Long-term Feasibility Research Articles

Regeneration of chromate galvanic solutions in membrane electrochemical devices

The regeneration processes of industry technological passivating baths of electrochemical cadmium lines and electrochemical galvanizing lines as an applied result of two-chamber membrane cation-exchange electrochemical devices researched. Actual industrial passivation baths of cadmium and zinc galvanic coatings applied as anode chambers. The cathode chamber contained sulfuric acid 1 % solution and a titanium cathode (BT-0). A window was cut in one of the walls with a RALEX®CM-PES 11-66 cation exchange membrane placed in it. The lead (С-0) was used as the anode. A comparative analysis of the performance of these technological baths before and after the using cation exchange membrane electrochemical devices was carried out. As a result of long-term experimental studies, the ecological and economic feasibility of their use was proven

Can we use mine waste as substrate in constructed wetlands to intensify nutrient removal? A critical assessment of key removal mechanisms and long-term environmental risks

The utilization of natural ores and/or mine waste as substrate in constructed wetlands (CWs) to enhance nutrient removal performance has been gaining high popularity recently. However, the knowledge regarding the long-term feasibility and key removal mechanisms, particularly the potential negative environmental effects of contaminants leached from mine waste is far insufficient. This study, for the first time, performed a critical assessment by using different CWs with three mine waste (coal gangue, iron ore and manganese ore) as substrates in a 385-day experiment treating wastewater with varying nutrient loadings. The results showed that the addition of mine waste in CWs increased removal of total phosphorus (TP) by 17-34%, and total nitrogen (TN) by 11-51%. The higher removal of TP is mainly attributed to the strong binding mechanism of phosphate with the oxides and hydroxides of Mn, Fe and/or Al, which are leached out of mine waste. Moreover, integration of mine waste in CWs also significantly stimulated biofilm establishment and enriched the relative abundance of key functional genes related to the nitrogen cycle, supporting the observed high-rate nitrogen removal. However, leaching of heavy metals (Fe, Mn, Cu and Cr) from the beded mine waste in the experimented CWs was monitored, which further influenced cytoplasmic enzymes and created oxidative stress damage to plants, resulting in a decline of nutrient uptake by plants.

An Apple a Day Keeps the Doctor Away: The Effect of a Low-Fat, High-Fiber Diet on Quality of Life, Inflammation, and Dysbiosis in Patients With Ulcerative Colitis

An Apple a Day Keeps the Doctor Away: The Effect of a Low-Fat, High-Fiber Diet on Quality of Life, Inflammation, and Dysbiosis in Patients With Ulcerative Colitis

Abstract 13251: Left Bundle Branchpacing Post-Atrioventricular Junction Ablation for Atrial Fibrillation: A Propensity Score Matching Analysis

Introduction: Although left bundle branch pacing (LBBP) has emerged as a novel pacing modality which can allow for safe atrioventricular junction (AVJ) ablation and lower pacing threshold compared to His bundle pacing (HBP), its long-term safety and efficacy in patients with atrial fibrillation (AF) is still unknown. Hypothesis: This study aimed to examine the long-term clinical feasibility, safety, and efficacy of LBBP in AF patients post-AVJ ablation and provide a balanced comparison of LBBP versus HBP. Methods: This study prospectively enrolled patients with AF and heart failure (HF) who underwent AVJ ablation and LBBP from July 2017 to December 2019. The control group patients were selected, by propensity score (PS) matching with a 1:1 ratio, among those HBP implantations performed in the years 2012-2019. Results: A total of 99 patients were enrolled in this study, with successful permanent LBBP post-AVJ ablation in 100% of patients (primary LBBP: 76; secondary LBBP: 23). Significantly improvements were observed in LVEF, tricuspid regurgitation, and mitral regurgitation at 1-year follow-up (p<0.05). The proportion of patients whose acute threshold <1 V@0.5ms was 97.9% and only one patient had an increase in threshold ≥1 V@0.5ms at 1-year follow-up. Further, patients with LBBP as an active-group was compared to patients with HBP (control-group) through PS matching with 170 successfully matched (PS-HBP, N=85; PS-LBBP, N=85). In the control-group, the success rate of permanent HBP was 81.9% (176/215), which was lower than that with LBBP (p<0.001). No significant differences in clinical outcomes were observed between groups (p>0.05), while lower thresholds, greater sensed R-wave amplitudes, and less complication were observed in PS-LBBP group (p<0.05). Conclusions: LBBP is feasible, safe, and effective in AF and HF patients post-AVJ ablation, which has comparable clinical benefit, higher success rate, better pacing parameters, and less complication than HBP.

