RESUMO
Purpose: To identify the main variables affecting the academic adaptability of hospital nursing interns and key areas for improvement in preparing for future unpredictable epidemics. Methods: The importance of academic resilience-related variables for all nursing interns was analyzed using the random forest method, and key variables were further identified. An importance-performance analysis was used to identify the key improvement gaps regarding the academic resilience of nursing interns in the case hospital. Results: The random forest showed that five items related to cooperation, motivation, confidence, communication, and difficulty with coping were the main variables impacting the academic resilience of nursing interns. Moreover, the importance-performance analysis revealed that three items regarding options examination, communication, and confidence were the key improvement areas for participating nursing interns in the case hospital. Conclusions: For the prevention and control of future unpredictable pandemics, hospital nursing departments can strengthen the link between interns, nurses, and physicians and promote their cooperation and communication during clinical practice. At the same time, an application can be created considering the results of this study and combined with machine learning methods for more in-depth research. These will improve the academic resilience of nursing interns during the routine management of pandemics within hospitals.
Assuntos
Resiliência Psicológica , Humanos , Internato e Residência/métodos , Masculino , Feminino , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricosRESUMO
Many public environmental decisions are wicked problems due to high complexity and uncertainty. We test a participatory value-based framework based on multi-criteria decision analysis (MCDA) to tackle such problems. Our framework addresses two important gaps identified in reviews of MCDA applications to environmental problems: including stakeholders and treating uncertainty. We applied our framework in two complex real-world cases concerning a paradigm shift in the wastewater sector; the transition from centralized wastewater systems to decentralized non-grid systems. Non-grid systems may solve some problems of centralized systems by reducing costs, increasing flexibility, and addressing growing demands on environmental issues, especially in rural areas. But non-grid systems have rarely been implemented in OECD countries, because it is unclear whether a transition is recommendable, and whether stakeholders would accept this shift. This problem allows addressing several fundamental research questions. As theoretical contribution, we found that stakeholder participation in MCDA is necessary, because different preferences of stakeholders can lead to different best-performing options in the assessments. Compared to the typical integrated assessment (IA) approach that excludes stakeholders' preferences, the MCDA process led to clearer outcomes. Results indicate that including the uncertainty of predicted consequences of options with Monte Carlo simulation helped discriminate between options and identify best-performing options. Challenging the uncertainty of elicited stakeholder preferences with sensitivity analyses, we found that best-performing options were especially sensitive to the MCDA aggregation model. Despite the high uncertainty, it was possible to suggest robust consensus options that would perform reasonably well for all stakeholders. As practical contribution, results indicated that a transition from the centralized to decentralized non-grid systems seems feasible. Most stakeholders assigned highest weights to environmental protection objectives in decision-making workshops. These stakeholder preferences implemented in MCDA led to a generally better assessment of innovative non-grid systems, especially when including urine source separation. Stakeholders perceived the MCDA process as beneficial and found results plausible. We conclude that the proposed participatory value-based framework is rigorous, but still feasible in practice. The framework is certainly transferable to any context and is open to testing and refinement in various applications to wicked decision problems.
Assuntos
Técnicas de Apoio para a Decisão , Águas Residuárias , Eliminação de Resíduos Líquidos/métodos , IncertezaRESUMO
The Colorado River has experienced a significant streamflow reduction in recent decades due to climate change, resulting in pronounced hydrological droughts that pose challenges to the environment and human activities. However, current models struggle to accurately capture complex drought patterns, and their accuracy decreases as the lead time increases. Thus, determining the reliability of drought forecasting for specific months ahead presents a challenging task. This study introduces a robust approach that utilizes the Beluga Whale Optimization (BWO) algorithm to train and optimize the parameters of the Regularized Extreme Learning Machine (RELM) and Random Forest (RF) models. The applied models are validated against a KNN benchmark model for forecasting drought from one- to six-month ahead across four hydrological stations distributed over the Colorado River. The achieved results demonstrate that RELM-BWO outperforms RF-BWO and KNN models, achieving the lowest root-mean square error (0.2795), uncertainty (U95 = 0.1077), mean absolute error (0.2104), and highest correlation coefficient (0.9135). Also, the current study uses Global Multi-Criteria Decision Analysis (GMCDA) as an evaluation metric to assess the reliability of the forecasting. The GMCDA results indicate that RELM-BWO provides reliable forecasts up to four months ahead. Overall, the research methodology is valuable for drought assessment and forecasting, enabling advanced early warning systems and effective drought countermeasures.
