Support Capacity Research Articles

Synergy of Traditional Ecological Knowledge (TEK) and Intellectual Property Rights (IPR) in Biodiversity Management and Conservation

Indigenous and local communities’ Traditional Ecological Knowledge (TEK) is a priceless source of information about animal behaviour, habitat, and traditional uses of wildlife. As the knowledge has grown and passed from one generation to another, it has played a pivotal role in biodiversity conservation. Nevertheless, blending TEK with zoology studies in intellectual property rights (IPR) poses separate challenges as well as benefits. The article explores the intricate relationship between TEK and IPR by emphasizing the significance of preserving this knowledge for its continuous contribution to biodiversity conservation and sustainable development. The research seeks to provide an extensive analysis of different legal frameworks such as international agreements and national laws that protect TEK. It further underscores the implementation of sui generis systems that are tailored specifically for traditional knowledge which cannot be categorized under any conventional IPR. This paper also provides practical examples of how TEK can be interwoven with other forms of knowledge to enhance scientific research and conservation. Illustrations are provided here about why benefit-sharing arrangements must recognize Indigenous people and local communities’ contributions. Among other important aspects, such agreements should lead to financial compensations, support capacity development efforts, provide co-authorship opportunities as well as promote technology transfer thus effectively empowering these communities. Besides; the research under discussion highlights several ethical issues that come into play while using TEK including showing respect for cultural values and customary laws held by those who own such knowledge. It therefore calls for an inclusive approach that encourages the development of trust and mutual respect among scholars and indigenous peoples. To this end, the article offers comprehensive techniques that will help improve the safeguarding of traditional ecological knowledge (TEK), to establish legally robust yet ethically considerate policies that preserve its relevance in zoological research and biodiversity conservation today.

Distributed energy storage participates in reactive power optimization strategy research of new distribution system

Abstract We studied the reactive power control strategy of distributed energy storage in distribution systems, improved reactive power support capacity, and enhanced system reliability and new energy carrying capacity. Firstly, the principles and methods of reactive power optimization in distribution networks are studied. Then, the principles and mechanisms of distributed energy storage participating in reactive power control in distribution networks are studied. Finally, the genetic algorithm optimization method for reactive power optimization in distribution networks is studied, including parameter setting, target selection, and genetic strategy improvement, providing support for fine control of reactive power and voltage in distribution systems and efficient operation. Through simulation analysis of the IEEE33 node system, it is shown that distributed energy storage can improve the reactive voltage level of the distribution system and promote the consumption of new energy.

Coordination analysis and evaluation of population, water resources, economy, and ecosystem coupling in the Tuha region of China

The non-coordination between the socio-economic systems and ecosystems of a region is a crucial obstacle to sustainable development. To reveal the relationships between complex urban systems and achieve the goal of sustainable and coordinated urban development, we constructed a coupling coordination degree model (CCDM) and coupling angle model (CAM) and analyzed the degree of coupling coordination and evolution process among the population, water resources, economy, and ecology (PWEE) system of the Tuha region for 2005–2020. The results indicated that: (1) During 2005–2020, the comprehensive development index (CDI) of the population, water resources and economy subsystems was 0.21–0.65, with the three subsystems portraying an overall increase; the average values of the RSEI at five-year intervals were 0.29, 0.28, 0.28, and 0.26, indicating a downward trend in the environmental quality. (2) The coupling coordination effect of the PWEE system portrayed a low level; the coupling coordination degree (CCD) values were 0.28–0.58, portraying a fluctuating upward trend. The level of CCD increased from low disorder to marginal coordination. (3) The PWEE system’s scissor difference reflects large evolutionary characteristics. The ecological support capacity was not observed until the late stage. We conclude that the PWEE composite system of the region is in a stage of disordered development. These findings significantly bolster the theoretical underpinnings of sustainable development studies, offering essential scientific theories and methodological frameworks for crafting sustainable development policies tailored to urban systems in the Tuha region.