Nature inspired evolutionary algorithm integrated performance assessment of floating solar photovoltaic module for low-carbon clean energy generation

Development and deployment of FSPV systems are still in the nascent stages hence long-term performance, control and feasibility study of FSPV systems are not well addressed. Precise and robust estimation of FSPV panel parameters will play an important role in determining the actual performance, carbon savings and long-term feasibility studies of FSPV systems. Here, hybrid stochastic firefly algorithm (HSFA) is used for parameter estimation and optimization. The hybrid algorithm is used to find out the parameters of single diode model, double diode model and FSPV module. An experiment is also performed using FSPV modules under varying irradiance conditions. The accuracy of model is evaluated by comparing the simulated results with the experimental results and computing the relative error and root mean square error (RMSE). The parameters extracted using the proposed method has a very low RMSE value of 9.83002E-04. Assessment of the experimental and estimated results show that the relative error for measured electricity on a sunny day is 0.57% while for an overcast day it is 0.89%. For partial shading condition, the relative error and RMSE was 0.79% and 6.5%, respectively. The results which are in well agreement with the experimental values demonstrate the superior performance of the model in determining the FSPV parameters. Proper estimation of the FSPV parameters will help researchers, scientists, engineers and all actors associated with solar PV systems in making sound judgements towards the deployment of FSPV systems and help the society in developing a sustainable ecosystem towards implementation of industry 4.0 by adapting to low-carbon power generation methods.

An industry survey of implementation strategies for clinical supply chain management of cell and gene therapies

Background aimsThe novelty of cell and gene therapies (CGTs) has introduced unique supply chain challenges and considerations not seen by chemically synthesized (small-molecule) drugs. These complexities increase during the clinical phases, where drug safety and efficacy milestones are still underdeveloped. For example, for autologous therapies such as chimeric antigen receptor T-cell therapies, in which the treatment is developed from the patient's own cells, supply chain management plays an integral role in chemistry, manufacturing and control processes. Supply chain management requires proactive planning because of the strict cold chain requirements and time sensitivity of CGTs. This research examines strategies and responses to challenges experienced by industry stakeholders (e.g., sponsors and manufacturers) during the implementation phases of clinical supply chain management. This research further evaluates the adequacy of the current regulatory framework for distribution and supply chain management of CGTs in the US. MethodsA survey methodology was used to query subject matter experts from the biopharmaceutical industry who were familiar with the clinical supply management of CGTs in the US. The survey instrument was developed using an implementation framework and disseminated electronically to mid- and senior-level subject matter experts who had experience with clinical trials, supply chain management and CGTs. ResultsA total of 128 respondents accessed the survey, and 105 respondents answered at least one question. Seventy-five respondents completed the survey. Results showed that a lack of harmonization in regulations across the supply chain, limited resources, challenges with vendor management, high costs and complexities in the supply chain due to product specificity and customization proved to be impediments for the industry. In addition, the coronavirus disease 2019 pandemic had a significant impact on supply chain implementation. The results revealed that less than half of the respondents had business continuity plans in place. These challenges increased for smaller and mid-size organizations. Thirty percent of small and mid-size organizations were less prepared to scale up than larger companies. ConclusionsSuggestions from industry stakeholders were to adopt and enforce Good Distribution Practices in the US (81%), pre-plan distribution strategies with internal and external stakeholders along the supply chain and develop agile systems and robust processes end to end. Hurdles in scaling up and scaling out from the clinical to commercial phases for time- and temperature-sensitive CGT products make it difficult to predict the supply chain's long-term feasibility. Although there are initiatives to improve these impediments, such as improving industry partnerships and creating global CGT transportation standards, there are still regulatory knowledge gaps present for CGTs. Therefore, it is essential to establish a baseline and foundation for CGT supply chains extending beyond the loading dock.

