Insufficient Monitoring Research Articles

The social leverage effect: Institutions transform weak reputation effects into strong incentives for cooperation

Institutions allow cooperation to persist when reciprocity and reputation provide insufficient incentives. Yet how they do so remains unclear, especially given that institutions are themselves a form of cooperation. To solve this puzzle, we develop a mathematical model of reputation-based cooperation in which two social dilemmas are nested within one another. The first dilemma, characterized by high individual costs or insufficient monitoring, cannot be solved by reputation alone. The second dilemma, an institutional collective action, involves individuals contributing to change the parameters of the first dilemma in a way that incentivizes cooperation. Our model demonstrates that this nested architecture creates a leverage effect. While insufficient on its own to incentivize cooperation in the first dilemma, reputation incentivizes contributions to the institutional collective action, which, in turn, strengthen the initially weak incentives for cooperation in the first dilemma. Just as a pulley system transforms minimal muscular strength into significant lifting capability, institutions act as cooperative pulleys, transforming initially weak reputational incentives into powerful drivers of cooperative behavior. Based on these results, we suggest that institutions have developed as social technologies, designed by humans to exploit this social leverage effect, just as material technologies are designed to exploit physical laws.

Potential Strategies to Improve Air Quality in Tirana for Current and Future Generations

Tirana, the capital of Albania, faces severe air pollution, posing significant health risks and environmental concerns for its residents. Referring to the data for the year 2023, KTA admits that Tirana exceeds the European Union norms for PM10 and nitrogen dioxide. Annual average concentrations of PM10 and NO2 in Tirana are above the limit values of National Air Quality Standard and World Health Organization. This paper looks at the several issues that lead to Tirana's air pollution and considers ways to lower pollution levels and enhance air quality. The problems with Tirana's air pollution are intricate and varied, resulting from a confluence of elements including as topography, industrial processes, burning of biomass, vehicular emissions, and insufficient monitoring programs. Addressing these challenges requires regulatory interventions, technological innovations, public awareness campaigns and stakeholder engagement to improve air quality. Tirana has a population of 528,000 inhabitants, with a surface area of 40 km² and a population density of 13.2 thousand inhabitants. Tirana has the capacity to develop more resilient, sustainable and habitable urban areas. To realize innovative ideas, enhance green areas, and improve air quality for present and future generations, cooperation amongst urban planners, legislators, community organizations, and citizens is imperative. We identify critical actions for policy makers, urban planners, and stakeholders to mitigate air pollution and build a healthier and more sustainable urban environment in Tirana based on pollution sources, regulatory frameworks, and ongoing initiatives. This paper's goal is to offer solutions for enhancing air quality while advancing environmental sustainability and public health. Received: 2 August 2024 / Accepted: 10 November 2024 / Published: 3 December 2024

Sustainable restoration: addressing critical challenges through university‐led projects

The urgency to restore ecosystems amid climate change and biodiversity loss has led to widespread engagement in habitat restoration projects. However, many projects fall short of their goals, highlighting the need for innovation. We use a case study at our university to explore how the integration of habitat restoration into university curricula might address some of the major challenges to long‐term restoration success. We demonstrate how integration with university activities could help address three key challenges in restoration: insufficient planning and monitoring, limited community engagement, and lack of long‐term funding. Our approach demonstrates how involving students and faculty in restoration projects can enhance adaptive management by including these efforts in science curricula, foster community participation through volunteer engagement, and reduce costs through volunteer efforts and collaboration with campus entities. These findings suggest that universities can play a vital role in advancing ecological restoration, benefiting both society and the environment.

