Pilot Sites Research Articles

Seagrass restoration trials in tropical seagrass meadows of Kenya

The degradation of seagrasses is becoming prevalent in the Western Indian Ocean (WIO) region due to anchor damage, sea urchin herbivory, extreme events such as cyclones and floods and anthropogenic factors such as pollution and sediment inflows. Consequently, there have been numerous efforts to advance the restoration of degraded seagrass beds in several countries in the region. In Kenya, experimental restoration efforts were started in 2007 in response to seagrass habitat degradation due to sea urchin herbivory. Although the initial efforts experienced challenges, there were lessons learned which provided insights into subsequent restoration work using different techniques. In this paper, insights are provided into three types of restoration techniques; the sod technique, the seagrass mimic technique, and the Hessian bag technique. In the case of the sod technique, Thalassodendron ciliatum showed a decline from 20 ± 1.7 shoots sod-1 in the first three weeks to 7 ± 4.4 shoots sod-1 at the end of the experimental period of the study, while Thalassia hemprichii sods showed an increase from 28 ± 3.4 shoots sod-1 to 32 ± 2.7 shoots sod-1 over the same period. For the Hessian bag method, the expectation was that the pilot site would be filled with the transplanted seagrass species, Thalassia hemprichii, but the findings showed that different species including Halodule uninervis, Syringodium isoetifolium, Halophila stipulacea, Cymodocea rotundata, and Cymodocea serrulata colonized the area. This indicated that it was not possible to restore the area to its original status, but that the area could be rehabilitated. The costs of restoration have also been assessed as well as community participation in such initiatives. These findings provide insights for restoration efforts in Kenya and provide a baseline for future work.

Abstract NS7: Steps To An Early And Successful Adoption Of Iv Tenecteplase By A Large Integrated Medical System

Background: In 2020, a large integrated healthcare system consisting of 21 stroke centers implemented IV tenecteplase as the first line pharmaceutical treatment for acute ischemic stroke (AIS) prior to universal adoption in national clinical practice guidelines and FDA approval for stroke. Purpose: To describe the steps taken for successful implementation of IV tenecteplase as a first therapy for AIS in 21 stroke centers, part of an integrated system. Methods: Pre-implementation steps included gaining systemwide acceptance, especially from key stakeholders such as emergency department staff, patient care services, tele-stroke and neurology physicians, as well as risk management. We addressed potential impacts to related to reimbursement, stroke certification, and national award status. Inclusive changes were made to related policy and procedures, order sets, and other documentation. Standardized training and beta-testing were conducted and a sequential roll-out implemented along the real-time central monitoring. Results: Stakeholder groups were engaged prior to implementation with town halls and in-person and desktop simulation exercises. Beta-testing took place in August 2020 with three pilot sites with full system wide implementation by Nov. 2020. Since full implementation, tenecteplase is the only thrombolytic that has been ordered (n=423). Door in door out times have decreased (median 131 minutes pre- to 88 minutes post; p<0.05). In addition, symptomatic ICH rates have decreased by greater than 50% (p<0.05) and there are no reports of systemic bleeding or angioedema. Conclusion: Tenecteplase has been shown to be safe and feasible as a first line thrombolytic within our organization. Strong nurse and physician leads, as well as thoughtful and inclusive implementation steps were key in the successful adoption of this system-wide change.

Cost–benefit analysis of coastal flood defence measures in the North Adriatic Sea

Abstract. The combined effect of global sea level rise and land subsidence phenomena poses a major threat to coastal settlements. Coastal flooding events are expected to grow in frequency and magnitude, increasing the potential economic losses and costs of adaptation. In Italy, a large share of the population and economic activities are located along the low-lying coastal plain of the North Adriatic coast, one of the most sensitive areas to relative sea level changes. Over the last half a century, this stretch of coast has experienced a significant rise in relative sea level, the main component of which was land subsidence; in the forthcoming decades, climate-induced sea level rise is expected to become the first driver of coastal inundation hazard. We propose an assessment of flood hazard and risk linked with extreme sea level scenarios, under both historical conditions and sea level rise projections in 2050 and 2100. We run a hydrodynamic inundation model on two pilot sites located along the North Adriatic coast of Emilia-Romagna: Rimini and Cesenatico. Here, we compare alternative extreme sea level scenarios accounting for the effect of planned and hypothetical seaside renovation projects against the historical baseline. We apply a flood damage model to estimate the potential economic damage linked to flood scenarios, and we calculate the change in expected annual damage according to changes in the relative sea level. Finally, damage reduction benefits are evaluated by means of cost–benefit analysis. Results suggest an overall profitability of the investigated projects over time, with increasing benefits due to increased probability of intense flooding in the near future.

