Feasibility Of Implementation Research Articles

Evaluation of large-scale poultry manure-derived biochar for efficient cadmium removal in zinc smelter wastewater

Cadmium (Cd), a carcinogen, is released from industrial activities like metal refineries and battery runoff, with significant contamination reported near zinc smelters in Korea. This study addresses the issue using an efficient, economical adsorption process with waste-derived biochar-based adsorbents known for high Cd removal. Poultry manure (PM), typically used as fertilizer, can lead to environmental pollution if mismanaged; therefore, it was pyrolyzed to produce biochar. The resulting poultry manure biochar (PMBC) was produced on a large scale (15 ton/day), demonstrating feasibility for large-scale implementation. The effectiveness of PMBC as an adsorbent for Cd was evaluated using wastewater discharged from a zinc smelter. The Cd adsorption capacity of PMBC (60.39 mg/g) was lower than that (302.0 mg/g) of hen manure biochar produced at a laboratory scale in our previous study but was comparable to other biochars reported in the literature. Response surface methodology analysis indicated that reaction time, dose, and agitation significantly influenced Cd removal by PMBC, whereas pH had a negligible impact. Notable contributions to Cd adsorption include the release of K+ from PMBC and the presence of O-containing functional groups. Under continuous flow conditions with real wastewater, Cd was not detected in the effluent for the initial 8 h, and PMBC sustained a removal efficiency of 40.77% until saturation was reached. The results from wastewater treatment and large-scale biochar production offer valuable insights into the potential of biochar as a medium for addressing environmental issues in real-world applications.

Virtual practice facilitation as an implementation strategy for launching opioid safety committees for quality improvement in primary care: feasibility, acceptability, and intervention fidelity

BackgroundPractice facilitation (PF) is an evidence-based multicomponent in-person implementation strategy. COVID-19-related lockdowns caused many implementation initiatives to rapidly shift to virtual settings, but there is limited evidence on PF deployed exclusively using virtual meeting platforms. Our objective was to assess the feasibility and acceptability of virtual PF used in a primary care setting to implement interdisciplinary opioid safety committees (OSCs) to improve care for patients using opioid medicines for persistent pain and reduce high-dose opioid prescribing. We also describe alignment of virtual PF with the core functions of PF and fidelity of participating clinics to the OSC intervention.MethodsWe applied qualitative and quantitative methods to evaluate virtual PF used to implement a quality improvement project at Kaiser Permanente Washington, an integrated health system in Washington State. We established interdisciplinary OSCs in primary care clinics using virtual PF. OSCs were tasked with promoting opioid safety and high-quality pain care through population management and chart reviews. We used administrative data to calculate feasibility measures including attendance and retention. Acceptability data came from interviews with OSC members conducted by evaluators. Measures of fidelity to the OSC intervention were abstracted from meeting notes and administrative data. We used qualitative methods to assess the adherence of virtual PF to the core functions of PF.ResultsFacilitators carried out a comprehensive PF approach virtually and demonstrated adherence to the core functions of PF. We established OSCs in eight clinics and conducted an average of 17.5 virtual PF meetings over eight months of PF for each clinic. Average attendance was 75% and we had 84% retention. OSC members were highly satisfied with virtual PF. Facilitators effectively supported teams through implementation and technical challenges and OSC members gained skills through virtual PF. We implemented OSCs with high fidelity, suggesting virtual PF is an effective implementation strategy.ConclusionsWe found virtual PF is a feasible and acceptable implementation strategy for this intervention and identified strategies to support care teams through challenges. Our findings can help inform future implementation efforts, especially those hoping to engage geographically dispersed clinics or remote clinical staff.Trial registrationNot applicable.

