Search results for: adaptive lookup tables

Authors: Ngoc-Nguyen Nguyen, Hsiu-Ling Chen, Thanh-Truc Lai Huynh

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In foreign language learning, vocabulary acquisition has consistently posed challenges to learners, especially for those at lower levels. Conventional approaches often fail to promote vocabulary learning and ensure engaging experiences alike. The emergence of mobile learning, particularly the integration of chatbot systems, has offered alternative ways to facilitate this practice. Chatbots have proven effective in educational contexts by offering interactive learning experiences in a constructivist manner. These tools have caught attention in the field of mobile-assisted language learning (MALL) in recent years. This research is conducted in an English for Specific Purposes (ESP) course at the A2 level of the CEFR, designed for non-English majors. Participants are first-year Vietnamese students aged 18 to 20 at a university. This quasi-experimental study follows a pretest-posttest control group design over five weeks, with two classes randomly assigned as the experimental and control groups. The experimental group engages in chatbot-assisted spaced practice with SRL components, while the control group uses the same spaced practice without SRL. The two classes are taught by the same lecturer. Data are collected through pre- and post-tests, cognitive load surveys, and semi-structured interviews. The combination of self-regulated learning (SRL) and distributed practice, grounded in the spacing effect, forms the basis of the present study. SRL elements, which concern goal setting and strategy planning, are integrated into the system. The spaced practice method, similar to those used in widely recognized learning platforms like Duolingo and Anki flashcards, spreads out learning over multiple sessions. This study’s design features quizzes progressively increasing in difficulty. These quizzes are aimed at targeting both the Recognition-Recall and Comprehension-Use dimensions for a comprehensive acquisition of vocabulary. The mobile-based chatbot system is built using Golang, an open-source programming language developed by Google. It follows a structured flow that guides learners through a series of 4 quizzes in each week of teacher-led learning. The quizzes start with less cognitively demanding tasks, such as multiple-choice questions, before moving on to more complex exercises. The integration of SRL elements allows students to self-evaluate the difficulty level of vocabulary items, predict scores achieved, and choose appropriate strategy. This research is part one of a two-part project. The initial findings will determine the development of an upgraded chatbot system in part two, where adaptive features in response to the integration of SRL components will be introduced. The research objectives are to assess the effectiveness of the chatbot-assisted approach, based on the combination of spaced practice and SRL, in improving vocabulary acquisition and managing cognitive load, as well as to understand students' perceptions of this learning tool. The insights from this study will contribute to the growing body of research on mobile-assisted language learning and offer practical implications for integrating chatbot systems with spaced practice into educational settings to enhance vocabulary learning.

Keywords: mobile learning, mobile-assisted language learning, MALL, chatbots, vocabulary learning, spaced practice, spacing effect, self-regulated learning, SRL, self-regulation, EFL, cognitive load

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Authors: M. Shahab Uddin, Pennung Warnitchai

