Search Results (1,481)

Background: Pancreatic cancer is a challenging malignancy with an aggressive biology and limited treatment options, contributing to low survival rates. Supportive and palliative care play a key role in improving the quality of life and psychological distress for patients and their families. However, appropriate delivery and effectiveness of these interventions may be influenced by social determinants of health (SDOH). These factors create significant barriers for patients, influencing their access to care and ability to make informed decisions. This review explores the role of SDOH in supportive and palliative care of pancreatic cancer patients and identifies areas for improvement to enhance this type of care for vulnerable populations. Methods: A thorough narrative review was carried out to evaluate the influence of social determinants of health on supportive and palliative care in the management of pancreatic cancer, focusing on symptom management, psychosocial support, nutritional support, advance care planning, rehabilitation, functional support, and care coordination. Results: This review demonstrates that disparities exist. Black and Asian patients receive less pain medications; those with lower level of education struggle to access psychological support; Hispanic and Black patients often do not receive needed nutritional care; and end-of-life planning is less common among non-White and less-educated patients. Conclusions: SDOH significantly affects the experience and delivery of supportive and palliative care in pancreatic cancer patients, exacerbating inequities across multiple domains of care. Addressing these disparities requires coordinated efforts at clinical, organizational, and policy levels to ensure equitable access to care for all patients in their final phase of life. Integrating attention to SODH into care delivery models can improve outcomes and enhance quality of life for these patients. Full article

This paper develops an economic evaluation framework for pumped storage hydropower (PSH) projects based on real options, addressing the limitations of traditional economic evaluation methods that neglect investment flexibility and path dependence. The framework integrates an annual net cash flow model with an improved mean-reverting electricity price model to generate thousands of electricity price trajectories, while backward dynamic programming dynamically values abandonment options. The core innovation of this study lies in the dynamic pricing mechanism of abandonment options, which explicitly captures the flexibility of terminating projects under adverse conditions. A comparative analysis between the traditional NPV approach and the real options method reveals significant differences: the average NPV under base scenario is −38.35 million CNY, whereas option scenario yields an average NPV of 143.15 million CNY. The average value of real options is 181.5 million yuan, and it increases the average internal rate of return by 0.34%. These results demonstrate that incorporating real options prevents the underestimation of project value and provides more robust decision-making support under uncertainty, thereby offering methodological and policy insights for the investment appraisal of large-scale energy storage projects. Full article

A balance between support and independence in guardianship systems is of high concern, especially with those who need help in making decisions. The research presents a novel approach to evaluating voluntary models of guardianship, focusing on the preservation of individual autonomy and examining the underlying decision symmetry in assessing diverse guardianship options. The ultimate solution to the inherent uncertainty and lack of objectivity in expert evaluations is to apply the circular q-rung orthopair fuzzy (Cq-ROF) combined compromise for ideal solution (CoCoFISo) approach, an effective multi-criteria decision-making (MCDM) model that integrates ranking and sorting views using a Cq-ROF framework within a symmetry-oriented analytical perspective. These are five major assessment factors: how well autonomy is preserved, legal and ethical adherence, psychological health, social integration aid, and risk prevention. It explores ten alternative approaches to guardianship, ranging from complete legal guardianship to community-based self-management solutions, and the use of technology as an element of support. The suggested approach can facilitate more sophisticated modelling of expert opinions, rather than relying on simplistic and straightforward distinctions and diverse evaluations. The case study results indicate that the hybrid and supported forms of decision-making could offer opportunities to preserve a high degree of personal autonomy while ensuring safety and compliance. The research gives a coherent, adaptable, and explainable approach to managing ethical and policy-level judgment concerning voluntary guardianship systems. Full article

Smart grid operators face escalating cyber threats and tight resource constraints, demanding the transparent, defensible prioritization of security controls. This paper asks how to select cybersecurity controls for smart grids while retaining picture fuzzy evidence throughout and supporting policy-sensitive “what-if” analyses. We propose a hybrid Picture Fuzzy Stepwise Weight Assessment Ratio Analysis (SWARA) and Combinative Distance-based Assessment (CODAS) framework that carries picture fuzzy evidence end-to-end over a domain-specific cost/benefit criteria system and a relative-assessment matrix, complemented by multi-scenario sensitivity analysis. Applied to ten prominent solutions across twenty-nine sub-criteria in four dimensions, the model highlights Performance as the most influential main criterion; at the sub-criterion level, the decisive factors are updating against new threats, threat-detection capability, and policy-customization flexibility; and Zero Trust Architecture emerges as the best overall alternative, with rankings stable under varied weighting scenarios. A managerial takeaway is that foundation controls (e.g., OT-integrated monitoring and ICS-aware detection) consistently remain near the top, while purely deceptive or access-centric options rank lower in this context. The framework contributes an end-to-end picture fuzzy risk-assessment model for smart grid cybersecurity and suggests future work on larger expert panels, cross-utility datasets, and dynamic, periodically refreshed assessments. Full article