RESUMO
OBJECTIVES: This study develops a prioritisation framework to aid healthcare funding decision- making in health technology assessment (HTA) in Australia using a multi-criteria decision analysis (MCDA) approach. METHODS: MCDA frameworks for HTAs were reviewed through literature survey to identify the initial criteria and levels within each criterion. Key stakeholders and experts were consulted to confirm these criteria and levels. A conjoint analysis using 1000Minds© was undertaken with policy makers from the Department of Health to establish ranking criteria and weighting scores. Monte Carlo simulations were used to examine the sensitivity of findings to factors affecting the ranking and weighting scores. The MCDA was then applied to six examples of chronic care models or technologies projects to demonstrate the performance of this approach. RESULTS: Five criteria (clinical efficacy/effectiveness; safety and tolerability; severity of the condition; quality/uncertainty; and direct impact on healthcare costs) were consistently ranked highest by healthcare decision-makers. Among the criteria, patient-level health outcomes were considered the most important, followed by social and ethical values. The analyses were robust to inform the uncertainty in the parameter. CONCLUSIONS: This study has developed an MCDA tool that effectively integrates key priorities for HTA reviews, reflecting the values and preferences of healthcare stakeholders in Australia. While this tool aims to align the assessment process more closely with health benefits, it also highlights the importance of considering other criteria.
RESUMO
BACKGROUND: A clinical tool to estimate the risk of treatment-resistant schizophrenia (TRS) in people with first-episode psychosis (FEP) would inform early detection of TRS and overcome the delay of up to 5 years in starting TRS medication. AIMS: To develop and evaluate a model that could predict the risk of TRS in routine clinical practice. METHOD: We used data from two UK-based FEP cohorts (GAP and AESOP-10) to develop and internally validate a prognostic model that supports identification of patients at high-risk of TRS soon after FEP diagnosis. Using sociodemographic and clinical predictors, a model for predicting risk of TRS was developed based on penalised logistic regression, with missing data handled using multiple imputation. Internal validation was undertaken via bootstrapping, obtaining optimism-adjusted estimates of the model's performance. Interviews and focus groups with clinicians were conducted to establish clinically relevant risk thresholds and understand the acceptability and perceived utility of the model. RESULTS: We included seven factors in the prediction model that are predominantly assessed in clinical practice in patients with FEP. The model predicted treatment resistance among the 1081 patients with reasonable accuracy; the model's C-statistic was 0.727 (95% CI 0.723-0.732) prior to shrinkage and 0.687 after adjustment for optimism. Calibration was good (expected/observed ratio: 0.999; calibration-in-the-large: 0.000584) after adjustment for optimism. CONCLUSIONS: We developed and internally validated a prediction model with reasonably good predictive metrics. Clinicians, patients and carers were involved in the development process. External validation of the tool is needed followed by co-design methodology to support implementation in early intervention services.
RESUMO
The Physical Internet (PI) is a paradigm-changing and technology-driven vision, which is expected to significantly impact the development of the freight transport and logistics (FTL) system of today. However, the development of the FTL system towards the PI creates much uncertainty for its current stakeholders. Ports are one of those stakeholders that are expected to be profoundly affected by these developments. However, research that focuses on port policy, under the uncertain developments towards the PI, is still lacking. By providing port authorities with insights and recommendations on robust policy areas, we address this void in literature. We conduct a scenario analysis in combination with multi-criteria decision analysis (MCDA) to determine the importance of port performance indicators and policy areas in different scenarios. The most significant, uncertain, and orthogonal factors for the development of the PI are technological development and institutional development. We find that for a proper alignment with the PI vision, in three out of four scenarios, ports should prioritize the implementation of digital solutions and standards, as opposed to an infrastructure focused policy.