Validation of EUCAST rapid antimicrobial susceptibility testing directly from positive blood cultures in a non-automated lab setting

ABSTRACT Introduction To speed up antimicrobial susceptibility testing (AST), the European Committee on Antimicrobial Susceptibility Testing (EUCAST) proposed rapid AST (RAST), a disk diffusion method to be read after 4, 6 and 8 hours of incubation. We investigated the feasibility of implementation of RAST in a non-automated lab setting. Materials & methods To this end, reference strains as well as a variety of clinical and resistant strains were used to spike sterile hemocultures (BioMérieux BACT/ALERT 3D® and Becton Dickinson BACTEC FX® systems), followed by RAST in comparison to classical long-incubation AST. Results & conclusion Our results with reference strains show that reading RAST after 4 hours is frequently too soon to obtain clinical results, and that Streptococcus pneumoniae reference strain did yield readable inhibition zones in RAST when harvested from BioMérieux BACT/ALERT 3D® bottle cultures. In a wider panel of strains, Gram positives RAST results were very similar to standard AST, while with Gram negative species errors were more frequently observed, limiting clinical implementation.

PO0417: Feasibility of Balloon Rectal Spacer Implementation in HDR and LDR Brachytherapy for Prostate Cancer Treatment

PO0417: Feasibility of Balloon Rectal Spacer Implementation in HDR and LDR Brachytherapy for Prostate Cancer Treatment

Transformation of Traditional Corporate Tax Planning into AI-Driven Corporate Tax Planning

Corporate tax planning has traditionally relied on manual processes and expert judgment to minimize tax liabilities. However, the rise of artificial intelligence (AI) presents new opportunities to transform these practices through automation, real-time analysis, and predictive capabilities. To conduct this research, a comprehensive review of academic literature, case studies, and existing AI tools in tax planning was carried out. The proposed AI-based tax planning model was developed based on these findings and validated through simulations and expert feedback. The study also examined the process of integrating AI systems with existing corporate tax structures to assess the feasibility and effectiveness of implementation. Results show that AI-driven corporate tax planning significantly enhances accuracy and efficiency compared to traditional methods. The AI model provides real-time analysis and predictive insights, enabling businesses to optimize tax strategies while ensuring compliance with evolving regulations. Tax authorities also benefit from AI implementation, gaining more transparent and equitable tax structures, along with stronger supervision capabilities. The proposed model can be developed into customized software tailored to individual companies, seamlessly integrating with existing corporate systems. These findings indicate that AI has the potential to revolutionize corporate tax planning by streamlining tax management and optimizing outcomes. For businesses, AI enables personalized tax strategies that adapt to specific data and regulations, improving both compliance and long-term tax optimization.

Hardware-in-the-Loop Implementation of an Optimized Energy Management Strategy for Range-Extended Electric Trucks

The reliance of the commercial transportation industry on fossil fuels has long contributed to pollutant and greenhouse gas emissions. Since full electrification of medium- and heavy-duty vehicles faces limitations due to the large battery capacity required for extended driving ranges, this study explores a Range-Extended Electric Vehicle (REEV) for medium-duty Class 6 pick-up and delivery trucks. This hybrid architecture combines an electric powertrain with an internal combustion engine range-extender. Maximizing the efficiency of REEVs requires an Energy Management Strategy (EMS) to optimally split the power between the two power sources. In this work, a hierarchical EMS is developed through model-based design and validated via Hardware-In-The-Loop (HIL) simulations. The proposed EMS demonstrated a 7% reduction in fuel consumption compared to a baseline control strategy, while maintaining emissions and engine start frequency comparable to a benchmark globally optimal EMS obtained with dynamic programming. Furthermore, HIL results confirmed the strategy’s real-time implementation feasibility, highlighting the practical viability of the controller. This research underscores the potential of REEVs in significantly reducing emissions and fuel consumption, as well as providing a sustainable alternative for medium-duty truck applications.