Condition of linear landscape elements improves with contiguity to protected habitats: Empirical evidence useful for agroecosystem accounting and restoration

In Mediterranean Europe, both intensification and abandonment of traditional cultural practices represent main drivers for the loss of natural and semi-natural elements in agricultural settings. Once common in rural landscapes, these habitats have to be conserved or restored to ensure resilience and resistance of agroecosystems against biodiversity loss and socio-ecological changes. In particular, linear landscape elements (LE) fall among the high-biodiversity landscape features that require to be increased in agricultural lands to facilitate species mobility and provide a wide range of ecosystem services. However, within the framework of environmental accounting procedures, there is still a need for a thorough methodology to assess conditions of LE and, subsequently, of the hosting agroecosystems. The present research is therefore aimed at (i) proposing a method for a thorough assessment of LE conditions, with a special focus on biodiversity support capacity, (ii) investigating the potential effect of extrinsic determinants on LE conditions, such as contiguity to protected habitats and governance framework, and (iii) identifying useful parameters to guide LE ecological restoration actions. Based on different structural, compositional and landscape indicators, the proposed assessment method was tested in eight administrative units of two Mediterranean Europe countries. In the study sites, favorable LE conditions were found to be strongly associated with contiguity to protected habitats, by showing marked structural continuity, dominance of trees, active dynamics, and good quality of the surrounding landscape mosaic. Potential applications of the results have been finally explored in both ecosystem accounting and ecological restoration processes.

From fasting to fat reshaping: exploring the molecular pathways of intermittent fasting-induced adipose tissue remodeling.

Obesity, characterised by excessive fat accumulation, is a complex chronic condition that results from dysfunctional adipose tissue expansion due to prolonged calorie surplus. This leads to rapid adipocyte enlargement that exceeds the support capacity of the surrounding neurovascular network, resulting in increased hypoxia, inflammation, and insulin resistance. Intermittent fasting (IF), a dietary regimen that cycles between periods of fasting and eating, has emerged as an effective strategy to combat obesity and improve metabolic homeostasis by promoting healthy adipose tissue remodeling. However, the precise molecular and cellular mechanisms behind the metabolic improvements and remodeling of white adipose tissue (WAT) driven by IF remain elusive. This review aims to summarise and discuss the relationship between IF and adipose tissue remodeling and explore the potential mechanisms through which IF induces alterations in WAT. This includes several key structural changes, including angiogenesis and sympathetic innervation of WAT. We will also discuss the involvement of key signalling pathways, such as PI3K, SIRT, mTOR, and AMPK, which potentially play a crucial role in IF-mediated metabolic adaptations.

Small-Signal Modeling and Frequency Support Capacity Analysis of Power Load Considering Voltage Variation Effect

Small-Signal Modeling and Frequency Support Capacity Analysis of Power Load Considering Voltage Variation Effect

Physician Reluctance to Intervene in Addiction

The overdose epidemic continues in the US, with 107 941 overdose deaths in 2022 and countless lives affected by the addiction crisis. Although widespread efforts to train and support physicians to implement medications and other evidence-based substance use disorder interventions have been ongoing, adoption of these evidence-based practices (EBPs) by physicians remains low. To describe physician-reported reasons for reluctance to address substance use and addiction in their clinical practices using screening, treatment, harm reduction, or recovery support interventions. A literature search of PubMed, Embase, Scopus, medRxiv, and SSRN Medical Research Network was conducted and returned articles published from January 1, 1960, through October 5, 2021. Publications that included physicians, discussed substance use interventions, and presented data on reasons for reluctance to intervene in addiction were included. Two reviewers (L.N., M.C., L.F., J.P., C.S., and S.W.) independently reviewed each publication; a third reviewer resolved discordant votes (M.C. and W.C.). This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and the theoretical domains framework was used to systematically extract reluctance reasons. The primary outcome was reasons for physician reluctance to address substance use disorder. The association of reasons for reluctance with practice setting and drug type was also measured. Reasons and other variables were determined according to predefined criteria. A total of 183 of 9308 returned studies reporting data collected from 66 732 physicians were included. Most studies reported survey data. Alcohol, nicotine, and opioids were the most often studied substances; screening and treatment were the most often studied interventions. The most common reluctance reasons were lack of institutional support (173 of 213 articles [81.2%]), knowledge (174 of 242 articles [71.9%]), skill (170 of 230 articles [73.9%]), and cognitive capacity (136 of 185 articles [73.5%]). Reimbursement concerns were also noted. Bivariate analysis revealed associations between these reasons and physician specialty, intervention type, and drug. In this systematic review of reasons for physician reluctance to intervene in addiction, the most common reasons were lack of institutional support, knowledge, skill, and cognitive capacity. Targeting these reasons with education and training, policy development, and program implementation may improve adoption by physicians of EBPs for substance use and addiction care. Future studies of physician-reported reasons for reluctance to adopt EBPs may be improved through use of a theoretical framework and improved adherence to and reporting of survey development best practices; development of a validated survey instrument may further improve study results.