RESUMO
The most suitable multi-model ensemble set of general circulation models is used to reduce the uncertainty associated with GCM selection and improve the accuracy of the model simulations. This study evaluated the performance of 20 global climate models participating in the Coupled Model Intercomparison Project Phase 6 (CMIP6) in reproducing precipitation patterns over the Abaya-Chamo Sub-basin, Ethiopia. For the validation and selection of the models' capabilities, datasets from the Climate Hazards Infrared Precipitation with Stations (CHIRPS) were used after comparing them with ground observational datasets. The objective was to identify the most suitable multi-model ensemble (MME) of a subset of CMIP6 GCMs to capture the rainfall for the 1981-2014 period over the region. Climate Data Operators (CDOs) were used in climate data processing and extraction, and the Mann-Kendall test and Theil-Sen slope estimator methods were utilized to analyze the trends of the CMIP6 simulations. Four statistical metrics (Nash-Sutcliffe coefficient, percent bias, normalized root mean square error, and Kling-Gupta efficiency) were used to further assess the performance of the models. A multi-criteria decision analysis approach, namely, the technique for order preferences by similarity to an ideal solution (TOPSIS) method, was used to obtain the overall ranks of CMIP6 models and to select the best-performing CMIP6 model in the region. The results indicated that CHIRPS and most of the CMIP6 simulations generally reproduced bimodal precipitation patterns over the region. The CESM2-WACCM, NorESM2-MM, NorESM2-LM, and NorESM2-LM models performed better than the other models in reproducing seasonal patterns for the winter, spring, summer, and autumn seasons, respectively. On the other hand, FGOALS-f3-L revealed the trends of the reference datasets for all seasons. In terms of the NSE, PB, NRMSE, and KGE metrics, EC-Earth3-C, EC-Earth3, EC-Earth3-C, and EC-Earth-C, respectively, were considered good at representing the observed features of precipitation over the region. EC-Earth3-C,EC-Earth3, EC-Earth3-Veg-LR, ACCESS-CM2, MPI-ESM1-2-HR, and CNRM-CM6-1-HR exhibited the best performances in the Abaya-Chamo Sub-basin.
RESUMO
Consumers can be exposed to many foodborne biological hazards that cause diseases with varying outcomes and incidence and, therefore, represent different levels of public health burden. To help the French risk managers to rank these hazards and to prioritize food safety actions, we have developed a three-step approach. The first step was to develop a list of foodborne hazards of health concern in mainland France. From an initial list of 335 human pathogenic biological agents, the final list of "retained hazards" consists of 24 hazards, including 12 bacteria (including bacterial toxins and metabolites), 3 viruses and 9 parasites. The second step was to collect data to estimate the disease burden (incidence, Disability Adjusted Life Years) associated with these hazards through food during two time periods: 2008-2013 and 2014-2019. The ranks of the different hazards changed slightly according to the considered period. The third step was the ranking of hazards according to a multicriteria decision support model using the ELECTRE III method. Three ranking criteria were used, where two reflect the severity of the effects (Years of life lost and Years lost due to disability) and one reflects the likelihood (incidence) of the disease. The multicriteria decision analysis approach takes into account the preferences of the risk managers through different sets of weights and the uncertainties associated with the data. The method and the data collected allowed to estimate the health burden of foodborne biological hazards in mainland France and to define a prioritization list for the health authorities.
RESUMO
Confronting the continuing risk of an attack, security systems have adopted target-hardening strategies through the allocation of security measures. Most previous work on defensive resource allocation considers the security system as a monolithic architecture. However, systems such as schools are typically characterized by multiple layers, where each layer is interconnected to help prevent single points of failure. In this paper, we study the defensive resource allocation problem in a multilayered system. We develop two new resource allocation models accounting for probabilistic and strategic risks, and provide analytical solutions and illustrative examples. We use real data for school shootings to illustrate the performance of the models, where the optimal investment strategies and sensitivity analysis are presented. We show that the defender would invest more in defending outer layers over inner layers in the face of probabilistic risks. While countering strategic risks, the defender would split resources in each layer to make the attacker feel indifferent between any individual layer. This paper provides new insights on resource allocation in layered systems to better enhance the overall security of the system.