Cycling Characteristics of Tubular Liquid Antimony Anode Solid Oxide Fuel Cells Prepared by Atmospheric Plasma Spraying

Liquid antimony anode solid oxide fuel cell (LAA-SOFC) is a promising technology for efficient conversion of solid carbon and hydrocarbon fuels. However, the operating process and the regeneration method of the fuel cells with LAAs are different from those with solid anodes and still need to be investigated. In the present research, a tubular LAA-SOFC unit was fabricated by atmospheric plasma spraying based on a stainless-steel support. The LAA-SOFC was cycled by a furnace control method and a “hot plug” method to simulate the normal start-stop and the anode/cell replacement processes, respectively. Scarce degradation was observed after the cycles with phase change, redox and temperature variation, which demonstrated the robustness of the sprayed electrolyte to the anode changes. The air leakage and the floating ash retarded the recovery rate of the “hot plug” cycles, but have no influence on the degradation degree. The cycling characteristics in the present research proved the long-term operating feasibility of SOFC with LAA.

Impacts of Desalinated and Recycled Water in the Abu Dhabi Surficial Aquifer

In Abu Dhabi, one of the most arid regions in the world, in recent decades, desalinated water has been identified as a prime solution in solving the water demand issues. In this study, a three-dimensional coupled density-dependent flow and solute transport model was set up in order to study the effect of the artificial recharge using desalinated water and the influence of nonconventional water with a salt concentration in the range 0.1–2 g/L The results confirm that this region demands the adoption of a more rational use of irrigation water or additional usage of desalinated water and recycled water together with optimizing groundwater pumping at locations that are vulnerable to further quality degradation and depletion. The long-term storage of desalinated freshwater with a maximum radial distance of 653 m in the dune surface is ensured with the formation of the transition zone, and change in the groundwater head up to 5 km. The maximum recovery obtained by immediate recovery is 70%. The study expresses the long-term feasibility of desalinated freshwater storage and the need for further management practices in quantifying the contribution of desalinated and recycled water for agriculture activities which might have improved groundwater quality and increased hydraulic head at some locations.

Managing Biofouling on Submerged Static Artificial Structures in the Marine Environment – Assessment of Current and Emerging Approaches

The number, extent, diversity, and global reach of submerged static artificial structures (SSAS) in the marine environment is increasing. These structures are prone to the accumulation of biofouling that can result in unwanted impacts, both immediate and long-term. Therefore, management of biofouling on SSAS has a range of potential benefits that can improve structure functions, cost-efficiency, sustainability, productivity, and biosecurity. This review and synthesis collates the range of methods and tools that exist or are emerging for managing SSAS biofouling for a variety of sectors, highlighting key criteria and knowledge gaps that affect development, and uptake to improve operational and environmental outcomes. The most common methods to manage biofouling on SSAS are mechanical and are applied reactively to manage biofouling assemblages after they have developed to substantial levels. Effective application of reactive methods is logistically challenging, occurs after impacts have accumulated, can pose health and safety risks, and is costly at large scales. Emerging technologies aim to shift this paradigm to a more proactive and preventive management approach, but uncertainty remains regarding their long-term efficacy, feasibility, and environmental effects at operational scales. Key priorities to promote more widespread biofouling management of SSAS include rigorous and transparent independent testing of emerging treatment systems, with more holistic cost-benefit analyses where efficacy is demonstrated.