Identifying factors which induce transitive processes in blasthole drilling in structurally complex rock masses

A new methodological approach is proposed to identify the effect of changing conditions on the performance of drilling operations in open pit mining. Drilling is presented as a subsystem of the more general system called a “mine”, the stability of which is affected by multiple factors. This paper describes the first stage of implementing the proposed methodological approach to identify the blasthole drilling factors that govern the transitive processes as necessary reactions of the “drilling operations” subsystem when adapting to the changing operating conditions. The revealed main factors which affect the “drilling operations” subsystem stability at the level of blasthole drilling at the pilot site of a mine are presented.

Newborn and infant hearing screening at primary healthcare clinics in South Africa designated as National Health Insurance pilot sites: An exploratory study.

BackgroundPrimary healthcare (PHC) is the first point of entry, providing basic services to individuals. South Africa is in the process of re-engineering its PHC as part of National Health Insurance (NHI) plans to ensure universal healthcare coverage.AimThis study aimed to establish whether newborn and infant hearing screening (NIHS) could be integrated into the re-engineering process of the PHC as part of the NHI framework.SettingThe NHI pilot clinics in five provinces in South Africa.MethodsA non-experimental, descriptive, cross-sectional survey research design was adopted. Questionnaires were sent to nursing managers, unit managers or acting managers at PHC facilities. Nineteen of these self-administered questionnaires were completed. Data were analysed using descriptive statistics.ResultsImmunisation services were the most common type of service offered at the clinics. Over a quarter of the respondents indicated that NIHS services were offered at their facility in the form of universal NIHS. Equipment was limited with a lack of valid and reliable screening measures. Only 2 (11%) respondents indicated budgetary resources. Follow-up and referral pathways were reported by 10 (53%) respondents, which did not include an audiologist.ConclusionsThere is a need for careful and systematic planning in terms of early hearing detection programmes at PHC level. Planning needs to commence with considerations of who will perform NIHS, training of these personnel by audiologists and the role of the audiologist within the teams outlined in the NHI Bill.

ESTIMATION OF FINANCIAL LOSSES OF RUSSIAN EXPORTERS OF CARBON DEPOSITS: A REGIONAL ASPECT

The article analyzes the impact of the EU climate strategy on the export of carbon-intensive products. The content of the draft law on cross-border carbon regulation (TUR) published by the European Commission (EU) is disclosed. It is argued that the tax burden will actually be borne by exporters exporting these products to EU countries. The negative financial consequences of the adoption of the TOUR are analyzed, which will be differentiated depending on the country of origin of the carbon-intensive product. The necessary actions of the EU's foreign economic partners to mitigate the negative consequences of the adoption of the TOUR are given. Regional initiatives on carbon pricing are named as a real measure to reduce the negative effect. Their assessment was made on the example of the North-Western Federal District of Russia (NWFD). Two variants of the potential impact of the TUR mechanism on the export of the NWFD regions are considered: basic and pessimistic. For each option, the potential volume of regional exports falling under the cross-border carbon regulation mechanism and the corresponding amount of financial losses of exporters of the NWFD subjects are determined. According to the results of the calculations carried out, the subjects of the Northwestern Federal District, the most vulnerable to the introduction of TUR, were identified. The relevance of regional projects of economic regulation of greenhouse emissions is substantiated, examples of pilot sites of the Northwestern Federal District for their implementation are given.