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Currently more than half of the world’s populations are living in cities, and the number and sizes of cities are growing faster than ever. Cities rely on the effective functioning of complex and interdependent critical infrastructures networks to provide public services, enhance the quality of life, and save the community from hazards and disasters. In contrast, complex connectivity and interdependency among the urban critical infrastructures bring management challenges and make the urban system prone to the domino effect. Unplanned rapid growth, increased connectivity, and interdependency among the infrastructures, resource scarcity, and many other socio-political factors are affecting the typical state of an urban system and making it susceptible to numerous sorts of diversion. In addition to internal vulnerabilities, urban systems are consistently facing external threats from natural and manmade hazards. Cities are not just complex, interdependent system, but also makeup hubs of the economy, politics, culture, education, etc. For survival and sustainability, complex urban systems in the current world need to manage their vulnerabilities and hazardous incidents more wisely and more interactively. Coordinated management in such systems makes for huge potential when it comes to absorbing negative effects in case some of its components were to function improperly. On the other hand, ineffective management during a similar situation of overall disorder from hazards devastation may make the system more fragile and push the system to an ultimate collapse. Following the quantum, the current research hypothesizes that a hazardous event starts its journey as an emergency, and the system’s internal vulnerability and response capacity determine its destination. Connectivity and interdependency among the urban critical infrastructures during this stage may transform its vulnerabilities into dynamic damaging force. An emergency may turn into a disaster in the absence of effective management; similarly, mismanagement or lack of management may lead the situation towards a catastrophe. Situation awareness and factual decision-making is the key to win a battle. The current research proposed a contextual decision support system for an urban critical infrastructure system while integrating three different models: 1) Damage cascade model which demonstrates damage propagation among the infrastructures through their connectivity and interdependency, 2) Restoration model, a dynamic restoration process of individual infrastructure, which is based on facility damage state and overall disruptions in surrounding support environment, and 3) Optimization model that ensures optimized utilization and distribution of available resources in and among the facilities. All three models are tightly connected, mutually interdependent, and together can assess the situation and forecast the dynamic outputs of every input. Moreover, this integrated model will hold disaster managers and decision makers responsible when it comes to checking all the alternative decision before any implementation, and support to produce maximum possible outputs from the available limited inputs. This proposed model will not only support to reduce the extent of damage cascade but will ensure priority restoration and optimize resource utilization through adaptive and collaborative management. Complex systems predictably fail but in unpredictable ways. System understanding, situation awareness, and factual decisions may significantly help urban system to survive and sustain.

Keywords: disaster prevention, decision support system, emergency response, urban critical infrastructure system

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Authors: Hoora Beheshti Haradasht, Abooali Golzary

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Environmental education plays a pivotal role in shaping the future stewards of our planet. Leveraging the power of artificial intelligence (AI) in this endeavor presents an innovative approach to captivate and educate elementary school children about environmental sustainability. This paper explores the application of AI technologies in designing interactive and personalized learning experiences that foster curiosity, critical thinking, and a deep connection to nature. By harnessing AI-driven tools, virtual simulations, and personalized content delivery, educators can create engaging platforms that empower children to comprehend complex environmental concepts while nurturing a lifelong commitment to protecting the Earth. With the pressing challenges of climate change and biodiversity loss, cultivating an environmentally conscious generation is imperative. Integrating AI in environmental education revolutionizes traditional teaching methods by tailoring content, adapting to individual learning styles, and immersing students in interactive scenarios. This paper delves into the potential of AI technologies to enhance engagement, comprehension, and pro-environmental behaviors among elementary school children. Modern AI technologies, including natural language processing, machine learning, and virtual reality, offer unique tools to craft immersive learning experiences. Adaptive platforms can analyze individual learning patterns and preferences, enabling real-time adjustments in content delivery. Virtual simulations, powered by AI, transport students into dynamic ecosystems, fostering experiential learning that goes beyond textbooks. AI-driven educational platforms provide tailored content, ensuring that environmental lessons resonate with each child's interests and cognitive level. By recognizing patterns in students' interactions, AI algorithms curate customized learning pathways, enhancing comprehension and knowledge retention. Utilizing AI, educators can develop virtual field trips and interactive nature explorations. Children can navigate virtual ecosystems, analyze real-time data, and make informed decisions, cultivating an understanding of the delicate balance between human actions and the environment. While AI offers promising educational opportunities, ethical concerns must be addressed. Safeguarding children's data privacy, ensuring content accuracy, and avoiding biases in AI algorithms are paramount to building a trustworthy learning environment. By merging AI with environmental education, educators can empower children not only with knowledge but also with the tools to become advocates for sustainable practices. As children engage in AI-enhanced learning, they develop a sense of agency and responsibility to address environmental challenges. The application of artificial intelligence in elementary environmental education presents a groundbreaking avenue to cultivate environmentally conscious citizens. By embracing AI-driven tools, educators can create transformative learning experiences that empower children to grasp intricate ecological concepts, forge an intimate connection with nature, and develop a strong commitment to safeguarding our planet for generations to come.

