahoma PCPs frequently see at-risk feet, realize poor access to care, and desire structural change to support excellent preventive care in diabetes and PAD. Limb preservation in Oklahoma is contingent upon shifting from disempowerment to engagement that requires systemic reform, clinical innovation, and community engagement. We identified several intervention strategies, including increasing education for PCPs to empower them to initiate early prevention, improving early identification and preventive therapy for patients at risk for limb loss, and cultivating specialty care access via networking and policy change. Full article

The South Korean government plans to increase the share of renewable energy (RE) used in public buildings by 10% from the current 30% to 40% by 2030. This article seeks to estimate the public willingness to pay (WTP) for this increase. To this end, a contingent valuation was applied, with 1000 households randomly selected and surveyed through one-on-one interviews. The payment vehicle and WTP elicitation method were determined to be income tax per household and the one-and-one-half-bound model, respectively. The annual WTP per household was estimated to be KRW 2712 (USD 2.04) with statistical significance. When expanded to the population, this produces an annual value of KRW 60.15 billion (USD 45.23 million). The increase in the RE use share can not only reduce greenhouse gas emissions but also result in savings on electricity bills. The sum of these two can be considered as benefits, and the sum of the construction and maintenance costs incurred due to the increase can be considered as costs. The cost–benefit analysis indicates that the present value of net benefits and the benefit-to-cost ratio were estimated to be KRW 667.3 billion (USD 501.7 million) and 1.48, respectively. Consequently, the increase is socially desirable and should be implemented immediately. Full article

Battery energy storage systems (BESSs) have become integral components of grid modernization because of their ability to provide system stabilization in the presence of high levels of renewable generation. Specifically, the dynamic response capabilities of BESSs can be a valuable tool in ensuring reliability and security of the grid during contingencies. This paper explores the utilization of BESSs in improving the contingency response of the SRP power system by providing selection criteria that enable a viable and cost-effective solution from a planning perspective. In particular, this study focuses on optimal BESS selection from a list of actual queued projects to enhance system stability by maintaining voltage and mitigating fault impacts. Additionally, the work involves generating both normal and abnormal operational scenarios for varying loads and renewable generation profiles of the system to capture diverse sources of uncertainty. A comprehensive reliability planning approach is adopted to identify the worst-case scenarios and ensure network robustness by optimizing BESS operations under these conditions. The results obtained by applying the proposed methodology to a 2500+-bus real-world system of SRP indicates that with as few as four strategically selected BESS units, the system is able to effectively mitigate more than 90% of under-voltage violations and approximately 75% of over-voltage violations. Full article

Foot-and-mouth disease (FMD) is a highly contagious disease of livestock caused by the FMD virus (FMDV). It is not dangerous to humans but can cause severe disruption to the farming sector and hampers trade in animals and animal products. Given the characteristic of transmissibility of the virus, the legislation in force in the European Union requires that some control activities be initiated in peacetime: the so-called “emergency preparedness”. As part of a research project on FMD, a dynamic transmission model was developed to test the effectiveness of the main control strategies in different livestock settings in Italy. This manuscript focuses on the control of the disease in densely populated livestock areas (DPLAs). Reduction in farm density was simulated to identify a threshold density compatible with disease control in the study area and to understand whether this was acceptable in terms of the sustainability of the livestock production system. Considering that in some municipalities the density of animals greatly exceeded the identified threshold, we adopted an original risk-based approach aimed at identifying farms which were most likely to play a central role in FMDV transmission. This approach has proven to be the most effective in controlling the spread of FMDV and can be proposed for practical applications where limited information on contacts between farms is available. Full article

The growing reliance on autonomy in uncrewed aircraft systems (UASs) necessitates a real-time solution for assured contingency landing management during in-flight emergencies. This paper presents a novel gradient-guided search algorithm for risk-aware emergency landing trajectory generation with a wing-lift UAS loss-of-thrust use case. This framework integrates a compact four-dimensional discrete search space with aircraft kinematic and ground-risk cost. A multi-objective cost function is employed, combining flight envelope feasibility, optimal descent, and overflown population risk terms. To ensure discrete search convergence, a constrained hypervolume definition is introduced around the destination. A holding pattern identification algorithm is defined to minimize risk during the necessary flight path angle-constrained descent to final approach. Planner effectiveness is validated through randomly generated case studies over a region of Long Island, NY, under steady wind conditions. Benchmark comparisons with a 3D Dubins solver demonstrate the approach’s improved risk mitigation and acceptable real-time computation overhead. Future development will focus on integrating collision avoidance into the discrete search-based landing planner. Full article