Implementation of an enhanced recovery after surgery protocol for bariatric surgery - A qualitative study

BackgroundEnhanced Recovery After Surgery (ERAS) Protocols are well-established in fields such as colorectal surgery but within bariatric surgery have not been uniformly adopted by all programs. MethodsQualitative study with focus groups at five hospitals participating in a statewide bariatric surgery quality improvement collaborative. Members of the clinical care team at each pilot site participated. Participants described barriers to implementation, and strategies to address these. ResultsParticipants expressed satisfaction with the implementation process. Barriers included a lack of buy-in from team members, availability of specific resources, staffing turnover, and interruption to implementation. Increased communication at all phases and a specific point-person to guide implementation would improve success. ConclusionsThese findings will be integrated into our work as we continue to implement this protocol at all hospitals participating within the collaborative. Future work will focus on the impact of the protocol on clinical outcomes and patient satisfaction following surgery.

Institutional development of circular economy in Russia and St. Petersburg

The term "circular economy" appeared relatively recently in Russia. Interest to the circular economy and the number of publications is growing. The concept of circular economy is very closely related to the green economy, bioeconomics, and low-carbon economy, which are based on moving away from fossil fuels and the development of new technologies. However, in Russia, most often circular economy means recycling system. The principles of circular economy are aimed at the economic, social, and environmental well-being of people. Experts identify factors that promote and hinder the development of circular economy in Russia. Issues of sustainable development, circular economy and energy transition are actively discussed by representatives of government, business and science at international and all-Russian forums. The principles of circular economy will allow achieving several Sustainable Development Goals. The circular economy is one of the key factors in achieving carbon-free energy goals. In St. Petersburg, profile committees, centers and associations are actively working in this direction. Consortia of international projects of most programs are formed from partners based on a triple helix approach- representatives of government, business and universities. The international projects of cross–border cooperation programmes "South-East Finland - Russia", "Estonia - Russia" and the INTERREG Baltic Sea region are considered. Pilot sites are being implemented within the framework of many international projects, with the possibility of further replication of successful experience. The legislative base of Russia and St. Petersburg in the field of circular economy is considered in detail.

Auto-SDA

Social distancing can reduce infection rates in respiratory pandemics such as COVID-19, especially in dense urban areas. To assess pedestrians' compliance with social distancing policies, we use the pilot site of the PAWR COSMOS wireless edge-cloud testbed in New York City to design and evaluate an Automated video-based Social Distancing Analyzer (Auto-SDA) pipeline (shown in Fig. 1). This pipeline measures the distance between unaffiliated pedestrians (i.e., the pedestrians who do not walk together as a social group) and assesses if they maintain 6 ft distance.

Swin Transformer and Deep Convolutional Neural Networks for Coastal Wetland Classification Using Sentinel-1, Sentinel-2, and LiDAR Data

The use of machine learning algorithms to classify complex landscapes has been revolutionized by the introduction of deep learning techniques, particularly in remote sensing. Convolutional neural networks (CNNs) have shown great success in the classification of complex high-dimensional remote sensing imagery, specifically in wetland classification. On the other hand, the state-of-the-art natural language processing (NLP) algorithms are transformers. Although the transformers have been studied for a few remote sensing applications, the integration of deep CNNs and transformers has not been studied, particularly in wetland mapping. As such, in this study, we explore the potential and possible limitations to be overcome regarding the use of a multi-model deep learning network with the integration of a modified version of the well-known deep CNN network of VGG-16, a 3D CNN network, and Swin transformer for complex coastal wetland classification. Moreover, we discuss the potential and limitation of the proposed multi-model technique over several solo models, including a random forest (RF), support vector machine (SVM), VGG-16, 3D CNN, and Swin transformer in the pilot site of Saint John city located in New Brunswick, Canada. In terms of F-1 score, the multi-model network obtained values of 0.87, 0.88, 0.89, 0.91, 0.93, 0.93, and 0.93 for the recognition of shrub wetland, fen, bog, aquatic bed, coastal marsh, forested wetland, and freshwater marsh, respectively. The results suggest that the multi-model network is superior to other solo classifiers from 3.36% to 33.35% in terms of average accuracy. Results achieved in this study suggest the high potential for integrating and using CNN networks with the cutting-edge transformers for the classification of complex landscapes in remote sensing.