Keywords: artificial intelligence, environmental education, elementary children, personalized learning, sustainability

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Authors: Silvia Baralla, Raffaella Zucaro, Romina Lorenzetti

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Water management needs to cope with economic, societal, and environmental changes. This could be guaranteed through 'shifting from government to governance'. In the last decades, it was applied in Europe through and within important legislative pillars (Water Framework Directive and Common Agricultural Policy) and their measures focused on resilience and adaptation to climate change, with particular attention to the creation of synergies among policies and all the actors involved at different levels. Within the climate change context, the agricultural sector can play, through sustainable water management, a leading role for climate-resilient growth and environmental integrity. A recent analysis on the water management governance of different countries identified some common gaps dealing with administrative, policy, information, capacity building, funding, objective, and accountability. The ability of a country to fill these gaps is an essential requirement to make some of the changes requested by Europe, in particular the improvement of the agro-ecosystem resilience to the effect of climatic change, supporting green and digital transitions, and sustainable water use. This research aims to contribute in sharing examples of water governances and related advantages useful to fill the highlighted gaps. Italy has developed a strong and exhaustive model of water governance in order to react with strategic and synergic actions since it is one of the European countries most threatened by climate change and its extreme events (drought, floods). In particular, the Italian water governance model was able to overcome several gaps, specifically as concerns the water use in agriculture, adopting strategies as a systemic/integrated approach, the stakeholder engagement, capacity building, the improvement of planning and monitoring ability, and an adaptive/resilient strategy for funding activities. They were carried out, putting in place regulatory, structural, and management actions. Regulatory actions include both the institution of technical committees grouping together water decision-makers and the elaboration of operative manuals and guidelines by means of a participative and cross-cutting approach. Structural actions deal with the funding of interventions within European and national funds according to the principles of coherence and complementarity. Finally, management actions regard the introduction of operational tools to support decision-makers in order to improve planning and monitoring ability. In particular, two cross-functional and interoperable web databases were introduced: SIGRIAN (National Information System for Water Resources Management in Agriculture) and DANIA (National Database of Investments for Irrigation and the Environment). Their interconnection allows to support sustainable investments, taking into account the compliance about irrigation volumes quantified in SIGRIAN, ensuring a high level of attention on water saving, and monitoring the efficiency of funding. Main positive results from the Italian water governance model deal with a synergic and coordinated work at the national, regional, and local level among institutions, the transparency on water use in agriculture, a deeper understanding from the stakeholder side of the importance of their roles and of their own potential benefits and the capacity to guarantee continuity to this model, through a sensitization process and the combined use of management operational tools.

Keywords: agricultural sustainability, governance model, water management, water policies

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Authors: Smita Singh

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Objective: The Faculty of Chemistry Education at Humboldt University has developed ‘Studium’, a web application designed to enhance long-term self-regulated learning (SRL) and academic achievement. Leveraging advanced generative AI, ‘Studium’ offers a dynamic and adaptive educational experience tailored to individual learning preferences and languages. The application includes evolving tools for personalized notetaking from preferred sources, customizable presentation capabilities, and AI-assisted guidance from academic documents or textbooks. It also features workflow automation and seamless integration with collaborative platforms like Miro, powered by AI. This study aims to propose a model that combines generative AI with traditional features and customization options, empowering students to create personalized learning environments that effectively address the challenges of SRL. Method: To achieve this, the study included graduate and undergraduate students from diverse subject streams, with 15 participants each from Germany and India, ensuring a diverse educational background. An exploratory design was employed using a speed dating method with enactment, where different scenario sessions were created to allow participants to experience various features of ‘Studium’. The session lasted for 50 minutes, providing an in-depth exploration of the platform's capabilities. Participants interacted with Studium’s features via Zoom conferencing and were then engaged in semi-structured interviews lasting 10-15 minutes to gain deeper insights into the effectiveness of ‘Studium’. Additionally, online questionnaire surveys were conducted before and after the session to gather feedback and evaluate satisfaction with self-regulated learning (SRL) after using ‘Studium’. The response rate of this survey was 100%. Results: The findings of this study indicate that students widely acknowledged the positive impact of ‘Studium’ on their learning experience, particularly its adaptability and intuitive design. They expressed a desire for more tools like ‘Studium’ to support self-regulated learning in the future. The application significantly fostered students' independence in organizing information and planning study workflows, which in turn enhanced their confidence in mastering complex concepts. Additionally, ‘Studium’ promoted strategic decision-making and helped students overcome various learning challenges, reinforcing their self-regulation, organization, and motivation skills. Conclusion: This proposed model emphasizes the need for effective integration of personalized AI tools into active learning and SRL environments. By addressing key research questions, our framework aims to demonstrate how AI-assisted platforms like “Studium” can facilitate deeper understanding, maintain student motivation, and support the achievement of academic goals. Thus, our ideal model for AI-assisted educational platforms provides a strategic approach to enhance student's learning experiences and promote their development as self-regulated learners. This proposed model emphasizes the need for effective integration of personalized AI tools into active learning and SRL environments. By addressing key research questions, our framework aims to demonstrate how AI-assisted platforms like ‘Studium’ can facilitate deeper understanding, maintain student motivation, and support the achievement of academic goals. Thus, our ideal model for AI-assisted educational platforms provides a strategic approach to enhance student's learning experiences and promote their development as self-regulated learners.