Assessing the implementation of suicide-focused treatments delivered in hybrid telemental health format in a real-world setting

Objective The purpose of this study was to assess the implementation of suicide-focused treatments delivered via a hybrid telemental health (TMH) and in-person format. Method This study was conducted at four university counseling centers (UCCs) across the United States. Treatment-seeking clients were recruited from their local UCCs and participated in adaptive treatment strategies (ATSs) involving Treatment as Usual (TAU), Collaborative Assessment and Management of Suicidality (CAMS), and Dialectical Behavior Therapy (DBT). Implementation outcomes, including appropriateness, acceptability, feasibility, fidelity, safety, and client satisfaction, were assessed. UCC clinicians participated in qualitative interviews focused on implementation of TMH for clients presenting with suicidal ideation (SI). Results Overall, treatments delivered via hybrid format were reported to be appropriate, acceptable, feasible, and satisfactory by clinicians and clients. Implementation of TMH was reported to be equivalent to in-person treatment across multiple measurement methods. Conclusion Results from this study demonstrate that TMH is an implementable treatment modality for addressing suicidality, particularly for college students presenting to UCCs with SI. This study has implications for real-world clinical settings planning to offer hybrid treatment modalities to address SI. Trial registration: ClinicalTrials.gov identifier: NCT04728815.

Evaluation of Measure Dx, a Resource to Accelerate Diagnostic Safety Learning and Improvement.

Several strategies have been developed to detect diagnostic errors for organizational learning and improvement. However, few health care organizations (HCOs) have integrated these strategies into routine operations. To address this gap, the Agency for Healthcare Research and Quality released "Measure Dx: A Resource To Identify, Analyze, and Learn From Diagnostic Safety Events" in 2022. We conducted an evaluation of Measure Dx to measure feasibility of implementation and effects on short-term and intermediate outcomes related to diagnostic safety. Prospective observational study. Teams from 11 HCOs, primarily academic medical centers. Participants were asked to use Measure Dx over approximately 6months and attend monthly virtual learning collaborative sessions to share and discuss approaches to measuring diagnostic safety. Descriptive outcomes were gathered at the HCO level and included uptake of different case-finding strategies and the number of cases reviewed and confirmed to have diagnostic safety improvement opportunities. We collected information on organizational practices related to diagnostic safety at each HCO at baseline and at the conclusion of the project. The 11 HCOs completed all requirements for the evaluation. Each of the four diagnostic safety case finding strategies outlined in Measure Dx were used by at least three HCOs. Across the cohort, participants reviewed 703 cases using a standardized data collection instrument. Of those cases, 224 (31.8%) were identified as diagnostic safety events with improvement opportunities. Unexpectedly, self-ratings on the checklist assessment declined for several organizations. Use of Measure Dx can help accelerate implementation of systematic approaches to diagnostic error measurement and learning across a variety of HCOs, while potentially enabling HCOs to identify opportunities to improve diagnostic safety practices.

Implementing a group singing intervention for postpartum depression within the Italian health service

BackgroundIn the United Kingdom a singing intervention for Postpartum Depression (PPD) titled “Music and Motherhood” was found to be effective. The World Health Organization Regional Office for Europe coordinated a study to assess the feasibility of implementing and adapting the intervention in other countries. In Italy, recent studies have highlighted the need to promote the availability of effective interventions for PPD in primary care.AimTo describe the implementation of “Music and Motherhood” within the Italian primary care services dedicated to pregnancy and postnatal care in three different geographical locations, thus providing an example of strategies for implementing an arts and health intervention in primary care that can improve health and well-being.MethodsA 10-week group singing intervention for mothers with PPD was conducted as part of a single arm feasibility study. Data were collected through one-to-one interviews, focus groups and questionnaires from the professionals involved in the implementation and selected participating mothers. A conceptual framework including acceptability, appropriateness, feasibility, fidelity, implementation process, costs and sustainability was adopted for analysis. Number of sessions attended by mothers and implementation outcome measures for acceptability, appropriateness and feasibility, each consisting of four items rated on a 5-point Likert scale were also gathered.ResultsThe intervention was found to be inclusive of women from different socio-cultural backgrounds and appropriate to the context. The group setting and the use of an arts-based intervention helped to de-medicalise the process of care maximising resources. Singing helped mothers to express their feelings and find strategies to improve interaction with their child. Attention to mothers’ needs and the co-presence of the professional singing leader and a health professional were among the key factors. The median number of sessions attended was nine out of 10. In terms of acceptability, almost 90% of the professionals were in complete agreement that they liked and approved the intervention.ConclusionOur study adds to the evidence that an arts and health intervention proven effective in one culture and linguistic context can be adapted to another. Collaboration among health professionals and artists in the implementation process and adequate funding are instrumental in moving from project to programme level.