RESUMO
Aquatic habitats provide a bridge for influenza transmission among wild and domestic species. However, water sources pose highly variable physicochemical and ecological characteristics that affect avian influenza virus (AIV) stability. Therefore, the risk of survival or transmissibility of AIV in the environment is quite variable and has been understudied. In this study, we determine the risk of waterborne transmission and environmental persistence of AIV in a wild/domestic bird interface in the Central Mexico plateau (North America) during the winter season using a multi-criteria decision analysis (MCDA). A total of 13 eco-epidemiological factors were selected from public-access databases to develop the risk assessment. The MCDA showed that the Atarasquillo wetland presents a higher persistence risk in January. Likewise, most of the backyard poultry farms at this wild-domestic interface present a high persistence risk (50%). Our results suggest that drinking water may represent a more enabling environment for AIV persistence in contrast with wastewater. Moreover, almost all backyard poultry farms evidence a moderate or high risk of waterborne transmission especially farms close to water bodies. The wildlife/domestic bird interface on the Atarasquillo wetland holds eco-epidemiological factors such as the presence of farms in flood-prone areas, the poultry access to outdoor water, and the use of drinking-water troughs among multiple animal species that may enhance waterborne transmission of AIV. These findings highlight the relevance of understanding the influence of multiple factors on AIV ecology for early intervention and long-term control strategies.
RESUMO
OBJECTIVES: This systematic literature review aimed to explore experiences worldwide of societal preferences integration into health technology assessments (HTAs) for rare diseases (RDs) and orphan drugs (ODs) through the implementation of multicriteria decision analysis (MCDA), discrete choice experiments (DCEs), and person trade-off (PTO) methods, among others. METHODS: A systematic search of the literature was conducted in April 2021 using PubMed, Cochrane, Embase, and Scopus databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach was used for the review phases. Finally, the Promoting Action on Research Implementation in Health Services framework was used to discuss the implementation of these instruments in the RD context. RESULTS: A total of 33 articles met the inclusion criteria. The studies measured societal preferences for RD and OD as part of HTA using MCDA (n = 17), DCE (n = 8), and PTO (n = 4), among other methods (n = 4). These found that patients and clinicians do not prioritize funding based on rarity. The public is willing to allocate funds only if the OD demonstrates effectiveness and improves the quality of life, considering as relevant factors disease severity, unmet health needs, and quality of life. Conversely, HTA agency experts preferred their current approach, placing more weight on cost-effectiveness and evidence quality, even though they expressed concern about the fairness of the drug review process. CONCLUSIONS: MCDA, PTO, and DCE are helpful and transparent methods for assessing societal preferences in HTA for RD and OD. However, their methodological limitations, such as arbitrary criteria selection, subjective scoring methods, framing effects, weighting adaptation, and value measurement models, could make implementation challenging.
RESUMO
The process of developing new reversed-phase liquid chromatography methods can be both time-consuming and challenging. To meet this challenge, statistics-based strategies have emerged as cost-effective, efficient and flexible solutions. In the present study, we use a Bayesian response surface methodology, which takes advantage of the knowledge of the pKa values of the compounds present in the analyzed sample to model their retention behavior. A multi-criteria decision analysis (MCDA) was then developed to exploit the uncertainty information inherent in the model distributions. This strategic approach is designed to integrate seamlessly with quantitative structure retention relationship (QSRR) models, forming an initial in-silico screening phase. Of the two methods presented for MCDA, one showed promising results. The method development process was carried out with the optimization phase, generating a design space that corroborates the results of the selection phase.
RESUMO
Network Meta-analysis and multi-criteria decision analysis(MCDA) model were performed to evaluate the benefit-risk of Compound Cantharis Capsules, Huisheng Oral Solution, and Jinlong Capsules in the adjuvant treatment of primary liver cancer(PLC). The randomized controlled trial(RCT) of Compound Cantharis Capsules, Huisheng Oral Solution, and Jinlong Capsules in treating PLC were retrieved from CNKI, Wanfang, VIP, Web of Science, PubMed, and Cochrane Library. R 4.2 was employed to conduct a network Meta-analysis, on the basis of which the effect values of the three medicines were obtained by indirect comparison. MCDA was performed to establish the value tree based on the benefit-risk indexes. Hiview 3.2 was used to calculate the benefit values, risk values, and benefit-risk values of the three medicines in treating PLC, and a sensitivity analysis was carried out to evaluate the robustness of the results. Oracle Crystal Ball 11.1 was employed to optimize the evaluation results by Monte Carlo simulation. A total of 39 RCTs were included. The results showed that Compound Cantharis Capsules, Huisheng Oral Solution, and Jinlong Capsules combined with transcatheter arterial chemoembolization(TACE) had the benefit values of 45, 51 and 45, the risk values of 59, 47, and 41, and the benefit-risk values of 52, 49, and 43, respectively. The benefit-risk differences and [95%CI] of Compound Cantharis Capsules vs Huisheng Oral Solution, Compound Cantharis Capsules vs Jinlong Capsules, and Huisheng Oral Solution vs Jinlong Capsules were 3.00[-13.09, 21.82], 9.00[-4.39, 24.62], and 6.00[-8.84, 20.28], respectively. Based on the results of MCDA, Huisheng Oral Solution, Jinlong Capsules, and Compound Cantharis Capsules combined with TACE had the greatest benefit, the greatest risk, and the best overall benefit, respectively. Considering the efficacy and safety, the priority of the three oral Chinese patent medicines combined with TACE for treating PLC followed the trend of Compound Cantharis Capsules, Huisheng Oral Solution, and Jinlong Capsules.