Keywords: self-regulated learning (SRL), generative AI, AI-assisted educational platforms

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Authors: H. K. Esfahani, B. Datta

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Groundwater is one of the most important natural resources in many parts of the world; however it is widely polluted due to human activities. Currently, effective and reliable groundwater management and remediation strategies are obtained using characterization of groundwater pollution sources, where the measured data in monitoring locations are utilized to estimate the unknown pollutant source location and magnitude. However, accurately identifying characteristics of contaminant sources is a challenging task due to uncertainties in terms of predicting source flux injection, hydro-geological and geo-chemical parameters, and the concentration field measurement. Reactive transport of chemical species in contaminated groundwater systems, especially with multiple species, is a complex and highly non-linear geochemical process. Although sufficient concentration measurement data is essential to accurately identify sources characteristics, available data are often sparse and limited in quantity. Therefore, this inverse problem-solving method for characterizing unknown groundwater pollution sources is often considered ill-posed, complex and non- unique. Different methods have been utilized to identify pollution sources; however, the linked simulation-optimization approach is one effective method to obtain acceptable results under uncertainties in complex real life scenarios. With this approach, the numerical flow and contaminant transport simulation models are externally linked to an optimization algorithm, with the objective of minimizing the difference between measured concentration and estimated pollutant concentration at observation locations. Concentration measurement data are very important to accurately estimate pollution source properties; therefore, optimal design of the monitoring network is essential to gather adequate measured data at desired times and locations. Due to budget and physical restrictions, an efficient and effective approach for groundwater pollutant source characterization is to design an optimal monitoring network, especially when only inadequate and arbitrary concentration measurement data are initially available. In this approach, preliminary concentration observation data are utilized for preliminary source location, magnitude and duration of source activity identification, and these results are utilized for monitoring network design. Further, feedback information from the monitoring network is used as inputs for sequential monitoring network design, to improve the identification of unknown source characteristics. To design an effective monitoring network of observation wells, optimization and interpolation techniques are used. A simulation model should be utilized to accurately describe the aquifer properties in terms of hydro-geochemical parameters and boundary conditions. However, the simulation of the transport processes becomes complex when the pollutants are chemically reactive. Three dimensional transient flow and reactive contaminant transport process is considered. The proposed methodology uses HYDROGEOCHEM 5.0 (HGCH) as the simulation model for flow and transport processes with chemically multiple reactive species. Adaptive Simulated Annealing (ASA) is used as optimization algorithm in linked simulation-optimization methodology to identify the unknown source characteristics. Therefore, the aim of the present study is to develop a methodology to optimally design an effective monitoring network for pollution source characterization with reactive species in polluted aquifers. The performance of the developed methodology will be evaluated for an illustrative polluted aquifer sites, for example an abandoned mine site in Queensland, Australia.