Development of an Expert-Based Scoring System for Early Identification of Patients with Inborn Errors of Immunity in Primary Care Settings - the PIDCAP Project.

Early diagnosis of inborn errors of immunity (IEIs) has been shown to reduce mortality, morbidity, and healthcare costs. The need for early diagnosis has led to the development of computational tools that trigger earlier clinical suspicion by physicians. Primary care professionals serve as the first line for improving early diagnosis. To this end, a computer-based tool (based on extended Jeffrey Modell Foundation (JMF) Warning Signs) was developed to assist physicians with diagnosis decisions for IEIs in the primary care setting. Two expert-guided scoring systems (one pediatric, one adult) were developed. IEI warning signs were identified and a panel of 36 experts reached a consensus on which signs to include and how they should be weighted. The resulting scoring system was tested against a retrospective registry of patients with confirmed IEI using primary care EHRs. A pilot study to assess the feasibility of implementation in primary care was conducted. The scoring system includes 27 warning signs for pediatric patients and 24 for adults, adding additional clinically relevant criteria established by expert consensus to the JMF Warning Signs. Cytopenias, ≥ 2 systemic infections, recurrent fever and bronchiectasis were the leading warning signs in children, as bronchiectasis, autoimmune diseases, cytopenias, and > 3 pneumonias were in adults. The PIDCAP (Primary Immune Deficiency "Centre d'Atenció Primària" that stands for Primary Care Center in Catalan) tool was implemented in the primary care workstation in a pilot area. The expert-based approach has the potential to lessen under-reporting and minimize diagnostic delays of IEIs. It can be seamlessly integrated into clinical primary care workstations.

Feasibility and Acceptability of a Bar-Staff Bystander Intervention Training Program for Reducing Sexual Aggression.

This paper explores the challenges, opportunities, and successes encountered in implementing Safer Bars, a bystander intervention training program to prevent sexual aggression in bars. The study aims to assess the feasibility of program implementation and its acceptability among bar staff and bar owners/managers. Utilizing a mixed-methods approach, the study assessed the feasibility of Safer Bars by documenting bar participation, reasons for declination, and the time elapsed during recruitment, offering insights into experienced challenges and successes. Acceptability was gauged through post-training surveys for bar staff (N = 220) and owners/managers (N = 22), including Likert-scale questions on various aspects of the program and open-ended inquiries about the training's best aspects and potential improvements. Despite challenges in bar enrollment due to time constraints and financial considerations, the program demonstrated high acceptability among participating bars. Bar staff expressed confidence in applying acquired bystander skills, emphasizing the importance of skilled and knowledgeable trainers. The qualitative analysis of participant feedback revealed valuable insights into the practicality and reception of the intervention. The study provides data from implementation to guide upscaling Safer Bars. Despite feasibility challenges amidst the COVID-19 pandemic, the program showed high acceptability among bar staff and owners/managers, indicating its potential impact on addressing sexual aggression in nightlife settings. Future efforts must consider the reality of the alcohol-serving industry and focus on innovative strategies to overcome additional industry-specific barriers to enhance program feasibility.

Use of Wireless Sensor Networks for Area-Based Speed Control and Traffic Monitoring