Micro-business participation in collective flood adaptation: lessons from scenario-based analysis in Ho Chi Minh City, Vietnam

Abstract. Although research on the impacts of climate change on small- and medium-sized enterprises (SMEs) and their adaptation to climate change risks has recently received more attention, the focus on micro-businesses and household businesses is still very limited. Micro-businesses and household businesses are adversely affected by compound flooding events – a situation that will become more acute in the future – but there is little attention in the scientific literature to their adaptation options and actual implementation. Against this background, the paper analyzes the following research questions. How are micro-businesses already responding to flooding? Are micro-businesses willing to collectively invest in future proactive adaptation efforts in their neighborhoods? What are the key drivers of and barriers to adaptation? Based on scenario-based field experiments in Ho Chi Minh City, our results show that micro-businesses could play a much larger role in collective adaptation. Often overlooked in adaptation research, their willingness to engage in collective action under severe constraints is surprising. The conceptual framework presented in this paper helps us to understand the key drivers of and barriers to micro-business willingness to participate in collective adaptation activities. The most important key barriers for micro-businesses are limited financial capacity and lack of support from local authorities. However, micro-businesses are willing to contribute depending on the concrete adaptation measure and financing options. If no financial contribution is expected, almost 70 % are willing to participate in awareness-raising campaigns. And although their financial capacity is very limited, 39 % of micro-businesses would contribute financially if the costs were shared with other businesses in their neighborhood and with local authorities. In this context, micro-businesses should be much more involved in adaptation plans and measures. Through their local embeddedness, they can be important multipliers in strengthening adaptive capacity at the local level.

ANALYSIS OF STUDENT NEEDS FOR DIGITAL-BASED TEACHING MATERIALS

This research aims to analyze the student needs for appropriate teaching materials for the Instructional Media and Technology course in the fourth semester of the Islamic Religious Education Department at STIT Ibnu Rusyd Tanah Grogot. The research method used is a qualitative method with a descriptive approach. The sample for this research was 29 students. The data collection technique was carried out by distributing questionnaires to 29 students. The analysis carried out is based on three indicators: the analysis of student conditions, the analysis of supporting capacity and campus conditions, and the analysis of the type of need for teaching materials. From the research results, it is known that as many as 52% of the digital teaching materials needed by students are web-based digital teaching materials. Apart from that, the research results found that there is a need for maximum campus support capacity so that digital-based learning can be implemented well, not only for certain subjects but also for a wider scope.

Faculty’s Role in Creating a (Remote) Sense of Community Among Faculty and Facilitating Contexts of Care for Students

Objectives: This qualitative study employed a sensemaking approach to understand faculty members’ sensemaking of their roles during the COVID-19 pandemic and the emergency transition to remote teaching and learning. Methods: An email invitation to participate in the study was sent to faculty who taught in an MBA program during both the 2019–2020 and 2020–2021 academic school years. Data were collected through in-depth, semi-structured interviews with 14 faculty members who self-selected to participate in the study. Results: Two salient themes emerged from the research: <em>creating a (remote) sense of community among faculty</em> and <em>facilitating contexts of care for students</em>. These findings highlight the mission-central importance of faculty, the role of teaching, and the need to support faculty as they support students in higher education. Conclusions: As a result of the emergency transition to remote teaching and learning, faculty gained an increased awareness of the importance of human connection and interaction, which made them develop a whole-person approach both to colleagues and students. Implications: How well institutions plan for and support their faculty during times of crises will influence the institution’s capacity for student support and the personal impact of the crisis on faculty.

Insight into the Stabilization Mechanism of Succinylation Modification on Black Bean Protein Gels: Molecular Conformation, Microstructure, and Gel Properties.

The objective of this work was to investigate the effect of succinylation treatment on the physicochemical properties of black bean proteins (BBPI), and the relationship mechanism between BBPI structure and gel properties was further analyzed. The results demonstrated that the covalent formation of higher-molecular-weight complexes with BBPI could be achieved by succinic anhydride (SA). With the addition of SA at 10% (v/v), the acylation of proteins amounted to 92.53 ± 1.10%, at which point there was a minimized particle size of the system (300.90 ± 9.57 nm). Meanwhile, the protein structure was stretched with an irregular curl content of 34.30% and the greatest processable flexibility (0.381 ± 0.004). The dense three-dimensional mesh structure of the hydrogel as revealed by scanning electron microscopy was the fundamental prerequisite for the ability to resist external extrusion. The thermally induced hydrogels of acylated proteins with 10% (v/v) addition of SA showed excellent gel elastic behavior (1.44 ± 0.002 nm) and support capacity. Correlation analysis showed that the hydrogel strength and stability of hydrogels were closely related to the changes in protein conformation. This study provides theoretical guidance for the discovery of flexible proteins and their application in hydrogels.

