•Start of Cooperation between reparian will be resulted from parallel effort on trust and capacity building.•Afghanistan current commitment and political-well in transboundary WM is a window of ...opportunity for its co-riparian.•Role of international facilitator/mediator for transformation process is considered vital.•The project-by-project approach to negotiations are deadlocked in the basin.
Managing water resource systems usually involves conflicts. Water recognizes no borders, defining the global geopolitics of water conflicts, cooperation, negotiations, management, and resource development. Negotiations to develop mechanisms for two or more states to share an international watercourse involve complex networks of natural, social and political system (Islam and Susskind, 2013). The Kabul River Basin presents unique circumstances for developing joint agreements for its utilization, rendering moot unproductive discussions of the rights of upstream and downstream states based on principles of absolute territorial sovereignty or absolute territorial integrity (McCaffrey, 2007). This paper analyses the different stages of water conflict transformation between Afghanistan and Pakistan. It first examines historical disputes between the upstream and downstream riparians, revolving around contending rights claims, resulting in zero-sum confrontations with one party’s loss as another’s gain, possibly ending in confrontation. The paper then formulates a decision support tool, a mechanism for transforming conflict into cooperation, and concludes by introducing practical methods for identifying basin needs and sharing benefits, enabling riparians to negotiate a win-win process.
There has been considerable recent research into the connection between Parkinson's disease (PD) and speech impairment. Recently, a wide range of speech signal processing algorithms (dysphonia ...measures) aiming to predict PD symptom severity using speech signals have been introduced. In this paper, we test how accurately these novel algorithms can be used to discriminate PD subjects from healthy controls. In total, we compute 132 dysphonia measures from sustained vowels. Then, we select four parsimonious subsets of these dysphonia measures using four feature selection algorithms, and map these feature subsets to a binary classification response using two statistical classifiers: random forests and support vector machines. We use an existing database consisting of 263 samples from 43 subjects, and demonstrate that these new dysphonia measures can outperform state-of-the-art results, reaching almost 99% overall classification accuracy using only ten dysphonia features. We find that some of the recently proposed dysphonia measures complement existing algorithms in maximizing the ability of the classifiers to discriminate healthy controls from PD subjects. We see these results as an important step toward noninvasive diagnostic decision support in PD.
Green public procurement can play an important role in reducing the environmental impact of societies. While its uptake is continuously growing, barriers to its use still remain. One barrier ...previously identified in literature is related to the lack of accessible and easy to use tools that help standardize the development of criteria in green tenders. In this paper, to help overcome this barrier, a method is presented that can be used to develop green public procurement tools that follow previous studies recommendations about including life-cycle assessment-based data and basing procurement criteria on national environmental objectives. The method was then applied to develop a procurement tool for green procurement of public transport services in Sweden based on the Swedish environmental quality objectives. Results from the assessment of 18 pre-defined fuel systems are shown together with an illustrative example of how the tool can be used in the process leading up to procurements to set relevant criteria and during the procurement to adjust incoming tender prices. The results showed that waste-based biomethane and hydrogenated vegetable oil systems were well aligned with the Swedish environmental quality objectives due to being able to contribute positively to several objectives. Crop-based biofuels, on the other hand, performed worse due to negative effects from agricultural practices. The performance of the electric vehicle systems depended in large on how the electricity was generated, where renewable sources and low carbon sources performed better than non-renewable alternatives.
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•A method was developed to guide creation of green public procurement tools.•The method may help formulation of green procurement criteria.•The method was applied to develop a tool for public transportation in Sweden.•The tool assessed the environmental impact of 18 fuel systems.•Waste-based biofuels and electric fuel systems had the lowest environmental impact.
Spatial conservation prioritization concerns the effective allocation of conservation action. Its stages include development of an ecologically based model of conservation value, data pre-processing, ...spatial prioritization analysis, and interpretation of results for conservation action. Here we investigate the details of each stage for analyses done using the Zonation prioritization framework. While there is much literature about analytical methods implemented in Zonation, there is only scattered information available about what happens before and after the computational analysis. Here we fill this information gap by summarizing the pre-analysis and post-analysis stages of the Zonation framework. Concerning the entire process, we summarize the full workflow and list examples of operational best-case, worst-case, and typical scenarios for each analysis stage. We discuss resources needed in different analysis stages. We also discuss benefits, disadvantages, and risks involved in the application of spatial prioritization from the perspective of different stakeholders. Concerning pre-analysis stages, we explain the development of the ecological model and discuss the setting of priority weights and connectivity responses. We also explain practical aspects of data pre-processing and the post-processing interpretation of results for different conservation objectives. This work facilitates well-informed design and application of Zonation analyses for the purpose of spatial conservation planning. It should be useful for both scientists working on conservation related research as well as for practitioners looking for useful tools for conservation resource allocation.