This paper reviews the potential of low-power wireless networks to improve road safety. The authors characterized this type of network and its application in road transport. They also presented the available technologies, highlighting one that was considered the most promising for transport applications. The study includes an innovative and proprietary concept of area-based vehicle speed monitoring using this technology and describes its potential for enhancing road safety. Assumptions and a model for the deployment of network equipment within the planned implementation area were developed. Using radio coverage planning software, the authors conducted a series of simulations to assess the radio coverage of the proposed solution. The results were used to evaluate the feasibility of deployment and to select system operating parameters. It was also noted that the proposed solution could be applied to traffic monitoring. The main objective of this paper is to present a new solution for improving road safety and to assess its feasibility for practical implementation. To achieve this, the authors conducted and presented the results of a series of simulations using radio coverage planning software. The key contribution of this research is the authors′ proposal to implement simultaneous vehicle speed control across the entire monitored area, rather than limiting it to specific, designated points. The simulation results, primarily related to the deployment and selection of operating parameters for wireless sensor network devices, as well as the type and height of antenna placement, suggest that the practical implementation of the proposed solution is feasible. This approach has the potential to significantly improve road safety and alter drivers′ perceptions of speed control. Additionally, the positive outcomes of the research could serve as a foundation for changing the selection of speed control sites, focusing on areas with the highest road safety risk at any given time.

Offshore grid planning considering restricted areas: An evolution game approach

In this paper, offshore wind farm cluster transmission network planning is examined in depth, based on the finite rational evolutionary game method. In the actual project, the game scenarios of offshore wind farm developers and transmission system operators and their respective interests are considered, while cable laying exclusion zones owing to the submarine environment are fully taken into account. Through simulation experiments, the significant effect of the proposed method in improving grid adaptability and interference immunity is verified. The results demonstrate that the proposed finite rational evolutionary game method increases the return on investment by 1.83 % compared to the traditional method, while the payoff ratio of the game participants is 12.81 % lower. In addition, the method excels in ensuring the feasibility of project implementation by successfully balancing the interests between the OWF developer and the power transmission system operator. This offers a new perspective for efficient planning of transmission networks for offshore wind farms that can better cope with complex engineering environments and balance the interests of all parties.

The Feasibility and Acceptability of Using a Digital Conversational Agent (Chatbot) for Delivering Parenting Interventions: Systematic Review.

Parenting interventions are crucial for promoting family well-being, reducing violence against children, and improving child development outcomes; however, scaling these programs remains a challenge. Prior reviews have characterized the feasibility, acceptability, and effectiveness of other more robust forms of digital parenting interventions (eg, via the web, mobile apps, and videoconferencing). Recently, chatbot technology has emerged as a possible mode for adapting and delivering parenting programs to larger populations (eg, Parenting for Lifelong Health, Incredible Years, and Triple P Parenting). This study aims to review the evidence of using chatbots to deliver parenting interventions and assess the feasibility of implementation, acceptability of these interventions, and preliminary outcomes. This review conducted a comprehensive search of databases, including Web of Science, MEDLINE, Scopus, ProQuest, and Cochrane Central Register of Controlled Trials. Cochrane Handbook for Systematic Review of Interventions and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to conduct the search. Eligible studies targeted parents of children aged 0 to 18 years; used chatbots via digital platforms, such as the internet, mobile apps, or SMS text messaging; and targeted improving family well-being through parenting. Implementation measures, acceptability, and any reported preliminary measures of effectiveness were included. Of the 1766 initial results, 10 studies met the inclusion criteria. The included studies, primarily conducted in high-income countries (8/10, 80%), demonstrated a high mean retention rate (72.8%) and reported high acceptability (10/10, 100%). However, significant heterogeneity in interventions, measurement methods, and study quality necessitate cautious interpretation. Reporting bias, lack of clarity in the operationalization of engagement measures, and platform limitations were identified as limiting factors in interpreting findings. This is the first study to review the implementation feasibility and acceptability of chatbots for delivering parenting programs. While preliminary evidence suggests that chatbots can be used to deliver parenting programs, further research, standardization of reporting, and scaling up of effectiveness testing are critical to harness the full benefits of chatbots for promoting family well-being.