Keywords: monitoring network design, source characterization, chemical reactive transport process, contaminated mine site

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Authors: C. Bel, J. Nevado, F. Ciceri, M. Ropacki, T. Hoffmann, P. Lapunzina, C. Buesa

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Background: The Phelan-McDermid syndrome (PMS) is a genetic disorder caused by the deletion of the terminal region of chromosome 22 or mutation of the SHANK3 gene. Shank3 disruption in mice leads to dysfunction of synaptic transmission, which can be restored by epigenetic regulation with both Lysine Specific Demethylase 1 (LSD1) inhibitors. PMS subjects result in a variable degree of intellectual disability, delay or absence of speech, autistic spectrum disorders symptoms, low muscle tone, motor delays and epilepsy. Vafidemstat is an LSD1 inhibitor in Phase II clinical development with a well-established and favorable safety profile, and data supporting the restoration of memory and cognition defects as well as reduction of agitation and aggression in several animal models and clinical studies. Therefore, vafidemstat has the potential to become a first-in-class precision medicine approach to treat PMS patients. Aims: The goal of this research is to perform an observational trial to psychometrically characterize individuals carrying deletions in SHANK3 and build a foundation for subsequent precision psychiatry clinical trials with vafidemstat. Methodology: This study is characterizing the clinical profile of 20 to 40 subjects, > 16-year-old, with genotypically confirmed PMS diagnosis. Subjects will complete a battery of neuropsychological scales, including the Repetitive Behavior Questionnaire (RBQ), Vineland Adaptive Behavior Scales, Escala de Observación para el Diagnostico del Autismo (Autism Diagnostic Observational Scale) (ADOS)-2, the Battelle Developmental Inventory and the Behavior Problems Inventory (BPI). Results: By March 2021, 19 patients have been enrolled. Unsupervised hierarchical clustering of the results obtained so far identifies 3 groups of patients, characterized by different profiles of cognitive and behavioral scores. The first cluster is characterized by low Battelle age, high ADOS and low Vineland, RBQ and BPI scores. Low Vineland, RBQ and BPI scores are also detected in the second cluster, which in contrast has high Battelle age and low ADOS scores. The third cluster is somewhat in the middle for the Battelle, Vineland and ADOS scores while displaying the highest levels of aggression (high BPI) and repeated behaviors (high RBQ). In line with the observation that female patients are generally affected by milder forms of autistic symptoms, no male patients are present in the second cluster. Dividing the results by gender highlights that male patients in the third cluster are characterized by a higher frequency of aggression, whereas female patients from the same cluster display a tendency toward higher repetitive behavior. Finally, statistically significant differences in deletion sizes are detected comparing the three clusters (also after correcting for gender), and deletion size appears to be positively correlated with ADOS and negatively correlated with Vineland A and C scores. No correlation is detected between deletion size and the BPI and RBQ scores. Conclusions: Precision medicine may open a new way to understand and treat Central Nervous System disorders. Epigenetic dysregulation has been proposed to be an important mechanism in the pathogenesis of schizophrenia and autism. Vafidemstat holds exciting therapeutic potential in PMS, and this study will provide data regarding the optimal endpoints for a future clinical study to explore vafidemstat ability to treat shank3-associated psychiatric disorders.

Keywords: autism, epigenetics, LSD1, personalized medicine

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Authors: Afrah S. M. Al-Mahfadi