Challenges And Strategies For Implementing Performance-Based Capitation In Indonesian Community Health Center : A Scoping Review

This study examines the implementation and challenges of performance-based capitation (KBK) at Community Health Centers (Puskesmas) in Indonesia, as a part of the National Health Insurance Program, aiming to improve the efficiency and quality of primary health services. Despite its potential, the implementation of KBK faces various challenges including inadequate human resources, limited infrastructure, and insufficient monitoring systems. The study uses a scoping review framework based on the Public Health Care Monitoring Conceptual Framework by WHO, analyzing 11 selected studies from 2021 to 2024. Findings indicate that internal factors such as management capacity, health worker competence, and organizational culture significantly impact the effectiveness of KBK. External factors like local government support, funding policies, and infrastructure availability also play crucial roles. Technological barriers, particularly in remote areas, hinder optimal policy implementation. The study emphasizes the need for clear regulations, consistent policy dissemination, and effective monitoring to ensure successful KBK implementation. Recommendations include strengthening leadership, training health workers, improving infrastructure, and enhancing digital health technology utilization. These strategies aim to optimize resource allocation, enhance service access, and improve patient satisfaction in Indonesia’s primary health care system.

Nutrigenomics-guided lifestyle intervention programmes: A critical scoping review with directions for future research

Genetic testing is increasingly used in clinical practice to provide personalized information and recommendations about health risks and lifestyle habits at a relatively low cost. Research on the effectiveness of nutrigenomics-guided lifestyle interventions is growing. A scoping review approach was adopted to identify pertinent published studies on nutrigenomics-guided intervention programmes from 2007 to 2023. The review shows that despite the growing interest in nutrigenomics-guided lifestyle interventions, there are still few empirically supported studies, primarily based on developed countries. Furthermore, the findings on the impact of personalised genetic advice are mixed, leaving the field unclear. Existing studies have some empirical strength, contributing to further understanding of the relationship between food and gene expression. However, some limitations that affect the robustness of findings exist, such as a small sample size, insufficient monitoring of the data collection process, and a short follow-up period. Future research needs to address reliability concerns and provide more robust practical evidence.

Quality in Norwegian Early Childhood Education and Care: Progress, Persistent Challenges, and Recommendations for the Future

AbstractIn Norway, children aged one to five years can attend subsidized and publicly regulated Early Childhood Education and Care (ECEC) centers. These centers focus on holistic child development through play, care, and learning. Therefore, Norway should be capable of providing young children with the best possible ECEC environment, thereby laying a solid foundation for their future school success. However, Norwegian 15-year-old students score at or below the average in mathematics, reading, and science compared to students in other OECD countries, and average scores are declining OECD (PISA 2022 Results (Volume I): The state of learning and equity in education, 2023). Several factors may contribute to Norwegian students’ average or below-average school performance, e.g., pedagogical weaknesses that were present even before school, in ECEC. An OECD report from 2015 pointed out several challenges in the Norwegian ECEC quality (Early childhood education and care policy review Norway, 2015), related to factors such as structural standards, monitoring of process quality, lack of independence of inspections, lack of understanding regarding monitoring, and insufficient monitoring practices. In this paper, we present: (1) Norwegian policy initiatives implemented in response to the OECD report, and (2) Research conducted after the OECD report on the quality levels of Norwegian ECEC, along with findings from interventions designed to improve quality. Based on this, we discuss the progress since the 2015 OECD report and highlight continuing challenges and important next steps to secure high ECEC quality in Norway for all children. We find that several policy initiatives have been implemented but observed ECEC quality levels after the 2015 report are still in the medium to low range.

Insufficient Referral and Monitoring of CKD in Germany: A Nationwide, Retrospective Cohort Study

Insufficient Referral and Monitoring of CKD in Germany: A Nationwide, Retrospective Cohort Study

Pesca sustentável em São Tomé e Príncipe: uma miragem ou uma realidade?Uma análise sobre a pesca em São Tomé nas últimas décadas

Fishing plays a crucial role in the socioeconomic development of São Tomé and Príncipe, contributing significantly to employment, food security, and poverty reduction. This study aims to examine the state of sustainable fishing in São Tomé and Príncipe by analyzing fishing regulations and proposing specific policies to promote sustainability. The research employs various methodologies, including document analysis and reviews of reports from national and international institutions, as well as consultations with the Ministries of Natural Resources and the Environment. Despite numerous initiatives aimed at achieving sustainable fishing, São Tomé and Príncipe has yet to attain this goal due to insufficient monitoring and enforcement capabilities. Achieving sustainability in fishing requires: Enhancing the country’s monitoring and enforcement capacities; Assessing and improving domestic fisheries management; Strengthening fishing regulations; Ensuring their effective implementation.