Investigating the effect of E30 fuel on long term vehicle performance, adaptability and economic feasibility

Due to the drawbacks associated with the use of petroleum derived fuels, the use of more sustainable fuel sources has garnered increasing attention in several sectors including road transportation. However, the transition away from gasoline is often hindered by the inability of currently operating vehicles to efficiently run under alternative fuels. Therefore, the logical short-term alternative is to transition to clean fuel sources including higher-ethanol fuel blends that are compatible with current fuel systems and spark-ignition engines. In this work, the long-term adaptability and economic feasibility of non-flex vehicles to consume a 30% ethanol (E30) fuel blend was investigated. Sixteen diagnostic and operating parameters were tracked in real-time in 50 vehicles over a one-year period. The vast amount of data generated was used to train sparse regression and machine learning models to explore differences in performance and operational robustness of commercial vehicles consuming E30 blends compared to the ones consuming 15% blends. Results indicate that although modest changes can be observed in the behavior of a subset of parameters, overall performance and adaptability are not compromised by consumption of E30. It was determined that an average price difference of 2.5% is sufficient to offset the mileage loss caused by the increased ethanol concentration.Finally, we discuss the large-scale environmental impact of an incremental nation-wide shift towards E30 consumption.

Cycling Characteristics of Tubular Liquid Antimony Anode Direct Carbon Fuel Cells Prepared by Atmospheric Plasma Spray

Liquid antimony anode direct carbon fuel cell (LAA-DCFC) is a promising technology for efficient conversion of solid carbon fuels. However, the operating process and the regeneration method of the fuel cells with LAAs are different from those with solid anodes and still need to be researched. In the present research, the tubular LAA-DCFC units were fabricated based on stainless steel support by atmospheric plasma spray (APS) technology. The LAA-DCFCs were cycled by furnace control method and “hot plug” method to simulate the normal start-stop and the anode regeneration processes, respectively. No degradation was observed after five temperature cycles of furnace control test, which showed that the phase change process of the LAA has no influence on the sprayed electrolyte and cathode. During the “hot plug” test, the tubular cell was measured in Ar atmosphere and was removed from and put back into the LAA at a speed of 20 mm min-1 and 50℃ min-1. The cell performance recovered once the cell was put back and a degradation of 0.1% cycle-1 was observed. Considering the low frequency of anode regeneration, the degradation rate is relatively acceptable. The environmental air leakage and the floating ash retarded the recovery rate, but have no influence on the degradation degree. The cycling characteristics in the present research proved the long-term operating feasibility of DCFC with LAA.

Novel District Heating Systems: Methods and Simulation Results

Fifth-generation district heating and cooling (5th DHC) systems offer promising approaches to decarbonizing space heating, cooling and domestic hot water supply. By using these systems, clustered buildings combined with industrial waste heat can achieve a net-zero energy balance on a variety of time scales. Thanks to the low exergy approach, these systems are highly efficient. As part of the Smart Anergy Quarter Baden (SANBA) project, the thermal energy grid simulation tool TEGSim has been further developed and used to design an ultra-low-temperature district heating (ULTDH) network with hydraulic and thermal components fitted to the specific regional characteristics of the investigated case. Borehole thermal energy storage (BTES) used as seasonal storage ensures long-term feasibility. The annual discrepancy of input of thermal energy provided by space cooling and output of energy demanded by space heating and domestic hot water is supplied by an external low-grade industrial waste heat source. This paper presents the functionality of the simulation and shows how to interpret the findings concerning the design of all components and their interplay, energy consumption and efficiencies.