Design and Analysis of a Planar Six-Bar Crank-Driven Leg Mechanism for Walking Robots

This study presents the design and a thorough analysis of a six-bar crank-driven leg mechanism integrated with a skew pantograph, developed for walking robots. The mechanism’s dimensions were optimized using a rigorous dimensional synthesis process in GIM software (version 2024). Subsequently, a detailed kinematic analysis was performed in GIM to simulate the leg’s motion trajectory, velocity, and acceleration. In parallel, kinematic equations were formulated using the vector loop method, implemented in MATLAB (version R2013-b), and compared with the GIM results for validation, demonstrating the strong agreement between both tools. These results confirm the mechanism’s ability to generate a compact, high-lift foot trajectory while maintaining system stability and energy efficiency. An inverse dynamic analysis was carried out to determine the actuator’s driving torque, ensuring efficient operation under expected load conditions. Furthermore, topology optimization conducted in SOLIDWORKS (version 2021) significantly reduced the weight of the ground-contacting link while preserving its structural integrity. A subsequent stress analysis validated the mechanical viability of the optimized design, supporting its feasibility for real-world implementation. This research provides a robust foundation for the development of a functional prototype. Its potential applications include mobile robots for sectors such as agriculture and all-terrain vehicles, where efficient, reliable, and adaptive locomotion is crucial. The proposed mechanism strikes an optimal balance between mechanical simplicity, cost-effectiveness, and high performance, making it well-suited for challenging operational environments.

Social Cost of Carbon as an International Benchmark to Drive Countries’ Carbon Pricing during the Transition

Building on updated estimates of the social cost of carbon obtained from the most recent literature, this article proposes a social cost of carbon-based benchmark for carbon pricing to drive world countries’ carbon pricing policies up to 2050, consistent with the Paris Agreement targets. By using a dataset on net effective carbon rates developed by the Organisation for Economic Co-operation and Development (OECD), we firstly compare both explicit and implicit carbon pricing in 2021 in 71 OECD and non-OECD countries with the social cost of carbon benchmark for 2021 and calculate the degree of internalization of the social cost of carbon averagely related to their carbon pricing instruments. We find that there is a serious gap in current climate policies, which are far from creating optimal pricing conditions to reduce global emissions to levels needed by the Paris Agreement. The economic and distributional feasibility of a full implementation of the carbon pricing benchmark is tested in the same set of countries using two indicators, which are calculated for 2025, 2030, 2040 and 2050. Since the test results are income-regressive among income country groups, benchmark implementation by countries within the cooperative approaches of Paris Agreement art. 6 should be accompanied by the creation of an international cooperative fund aimed to recycle at least part of the revenues collected by high-income countries to compensate affected population in lower-income countries.

Processing techniques for metrological improvement of low-cost smart meter hardware solution for IEC 61000-4-7 Class I harmonics measurements

The work investigates the feasibility of harmonic analysis implementation on smart meter microcontroller devices, according to IEC 61000-4-30 Class A and IEC 61000-4-7 Class I requirements. The final aim was to evaluate to what extent Class I harmonic analysis can be integrated into existing low-cost hardware platforms for smart metering, which normally have limited hardware features, especially concerning the ADC and the possibility of varying the sampling frequency with high resolution, according to the power system signal frequency. An extended experimental characterization is carried out on a case study device, aimed at analyzing its performances in terms of both measurement accuracy and computational burden. To increase metrological ADC behavior and decrease computational costs, sampling strategies and optimized interpolation algorithm have been implemented and tested verifying the feasibility of harmonic analysis implementation on smart meter microcontroller devices, according to IEC 61000-4-30 Class A and IEC 61000-4-7 Class I requirements.