Assuntos
Medicamentos de Ervas Chinesas , Neoplasias Hepáticas , Humanos , Medicamentos de Ervas Chinesas/administração & dosagem , Neoplasias Hepáticas/tratamento farmacológico , Medição de Risco , Metanálise em Rede , Administração Oral , Técnicas de Apoio para a Decisão , Ensaios Clínicos Controlados Aleatórios como Assunto , Medicamentos sem PrescriçãoRESUMO
BACKGROUND: Policymakers, who are constantly discussing growing health expenditures, should know whether the health system is efficient. We can provide them with such information through international health system efficiency evaluations. The main objectives of this study are: (a) to evaluate the efficiency of health systems in 28 developed countries by multiple-criteria decision analysis (MCDA) and data envelopment analysis (DEA) and (b) to identify reasonable benchmark countries for the Czech Republic, for which we collect information on the relative importance of health system inputs and outputs. METHODS: We used MCDA and DEA to evaluate the efficiency of the health systems of 28 developed countries. The models included four health system inputs (health expenditure as a relative share of GDP, the number of physicians, nurses, and hospital beds) and three health system outputs (life expectancy at birth, healthy life expectancy, and infant mortality rate). The sample covers 27 OECD countries and Russia, which is also included in the OECD database. To determine the input and output weights, we used a questionnaire sent to health policy experts in the Czech Republic. RESULTS: We obtained subjective information on the relative importance of the health system inputs and outputs from 27 Czech health policy experts. We evaluated health system efficiency using four MCDA and two DEA models. According to the MCDA models, Turkey, Poland, and Israel were found to have efficient health systems. The Czech Republic ranked 16th, 19th, 15th, and 17th. The benchmark countries for the Czech Republic's health system were Israel, Estonia, Luxembourg, Italy, the UK, Spain, Slovenia, and Canada. The DEA model with the constant returns to scale identified four technically efficient health systems: Turkey, the UK, Canada, and Sweden. The Czech Republic was found to be one of the worst-performing health systems. The DEA model with the variable returns to scale identified 15 technically efficient health systems. We found that efficiency results are quite robust. With two exceptions, the Spearman rank correlations between each pair of models were statistically significant at the 0.05 level. CONCLUSIONS: During the model formulation, we investigated the pitfalls of efficiency measurement in health care and used several practical solutions. We consider MCDA and DEA, above all, as exploratory methods, not methods providing definitive answers.