Cycling Characteristics of Tubular Liquid Antimony Anode Direct Carbon Fuel Cells Prepared by Atmospheric Plasma Spray

Liquid antimony anode solid oxide fuel cell (LAA-SOFC) is a promising technology for efficient conversion of solid carbon and hydrocarbon fuels. However, the operating process and the regeneration method of the fuel cells with LAAs are different from those with solid anodes and still need to be investigated. In the present research, a tubular LAA-SOFC unit was fabricated by atmospheric plasma spraying based on a stainless-steel support. The LAA-SOFC was cycled by a furnace control method and a “hot plug” method to simulate the normal start-stop and the anode/cell replacement processes, respectively. Scarce degradation was observed after the cycles with phase change, redox, and temperature variation, which demonstrated the robustness of the sprayed electrolyte to the anode changes. The air leakage and the floating ash retarded the recovery rate of the “hot plug” cycles, but have no influence on the degradation degree. The cycling characteristics in the present research proved the long-term operating feasibility of SOFC with LAA.

Imitated Whole Tree Harvesting Show Negligible Effect on Economic Value of Spruce Stands

The increased removal of forest-derived biomass with whole-tree harvesting (WTH) has raised concerns about the long-term productivity and sustainability of forest ecosystems. If true, this effect needs to be factored in the assessment of long-term feasibility to implement such a drastic forest management measure. Therefore, the economic performance of five experimental plantations in three different forest types, where in 1971 simulated WTH event occurred, was compared with pure, planted and conventionally managed (CH) Norway spruce stands of similar age and growing conditions. Potential incomes of CH and WTH stands were based on timber prices for period 2014–2020. However, regarding the economics of root and stump biomass utilization, they were not included in the estimates. In any given price level, the difference of internal rate of return between the forest types and selected managements were from 2.5% to 6.2%. Therefore, Norway spruce stands demonstrate good potential of independence regardless of stump removal at the previous rotation.

Demonstration of proof-of-concept of StrokeShield system for complete closure and occlusion of the left atrial appendage for non-valvular atrial fibrillation therapy.

In the US, the most significant morbidity and mortality associated with non-valvular atrial fibrillation (NVAF) is embolic stroke, with 90% of thrombus originating from the left atrial appendage (LAA). Anticoagulation is the preferred treatment for the prevention of stroke in NVAF patients, but clinical studies have demonstrated high levels of non-compliance and increased risk of bleeding or ineligibility for anticoagulation therapy, especially in the elderly population where the incidence of NVAF is highest. Alternatively, stroke may be preventing using clinically approved surgical and catheter-based devices to exclude or occlude the LAA, but these devices continue to be plagued by peri-device leaks and thrombus formation because of residual volume. To overcome these limitations, Cor Habere (Louisville, KY) and the University of Louisville are developing a LAA closure device (StrokeShield) that completely occludes and collapses the LAA to minimize the risk of stroke. The StrokeShield device is a collapsible occluder (nitinol reinforced membrane) that completely covers the LAA orifice with an expandable conical coil anchor that attaches to the myocardium. The device is designed for catheter-based delivery and expands to completely occlude the LAA orifice and collapse the LAA. The primary advantages of the StrokeShield system are a completely sealed LAA (no peri-device flow or residual space) and smooth endothelialized connection to the left atrial wall with minimal risk of cardiac bleeding and tamponade. We tested proof-of-concept of a prototype StrokeShield device in acute (n = 2) and chronic 60-day (n = 2) healthy canine models. Acute results demonstrated that the conical coil securely attached to the myocardium (5N pull-out force) and the Nitinol umbrella fully deployed and covered the LAA ostium. Results from the chronic implants demonstrated long-term feasibility of device placement with no procedural or device-related intra- or post-operative complications, secure placement and correct positioning of the device with no device migration. The device successfully occluded the LAA ostium and collapsed the LAA with no interference with the mitral valve, circumflex coronary artery, or pulmonary veins. Necropsy demonstrated no gross signs of thrombus or end-organ damage and the device was encapsulated in the LAA. Histology demonstrated mature neointima covering the device with expected foreign body inflammatory response. These early positive results will help to guide the iterative design process for the continued development of the StrokeShield system.

