An AI-based multiphase framework for improving the mechanical ventilation availability in emergency departments during respiratory disease seasons: a case study.

BACKGROUND: Shortages of mechanical ventilation have become a constant problem in Emergency Departments (EDs), thereby affecting the timely deployment of medical interventions that counteract the severe health complications experienced during respiratory disease seasons. It is then necessary to count on agile and robust methodological approaches predicting the expected demand loads to EDs while supporting the timely allocation of ventilators. In this paper, we propose an integration of Artificial Intelligence (AI) and Discrete-event Simulation (DES) to design effective interventions ensuring the high availability of ventilators for patients needing these devices. METHODS: First, we applied Random Forest (RF) to estimate the mechanical ventilation probability of respiratory-affected patients entering the emergency wards. Second, we introduced the RF predictions into a DES model to diagnose the response of EDs in terms of mechanical ventilator availability. Lately, we pretested two different interventions suggested by decision-makers to address the scarcity of this resource. A case study in a European hospital group was used to validate the proposed methodology. RESULTS: The number of patients in the training cohort was 734, while the test group comprised 315. The sensitivity of the AI model was 93.08% (95% confidence interval, [88.46 - 96.26%]), whilst the specificity was 85.45% [77.45 - 91.45%]. On the other hand, the positive and negative predictive values were 91.62% (86.75 - 95.13%) and 87.85% (80.12 - 93.36%). Also, the Receiver Operator Characteristic (ROC) curve plot was 95.00% (89.25 - 100%). Finally, the median waiting time for mechanical ventilation was decreased by 17.48% after implementing a new resource capacity strategy. CONCLUSIONS: Combining AI and DES helps healthcare decision-makers to elucidate interventions shortening the waiting times for mechanical ventilators in EDs during respiratory disease epidemics and pandemics.

Underground geological sequestration of carbon dioxide (CO2) and its effect on possible enhanced gas and oil recovery in a fractured reservoir of Eastern Potwar Basin, Pakistan.

Due to concerns over rising emissions of carbon dioxide (CO2) from fossil fuel utilization, there has been a strong emphasis on the development of a safe, economical, practical method of carbon capture utilization and storage (CCUS). One way to reduce these CO2 emissions is underground geological sequestration in depleted oil fields or exhausted reservoirs. CO2 injection into oil reservoirs is an established technology, these reservoirs not only offer the potential for high storage of CO2 but this process could also target a large amount of oil and gas recovery through a technique called enhanced oil recovery (EOR). The main objective of this research was to evaluate the storage potential of CO2 in the depleted oil field while also investigating the effect of CO2 injection on reservoir pressure maintenance, and additional oil and gas recovery, in the same field. This paper presented the model of CO2 flooding based on the CO2 displacement mechanism with different scenarios of natural depletion, CO2 injection, and water injection simulated by the ECLIPSE 300 reservoir simulator, and the results of different scenarios were compared. Results of this study showed the site selected for CO2 injection has the potential to store more than 9 billion cubic feet (BCF) of CO2 in each case and witnessed improved gas recovery, while also having a major effect on reservoir pressure maintenance where pressure increased from 2120 psi to 6584 psi. The finding of this work ought to help in preparing for future improvement in underground geological sequestration of CO2 in depleted fields with the same field specifications.

Circular economy and its implementation in cement industry: A case point in Pakistan.

The cement industry contributes substantially to world emissions. Sustainable and circular practices are adopted globally to mitigate such emissions. Developing countries like Pakistan lack adaptation to circular and sustainable practices. The study proposes an alternative mix of coal and crop residues that can be used for cement production. The study aims to find the best mixtures of coal with crop residue for combustion purposes in cement industries. The Life Cycle Assessment (LCA) and Life Cycle Cost Analysis (LCCA) are implemented for the environmental and economic viability of the proposed material mixtures. Moreover, the study seeks to explore risks associated with the implementation of circular practices in the cement industry of a developing country. The study adopts Modified Safety Improvement Risk Assessment (SIRA) for assessing the risks. The results suggest that the partial replacement of coal with bagasse is the most viable mixture with lower environmental emissions and is economically feasible among other alternate mixtures. In terms of risk assessment, there is a lack of governmental support for adopting circular economy (CE) practices and profit uncertainties of these CE practices.

Risk assessment of circular economy practices in construction industry of Pakistan.

The construction industry (CI) is responsible for consuming 3 billion tons of natural raw materials annually. Also, as per the survey by World Resources Institute, the CI accounts for 40 % of the total waste generated globally. The solution to this inefficient resource usage and adverse effects on the ecosystem is implementing Circular Economy (CE) practices in CI. However, the concept of circular construction is in developmental stages. Therefore, it is more prone to damaging risks than traditional construction. The primary aim of this study is to identify and assess the risk related to implementing CE practices in developing country construction sector. To achieve this aim, 25 risks were shortlisted from the literature review and evaluated upon the probability, detection, and severity risk criteria. This study proposed a novel hybrid fuzzy Multi-Criteria Decision Making (MCDM) approach to analyze the shortlisted risks. Fuzzy Step Wise Assessment Ratio Analysis (FSWARA) is employed to gauge the risk criterion weightage. Moreover, Fuzzy VIKOR (FVIKOR) is used to determine the risks' ranking as per the weightage of the risk criterion. The analyses ranked "lack of political support and incentives for circular construction", "difficulty in selection of circular construction experts", "profit uncertainty", and "circular material quality" as the most critical risks. Therefore, it is recommended for legislative authority to devise a framework that promotes and provides support to circular construction. Moreover, this study fills the literature gap by assessing the risks of CE practices in the CI of Pakistan.