Spatiotemporal Evolution Characteristics of Carbon Sources and Carbon Sinks and Carbon Balance Zoning in the Yangtze River Delta Region

Mastering the spatiotemporal evolution laws of carbon sources and sinks is of great significance to promote the coordinated development of regional low-carbon, improve the science of carbon reduction and sink increase policies, and realize the goal of "double carbon." Taking 41 cities in the Yangtze River Delta Region as the research object, this study analyzed the spatiotemporal evolution characteristics of carbon sources and sinks in the Yangtze River Delta Region from 2000 to 2020 and conducted the carbon balance zoning. The results were as follows： ① The carbon emissions increased rapidly in the Yangtze River Delta Region from 2000 to 2011 but with some fluctuations after 2011. Carbon sinks increased slowly in the Yangtze River Delta Region from 2000 to 2020. The regional differences in carbon emissions and carbon sinks were significant, and the spatial pattern was relatively stable. ② The carbon compensation rate in the Yangtze River Delta Region showed a downward trend, and the carbon productivity, energy utilization efficiency, and carbon ecological support capacity were constantly enhanced. Interregional differences were the main source of carbon compensation rate in the Yangtze River Delta Region. Both the carbon compensation rate and carbon ecological support coefficient showed a spatial pattern of "high in the west and low in the east, high in the south and low in the north." The areas with high carbon economy contributive coefficient were concentrated in the central and southern areas of the Yangtze River Delta regions, and the areas with low carbon economy contributive coefficient were concentrated in Anhui Province. ③ Based on the carbon economy contributive coefficient and the carbon ecological support coefficient, cities in the Yangtze River Delta Region were classified into low-carbon maintenance areas, economic development areas, carbon sink development areas, and comprehensive optimization areas. Recommendations were proposed for each category of cities in order to promote the coordinated development of regional low-carbon and realize the goal of "double carbon".

Optimized coordinated control method with virtual inertia based on fractional impedance model for charging stations

Due to the EV (Electric Vehicles) charging stations are characterized by weak damping and low inertia, the EV with a high degree of uncertainty can easily have an impact on the stability of the charging station system. Therefore, this paper proposes an optimization control method to improve the system inertia effect based on the fractional order impedance model of the charging station. This paper presents a study on establishing a fractional impedance model for charging stations, using the deviation between theoretical impedance spectra and actual measurements as a criterion. The goal is to enhance system inertia and optimize the parameters of the fractional-order controller to improve the supporting capacity of the charging station system and enhance its dynamic response. Initially, considering the fractional characteristics of the EV load, a fractional impedance model of the charging station is established. The analysis demonstrates that the fractional-order capacitor provides inertia to the system, enhancing its inertia support capability. In addition, a virtual inertia control strategy based on fractional-order PID (FOPID) is designed. Finally, an improved particle swarm optimization algorithm is utilized to optimize the control parameters. Through experimental verification under different operating conditions, it has been demonstrated that the fractional-order control strategy can achieve a dynamic response time of approximately 0.025s and limit the voltage deviation within 5%. Furthermore, the rotational inertia can rapidly increase to the maximum value satisfying the objective function within 0.05s. The results indicate that this control method effectively suppresses the DC voltage and power oscillations in the distribution grid.

SE-CNN based emergency control coordination strategy against voltage instability in multi-infeed hybrid AC/DC systems

For receiving-end power systems with multi-infeed HVDCs and large-scale renewable energy generation, the challenges of weak reactive power support and limited anti-interference capacity pose a threat to the power system voltage stability. To enhance the voltage stability under large disturbances, this paper proposes a data-driven method for coordinated emergency control strategy against voltage instability in multi-infeed hybrid AC/DC systems based on the squeeze and excitation (SE) module and convolutional neural network (CNN). Firstly, the SE module and CNN are integrated to intuitively capture correlations among various feature channels and extract key features related to voltage stability levels. Secondly, a voltage stability evaluation method is proposed based on the SE-CNN model, utilizing a dual channel structure to unveil the quantitative relationship between key response characteristics and voltage stability margin. Finally, regarding the control measures containing load shedding and DC modulation, the emergency control sensitivity index is proposed to assess the stability margin improvement effect of various control objects, and the optimal emergency control strategy is formulated to coordinate multiple voltage stability emergency control measures. Case studies were conducted on a typical China local region receiving-end power grid test system with voltage instability problems, and the simulation results verified the effectiveness of the proposed method. © 2017 Elsevier Inc. All rights reserved.