Mechanical-biological treatment of municipal solid waste: Case study of 100 TPD Goa plant, India

A long-term feasibility analysis of a 100 ton per day mechanical biological treatment (MBT) plant for municipal solid waste (MSW) valorization and material and energy recovery was carried out. It involves the material recovery and segregation stage (MRSS), organic extraction (pulping), thermophilic anaerobic digestion (AD), composting, effluent treatment plant (ETP), and biogas genset stages producing: 11.90% recyclables, 33% refused derived fuel (RDF), 5% compost of total waste received, 70 m3/day recyclable water and 0.435 MWh/day electricity. The biogas and methane yield were 0.535 and 0.350 m3/kg VSadded (avg.), respectively, with 40% VS removal (avg total solids (TS) 10%). Less than 3% (inert) of total waste received was subjected to landfill disposal. The MBT plant's revenue generation is 995 US$ per day/148 tons ($ 6.72/ton) waste processed. The gross OPEX is 24 US$/ton making the net OPEX of 17 US$/ton (minus revenue), which could be considered as the excellent OPEX for MSW based MBT plants as per global benchmarks. Further, local usage of RDF can significantly reduce the OPEX to 14 US$/ton, as almost 16% of the OPEX goes towards RDF disposal to cement companies located at a distance of 200–500 km from the MBT plant site. As per LCA study, the total GHG emissions have been calculated to be −25.68 tons CO2 eq./100 tons MSW. The negative emissions result from the export of electricity, compost, and RDF as well as recycling of paper and plastic products. Our study presents a cutting-edge scenario of all-inclusive recycling, recovery, and reuse loop of MSW direly required for accomplishing a circular economy.

Quality control of long-term mass-reared Aedes albopictus for population suppression

The endosymbiotic bacterium Wolbachia is being developed as a tool to suppress mosquito populations and their transmitted pathogens, with successful field trials in multiple countries having resulted in efforts to scale up the capacity to mass-produce mosquitoes for release. However, major challenges exist to achieving this goal, including concerns that mass-reared mosquitoes will adapt to laboratory conditions during long-term maintenance and experience inbreeding depression, resulting in poor performance of the released mosquitoes in the field. Here, we assessed the performance of the Aedes albopictus HC line infected with a triple-strain Wolbachia after mass-rearing at scaled-up densities of up to 15 million mosquitoes per week for over 50 generations. In comparison with the wild-type GUA line, the HC mosquitoes had desirable characteristics for mass-rearing and release, including robust male mating competitiveness, high female reproductive capacity, reduced vector competence for dengue virus, and increased Wolbachia density. Although the larval survival rate of the HC and GUA lines was similar, the HC larvae developed significantly faster, possibly because of up-regulation of the molting hormone 20-hydroxyecdysone-related gene E75 in the HC larvae. Our results indicate that over many generations mass-reared mosquito lines can retain their quality if large effective population sizes with sufficient genetic heterogeneity are maintained under optimized rearing conditions and demonstrate the long-term feasibility of deploying Wolbachia-based approaches for area-wide management of mosquito vectors for disease control.

Feasibility of long-term continuous flow total heart replacement in calves.

Implementation of continuous flow (CF) technology in modern ventricular assist devices (VAD) has afforded a wealth of engineering and design advantages in the development of a total artificial heart (TAH). However, clinical application of CF has created a unique physiologic state, the consequences of which remain largely unknown. We sought to evaluate clinical and biochemical markers of end-organ function in calves supported with biventricular CF VADs for more than 30 days. Eight calves survived longer than 30 days following biventriculectomy and implantation of dual CF VADs. Four types of CF pumps were utilized for the study. Serial hematologic and biochemical profiles were drawn as markers for end-organ function, and hemodynamic data-including pump flows and intravascular pressures-were continuously monitored. The eight calves survived an average of 58.8 days (range 30-92 days). Two of the calves were electively terminated at the conclusion of the study period, while the remaining animals were euthanized as a result of respiratory distress (n = 2) or impaired pump flows (n = 4). In each case, serial biochemical and hematologic values were suggestive of preserved end-organ function. Six animals successfully participated in treadmill exercise evaluations. No evidence of end-organ damage was encountered upon necropsy or histologic tissue analysis. Biventricular CF VAD implantation permits a viable bovine CFTAH model capable of demonstrating long-term survival. After 30 days of completely nonpulsatile flow, cumulative hemodynamic, clinical, biochemical, and histological analyses were consistent with preserved end-organ function, suggesting previously unreported long-term feasibility of a CFTAH design.