Invasion Characteristics of Marginal Water under the Control of High-Permeability Zones and Its Influence on the Development of Vertical Heterogeneous Gas Reservoirs

In-depth understanding of the gas–water seepage law caused by different degrees of gas layer perforation and varying gas production rates is key to determining a reasonable development technology policy for vertical heterogeneous edge-water gas reservoirs. Based on core physical data from the entire section of the X2 well, a large-scale high-pressure positive-rhythm profile model that takes into account the influence of “discontinuous interlayer” was innovatively established. The water intrusion process of the gas layer profile under different gas production rates and degrees of gas layer perforation was simulated using an electrical resistivity scanning device. The experimental model has an area of 3000 cm2, with a maximum pressure of 70 MPa and a maximum temperature resistance of 150 °C. It includes 456 evenly distributed fluid saturation test points to accurately monitor the gas–water distribution, addressing the issues of small bearing pressure and insufficient saturation monitoring points found in other large-scale models. The experimental results show that, in heterogeneous reservoirs, the high-permeability zone controls the invasion path of edge water, which is the main reason for the uneven invasion of edge water. For the positive-rhythm profile of the F layer, a higher gas production rate (1000 mL/min) shortens the water-free gas recovery period of the gas well and reduces the recovery rate. Perforating the upper two-thirds of the layer can inhibit edge-water breakthrough, prolong the water-free gas recovery period of the gas well, enable the gas–water interface to advance more uniformly, and enhance the recovery degree. The results of this study greatly enhance our understanding of the water invasion characteristics of positive-rhythm reservoirs under the influence of different gas production rates and varying degrees of gas layer perforation.

A review of small cetacean hunts in Greenland

Seven odontocete species are targeted by hunters in Greenland. Beluga (Delphinapterus leucas) and narwhal (Monodon monoceros) are hunted under annual quotas. Atlantic white-sided dolphin (Lagenorhynchus acutus), white beaked dolphin (Lagenorhynchus albirostris), harbour porpoise (Phocoena phocoena), killer whale (Orcinus orca) and long-finned pilot whale (Globicephala melas) are hunted without quotas. From 1993–2023, 109, 645 small cetaceans have been recorded in the North Atlantic Marine Mammal Commission (NAMMCO) catch database as hunted in Greenland. The hunt follows the scientific advice in 3 out of 25 populations considered: the hunt is higher than the advice for 12 and there has been no assessment or advice for 10. Population trends are unknown for 14 populations, while numbers are stable or increasing in 6 and decreasing in 4. One population has been extirpated by hunting. Catches of all small cetaceans have increased since data records are available, including for narwhal and beluga since quotas have been in place. In some cases, insufficient monitoring and inaccurate reporting occur and there is a lack of data to assess struck and lost rates and times to death. Narwhals are experiencing significant declines in abundance due to hunting, particularly in East Greenland, where recovery may be compromised. To ensure the protection of small cetaceans in Greenland, management is required for all hunts, consistent with international conservation management recommendations. Measures should ensure sustainability, include stuck and lost and additional anthropogenic threats, be precautionary, based upon up-to-date knowledge of population status and trends and consider welfare aspects and recovery rates.

Impact of anthropogenic activities on atmospheric chlorinated paraffins in Ghana using polyurethane foam disk - passive air sampler