Improving screening and management of latent tuberculosis infection: development and evaluation of latent tuberculosis infection primary care model

BackgroundIn Australia, demand for specialist infectious diseases services exceeds capacity to provide timely management of latent tuberculosis infection (LTBI) in areas of high refugee and asylum seeker settlement. A model for treating LTBI patients in primary care has been developed and piloted in a refugee-focused primary health service (Monash Health Refugee Health and Wellbeing [MHRHW]) and a universal primary care clinic. This study reports on the development and evaluation of the model, focusing on the model feasibility, and barriers and enablers to its success.MethodsA convergent mix-methods design was used to evaluate the model for treating LTBI patients in primary care, where a prospective cohort study of patients commencing treatment either at MHRHW or the universal primary care clinic determined the model feasibility, while focus groups with clinicians directly involved in treating these patients explored barriers and enablers to sustainability and success of the model.ResultsFrom January 2017 to April 2018, 65 patients with confirmed LTBI presented at participating clinics. Treatment was accepted by 31 (48%) patients, of whom 15(48%) were treated at MHRHW and 16 (52%) at the universal primary care clinic. The 6-months’ treatment completion rate was higher at MHRHW compared to the universal primary care clinic (14 (93%) compared to 9 (56%) respectively, p = 0.0373). Reasons for non-completion included adverse reaction, opting out and relocation. At the completion of the pilot, 15 clinicians participated in two focus groups. Clinicians identified barriers and enablers for successful LTBI management at patient, provider, organisational and clinical levels. While barriers for treatment completion and adherence were consistent across the two pilot sites, enablers, such as resources to facilitate patient education and follow-up, were available only at MHRHW.ConclusionScreening and management of LTBI patients can be achieved within the primary care setting, considerate of barriers and enablers at patient, provider, organisational and clinical levels. Upscaling of a primary care response to the management of LTBI will require supporting primary care clinics with resources to employ dedicated clinical staff for patient education, follow-up communication and monitoring medication adherence.

Dynamics of the structure of the forage stock of the main pastures of the desert of Kazakhstan

The article is devoted to the study of the pasture flora and the analysis of the structure of the forage reserve of the main pastures of the desert of Kazakhstan. The composition and structure of the vegetation cover of the pasture areas of 4 pilot sites has been analyzed. The results of the distribution of forage plants by biotopes show that the botanical composition of the structure of the forage reserve and the nutritional value of pasture forage vary significantly depending on the type of desert pastures and the season of their use.

Techno-socio-economic analysis of geological carbon sequestration opportunities

Although geological carbon sequestration is considered one of the pillars required to achieve the goals of the Paris Agreement, only a few demonstration sites are currently being developed around the globe. A workflow is presented here to identify potential new pilot sites.

Data Investigation in the Process of Selecting a CO2 Geological Pilot Site: example of the Paris Basin (France)

Data Investigation in the Process of Selecting a CO2 Geological Pilot Site: example of the Paris Basin (France)

The Implementation of Whole-School Approaches to Transform Mental Health in UK Schools: A Realist Evaluation Protocol

Evidence suggests that mental health interventions are more effective when they consider the whole context of schools; addressing the needs of all students, their families, and staff; otherwise known as a whole-school approach (WSA). The UK Government is piloting WSAs to transform mental health and wellbeing by locating educational mental health practitioners in educational settings across England. This study aims to develop a ‘bottom-up’ understanding of the contextual factors and mechanisms that underlie WSAs in Trailblazer schools in the North East and North Cumbria, to gain insight into the facilitators and barriers of delivering a WSA, and optimal evaluation methods. To undertake a realist evaluation, we included the generation of initial programme theories from existing academic literature and policy documents; ‘theory gleaning’ interviews with NHS/local authority stakeholders, Trailblazer staff and school senior leaders; refining and development of theories; and individual interviews and focus groups with pupils, parent/carers and school staff. The findings will enable Trailblazer partners to better understand how their WSAs to mental health contain the essential components for transformation in schools in the region. This will contribute to the embedding of continuous evaluation into regional Trailblazers’ practice for participating schools, for subsequent annual waves and producing relevant findings for non-Trailblazer schools. Complementing the national evaluation of all 25 Wave 1 Trailblazer pilot sites, this study will generate an explanatory theoretical account of how to optimally design, implement and evaluate WSAs by exploring the contextual factors associated with implementation of WSAs.