Long-Term Safety and Feasibility of Left Bundle Branch Pacing in a Large Single-Center Study.

Left bundle branch pacing (LBBP) is a novel pacing method and has been observed to have low and stable pacing thresholds in prior small short-term studies. The objective of this study was to evaluate the feasibility and safety of LBBP in a large consecutive diverse group of patients with long-term follow-up. This study prospectively enrolled 632 consecutive pacemaker patients with attempted LBBP from April 2017 to July 2019. Pacing parameters, complications, ECG, and echocardiographic measurements were assessed at implant and during follow-up of 1, 6, 12, and 24 months. LBBP was successful in 618/632 (97.8%) patients according to strict criteria for LBB capture. Mean follow-up time was 18.6±6.7 months. Two hundred thirty-one patients had follow-up over 2 years. LBB capture threshold at implant was 0.65±0.27 mV at 0.5 ms and 0.69±0.24 mV at 0.5 ms at 2-year follow-up. A significant decrease in QRS duration was observed in patients with left bundle branch block (167.22±18.99 versus 124.02±24.15 ms, P<0.001). Postimplantation left ventricular ejection fraction improved in patients with QRS≥120 ms (48.82±17.78% versus 58.12±13.04%, P<0.001). The number of patients with moderate and severe tricuspid regurgitation decreased at 1 year. Permanent right bundle branch injury occurred in 55 (8.9%) patients. LBB capture threshold increased to >3 V or loss of bundle capture in 6 patients (1%), 2 patients of them had a loss of conduction system capture. Two patients required lead revision due to dislodgement. This large observational study suggests that LBBP is feasible with high success rates and low complication rates during long-term follow-up. Therefore, LBBP appears to be a reliable method for physiological pacing for patients with either a bradycardia or heart failure pacing indication.

ROBUST DECISION MAKING (RDM) INVESTIGATION IN WATER RESOURCES PLANNING AND DISASTER MITIGATION IN MAKASSAR CITY, INDONESIA

The Kota Makassar water utility serving (&lt;em&gt;Perusahaan Daerah Air Minum&lt;/em&gt; - PDAM) faces a significant problem in managing water resources for their drinking water supply. The problems comprise raw water supply, the vulnerability of water quality, infrastructures, costs, and climate change uncertainty. The availability of clean water is one of the problems in the field of national defense. Because water is the main source of life in all sectors, be it agriculture or livestock. This study is aimed at assisting officials in making an adaptive and resilient decision. It involves inter-and cross-disciplinary studies within Robust Decision-Making (RDM) in water resources management planning for drinking water supply and disaster mitigation in Makassar. This research applies a qualitative approach in data analysis; reviewing strategies used by the utility management to anticipate all uncertainty, long-term strategies feasibility from simulation models, analyzing potential vulnerability scenarios, and the trade-off for an adaptive and robust decision in water resources management planning for drinking water supply in Makassar through RDM. The novelty lies in the raw water management policy that is more adaptive toward potential vulnerability and presents a variety of raw water supply alternatives in the long term. Reviews against the document of drinking water Master Plan found that the absence of harmony along with a high level of anticipation towards the threat of climate change along with their impact, as well as the threat of the raw water supply limitations due to the exogenous problems beyond the reach of human beings capacity, will result in global and long-term impact.