Chlorinated paraffins (CPs) are a global concern due to their high production, ubiquity in the environment and potential toxicity. In Ghana, there is a significant research gap on the concentration and sources of CPs in the air, as well as insufficient regular monitoring programs to track CP levels over time. This study utilized polyurethane foam-based passive air samplers (PUF-PAS) to examine the concentrations, sources and potential human health risks of CPs in the atmosphere surrounding e-waste sites, urban areas, commercial areas and control/background areas in Ghana. The medium-chain CPs (MCCPs) dominated with an average concentration of 26.0 ± 40.1 ng/m3 and ranged from 1.78 to 240 ng/m3. Short-chain CPs (SCCPs) ranged from 0.05 to 15.2 ng/m3 and had an average concentration of 3.48 ± 3.99 ng/m3. The very short-chain CPs (C9-CPs), had an average concentration of 0.544 ± 0.524 ng/m3 and ranged from 0.091 to 2.14 ng/m3. MCCPs exceeded SCCPs by a factor of 7.5 and C9-CPs by a factor of 48. C14Cl8 was the dominant congener in MCCPs and C10Cl7 was also the dominant congener in SCCPs. E-waste was the main contributor to SCCPs and MCCPs (>30 %) in Ghana. The assessed non-cancer risks associated with CP exposure were within acceptable ranges. For cancer risk, MCCPs indicated high potential health risk but C9-CPs and SCCPs showed low risk. To the best of our knowledge, this is the first study on CPs in Ghana's atmosphere, and e-waste was identified as the country's main source of CPs. This study will help regulatory bodies create policies and procedures to control the use and disposal of chlorinated paraffins.

Recurrence interval of riverbed sand mining hotspots in the Mekong delta: Potential indications of unsustainable replenishment rates

Rampant and illegal river sand mining in the Vietnamese Mekong Delta (VMD) has led to substantial sediment losses and bank erosion. However, regulation of this issue remains a significant challenge due to insufficient monitoring and enforcement efforts, partly attributed to limited data and technology. To support an improved monitoring system in the VMD, this study investigates the spatiotemporal changes in sand mining hotspots and their underlying drivers. The recurrence intervals of sand mining boats were assessed from 2014 to 2020 using Sentinel-1A, and its association with riverbed incisions were examined from bathymetry field surveys between 2017 and 2020. Our results attest to sand mining intensification from 2015 to 2020, particularly in the upstream section of the VMD, where 70% of the activity was recorded. Not only was there an apparent increase in sand mining hotspots by 32.4%, but most hotspots recorded a recurrence interval of 2 years. This potentially indicates a minimal timeframe of sediment replenishment before the same locations become economically viable for further sand extraction. Additionally, a correlation was detected between sand mining hotspots and significant riverbed incisions, although the lack of spatial overlaps in some regions suggests other upstream influences like bank collapse and river damming. Our study, through the meticulous assessment of sand mining boat movement and river bathymetry data, ultimately sheds light on the potentially unsustainable scale of sand mining activities in the VMD. It aims to support informed decision-making and effective regulations that tackle excessive sand extraction amid the dynamic environmental challenges we face, while offering valuable insights to similar deltas worldwide.

A Novel Areal Maintenance Strategy for Large-Scale Distributed Photovoltaic Maintenance

A smart grid is designed to enable the massive deployment and efficient use of distributed energy resources, including distributed photovoltaics (DPV). Due to the large number, wide distribution, and insufficient monitoring information of DPV stations, the pressure to maintain them has increased rapidly. Furthermore, based on reports in the relevant literature, there is still a lack of efficient large-scale maintenance strategies for DPV stations at present, leading to the high maintenance costs and overall low efficiency of DPV stations. Therefore, this paper proposes a maintenance period decision model and an areal maintenance strategy. The implementation steps of the method are as follows: firstly, based on the reliability model and dust accumulation model of the DPV components, the maintenance period decision model is established for different numbers of DPV stations and different driving distances; secondly, the optimal maintenance period is determined by using the Monte Carlo method to calculate the average economic benefits of daily maintenance during different periods; then, an areal maintenance strategy is proposed to classify all the DPV stations into different areas optimally, where each area is maintained to reach the overall economic optimum for the DPV stations; finally, the validity and rationality of this strategy are verified with the case study of the DPV poverty alleviation project in Badong County, Hubei Province. The results indicate that compared with an independent maintenance strategy, the proposed strategy can decrease the maintenance cost by 10.38% per year, which will help promote the construction of the smart grid and the development of sustainable cities. The results prove that the method proposed in this paper can effectively reduce maintenance costs and improve maintenance efficiency.