RESUMO
BACKGROUND: Treatment strategies for a symptomatic accessory navicular include both operative and nonoperative approaches. The primary aim of this study is to define health utility values for 7 health states experienced by those with a symptomatic accessory navicular who undergo operative and/or nonoperative treatment. Secondarily, the study incorporates the health utility values with treatment costs, probabilities of various outcomes, and duration of health states into a cost-effectiveness model comparing the nonoperative treatment protocol at our institution vs surgical excision. METHODS: Institutional review board approval was obtained to call parents of patients 10-20 years old at the time of interview who were evaluated for a symptomatic accessory navicular from February 1, 2016, to March 2, 2023, at a single institution by one of 4 pediatric orthopaedic surgeons. Participants were asked to rate 7 health states from 0 to 100, with 0 representing death (if 18 years or older) or the worst health imaginable (if under 18 years) and 100 representing perfect health. Using published values for the probabilities of various treatment outcomes, time spent in various health states, and Medicare costs from the perspective of the payor and society, a decision analysis was constructed. RESULTS: Health utility values for 7 health states were obtained. Operative treatment was preferred to nonoperative treatment in the base case model. Surgery was more expensive ($16 825) than nonoperative treatment ($7486). Using a willingness-to-pay threshold of <$50 000 per quality-adjusted life year (QALY), surgery was cost-effective compared to nonoperative treatment with an incremental cost-effectiveness ratio of $20 303/QALY. Sensitivity analysis revealed that the only variable that indicated a preference for nonoperative treatment is a 71% likelihood of nonoperative treatment resolving the condition. CONCLUSION: Unless a physician suspects at least a 71% chance of a symptomatic accessory navicular resolving without operative treatment, surgical excision is recommended from a cost-effectiveness perspective.
RESUMO
Novel anti-obesity medications, particularly glucagon-like peptide-1 receptor agonists (GLP-1RAs), have expanded weight loss (WL) options for kidney transplant (KT) candidates with obesity beyond lifestyle modifications and bariatric surgery. However, varying effectiveness, risk profiles, and costs make strategy choice challenging. To aid decision-making, we used a Markov model to examine the cost-effectiveness of different WL strategies over a 10-year horizon. A target WL of 15% of total body weight was used for the base-case scenario, and we compared these strategies to a 'liberal' KT strategy of transplanting candidates with obesity. Outcomes included costs (2023 US dollars), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. In analysis, a liberal KT strategy was favored over lifestyle modifications and GLP-1RAs. Among WL strategies, bariatric surgery was most effective and cost the least, while lifestyle modification had the highest cumulative costs and was least effective. Compared to liberal KT, bariatric surgery cost $45,859 per QALY gained. GLP-1RAs were favored over bariatric surgery only when drug costs were below $5,000 per year (base cost $12,077). In conclusion, for KT candidates with obesity, a liberal KT strategy and bariatric surgery are preferred over lifestyle modifications alone and GLP-1RAs based on outcomes and cost-effectiveness.
RESUMO
In the last decades, several studies have highlighted the significant impacts of the food sector. Therefore, enhancing sustainability within this sector has become of paramount importance. A crucial step towards achieving this goal involves the definition and implementation of effective sustainability metric and measurements. In this regard, the adoption of multi-criteria decision analysis (MCDA) methods can be seen as one of the most suitable and promising approach to comprehensively capture the complex and broad-ranging effects of agricultural practices and food supply chains. In such context, a systematic review of the scientific literature on multi-criteria approaches and tools for measuring the sustainability of food supply chains (harvest and post-harvest stages) has been carried out, resulting in the selection and analysis of 42 articles. To delve into the selected articles, three main areas of focus have been identified. The first about MCDA methods and their features, revealing the most adopted methods for sustainability assessments of food supply chains. The second, focusing on the participatory approach, led to the definition of a stakeholder's engagement map, highlighting the typology of stakeholders involved, the reasons of their involvement and engagement methods. Lastly, the third focus is related to the analysis and classification of indicators adopted in each study and the sustainability dimensions to which they refer to. The results of the present review study provide a comprehensive overview of the essential aspects to be considered when developing a MCDA for sustainability assessment in the food sector, serving as a valuable resource for both scholars and practitioners.
