Assessing the association of healthy lifestyle indicators (life's simple 7) with bacterial vaginosis in reproductive-age women: A cross-sectional analysis of a nationwide survey.

Modern port operations involve the joint participation of multiple independent organizations, including port authorities, terminal operators, customs agencies, shipping lines, and regulatory bodies. These actors collectively manage safety‐ and risk‐critical activities such as vessel traffic control, cargo handling, bunkering, and emergency response. These operations occur in an environment that is highly regulated, technologically dynamic, globally interconnected and increasingly subject to digitalization, automation, and the demands of sustainability (Geerlings et al. ; Meléndez and Goerlandt ). Despite significant investments in formal risk and safety management systems, port risk governance remains challenged by the fragmentation of control structures and the diffusion of responsibility across organizational boundaries. Such fragmentation compromises not only operational efficiency but also systemic risk governance, as misaligned roles and ineffective feedback loops allow risks to propagate across organizations and networked systems (Nikghadam et al. ; Zhang et al. ). Within the risk‐analysis literature, the concept of systemic risk has emerged as a central concern for complex, interconnected systems where small perturbations can escalate into large‐scale consequences (Aven , ; Renn et al. ). Ports exemplify such systems: they operate as interdependent sociotechnical networks where decision making and control are distributed among multiple actors. Under uncertainty, coordination mechanisms become essential for maintaining stable control and preventing risk amplification. Studies in risk analysis have demonstrated that coordination failures, whether in information sharing, crisis response, or communication, can significantly influence systemic outcomes (Ji and Fan ; Kim et al. ; Liu et al. ). These findings indicate that formal control structures alone are insufficient; dependable coordination mechanisms and the organizational arrangements that sustain them are equally important for maintaining accountability, resilience, and effective control across organizational boundaries. Traditional risk‐analysis approaches have emphasized component reliability, probabilistic assessment, intraorganizational compliance, and safety controls (Aven ; N. Leveson ). However, contemporary risk science increasingly recognizes that systemic risks emerge through interconnected governance structures, uncertainty, and interdependencies across sociotechnical systems (Aven ; Renn et al. ). As a result, traditional approaches may provide limited visibility into the role of interorganizational coordination in analyzing systemic risk within fragmented operational environments.