WP7.3 - FAMiSH: FAsting prior to eMergency general Surgery in Hospital – Quality improvement project protocol

Abstract This study was conducted to evaluate adherence to preoperative fasting guidelines at the RD&E hospital, focusing on safety and reducing prolonged fasting complications particularly in patients with extremes of age, diabetic or co-morbid. Data were gathered anonymously over 2 cycles for 4 weeks through patient records and questionnaire to access patient given instructions for fasting. All patients with planned procedures were included, excluding emergency operations (NCEPOD) 1 or 2a/2b classification. Issues such as inadequate communication, excessive fasting, insufficient monitoring, and medication mismanagement were addressed. Cycle one revealed 25% of patients fasted for more than 6 hours, 56.25% did not consume liquids for more than 12 hours, and 25% abstained from drinking for more than 8 hours preoperatively. It was noted that guidelines were not thoroughly adhered to. Some patients have missed their medications, as well as diabetic patients with prolonged hours of fasting. We have provided a session for junior doctors and nurses aiming education on ASA guidelines and encouraging individualised fasting plans for patients. Information leaflets were created to be distributed to patients planned for surgery. In the second cycle only 20% and 24% of patients didn’t follow fasting guidelines for solids and liquids respectively as compared to 68.75% of the patients receiving inappropriate instructions in 1st cycle, showing significant improvement in patient care. In our study at the RD&E we have noted an improvement in departmental focus on adherence to fasting guidelines, which focus on abstaining from solid foods up to 6 hours and drinks up to 2 hours prior to surgery, aiding patient safety and improvement of quality of care.

Mechanisms of evolution and pollution source identification in groundwater quality of the Fen River Basin driven by precipitation

Groundwater pollution has attracted widespread attention as a threat to human health and aquatic ecosystems. However, the mechanisms of pollutant enrichment and migration are unclear, and the spatiotemporal distributions of human health risks are poorly understood, indicating insufficient groundwater management and monitoring. This study assessed groundwater quality, human health risks, and pollutant sources in the Fen River Basin(FRB). Groundwater quality in the FRB is good, with approximately 87 % of groundwater samples rated as “excellent” or “good” in both the dry and rainy seasons. Significant precipitation elevates groundwater levels, making it more susceptible to human activities during the rainy season, slightly deteriorating water quality. Some sampling points in the southern of Taiyuan Basin are severely contaminated by mine drainage, with water quality index values up to 533.80, over twice the limit. Human health risks are mainly from As, F, NO3−, and Cr. Drinking water is the primary pathway of risk. From 2019 to 2020, the average non-carcinogenic risk of As, F, and NO3− increased by approximately 28 %, 170 % and 8.5 %, respectively. The average carcinogenic risk of As and Cr increased by 28 % and 786 %, the overall trend of human health risks is increasing. Source tracing indicates As and F mainly originate from geological factors, while NO3− and Cr are significantly influenced by human activities. Various natural factors, such as hydrogeochemical conditions and aquifer environments, and processes like evaporation, cation exchange, and nitrification/denitrification, affect pollutant concentrations. A multi-tracer approach, integrating hydrochemical and isotopic tracers, was employed to identify the groundwater pollution in the FRB, and the response of groundwater environment to pollutant enrichment. This study provides a scientific basis for the effective control of groundwater pollution at the watershed scale, which is very important in the Loess Plateau.

Security Analysis of Web-Based Academic Information System using OWASP Framework

A The Academic Information System plays a crucial role in efficiently managing student, faculty, and campus administration data. However, system security needs to be a primary concern as it is vulnerable to cyber attacks. This research aims to analyze the security of the Academic Information System at the Muhammadiyah Business Institute Bekasi. The research method used is a comprehensive security analysis based on the OWASP framework. The study includes identifying potential vulnerabilities, penetration testing, and system improvement recommendations. Testing is conducted through simulated attacks based on the OWASP-released security risk list (OWASP Top Ten Most Critical Web Application Security Risks). The analysis results indicate that the system is vulnerable to Broken Authentication due to weak passwords, Sensitive Data Exposure due to URLs pointing to direct directories, and Security Misconfiguration due to open protocols. Furthermore, in CVSS scoring, SQL Injection scored 2.6 (Low), Broken Authentication scored 4.8 (Medium), Sensitive Data Exposure and Security Misconfiguration scored 5.3 (Medium), Cross-Site Scripting scored 2.0 (Low), while XXE, Broken Access Control, Insecure Deserialization, Using Components with Known Vulnerabilities, and Insufficient Logging and Monitoring scored 0.0 (No Vulnerability). Recommendations for future system improvements include regularly updating the system to prevent new security vulnerabilities, tighter server configurations, and routine system monitoring to promptly anticipate suspicious activities.