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Climate change is a global issue that has significant impacts on water resources, resulting in environmental, economic, and political consequences. Groundwater reserves, particularly in coastal areas, are facing depletion, leading to serious problems in regions such as Yemen. This study focuses on the western coastal region of Yemen, which already faces risks such as water crises, food insecurity, and widespread poverty. Climate change exacerbates these risks by causing high temperatures, sea level rise, inadequate sea level rise, and inadequate environmental policies. Research Aim: The aim of this research is to provide a comprehensive overview of the impact of climate change on the western coastal region of Yemen. Specifically, the study aims to analyze the relationship between climate change and the loss of fresh groundwater resources in this area. Methodology: The research utilizes a combination of a literature review and three case studies conducted through site visits. Arch-GIS mapping is employed to analyze and visualize the relationship between climate change and the depletion of fresh groundwater resources. Additionally, data on precipitation from 1981 to 2020 and scenarios of projected sea level rise (SLR) are considered. Findings: The study reveals several future issues resulting from climate change. It is projected that the annual temperature will increase while the rainfall rate will decrease. Furthermore, the sea level is expected to rise by approximately 0.30 to 0.72 meters by 2100. These factors contribute to the loss of wetlands, the retreat of shorelines and estuaries, and the intrusion of seawater into the coastal aquifer, rendering drinking water from wells increasingly saline. Data Collection and Analysis Procedures: Data for this research are collected through a literature review, including studies on climate change impacts in coastal areas and the hydrogeology of the study region. Furthermore, three case studies are conducted through site visits. Arch-GIS mapping techniques are utilized to analyze the relationship between climate change and the loss of fresh groundwater resources. Historical precipitation data from 1981 to 2020 and scenarios of projected sea level rise are also analyzed. Questions Addressed: (1) What is the impact of climate change on the western coastal region of Yemen? (2) How does climate change affect the availability of fresh groundwater resources in this area? Conclusion: The study concludes that the western coastal region of Yemen is facing significant challenges due to climate change. The projected increase in temperature, decrease in rainfall, and rise in sea levels have severe implications, such as the loss of wetlands, shorelines, and estuaries. Additionally, the intrusion of seawater into the coastal aquifer further exacerbates the issue of saline drinking water. Urgent measures are needed to address climate change, including improving water management, implementing integrated coastal zone planning, raising awareness among stakeholders, and implementing emergency projects to mitigate the impacts. Recommendations: To mitigate the adverse effects of climate change, several recommendations are provided. These include improving water management practices, developing integrated coastal zone planning strategies, raising awareness among all stakeholders, improving health and education, and implementing emergency projects to combat climate change. These measures aim to enhance adaptive capacity and resilience in the face of future climate change impacts.

Keywords: climate change, groundwater, coastal wetlands, Yemen

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Authors: Jane Furness, Neville Robertson, Judy Hunter, Darrin Hodgetts, Linda Nikora

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Background and significance: This paper describes the first use of community psychology theories to investigate family-focused literacy education programmes, enabling a wide range of wellbeing effects of such programmes to be identified for the first time. Evaluations of family literacy programmes usually focus on the economic advantage of gains in literacy skills. By identifying other effects on aspects of participants’ lives that are important to them, and how they occur, understanding of how such programmes contribute to wellbeing and social justice is augmented. Drawn from community psychology, an ecological systems-based, culturally adaptive framework for personal, relational and collective wellbeing illuminated outcomes of family literacy programmes that enhanced wellbeing and quality of life for adult participants, their families and their communities. All programmes, irrespective of their institutional location, could be similarly scrutinized. Methodology: The study traced the experiences of nineteen adult participants in four family-focused literacy programmes located in geographically and culturally different communities throughout New Zealand. A critical social constructionist paradigm framed this interpretive study. Participants were mainly Māori, Pacific islands, or European New Zealanders. Seventy-nine repeated conversational interviews were conducted over 18 months with the adult participants, programme staff and people who knew the participants well. Twelve participant observations of programme sessions were conducted, and programme documentation was reviewed. Latent theoretical thematic analysis of data drew on broad perspectives of literacy and ecological systems theory, network theory and holistic, integrative theories of wellbeing. Steps taken to co-construct meaning with participants included the repeated conversational interviews and participant checking of interview transcripts and section drafts. The researcher (this paper’s first author) followed methodological guidelines developed by indigenous peoples for non-indigenous researchers. Findings: The study found that the four family literacy programmes, differing in structure, content, aims and foci, nevertheless shared common principles and practices that reflected programme staff’s overarching concern for people’s wellbeing along with their desire to enhance literacy abilities. A human rights and strengths-based based view of people based on respect for diverse culturally based values and practices were evident in staff expression of their values and beliefs and in their practices. This enacted stance influenced the outcomes of programme participation for the adult participants, their families and their communities. Alongside the literacy and learning gains identified, participants experienced positive social and relational events and changes, affirmation and strengthening of their culturally based values, and affirmation and building of positive identity. Systemically, interconnectedness of programme effects with participants’ personal histories and circumstances; the flow on of effects to other aspects of people’s lives and to their families and communities; and the personalised character of the pathways people journeyed towards enhanced wellbeing were identified. Concluding statement: This paper demonstrates the critical contribution of community psychology to a fuller understanding of family-focused educational programme outcomes than has been previously attainable, the meaning of these broader outcomes to people in their lives, and their role in wellbeing and social justice.