Assuntos
Agricultura , Conservação dos Recursos Naturais , Técnicas de Apoio para a Decisão , Abastecimento de Alimentos , Agricultura/métodos , Conservação dos Recursos Naturais/métodosRESUMO
Soluble fertilizers, particularly potash, are often prohibitively expensive or unavailable in Africa. Consequently, alternatives such as powdered silicate rocks, both raw and hydrothermally treated, are being explored as potential solutions, especially for acidic tropical soils. This study investigates the possible impacts of these rocks (syenite) on groundwater quality, which is a critical factor for agricultural activities. The powdered raw material underwent chemical and mineralogical characterization, including X-ray fluorescence and X-ray diffraction, followed by quantitative evaluation of materials by scanning electron microscopy. Both raw and 46 hydrothermally treated materials were subjected to sequential leaching cycles (1, 24, and 192 h) using deionized water, and the resulting leachates were analyzed by inductively coupled plasma atomic emission spectroscopy. Parameters such as electrical conductivity, total dissolved solids, soluble sodium percentage, sodium adsorption ratio, magnesium hazard, Kelly's ratio, and permeability index were also evaluated. Results from the 47 leachates indicated that 64 % of the samples exhibited excellent to acceptable water quality for irrigation purposes across all parameters. Conversely, 6 % to 13 % fell into the doubtful category, and 2 % to 24 % were classified as unsuitable. Consistency index and ratios of approximately 0.07 and 0.042, respectively, were determined using multi-criteria decision analysis (analytic hierarchy process: AHP), confirming the coherence of the decision and pairwise comparison matrix. The weighted coefficients for each criterion ranged from 0.06 to 0.2. Consequently, the optimal sample (Treatment 23) was identified, showing a hydrothermal temperature of 176 °C, a time of 3.9 h, a normality of 4.62, and a liquid-solid ratio of 0.24. This treatment met all high-water quality standards, including low salinity and sodium hazard, as corroborated by the US salinity laboratory and Wilcox diagrams. Furthermore, due to their nutrient release, low concentration of toxic elements, and effective buffering capacity (pH â¼ 10.6), these powdered syenites are suitable for application in acidic soils.
RESUMO
The concept of ecotourism has experienced a significant surge in popularity over the past two decades, primarily driven by the multitude of adverse impacts associated with mass tourism. The objective of the study was to develop a comprehensive ecotourism suitability index to guide policymakers in implementing tourism development policies. Given the considerable appeal of the study area to both local and international tourists, it is essential to conduct a systematic evaluation to pinpoint suitable areas for ecotourism development. This necessity arises from the study area's placement within a fragile ecosystem and its proximity to a UNESCO World Heritage site. We employed a Geographic Information Systems (GIS) integrated environment coupled with a fuzzy Multi-Criteria Decision Analysis (MCDA) methodology. The GIS-MCDA integrated framework leverages the Analytic Hierarchy Process (AHP) and a weighted linear combination that seeks to amalgamate many features and criteria to assess ecotourism potential by integrating 20 criteria into six separate categories: landscape, topography, accessibility, climate, forest and wildlife, and negative factors. Weights were allocated to each criterion and factor based on the expert's opinions of their impact on the development of ecotourism. The final ecotourism suitability index comprised five unique classes: very high, high, moderate, less, and not suitable. Results reveal that out of the total areas, 45.4 % (259 km2) are within the high and very high suitable classes. The sensitivity analysis suggested that ecotourism potentials are more favorable to forest and accessibility variables. The generated index can be utilized as a road map since validation verified a 64 % accuracy. Given the dearth of earlier research, this study provides vital support for the development of sustainable ecotourism projects in the study area.
RESUMO
BACKGROUND: Travel-related strategies to reduce the spread of COVID-19 evolved rapidly in response to changes in the understanding of SARS-CoV-2 and newly available tools for prevention, diagnosis, and treatment. Modeling is an important methodology to investigate the range of outcomes that could occur from different disease containment strategies. METHODS: We examined 43 articles published from December 2019 through September 2022 that used modeling to evaluate travel-related COVID-19 containment strategies. We extracted and synthesized data regarding study objectives, methods, outcomes, populations, settings, strategies, and costs. We used a standardized approach to evaluate each analysis according to 26 criteria for modeling quality and rigor. RESULTS: The most frequent approaches included compartmental modeling to examine quarantine, isolation, or testing. Early in the pandemic, the goal was to prevent travel-related COVID-19 cases with a focus on individual-level outcomes and assessing strategies such as travel restrictions, quarantine without testing, social distancing, and on-arrival PCR testing. After the development of diagnostic tests and vaccines, modeling studies projected population-level outcomes and investigated these tools to limit COVID-19 spread. Very few published studies included rapid antigen screening strategies, costs, explicit model calibration, or critical evaluation of the modeling approaches. CONCLUSION: Future modeling analyses should leverage open-source data, improve the transparency of modeling methods, incorporate newly available prevention, diagnostics, and treatments, and include costs and cost-effectiveness so that modeling analyses can be informative to address future SARS-CoV-2 variants of concern and other emerging infectious diseases (e.g., mpox and Ebola) for travel-related health policies.