The increasing demand for high-quality geospatial visualizations in scientific publications has highlighted the need for accessible and standardized tools that support reproducible research. Researchers from various disciplines—often without expertise in Geographic Information Systems (GIS)—frequently require a map figure to locate their study area. This paper presents the Study Area Map Generator, a web-based application developed using Shiny for Python, designed to automate the creation of country- and city-level study area maps. The tool integrates geospatial data processing, cartographic rendering, and user-friendly customization features within a browser-based interface. It enables users—regardless of GIS proficiency—to generate publication-ready maps with customizable titles, basemaps, and inset views. A usability survey involving 92 participants from diverse professional and geographic-based backgrounds revealed high levels of satisfaction, ease of use, and perceived usefulness, with no significant differences across GIS experience levels. The application has already been adopted in academic and policy contexts, particularly in low-resource settings, demonstrating its potential to democratize access to cartographic tools. By aligning with open science principles and supporting reproducible workflows, the Study Area Map Generator contributes to more equitable and efficient scientific communication. The application is freely available online. Future developments include support for subnational units, thematic overlays, multilingual interfaces, and enhanced export options. Full article

The COVID-19 pandemic caused the world to pause temporarily on an almost planetary scale. The creation and diffusion of knowledge about environmental planning and public health are now almost taken for granted. However, such processes were rather different in pre-pandemic times. It took a substantial dose of labor and resources to generate the information needed to produce useful and usable knowledge, and especially to make it available to others in a timely and effective way. As automobility has come to occupy center stage in the lives of an increasing number of suburbanized dwellers, it has taken multiple energy and public health crises, bold leadership, and the real threat of climate change to create the conditions needed to bolster sustainable Non-Motorized Transportation (NMT) as a complement to cleaner and more convenient mass transit options in cities. How does knowledge about sustainable NMT get created? How are sustainable NMT innovations diffused? How can technological and societal transitions to more sustainable realities be nurtured and augmented? This article utilizes a longitudinal and integrated knowledge creation and diffusion model with a Participatory Planning Process to analyze the adoption of measures aimed at reducing the negative consequences of too much automobility and encouraging higher levels of walking, cycling, and mass transportation. The research methods comprised autoethnographic, qualitative, and policy evaluation techniques. The study makes use of the means and ends matrix to discuss cases from five distinct realms: personal, academic, institutional, volunteering NGO, and private sector. The key findings and lessons learned promote scenarios of managed degrowth and sustainable urban transitions. Full article

This paper presents an experimental evaluation of the connectivity reliability of a LoRaWAN (Long Range Wide Area Network), deployed in a rural area of Mozambique, focusing on the influence of distance and relative altitude between end nodes and the gateway. The absence of telecommunications and power infrastructure in the study region provided a realistic and challenging scenario to assess LoRaWAN’s feasibility as a low-cost, low-power solution for remote sensing in disconnected environments. Field trials were conducted using an Arduino-based node (with 2 dBi antenna) powered by a 2200 mAh power bank, with no GPS or cellular support. Data were collected at four georeferenced points along a 1 km path, capturing Received Signal Strength Indicator (RSSI), Signal-to-Noise Ratio (SNR), and Packet Delivery Rate (PDR). Results confirmed that both distance and terrain elevation strongly affect performance, with significantly degraded metrics when the end nodes were located at lower altitudes relative to the gateway. Despite operational constraints, such as the need for manual firmware resets and lack of real-time monitoring, the network consistently achieved PDR above 89% and remained operational autonomously for over 24 h. The study highlights the effectiveness of installing gateways on natural elevations to improve coverage and demonstrates that even with basic hardware, LoRaWAN (Low Power Wide Area Network), is a viable and scalable option for rural connectivity. These findings offer valuable empirical evidence to promote national digital inclusion policies and future LPWAN deployments. Full article

This study examines the challenges and opportunities of managing electronic waste (e-waste) in the Galapagos Islands, a globally significant yet vulnerable subnational insular jurisdiction (SNIJ). Drawing on theories of Circular Economy (CE) and Political Industrial Ecology (PIE), the research investigates the status of e-waste in the archipelago, the barriers to implementing CE practices, and the institutional dynamics shaping material flows. Using a mixed-methods approach—including archival analysis, participant observation, and semi-structured interviews with key informants from government, private, and nonprofit sectors—the findings presented here demonstrate that e-waste management is hindered by limited capital, infrastructure, public awareness, and fragmented governance. While some high-capital institutions can export e-waste to mainland Ecuador, most residents and low-capital entities lack viable disposal options, leading to accumulation and improper disposal. The PIE analysis yielded findings that highlight how institutional power and financial capacity dictate the sustainability of e-waste pathways, with CE loops remaining largely incomplete. Despite national policy support for CE, implementation in Galapagos remains aspirational without targeted financial and logistical support. This case contributes to broader discussions on waste governance in island settings and underscores the need for integrated, equity-focused strategies to address e-waste in small island developing states (SIDS) and SNIJs globally. Full article