This paper explores Carl Schmitt’s concepts of the friend and the enemy through the lens of Katechon. Contemporary scholarship often treats Schmitt’s friend–enemy distinction as an occasional decision driven by political contingency. This paper refutes such a purely political reading and instead argues Schmitt’s political enemies have a deeper theological origin—Gnosticism. The Gnostics, emerging from a mistaken rejection of theodicy, developed a cosmological dualism and apocalypticism that, in the 20th century, manifested politically in the forms of liberal universalism and social pluralism. To illuminate the theological depth of Schmitt’s thought, this paper investigates a recurring yet underexplored concept—Katechon, the restrainer who holds back the end times. By linking Katechon to Schmitt’s political projects—the nomos of the earth and the decisionist state—this paper reveals the theological foundation underlying his understanding of the political: enmity is not contingent but theologically predestined by human fallenness and God’s redemptive plan. However, Schmitt’s project of political theology ends in paradox: Katechon, meant to restrain chaos, turns into its opposite owing to its intrinsic logical flaw. Full article

Background: Inpatient palliative care consultation services operate with an interdisciplinary team, where effective handoffs are crucial for coordinated patient care. We aimed to replace encrypted email handoffs with a more concise and uniform handoff using I-PASS (illness severity, patient summary, action list, situational awareness, contingency planning, and synthesis by receiver) integrated within the electronic medical record (EMR). Aim and Measures: Within six months of launch, our goal was to achieve 90% I-PASS utilization for hospitalized acutely ill patients with cancer receiving palliative care consultation. Intervention: In January 2021, our quality improvement team, consisting of physicians, advanced practice providers, and trainees, began implementing I-PASS using the plan–do–study–act cycle. After providing training sessions for all palliative care clinicians, I-PASS went live on October 1, 2021. I-PASS utilization was tracked via random and monthly audits of EMRs. Through anonymous surveys, both pre- and post-implementation, we gathered clinician feedback and concerns about the handoff system. Survey responses were compared using the Mann–Whitney test. Outcomes: Within six months of implementation, the I-PASS utilization rate reached > 99%. The survey participation rates were 70% (45/64) and 82% (49/60) for the pre-and post-implementation periods, respectively. Respondents provided answers on one to five scale (mean, standard deviation, SD): lower accuracy with email (3.53, SD = 0.98) vs. I-PASS (4.20, SD = 0.83), p < 0.001; handoff lengthier with email (4.17, SD = 1.05) vs. I-PASS (2.1, SD = 1.15), p < 0.001; the time required was longer with email (3.0, SD = 1.22) vs. I-PASS (1.71, SD = 0.73), p < 0.001. Overall, respondents found I-PASS to be significantly better (4.69, SD = 0.58). Conclusion: I-PASS was fully adopted by the team, with nearly 100% utilization and strong clinician endorsement as an effective communication tool. Future efforts should focus on optimizing usability, particularly by educating clinicians on smartphone EMR access and enabling the timely and streamlined editing of I-PASS. Full article

Renewable energy sources play a crucial role in the urgent global pursuit of decarbonizing electricity systems. However, persistent grid congestion and lengthy planning approval processes remain the main barriers to the accelerated deployment of new green energy source capacities. Capitalizing on the synergies afforded by co-locating hybrid power plants—particularly those that harness temporally anti-correlated renewable sources such as wind and solar—behind a unified connection point presents a compelling opportunity. To this end, this paper pioneers a comprehensive planning framework for hybrid configurations, integrating transmission grid and renewable energy assets planning to include energy storage systems, wind, and solar energy capacities within a long-term planning horizon. A mixed-integer linear programming model is developed that considers both the technical and economic aspects of combined grid planning and hybrid power plant allocation. Additionally, the proposed framework incorporates the N − 1 contingency criterion, ensuring system reliability in the face of potential transmission line outages, thereby adding a layer of versatility and resilience to the approach. The model minimizes the net present value of costs, encompassing both capital and operational expenditures as well as curtailment costs. The efficacy of the proposed model is demonstrated through its implementation on the benchmark IEEE 24-bus RTS system, with findings underscoring the pivotal role of hybrid power plants in enabling cost-effective and rapid sustainable energy integration. Full article