Research on Security Model of Airport Luggage Remote Office System Based on Zero Trust

With the continuous development of modern information society, remote office equipment itself has many benefits and is widely respected by the public, but at the same time, it also brings many network security issues. In order to help the airport luggage remote office system achieve stability and solve security issues encountered during luggage inspection, an analysis of existing system security risks based on the zero trust concept is conducted, including factors such as data leakage, insufficient monitoring, and incomplete identity authentication. Combined with the characteristics of the luggage system and remote office technology, the security model is ensured to be sufficiently reliable, providing some reference for airlines preparing to implement zero trust airport luggage remote office.

PREGNANT WOMEN WITH INADEQUATE PRENATAL CARE AND NEUROLOGICAL REPERCUSSIONS ON NEWBORNS

To understand the neurological repercussions on newborns of pregnant women with inadequate prenatal care, it is crucial to explore how the quality of prenatal care can influence children's neurological development. Inadequate prenatal care can result in deficiencies in medical monitoring, such as lack of nutritional supplementation, insufficient monitoring of fetal growth and inadequate treatment of maternal conditions that directly affect the neurological development of the fetus. Objective: Analyze and synthesize the available evidence on the implications neurological disorders in newborns whose mothers received inadequate prenatal care. Methodology: followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist, using databases such as PubMed, Scielo and Web of Science. The descriptors used were "prenatal care", "neurological outcomes", "neonates", "inadequate care" and "neurodevelopment". The inclusion criteria were studies published in the last 10 years, focused on inadequate prenatal interventions and their neurological consequences in newborns, available in English, Spanish or Portuguese. Exclusion criteria included studies unrelated to the topic, non-systematic reviews and studies with small samples. Results: revealed that pregnant women with inadequate prenatal care have a higher incidence of neurological complications in newborns, such as delays in motor and cognitive development, in addition to greater vulnerability neurological diseases such as cerebral palsy. Conclusion: improvements in the quality of prenatal care are essential to mitigate these repercussions and promote better neurological health outcomes in newborns. This review highlights the importance of public health policies that guarantee adequate prenatal care for all pregnant women.

Development of an Intelligent Multi-Parameter Sleep Diagnosis and Analysis System

Sleep disordered breathing (SDB) is a common sleep disorder with an increasing prevalence. The current gold standard for diagnosing SDB is polysomnography (PSG), but existing PSG techniques have some limitations, such as long manual interpretation times, a lack of data quality control, and insufficient monitoring of gas metabolism and hemodynamics. Therefore, there is an urgent need in China's sleep clinical applications to develop a new intelligent PSG system with data quality control, gas metabolism assessment, and hemodynamic monitoring capabilities. The new system, in terms of hardware, detects traditional parameters like nasal airflow, blood oxygen levels, electrocardiography (ECG), electroencephalography (EEG), electromyography (EMG), electrooculogram (EOG), and includes additional modules for gas metabolism assessment via end-tidal CO 2 and O 2 concentration, and hemodynamic function assessment through impedance cardiography. On the software side, deep learning methods are being employed to develop intelligent data quality control and diagnostic techniques. The goal is to provide detailed sleep quality assessments that effectively assist doctors in evaluating the sleep quality of SDB patients.

Addressing human factors in the recognition and management of local anaesthetic systemic toxicity.

In the perioperative environment, local anaesthetics are commonly administered to patients to provide analgesia and anaesthesia for a large range of surgical procedures. Although rare, their use can result in systemic toxicity, which is a life-threatening complication, underscoring the importance of early recognition and prompt management to mitigate patient risks. This article evaluates the impact of human factors and other aspects such as insufficient monitoring, errors in drug administration and poor adherence to safety protocols on the development and management of local anaesthetic systemic toxicity and provides practical considerations to minimise its occurrence.