This research examines Champing, a new niche tourism phenomenon, enjoyed by over 10,000 people, that until now has not been examined in academic literature. The study analyses how Champing markets itself and is perceived by users to evaluate its proposition and its possible categorization as a form of camping and staycation. The research also explores Champing’s potential to contribute to more authentic and experiential forms of tourism and a possible solution to the challenges of overtourism. A netnographic approach was adopted, combining content analysis from the Champing website with thematic analysis of over 142 ‘Champers’ reviews of their Champing experience. The website content and thematic analysis highlights how Champing is promoted through heritage narratives, minimalist facilities, and links to local cultural and natural attractions through three core themes: Peaceful, Explore, and Novel and New. Findings position Champing as a niche tourism product that extends the camping and staycation portfolio. Analysis highlights how Champing aligns with policy objectives of local economies and heritage and as an option to mitigate against overtourism and foster experiential travel. This paper provides the first empirical analysis of Champing and extends research on camping and staycations; and it demonstrates the value of Netnography to tourism practices research. Full article

Carbon Capture and Storage (CCS) is a vital climate mitigation strategy aimed at reducing CO₂ emissions from industrial and energy sectors. This review presents a comprehensive analysis of CCS technologies, focusing on capture methods, transport systems, geological storage, geomechanical and geochemical aspects, modeling, risk assessment, monitoring, and economic feasibility. Among capture technologies, pre-combustion capture is identified as the most efficient (90–95%) due to its high purity and integration potential. Notably, most operational CCS projects in 2025 utilize pre-combustion capture, particularly in hydrogen production and natural gas processing. For geological storage, saline aquifers and depleted oil and gas reservoirs are highlighted as the most promising due to their vast capacity and proven containment. In the transport phase, pipeline systems are considered the most effective and scalable method, offering high efficiency and cost-effectiveness for large-scale CO₂ movement, especially in the supercritical phase. The study also emphasizes the importance of hybrid integrated risk assessment models, such as NRAP-Open-IAM, which combine deterministic simulations with probabilistic frameworks for robust site evaluation. In terms of monitoring, Seismic monitoring methods are regarded as the most reliable subsurface technique for tracking CO₂ plume migration and ensuring storage integrity. Economically, depleted reservoirs offer the most feasible option when integrated with existing infrastructure and supported by incentives like 45Q tax credits. The review concludes that successful CCS deployment requires interdisciplinary innovation, standardized risk protocols, and strong policy support. This work serves as a strategic reference for researchers, policymakers, and industry professionals aiming to scale CCS technologies for global decarbonization. Full article

Per- and polyfluoroalkyl substances (PFASs) represent one of the most challenging classes of persistent organic pollutants, and adsorption is currently one of the most widely deployed method for their removal from water. However, the long-term sustainability of adsorption-based treatment depends on how adsorbents are regenerated, managed after exhaustion, and integrated into broader environmental and regulatory frameworks. This review synthesises recent advances in regeneration strategies for PFAS-saturated adsorbents, including thermal, solvent-based, chemical, hybrid, and emerging methods, and provides a targeted analysis of policy and regulatory frameworks governing PFAS management in water. Evidence from the literature is critically assessed with attention to regeneration efficiencies, adsorbent stability, secondary waste generation, and long-term reuse potential. Life cycle assessment (LCA) studies are also examined to evaluate the environmental and cost implications of different management options. The analysis highlights that while solvent and chemical regeneration achieve high short-term recovery, thermal processes offer partial destructive potential, and electrochemical methods are emerging as promising but unproven alternatives. Persistent challenges include incomplete PFAS desorption, performance decline over multiple cycles, energy intensity, and secondary waste burdens. Advancing sustainable PFAS treatment requires integrated evaluation frameworks linking technical performance with environmental impact and cost, supported by policy drivers that incentivize regeneration and safe end-of-life management. Full article