This study assesses the financial soundness of Sudanese commercial banks during escalating civil conflict by integrating Altman’s Z-score models with scenario-based stress testing. Using audited financial data from 2016 to 2022 (pre-war) and projections through to 2028, the analysis evaluates resilience under low- and high-intensity conflict scenarios. Altman’s Model 3 (for non-industrial firms) and Model 4 (for emerging markets) are applied to capture liquidity, retained earnings, profitability, and leverage dynamics. The findings reveal relative stability between 2017–2020 and in 2022, contrasted by significant vulnerability in 2016 and 2021 due to macroeconomic deterioration, sanctions, and political instability. Liquidity emerged as the most critical driver of Z-score performance, followed by earnings retention and profitability, while leverage showed a context-specific positive effect under Sudan’s Islamic finance framework. Stress testing indicates that even under low-intensity conflict, rising liquidity risk, capital erosion, and credit risk threaten sectoral stability by 2025. High-intensity conflict projections suggest systemic collapse by 2028, characterized by unsustainable liquidity depletion, near-zero capital adequacy, and widespread defaults. The results demonstrate a direct relationship between conflict duration and systemic fragility, affirming the predictive value of Altman’s models when combined with stress testing. Policy implications include the urgent need for enhanced risk-based supervision, Basel II/III implementation, crisis reserves, contingency planning, and coordinated regulatory interventions to safeguard the stability of the banking sector in fragile states. Full article

Climate change poses a significant challenge to agriculture in southern Angola, particularly for smallholder farming systems that are highly exposed and vulnerable, lacking the resources and capacity to respond effectively. This study analyses climate trends from 1950 to 2024 in Huíla, Namibe, and Cunene, focusing on eight variables: Tmax, Tmin, Tmean, PRCPTOT, R95p, R95pTOT, CDD, and CWD. Due to inconsistencies in local meteorological station data, ERA5-Land reanalysis was used. Trends such as rising Tmin in Namibe (+0.32 °C/decade), Tmean in Huíla (+0.16 °C/decade), and increased precipitation in Huíla (+29.3 mm/decade), along with fewer dry days in Namibe (–2.7 days/decade), were observed. Crop–climate relationships (2000–2023) were explored using a categorical contingency analysis. Maize showed its highest yield frequency (46%) during hot years; cassava and beans were more stable under cooler, drier conditions; millet yielded above average (31%) in dry years, confirming drought resilience; potatoes performed poorly in wet years (17% above-average yields). The contingency method provided insights where linear models were insufficient, helping to understand climate–yield interactions in data-limited environments. This study offers the first long-term climate–agriculture assessment for southern Angola, providing critical evidence for climate-informed agricultural strategies in regions with scarce and unreliable observational records. The findings emphasise the urgent need for adaptation policies focused on crop-specific climate vulnerabilities. They also demonstrate the value of combining reanalysis data and categorical analysis to overcome data gaps and guide sustainable agricultural planning. Full article

China frequently experiences natural disasters, making emergency language services a key link in information transmission, cross-lingual communication, and resource coordination during disaster relief. Traditional contingency plans rely on manual experience, which results in low efficiency, limited coverage, and insufficient dynamic adaptability. Large language models (LLMs), with their advantages in semantic understanding, multilingual adaptation, and scalability, provide new technical approaches for emergency language services. Our study establishes the country’s first generative evaluation index system for emergency language service contingency plans, covering eight major dimensions. Through an evaluation of 11 mainstream large language models, including Deepseek, we find that these models perform excellently in precise service stratification and resource network stereoscopic coordination but show significant shortcomings in legal/regulatory frameworks and mechanisms for dynamic evolution. It is recommended to construct a more comprehensive emergency language service system by means of targeted data augmentation, multi-model collaboration, and human–machine integration so as to improve cross-linguistic communication efficiency in emergencies and reduce secondary risks caused by information transmission barriers. Full article