Keywords: community psychology, ecological theory, family literacy education, flow on effects, holistic wellbeing

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Authors: Mary-Ann N. Jallad, Dalal F. Jaber, Alexander M. Abdelnoor

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Introduction: Current evidence confirms that both innate and adaptive immune systems are capable of recognizing and abolishing malignant cells. The emergence of cancerous tumors in patients is, therefore, an indication that certain cancer cells can resist elimination by the immune system through a process known as “immune evasion”. In fact, cancer cells often exploit regulatory mechanisms to escape immunity. Such mechanisms normally exist to control the immune responses and prohibit exaggerated or autoimmune reactions. Recently, immunotherapies have shown promising yet limited results. Therefore this study investigates several immunotherapeutic combinations and devises a triple immunotherapy which harnesses the innate and acquired immune responses towards the annihilation of malignant cells through overcoming their ability of immune evasion, consequently hampering malignant progression and eliminating established tumors. The aims of the study are to rule out acute/chronic toxic effects of the proposed treatment combinations, to assess the effect of these combinations on tumor growth and survival rates, and to investigate potential mechanisms underlying the phenotypic results through analyzing serum levels of anti-tumor cytokines, angiogenic factors and tumor progression indicator, and the tumor-infiltrating immune-cells populations. Methodology: For toxicity analysis, cancer-free C57BL/6 mice are randomized into 9 groups: Group 1 untreated, group 2 treated with sterile saline (solvent of used treatments), group 3 treated with Monophosphoryl-lipid-A, group 4 with anti-CTLA4-antibodies, group 5 with 1-Methyl-Tryptophan (Indolamine-Dioxygenase-1 inhibitor), group 6 with both MPLA and anti-CTLA4-antibodies, group 7 with both MPLA and 1-MT, group 8 with both anti-CTLA4-antibodies and 1-MT, and group 9 with all three: MPLA, anti-CTLA4-antibodies and 1-MT. Mice are monitored throughout the treatment period and for three following months. At that point, histological sections from their main organs are assessed. For tumor progression and survival analysis, a murine melanoma model is generated by injecting analogous mice with B16F10 melanoma cells. These mice are segregated into the listed nine groups. Their tumor size and survival are monitored. For a depiction of underlying mechanisms, melanoma-bearing mice from each group are sacrificed at several time-points. Sera are tested to assess the levels of Interleukin-12 (IL-12), Vascular-Endothelial-Growth Factor (VEGF), and S100B. Furthermore, tumors are excised for analysis of infiltrated immune cell populations including T-cells, macrophages, natural killer cells and immune-regulatory cells. Results: Toxicity analysis shows that all treated groups present no signs of neither acute nor chronic toxicity. Their appearance and weights were comparable to those of control groups throughout the treatment period and for the following 3 months. Moreover, histological sections from their hearts, kidneys, lungs, and livers were normal. Work is ongoing for completion of the remaining study aims. Conclusion: Toxicity was the major concern for the success of the proposed comprehensive combinational therapy. Data generated so far ruled out any acute or chronic toxic effects. Consequently, ongoing work is quite promising and may significantly contribute to the development of more effective immunotherapeutic strategies for the treatment of cancer patients.