Sustainable production of diapers and their potential outputs for the Pakistani market in the circular economy perspective.

One of the challenging issues of any country's agenda today is the management of solid waste in the circular economy and eco-efficiency perspective. In this context, there has been much debate about the disposal of diapers, but the current research lacks data for developing countries. Furthermore, the research lacks quantification of data, in terms of output products generated through sustainable waste management practices particularly for diapers. Thus, this research aims to develop a quantitative study based on Life Cycle Assessment (LCA) and Life Cycle Costing Analysis (LCCA) which help to evaluate the overall eco-efficiency of various disposal methods by taking into account their net input and resultant monetary value, in the context of Pakistan. To cover limitations of LCA approach, results have been compared along with the expert's opinion using the well-known multi-criteria method Fuzzy logic and Technique for Order of preference by similarity to ideal solution (TOPSIS) technique. Human health and environment have been used as end-point indicators. The main research result points out that incorporating small scale incineration plants along with recycling using Thermal Pyrolysis Hydrolysis (TPH) plants can help to sustainably dispose-off diapers. The results also indicate the importance for policy makers and industrial sector to find solutions to facilitate implementation of circular economy principles for diapers. In fact, the recycling of diapers using waste-to-energy technologies is a significantly eco-efficient alternative for the Pakistani market, which can be pivotal for Sustainable development and initiation of a circular economy model.

Impact of brick kilns industry on environment and human health in Pakistan.

The increase in population has led to the rise in the construction and manufacturing of bricks. Bricks are manufactured in brick kilns that emit very harmful gases which in turn affect the human health, environment and economy. In Pakistan, the diseases related to skin, and respiratory system have created a lot of problems for the humans and animals. According to experts and professionals, one of the main causes of the environment and health related problems is brick kiln. It is very important to identify the brick kilns and emissions that are extremely harmful for the environment and human health. Therefore, the objective of this research paper is threefold. Firstly, to identify and rank the emissions from brick kilns based on their harmful impact on human health and environment. Secondly, to rank the three types of brick kilns i.e. Traditional Brick Kilns (TBK) with coal as a fuel, Traditional Brick Kilns (TBK) with rubber as a fuel and Contemporary Brick Kilns (CBK) (technologically advanced brick kilns) based on their impact on human health and environment. Thirdly, to identify the relation of three alternative brick kilns with health and environmental problems, respectively. DEMATEL and Fuzzy-TOPSIS have used for achieving the objectives. The results show that CO2, CO and SO2 have the most harmful effects on the environment. Similarly, carcinogenic dioxin, SO2 and PM have the adverse effects on the human health. TBK in which rubber is used as a fuel is the most harmful and CBK is the safest types of brick kilns, respectively. In the light of the results, it is recommended to the government of Pakistan to formulate and implement the rules and regulations for minimizing the negative impacts of brick kilns on human health and environment. Moreover, new technologies should be used in order to reduce the harmful impacts.

A VIKOR based approach for assessing the social, environmental and economic effects of "smog" on human health.

Nowadays, the excessive industrialization, increased use of fossil fuels, elevated levels of vehicular emissions are causing high level of air pollution reaching epidemic levels. The effects of "smog" or in other words of air pollution can be very dangerous for humans, and plants. In fact, air pollution can be linked to many health-related issues, as it is one of the leading causes of pulmonary, respiratory and skin diseases across the globe. In this context, Pakistan being an underdeveloped country, faces the hazardous impacts of smog on health, environment, transportation and educational sectors. The aim of the present research was to establish a correlation between smog/air pollution (the independent variable) and different dependent variables. The final goal was to define different precautionary measures and find their practicality and selection. Fuzzy VIKOR, a multi-criteria decision-making tool, was proposed in this research. It was applied to select an optimal alternative based on closeness to positive-ideal solution and deviation from the negative-ideal solution. Through this research, an environmental-friendly and health-promoting policy can be reach. This research will also help government in making future policies regarding environmental and industrial pollution. A case study settled in Pakistan was used to demonstrate the effectiveness of the proposed fuzzy model.

Identifying the critical factors of green supply chain management: Environmental benefits in Pakistan.

Pakistan is a developing country characterized by a growing industrialization, which is the major cause of environmental pollution in the country. To control the significant increase in pollution a green incentive has started, aiming to moderate the adverse effects of environmental pollution. Thus, Green Supply Chain Management (GSCM) plays an important role in influencing the total environment impact of any organizations. This study considers ten Pakistani industries that have implemented GSCM practices. The Decision-Making Trial and Evaluation Laboratory technique (DEMATEL) is used to find influential factors in selecting GSCM criteria. The results show that organizational involvement is the most important dimension useful to implement GSCM practices. In addition, commitment from senior managers, ISO 14000 certification of suppliers and recycle of waste heat are considered significant factors. The paper also signifies the casual relationship among the dimensions and the factors in the form of diagraphs. The main management implication of the paper is to help decision makers to focus on the critical dimensions/factors in order to implement the GSCM practices more effectively in Pakistan.

Efficiency Analysis of Integrated Public Hospital Networks in Outpatient Internal Medicine.

Healthcare systems are evolving towards a complex network of interconnected services due to the increasing costs and the increasing expectations for high service levels. It is evidenced in the literature the importance of implementing management techniques and sophisticated methods to improve the efficiency of healthcare systems, especially in emerging economies. This paper proposes an integrated collaboration model between two public hospitals to reach the reduction of weighted average lead time in outpatient internal medicine department. A strategic framework based on value stream mapping and collaborative practices has been developed in real case study settled in Colombia.