The healthcare industry faces mounting pressure to enhance efficiency and accuracy in logistics operations. Despite its critical role, the sector demonstrates a low adoption rate of logistics automation, with the investment ratio at 14.9%, significantly lower than the industrial average of 18%. This study explores the current state and strategic application of logistics automation in healthcare through 20 in-depth interviews with stakeholders across manufacturers, wholesalers, hospitals, clinics, and pharmacies in South Korea. Analysis revealed that automation adoption is largely contingent on two key factors: annual order volumes and inventory complexity. Companies handling over 100,000 order lines annually and managing over 1000 SKUs were more likely to have adopted or planned automation systems such as AS/RSs, AMRs, or Cube-based AS/RS. The research culminates in a directional map that aligns automation strategies with operational scale and product characteristics. This study contributes novel empirical insights into the fragmented healthcare logistics sector, offering actionable guidance for phased automation implementation based on contextual constraints and stakeholder typologies. Full article

Introduction: Polio supplementary immunisation activities (SIA) are implemented to rapidly increase vaccination coverage and interrupt the transmission of poliovirus in a specified geographical area. Polio SIA complements routine immunisation and is crucial for the eradication of the disease by increasing population immunity. However, several contextual factors (i.e., implementation determinants) can influence the success or failure of polio SIA implementation; as such, understanding their dynamics can enhance proactive planning for practice improvement. This study aimed to explore and map the contextual factors of polio SIA implementation in the African region using a critical systems thinking approach. Methods: A rapid review of published and grey literature was conducted. The search included the Global Polio Eradication Initiative library for programmatic reports and two databases (PubMed and Google Scholar). Data extraction was performed using a structured tool. Thematic analysis was performed to categorise the identified contextual factors according to the domains and constructs of the Consolidated Framework for Implementation Research (CFIR). Then, a causal loop diagram (CLD) was used to map the linkages between the identified factors. Results: A total of seventy-eight contextual factors across the five CFIR domains were identified: three for innovation, twenty for outer setting, sixteen for inner setting, twenty-six for individuals, and thirteen for the implementation process. A system map of all the factors using CLD revealed multiple contingent connections, with eleven reinforcing loops and four balancing loops. Conclusions: This study identified the multilevel nature of the contextual factors that influence polio SIA, including their dynamics. The integration of CLD and CFIR in this study offers critical insights into the potential feedback loops that exists between the contextual factors which can be used as leverage points for policy and practice improvements, including tailoring strategies to enhance polio campaign implementation effectiveness, especially with the expanded use of the novel Oral Polio Vaccine type 2 (nOPV2) across countries in the region. Full article

Background/Objective: The COVID-19 pandemic profoundly transformed social life worldwide, indiscriminately affecting individuals across all age groups. Children have not been exempted from the risk of severe illness and death caused by COVID-19. Objective: This paper sought to describe the clinical findings, laboratory and imaging results, and hospital care provided for severe and critical cases of COVID-19 in unvaccinated children, with or without severe asthma, hospitalized in a public referral service for COVID-19 treatment in the Brazilian state of Pernambuco. Methods: This was a case series study of severe and critical COVID-19 in hospitalized, unvaccinated children, with or without severe asthma, conducted in a public referral hospital between March 2020 and June 2021. Results: The case series included 80 children, aged from 1 month to 11 years, with the highest frequency among those under 2 years old (58.8%) and a predominance of males (65%). Respiratory diseases, including severe asthma, were present in 73.8% of the cases. Pediatric multisystem inflammatory syndrome occurred in 15% of the children, some of whom presented with cardiac involvement. Oxygen therapy was required in 65% of the cases, mechanical ventilation in 15%, and 33.7% of the children required intensive care in a pediatric intensive care unit. Pulmonary infiltrates and ground-glass opacities were common findings on chest X-rays and CT scans; inflammatory markers were elevated, and the most commonly used medications were antibiotics, bronchodilators, and corticosteroids. Conclusions: This case series has identified key characteristics of children with severe and critical COVID-19 during a period when vaccines were not yet available in Brazil for the study age group. However, the persistence of low vaccination coverage, largely due to parental vaccine hesitancy, continues to leave children vulnerable to potentially severe illness from COVID-19. These findings may inform the development of public health emergency contingency plans, as well as clinical protocols and care pathways, which can guide decision-making in pediatric care and ensure appropriate clinical management, ultimately improving the quality of care provided. Full article