•We summarize spatial conservation prioritization analysis workflow using Zonation.•We focus on common pre- and post-processing stages of analysis.•The utility of several Zonation analysis types are discussed.•We summarize operational best-case and worst-case scenarios for analysis stages.•This study helps conservation practitioners implement prioritization analyses.
Highlights • The choice of a contraceptive method is a preference-sensitive decision, and previous studies have suggested that shared decision making is an appropriate counseling approach for ...contraceptive care.. • We developed a tablet-based contraceptive decision support tool drawing on best practices for decision support tool development and intuitive and deliberative models of decision making, and utilizing intensive provider and patient engagement. • The tool is designed to facilitate shared decision making between provider and patients by assisting in the first two phases of decision making (information sharing and deliberation), and then using a printout to facilitate ongoing deliberation and decision making between the patient and provider. • Qualitative and quantitative data from pilot testing indicated that the tool was acceptable and appropriate for the target population. • The systemic and theoretically-informed nature of tool development, the focus on stakeholder involvement, and the customization of the tool content and structure to the specific decision-making context, can serve as a model for development of decision support tools for a broad range of health care decisions.
Next-generation RNA sequencing allows alternative splicing (AS) quantification with unprecedented resolution, with the relative inclusion of an alternative sequence in transcripts being commonly ...quantified by the proportion of reads supporting it as percent spliced-in (PSI). However, PSI values do not incorporate information about precision, proportional to the respective AS events' read coverage. Beta distributions are suitable to quantify inclusion levels of alternative sequences, using reads supporting their inclusion and exclusion as surrogates for the two distribution shape parameters. Each such beta distribution has the PSI as its mean value and is narrower when the read coverage is higher, facilitating the interpretability of its precision when plotted. We herein introduce a computational pipeline, based on beta distributions accurately modeling PSI values and their precision, to quantitatively and visually compare AS between groups of samples. Our methodology includes a differential splicing significance metric that compromises the magnitude of intergroup differences, the estimation uncertainty in individual samples, and the intragroup variability, being therefore suitable for multiple-group comparisons. To make our approach accessible and clear to both noncomputational and computational biologists, we developed betAS, an interactive web app and user-friendly R package for visual and intuitive differential splicing analysis from read count data.
The concept of Circular Economy (CE) is gaining increasing attention as an indispensable renewal of linear economy without neglecting sustainable development goals. Closing resource loops and keeping ...resources in the system at the highest level of use for as long as possible are cited as the main goals of CE. However, due to missing information exchange, the lack of consistency between the existing end-of-life (EOL) infrastructure and the respective product designs hinders a successful circularity of resources. This research presents a method to collect, process, and apply EOL process data to provide the beginning-of-life (BOL) with important EOL-knowledge through a CE-adapted product design assessment. EOL-data is collected using a Circular Value Stream Mapping (C-VSM), EOL-information is processed using a digital state flow representation, and EOL-knowledge is applied by providing a decision-support tool for product designers in the context of a PET bottle case study in Luxembourg. The goal is to anticipate a circular flow of resources by reflectively aligning product design with the relevant EOL infrastructure. In contrast to the linear economy, the developed method makes it possible to consider not only the requirements of users but also the actual end users, the EOL process chains, when designing products.
In recent years, particularly following the definition of the UN Sustainable Development Goals (SDGs) for 2030, Nature-Based Solutions (NBS) have gained considerable attention, capturing the interest ...of both the scientific community and policymakers committed to addressing urban environmental issues. However, the need for studies to guide decision-makers in identifying suitable locations for NBS implementation within urban stormwater management is evident. To address this gap, the present study employs a methodological approach grounded in multi-criteria analysis integrated with Geographic Information Systems (GIS) to identify areas with potential for NBS implementation. In this process, ten NBS were proposed and tested in the drainage area of a shallow tropical urban lake in Londrina, southern Brazil. Additionally, the study investigates areas hosting lower-income populations, a relevant aspect for public managers given the diverse economic subsidies required to implement NBS. Furthermore, the study incorporates a preliminary analysis that evaluates the potential ecosystem benefits to determine the most suitable NBS for a specific site. The result shows that all the ten analyzed NBS were deemed suitable for the study area. Rain barrels had the highest percentage coverage in the study area (37.1%), followed by tree pits (27.9%), and rain gardens (25.4%). Despite having the highest distribution in the basin area, rain barrels exhibited only moderate ecosystem benefits, prompting the prioritization of other NBS with more significant ecological advantages in the final integrated map. In summary, the methodology proposed showed to be a robust approach to selecting optimal solutions in densely populated urban areas.
•Nature-Based Solutions (NBS) are evaluated in stormwater management in urban areas.•The study presents a robust methodology that simplifies NBS selection for urban areas.•Multi-Criteria Decision Analysis and GIS can identify suitable locations for NBS.•All ten analyzed NBS were deemed suitable for the study area.•Rain Garden is the NBS with the highest potential when considering ecosystem services.