Anaphylaxis in Practice: A Guide to the 2023 Practice Parameter Update

This review summarizes new research developments and clinical practice recommendations for the diagnosis and management of anaphylaxis presented in the Joint Task Force on Practice Parameters 2023 Anaphylaxis practice parameter Update. It is intended to serve as a high-level summary of the 2023 practice parameter, which makes clinically impactful recommendations based on evidence that has emerged since the 2015 practice parameter. We invite clinicians to explore the full 2023 practice parameter to understand the research methods and underlying evidence that have informed the recommendations summarized here. There are new and evolving diagnostic criteria for anaphylaxis, rules for defining elevated tryptase levels, and recognition of signs and symptoms particular to infants and toddlers. The administration of epinephrine should not be used as a surrogate to diagnose anaphylaxis. Risk factors for anaphylaxis should be assessed on a case-by-case basis. Patient counseling and shared decision-making are essential to support patients' treatment decisions and capacity to manage the risk of anaphylaxis at home and in other community settings. Activation of emergency medical services after home epinephrine administration may not be required in all cases, and patients should be engaged in shared decision-making to determine when home management may be appropriate.

An enhanced strategy for new energy generation black-start based on hybrid energy storage system

Abstract In the past few years, the connection of extensive power grids with a substantial influx of renewable energy has resulted in a growing hazard of significant power failures. Conventional black-start systems are inadequate in promptly and adaptively recuperating from such outages. Consequently, the emergence of new energy generation integrated with energy storage technology to deliver black-start services has become a prevailing trajectory. In this research article, hybrid energy storage is implemented for the wind and solar power generation system to address the issue of inadequate inertia support capacity during the black-start process. The system incorporates a virtual synchronizer to manage and replicate its inertia and damping features, thereby enhancing the black-start capability of renewable energy generation. The effectiveness of the proposed strategy is verified through simulation in Matlab/Simulink.

Evaluation of marine economic development demonstration zone policy on marine industrial structure optimization: a case study of Zhejiang, China

The marine economic development demonstration zone (MEDDZ) is the regional marine functional policy that assumes the significant tasks of innovation in the system and mechanism of the marine economy, optimization of the marine industrial structures, and the construction of marine ecological civilization. This paper constructs a panel database of 11 coastal provinces in China from 2006 to 2019, takes the Zhejiang Marine Economy Development Demonstration Zone Plan officially approved by the State Council of China in 2011 as a quasi-natural experiment, applies the synthetic control method (SCM) to evaluate the effect of implementation of the MEDDZ policy on marine industrial structure optimization in Zhejiang. The results show that: (1) The MEDDZ policy significantly promotes the structure optimization of the marine industry in Zhejiang and the existence of the policy lag phenomenon. (2) Based on the results of the robustness tests, we find that the fitted path of policy effects is better when the time of MEDDZ implementation is adjusted to 2012. (3) Government financial support and marine cargo capacity play a role in implementing the MEDDZ policy, positively affecting and optimizing the coastal marine industry’s structure. Therefore, we make some suggestions from the perspectives of strengthening the policy implementation process, focusing on the policy lag phenomenon, and broadening funding sources, thus enriching theoretical research on policies in the field of the marine industry and providing practical references for the development of other coastal demonstration zones.

Process evaluation of implementation of the early stages of a whole systems approach to obesity in a small Island.