Using Telehealth to Improve the Accuracy of Delirium Screening by Bedside Critical Care Nurses.

Delirium affects up to 80% of patients in the intensive care unit (ICU) but is missed in up to 75% of cases. Telehealth in the ICU (tele-ICU) has become the standard for providing timely, expert care to remotely located ICUs. This pilot study assessed the feasibility and acceptability of using tele-ICU to increase the accuracy of delirium screening and recognition by ICU nurses. The pilot sites included 4 ICUs across 3 hospitals. A geriatrician with delirium expertise remotely observed 13 bedside ICU nurses administering the Confusion Assessment Method for the ICU (CAM-ICU) to patients in real time via the tele-ICU platform and subsequently provided training on CAM-ICU performance and delirium management. Training evaluation consisted of a validated spot check form, a 2-item satisfaction/change-of-practice survey, and a qualitative question on acceptability. Thirteen ICU nurses were observed performing 26 bedside delirium assessments. The top observed barriers to accurate delirium screening were CAM-ICU knowledge deficits, establishment of baseline cognition, and inappropriate use of the "unable to assess" designation. The mean percentage of correct observations improved from 40% (first observation) to 90% (second observation) (P < .001). All 13 nurses strongly agreed that the training was beneficial and practice changing. The use of tele-ICU to improve the accuracy of delirium screening by ICU nurses appears to be feasible and efficient for leveraging delirium expertise across multiple ICUs. Future studies should evaluate the effects of tele-ICU delirium training on patient-centered outcomes.

Evaluation of the Physical and Chemical Fertility of Soils in the Sylvopastoral Zone: Case of the Pilot Site of the National Institute of Pedology in the Commune of Kelle Gueye (Louga/Senegal)

The study of the reference state of the physico-chemical fertility of the soils of the pilot site of the National Institute of Pedology in the commune of Kelle Gueye to test the effect of phosphocomposte on cowpea and groundnut, allowed us to better understand the aptitudes of the above-mentioned crops. The methodology used consisted of taking soil samples on a regular 25 m grid, carrying out complete physico-chemical analyses at the INP laboratory and an analysis of climatic parameters. The results obtained were used to produce thematic maps to better interpret the various parameters. The physico-chemical analyses at the 0 - 20 cm horizon show a pH (6.1 - 7.9) close to neutral and a non-saline soil (EC < 250 μS/cm). The site is poor in organic matter; it is of the order of 0.1 ≤ MO ≤ 0.9. The granulometric results determined from a laser granulometry which gives more precision, show that the soils have a texture dominated by fine sands with more than 50% in the site. This study reveals that the site is suitable for groundnut and cowpea cultivation. However, some chemical parameters need to be improved to make the soil more fertile.

Reverse Engineering and Design of a Windmill Pumping System suitable for Wind Conditions: A Case Study in a Suburb of Tajoura, Libya