Digital transformation embeds smart cities, e-health, and Industry 4.0 into critical infrastructures, thereby increasing reliance on digital systems and exposure to cyber threats and boosting complexity and dependency. Research involving over 200 executives reveals that under rising complexity, only 15% of cyber risk investments are effective, leaving most organizations misaligned or vulnerable. In this context, the role of artificial intelligence (AI) in cybersecurity requires systemic scrutiny. This study analyzes how AI reshapes systemic structures in cyber risk management through a multi-method approach: literature review, expert workshops with practitioners and policymakers, and a structured kill chain analysis of the Colonial Pipeline attack. The findings reveal three new feedback loops: (1) deceptive defense structures that misdirect adversaries while protecting assets, (2) two-step success-to-success attacks that disable defenses before targeting infrastructure, and (3) autonomous proliferation when AI applications go rogue. These dynamics shift cyber risk from linear patterns to adaptive, compounding interactions. The principal conclusion is that AI both amplifies and mitigates systemic risk. The core recommendation is to institutionalize deception in security standards and address drifting AI-powered systems. Deliverables include validated systemic structures, policy options, and a foundation for creating future simulation models to support strategic cyber risk management investment. Full article

With accelerated urbanization and the pursuit of the “dual carbon” goals, shared bicycles have re-emerged as a green travel option. This study focuses on the central urban area of Nanjing and develops a carbon emissions reduction (CER) estimation model for shared bicycles. By analyzing spatio-temporal dimensions, it systematically assesses carbon reduction benefits and highlights the synergy with metro-connected travel. Key findings are as follows: (1) shared bicycles primarily support short-distance commuting, with a daily cycling pattern exhibiting a bi-modal distribution and a pronounced peak period demand; (2) cycling trips concentrate in densely populated and commercially vibrant zones, with a spatial pattern of central aggregation and multi-point diffusion; (3) each kilometer cycled by a shared bicycle reduces carbon emissions by about 96.19 g, with daily reductions of around 42.72 t and annual reductions up to 15,591.04 t; (4) the CER benefits of bicycle–metro integration are especially pronounced, contributing nearly 45.00% during peak periods; and (5) factors such as travel mode shifts, metro station layouts, and the development of electric vehicles continue to influence the CER benefits of shared bicycles. This work provides scientific evidence to inform urban green travel policies and transportation infrastructure optimization in cities. Full article

This paper proposes a comprehensive framework for strategic power system decarbonization planning that integrates the William Newman method (diagnosis–options–forecast–decision) with a multi-objective Mixed-Integer Linear Programming (MILP) model. The approach simultaneously minimizes (i) generation cost, (ii) expected cost of energy not supplied (Value of Lost Load, VoLL), (iii) demand response cost, and (iv) CO₂ emissions, subject to power balance, technical limits, and binary unit commitment decisions. The methodology is validated on the IEEE RTS 24-bus system with increasing demand profiles and representative cost and emission parameters by technology. Three transition pathways are analyzed: baseline scenario (no environmental restrictions), gradual transition (−50% target in 20 years), and accelerated transition (−75% target in 10 years). In the baseline case, the oil- and coal-dominated mix concentrates emissions (≈14 ktCO₂ and ≈12 ktCO₂, respectively). Under gradual transition, progressive substitution with wind and hydro reduces emissions by 15.38%, falling short of the target, showing that renewable expansion alone is insufficient without storage and demand-side management. In the accelerated transition, the model achieves −75% by year 10 while maintaining supply, with a cost–emissions trade-off highly sensitive to the carbon price. Results demonstrate that decarbonization is technically feasible and economically manageable when three enablers are combined: higher renewable penetration, storage capacity, and policy instruments that both accelerate fossil phase-out and valorize demand-side flexibility. The proposed framework is replicable and valuable for outlining realistic, verifiable transition pathways in power system planning. Full article

Background/Objectives: This study examines the development of clinical trials investigating psilocybin for the treatment of psychopathologies, with a comparative focus on the United States (US) and the European Union (EU). The objective is to identify regional differences in trial progression, research infrastructure, and regulatory frameworks. Methods: A mixed-methods approach was applied, combining case studies, qualitative and quantitative research. Key variables included trial phase, geographical distribution, demographic factors, funding, governmental support, and public health policies. Results: The US demonstrated a substantially higher number of psilocybin trials across both early and advanced phases. This reflects a strong research infrastructure, growing financial investment, and increasing interest in psychedelic-assisted therapies. In contrast, the EU showed fewer trials and slower advancement, reflecting a more cautious stance that emphasizes patient safety and therapeutic efficacy. These divergences are shaped by differences in regulation, funding mechanisms, and sociocultural attitudes toward psychedelics in psychiatry. Conclusion: This comparative analysis highlights the uneven pace of psilocybin research across different regions. It also emphasizes the importance of international collaboration, harmonization of public health policies, and the development of standardized procedures prioritizing safety and effectiveness. Integrating psilocybin-assisted interventions into psychiatric practice has the potential to expand treatment options and strengthen mental health care, but coordinated global efforts are essential to ensure both scientific rigor and patient protection. Full article