The small Atlantic island of St Helena is a United Kingdom Overseas Territory (UKOT) with a high prevalence of childhood obesity (over a quarter of 4-5 and 10-11 year olds) and, anecdotally, adulthood obesity and its associated health detriments. St Helena have taken a whole systems approach to obesity (WSAO) to address the issue. A WSAO recognises the factors that impact obesity as a complex system and requires a 'health in all policies' approach. UK academic and public health technical support was provided to the local St Helena delivery team. This process evaluation sought to explore the early stages of the WSAO implementation and implications for the transferability of the approach to other small island developing states and UKOT. Data was collected via eight semi-structured interviews, paper based and online surveys, and document analysis. Thematic analysis was used to analyse the data. The analysis identified three factors which aided the first phase of WSAO implementation: (1) senior leaders support for the approach; (2) the academic support provided to establish and develop the approach; and (3) effective adaptation of UK Government resources to suit the local context. Key challenges of early implementation included: maintaining and broadening stakeholder engagement; limited local workforce capacity and baseline knowledge related to obesity and systems thinking; and limited capacity for support from the UK-based academic team due to contract terms and COVID-19 restrictions. Early stages of implementation of a WSAO in a UKOT can be successful when using UK's resources as a guide and adapting them to a small island context. All participants recommended other small islands adopt this approach. Continued senior support, dedicated leadership, and comprehensive community engagement is needed to progress implementation and provide the foundation for long-term impact. Small island developing states considering adopting a WSAO should consider political will, senior level buy-in and support, funding, and local workforce knowledge and capacity to enable the best chances of successful and sustainable implementation.

Micro and Small Industry (MSI) Based on Halal Products in Lampung: What Has the Government Done?

Micro and small industries (MSI) play a strategically vital role in supporting the dynamics of the economy, both globally and locally, particularly in the context of poverty alleviation and the enhancement of community welfare. The primary objective of this research is to delve into it in a more detailed and comprehensive manner by thoroughly exploring the potential and support capacity of the government for MSI focused on the development of halal products, with the aspiration of generating a substantial positive impact on overall economic growth and community welfare at a significant level. Keywords: micro and small enterprises, halal products

Clinical Practice Guidelines to Support Capacity Building in Orthopaedic Surgical Outreach: An International Consensus Building Approach.

Surgical outreach to low- and middle-income countries (LMICs) by organizations from high- income countries is on the rise to help address the growing burden of conditions warranting surgery. However, concerns remain about the impact and sustainability of such outreach. Leading organizations (e.g., the World Health Organization) advocate for a capacity-building approach to ensure the safety, quality, and sustainability of the local health-care system. Despite this, to our knowledge, no guidelines exist to inform such efforts. We aimed to develop clinical practice guidelines (CPGs) to support capacity-building in orthopaedic surgical outreach utilizing a multistakeholder and international voting panel. We followed a modified American Academy of Orthopaedic Surgeons (AAOS) CPG development process. We systematically reviewed the existing literature across 7 predefined capacity-building domains (partnership, professional development, governance, community impact, finance, coordination, and culture). A writing panel composed of 6 orthopaedic surgeons with extensive experience in surgical outreach reviewed the existing literature and developed a consensus-based CPG for each domain. We created an international voting panel of orthopaedic surgeons and administrators who have leadership roles in outreach organizations or hospitals with which outreach organizations partner. Members individually reviewed the CPGs and voted to approve or disapprove each guideline. A CPG was considered approved if >80% of panel members voted to approve it. An international voting panel of 14 surgeons and administrators from 6 countries approved all 7 of the CPGs. Each CPG provides recommendations for capacity-building in a specific domain. For example, in the domain of partnership, the CPG recommends the development of a documented plan for ongoing, bidirectional partnership between the outreach organization and the local team. In the domain of professional development, the CPG recommends the development of a needs-based curriculum focused on both surgical and nonsurgical patient care utilizing didactic and hands-on techniques. As orthopaedic surgical outreach grows, best-practice CPGs to inform capacity-building initiatives can help to ensure that resources and efforts are optimized to support the sustainability of care delivery at local sites. These guidelines can be reviewed and updated in the future as evidence that supports capacity-building in LMICs evolves.The global burden of disease warranting surgery is substantial, and morbidity and mortality from otherwise treatable conditions remain disproportionately high in low- and middle-income countries (LMICs)1,2. It is estimated that up to 2 million (about 40%) of injury-related deaths in LMICs could be avoided annually if mortality rates were reduced to the level of those in high-income countries (HICs)3. Despite this, progress toward improved access to safe, timely surgery in resource-poor areas has been slow. Historically, nongovernmental organizations (NGOs) have tried to address unmet surgical needs through short-term outreach trips; however, growing criticism has highlighted the limitations of short-term trips, including limited follow-up, an increased burden on the local workforce, and further depletion of local resources4-6. In light of ongoing concerns, public health priorities have shifted toward models that emphasize long-term capacity-building rather than short-term care delivery. Capacity-building is an approach to health-care development that builds independence through infrastructure development, sustainability, and enhanced problem-solving while taking context into account7,8.