Water-pumping windmills are reliable alternatives to provide water in some areas isolated from the electricity network, especially those with poor wind sources that are insufficient to operate wind turbines to generate electricity. The successful design of windmills for water pumping requires careful study of many variable parameters depending on the wind pattern and topography of the site. However, in this study, the researchers relied on the application of an integrated approach between forwarding Engineering (FE) and Reverse Engineering (RE), with the aim of obtaining a 3D CAD model of a water pumping windmill system.This 3D model will be the basis for manufacturing the windmill prototype that will be installed at a pilot site in a suburb of the city of Tajoura within a research project. The FE activities cannot be neglected when applying RE for the successful manufacturing of the windmills. The wind data recorded at the Center for Solar Energy Research and Studies (CSERS) for several years was used for calculating daily and monthly average wind speed and studying the daily wind pattern. The analysis of the collected wind data showed that the minimum and maximum daily average wind speed at Tajoura varies from 2.35m/s to 4.69 m/s, and theannual average wind speed is 3.24m/s. Among the Forward design, activity is estimating the wind resources available at the site for sizing the system to provide the site water requirements of 5 m³/day. From this point on, a commercial water-pumping windmill of 4.88m (16ft and a standard tower height of 12m were chosen to be the target of a RE application to obtain a CAD model. RE is accomplished in three phases: digitizing the component (part), processing the measured data, and creating the CAD model. To adopt the 3D model for all parts, they must be compared with the original scanned data using Deviation Analysis in CATIA. Afteradopting the 3D models of all the system components, the 3D assembly models were created based on the integrated approach between RE and FE. Finally, it is worth noting that the windmills for water pumping could not be manufactured solely by just applying reverse engineering.

Assessing the influence of the hydraulic boundary conditions on clay slope stability: The Fontana Monte case study

Recent studies have assessed that slope-vegetation-atmosphere, SLVA, interaction may trigger the activity of deep landslides in clayey slopes. In some cases, the presence of an underground aquifer, fed by an upstream hydraulic recharging area, may represent a predisposing factor of such activity, being co-responsible of deep piezometric heads, which can undergo seasonal fluctuations due to the SLVA interaction. In this perspective, the present paper illustrates the results of a scientific research, carried out in a pilot site of the Daunia Apennines, the Fontana Monte slope at Volturino (Foggia, Italy), considered as a prototype of the class of landslide mechanisms controlled by both the rainfall water infiltration and the presence of a water-bearing aquifer in the hillslope.Numerical simulations of the saturated/partially saturated transient seepage flow in the slope have been performed by means of uncoupled hydraulic finite element analyses, with the aim of investigating the sources of large piezometric heads, related to climatic, hydrogeological and hydraulic slope features. The rainfall and evapotranspiration fluxes, the latter defined through the FAO Penman-Monteith method, are both implemented as ground surface input, while seasonal variations of the upstream hydraulic boundary conditions are imposed to predict the seasonal piezometric excursion at shallow and deep monitoring points. The transient seepage results are then used as input for limit equilibrium analyses to assess the influence of the hydraulic settings on the stability of the considered landslide body. The work shows the impact of both climatic and hydraulic factors on the seepage processes, affecting the stability of the slope. Moreover, it is highlighted that the accurate implementation of the upstream hydraulic feeding is fundamental for a reliable prediction of the monitored piezometric regime, strictly related to the recharge of the water-bearing aquifer.

Effects of customized climate services on land and labor productivity in Burkina Faso and Ghana

Climate services favor adopting strategies to increase agricultural productivity, enhance sustainable development, and adapt to unavoidable climate variability and change. However, for climates services to be effective, they must be accessible and suitable to user needs. This study investigated the effects of customized climate services (CCS) on land and labor productivity. Portraying the case of CCS delivered in the districts of Bolgatanga (Northern Ghana), Dano and Ouahigouya (western and northern Burkina Faso) in West Africa, it used: i) historical panel data of daily rainfall, yields, agricultural input, and output prices; ii) cost statements of farm operations and iii) other survey data from beneficiaries of on-farm demonstrations (pilot sites). Different results were found across farmers on the demonstrator sites, with Dano and Bolgatanga recording the best land and labor productivity. Strong and positive effects were observed in Dano, where land productivity increased by 200% and labor productivity doubled despite consecutive pluviometric extremes such as heavy rain events and prolonged dry spells in the 2017 and 2018 cropping seasons. Further investigation showed that CCS was particularly favorable to land and labor productivity of farmers who were committed to the advisory given by the CCS providers. Therefore, as perishable goods, the success of CCS applications would require thorough co-production, delivery, and monitoring for their effectiveness in improving land and labor productivity for agriculture in semi-arid regions of West Africa.