Eco-efficiency is a key concept encompassing economic and environmental aspects to promote a more efficient use of resources and lower emissions. An eco-efficiency perspective in the design of ...products and services is thus essential in the pursuit of sustainability. This article proposes a novel decision-support methodological approach to assess the environmental impacts and costs in early design stages, aimed at providing informed recommendations to designers, manufacturers and decision-makers. This multimethodology approach integrates a streamlined life-cycle environmental and cost assessment with a data envelopment analysis (DEA) model that derives eco-efficiency ratios and compares alternative designs, without the need to subjectively weigh the different environmental and cost life-cycle metrics. A linear regression model is then used to indicate the most influential decision variables. This approach was applied to a retrofit process of a historic residential building located in Southern Europe. The metrics used to assess the design parameters are: climate change, acidification, eutrophication, non-renewable primary energy, and net present value. A sensitivity analysis on the decarbonization of the electricity mix was also performed. The multimethodology offers valuable guidance to allow decision-makers to progressively specify the decision variables in an iterative way, using robust methods allowing for the statistical validation of results. The case study revealed robust empirical results for building retrofits in Southern European climates, indicating that the variables that most impact eco-efficiency (in both short and long-term) are roof insulation thickness and material followed by exterior wall insulation material. After three variables specification, the average eco-efficiency always increased, with higher gains obtained for the scenarios with the current electricity mix (22–25% increase) and more modest gains obtained for the electricity decarbonization scenarios (8–15% increase).
•A multimethodology decision support tool combining LCA, DEA and linear regression.•- Multimethodology offers more information in early design for sustainable decisions.•- Identify most influential variables on eco-efficiency of buildings retrofits.•- Specifying three variables increased average ecoefficiency by more than 20%.
Cisgender women account for 1 of every 5 new US HIV diagnoses, with most cases (85%) attributed to heterosexual contact. HIV preexposure prophylaxis is an effective prevention strategy; however, ...preexposure prophylaxis awareness and prescriptions among women are low.
This study aimed to increase preexposure prophylaxis counseling and uptake among cisgender women attending obstetrics and gynecology clinics.
The study included 3 obstetrics and gynecology clinics within a single health system in a high HIV prevalence region. There were 3 phases: baseline (the 3-month period before the clinical trial that included provider education and training of a registered nurse about preexposure prophylaxis), clinical trial (the 3-month period during which eligible patients were randomized to an active control or preexposure prophylaxis registered nurse intervention), and maintenance (the 3-month period after the trial ended). Electronic medical record clinical decision support tools were available to both arms during the clinical trial, which included best practice alerts, order sets, progress note templates, and written and video preexposure prophylaxis educational materials for patients. In the intervention arm, a preexposure prophylaxis nurse contacted and counseled patients and was equipped to prescribe preexposure prophylaxis. Moreover, this study evaluated the phases through the “reach, effectiveness, adoption, implementation, and maintenance” framework. The primary outcome of the study was effectiveness (eg, percentage of eligible patients with documented HIV prevention counseling in the electronic medical record or preexposure prophylaxis prescriptions). The secondary outcomes included reach (eg, percentage of best practice alerts that providers acted on or the percentage of eligible patients who spoke with the preexposure prophylaxis registered nurse), adoption (eg, percentage of eligible patients with a best practice alert that triggered or the percentage of eligible patients the preexposure prophylaxis registered nurse attempted to contact), and maintenance (eg, percentage of patients with documented HIV prevention counseling or preexposure prophylaxis prescriptions during the maintenance phase).
There were 904 unique patients in all phases with a mean age of 28.8±7.7 years, and 416 patients (46%) were pregnant; moreover, 436 patients were randomized in the clinical trial phase. Concerning reach and adoption, best practice alerts were triggered for 100% of eligible encounters; however, the providers acted on 52% of them. The preexposure prophylaxis nurse attempted to contact every patient and successfully spoke with 81.2% of them in the preexposure prophylaxis registered nurse arm. Concerning effectiveness, there were significantly more patients counseled about preexposure prophylaxis in the preexposure prophylaxis registered nurse group than in the active control group (66.5% vs 12.3%, respectively; P<.001), although preexposure prophylaxis prescriptions were equivalent (P=1.0). Among the subgroup of patients who were counseled about preexposure prophylaxis, 18.5% of patients in the active control arm and 3.4% in the preexposure prophylaxis registered nurse arm were prescribed preexposure prophylaxis (P=.02). Concerning maintenance, clinical decision support tools alone resulted in preexposure prophylaxis counseling of 1.0% of patients during the maintenance phase vs 0.6% of patients during the baseline phase and 11.2% of patients during the clinical trial phase (P<.001). Preexposure prophylaxis prescriptions were not statistically different among the 3 phases (P=.096).
A preexposure prophylaxis nurse effectively increased HIV prevention discussions but did not lead to more preexposure prophylaxis prescriptions than the preexposure prophylaxis–focused clinical decision support tools used by providers. The decrease in preexposure prophylaxis counseling after the trial phase suggests that persistent interventions are needed to maintain effects.
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