Development and Usability of an Endoscopist Report Card Assessing ERCP Quality

Audit and feedback (A&F) for endoscopic retrograde cholangiopancreatography (ERCP) is relatively understudied despite the demonstrated effectiveness of A&F for endoscopic procedures such as colonoscopy. Endoscopist 'report cards' are one A&F tool. We aimed to develop an ERCP report card and assess its appropriateness, acceptability and feasibility through usability testing. A prototype report card was designed using a combination of published quality indicators and established predictors of adverse events (AE). Exploratory analyses from a prospective multi-center registry were performed to further identify novel and/or understudied parameters for possible inclusion. Semi-structured interviews with ERCP endoscopists were conducted and framework analysis performed. Validated post-interview usability instruments were administered. Feedback was incorporated to create a final report card. The report card included domains of technical parameters, AE rates/prevention, and patient-reported experience measures (PREMs). Qualitative feedback was positive, with respondents agreeing with inclusion of relevant content in most domains. Post-interview instruments revealed adequate appropriateness and acceptability. PREMs were felt by respondents to be poorly actionable and were replaced with appropriateness of indication and fluoroscopy usage parameters in the final report card. Concerns were raised regarding the feasibility of implementation due to reliance on difficult-to-obtain granular intraprocedural data. We designed and tested an ERCP report card that has potential to be an effective A&F intervention for endoscopists in clinical practice. Though feasibility of data capture and implementation are currently limitations, advances in video recording and artificial intelligence technologies could accelerate widespread adoption of such a tool.

Sexual orientation and gender identity (SOGI) data collection: Feasibility of implementation.

338 Background: The 2011 Institute of Medicine report, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding called for consistent recording of sexual orientation and gender identity (SOGI) data in clinical settings. In 2016, SOGI data were listed as required elements in the Uniform Data System (HRSA); however, implementation of this recommendation is inconsistent. The state of New Jersey (NJ) mandated SOGI data collection for patients seen within any healthcare system in NJ to start in June 2023. Jefferson Health (JH), a health system with locations in both Pennsylvania (PA) and NJ, provided SOGI data collection education for its NJ staff. The Sidney Kimmel Cancer Center (SKCC) at JH has clinical sites in both states. In this study, we report on SOGI data collection between SKCC PA (Center City/CC) and SKCC NJ to assess the impact of the educational preparation on data collection. Methods: Patients seen at SKCC’s CC and NJ locations from May 16, 2023 to May 15, 2024 were included. SOGI data between both locations were compared to assess the impact of the educational preparation. Data were collected from the electronic record. Results: Of the 6,921 patients in CC, 1,725 identified as female, 859 identified as male, 67 chose not to disclose their gender identity, and 4270 had missing data. Of the 1788 patients in NJ, 1,118 identified as female, 449 identified as male, 12 chose not to disclose, 209 had missing data. (Table). Conclusions: Educational preparation resulted in significantly improved SOGI data collection with a significant drop in missing data. Regular recording and analysis of SOGI data can identify health inequities, support the design of targeted interventions, and evaluate the effectiveness of LGBTQIA+ healthcare initiatives. SOGI data comparison. Center City (CC)/PA New Jersey (NJ) Total 6921 1788 Female Gender 1725 (24.9%) 1118 (62.5%) Male Gender 859 (12.4%) 449 (25.1%) Chose not to disclose 67 (0.01%) 12 (0.01%) Missing data 4270 (61.7%) 209 (11.7%)

Potential of Tambo Dam implementation as a flood control measure

AbstractRecent climate change has resulted in severe and frequent natural disasters globally, prompting the need for adaptation to these events. As an adaptation measure, disaster prevention and mitigation using natural processes and mechanisms (or ‘green infrastructure’) have become widely recognized in many countries. Ecosystem‐based disaster risk reduction has been promoted in Japan since 2015. The ‘Tambo Dam’, a flood mitigation project using paddy fields in which the authors have participated, has the potential to become one of the most extensive forms of green infrastructure in Japan. This study outlines the runoff control mechanisms of Tambo Dams, demonstrates their effectiveness in reducing flood damage at the watershed scale, and discusses two key factors for successful sustainable efforts: the design of appropriate runoff control equipment and administrative schemes that support incentives for the efforts of farmers. The results indicated that Tambo Dam implementation represented a crucial strategy for managing agricultural resources. The functionality of paddy fields could be preserved by managing them as Tambo Dams. This approach not only contributes to flood control but also ensures a swift return to rice cultivation during emergencies. Moreover, establishing a system akin to the Tambo Dam initiative of Mitsuke City, supported by the ‘Direct Payment Scheme for Multifunctional Activities’ for maintenance and management, could ensure the feasibility of Tambo Dam implementation.