Keywords: cancer immunotherapy, check-point blockade, combination therapy, melanoma

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Authors: Leo Byrne, Neil Watts

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In the complex and evolving landscape of global trade, maritime sanctions emerge as a critical tool wielded by the international community to curb illegal activities and alter the behavior of non-compliant states and entities. These sanctions, designed to restrict or prohibit trade by sea with sanctioned jurisdictions, entities, or individuals, face continuous challenges due to the sophisticated evasion tactics employed by countries like North Korea. As the Democratic People's Republic of Korea (DPRK) diverts significant resources to circumvent these measures, understanding the nuances of their methodologies becomes imperative for maintaining the integrity of global trade systems. The DPRK, one of the most sanctioned nations globally, has developed an intricate network to facilitate its trade in illicit goods, ensuring the flow of revenue from designated activities continues unabated. Given its geographic and economic conditions, North Korea predominantly relies on maritime routes, utilizing foreign ports to route its illicit trade. This reliance on the sea is exploited through various sophisticated methods, including the use of front companies, falsification of documentation, commingling of bulk cargos, and physical alterations to vessels. These tactics enable the DPRK to navigate through the gaps in regulatory frameworks and lax oversight, effectively undermining international sanctions regimes Maritime sanctions carry significant implications for global trade, imposing heightened risks in the maritime domain. The deceptive practices employed not only by the DPRK but also by other high-risk jurisdictions, necessitate a comprehensive understanding of UN targeted sanctions. For stakeholders in the maritime sector—including maritime authorities, vessel owners, shipping companies, flag registries, and financial institutions serving the shipping industry—awareness and compliance are paramount. Violations can lead to severe consequences, including reputational damage, sanctions, hefty fines, and even imprisonment. To mitigate risks associated with these deceptive practices, it is crucial for maritime sector stakeholders to employ rigorous due diligence and regulatory compliance screening measures. Effective sanctions compliance serves as a protective shield against legal, financial, and reputational risks, preventing exploitation by international bad actors. This requires not only a deep understanding of the sanctions landscape but also the capability to identify and manage risks through informed decision-making and proactive risk management practices. As the DPRK and other sanctioned entities continue to evolve their sanctions evasion tactics, the international community must enhance its collective efforts to demystify and counter these practices. By leveraging more stringent compliance measures, stakeholders can safeguard against the illicit use of the maritime domain, reinforcing the effectiveness of maritime sanctions as a tool for global security. This paper seeks to dissect North Korea's adaptive strategies in the face of maritime sanctions. By examining up-to-date, geographically, and temporally relevant case studies, it aims to shed light on the primary nodes through which Pyongyang evades sanctions and smuggles goods via third-party ports. The goal is to propose multi-level interaction strategies, ranging from governmental interventions to localized enforcement mechanisms, to counteract these evasion tactics.

Keywords: maritime, maritime sanctions, international sanctions, compliance, risk

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Authors: Juliet Sorensen, Anna Maitland

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Introduction: Characterized by lack of water and sanitation, food insecurity, and low access to hospitals and clinics, informal urban settlements in Lagos, Nigeria have very poor health outcomes. With little education and a general inability to demand basic rights, these communities are often disempowered and isolated from understanding, claiming, or owning their health needs. Utilizing community-based participatory research characterized by interdisciplinary, cross-cultural partnerships, evidence-based assessments, and both primary and secondary source research, a holistic health education and advocacy program was developed in Lagos to address health barriers for targeted communities. This includes a first of its kind guide formulated to teach community-based health educators how to transmit health information to low-literacy Nigerian audiences while supporting behavior change models and social support mechanisms. This paper discusses the interdisciplinary contributions to developing a health education program while also looking at the need for greater beneficiary ownership and implementation of health justice and access. Methods: In March 2016, an interdisciplinary group of medical, legal, and business graduate students and faculty from Northwestern University conduced a Health Needs Assessment (HNA) in Lagos with a partner and a local non-governmental organization. The HNA revealed that members of informal urban communities in Lagos were lacking basic health literacy, but desired to remedy this lacuna. Further, the HNA revealed that even where the government mandates specific services, many vulnerable populations are unable to access these services. The HNA concluded that a program focused on education, advocacy, and organizing around anatomy, maternal and sexual health, infectious disease and malaria, HIV/AIDS, emergency care, and water and sanitation would respond to stated needs while also building capacity in communities to address health barriers. Results: Based on the HNA, including both primary and secondary source research on integrated health education approaches and behavior change models and responsive, adaptive material development, a holistic program was developed for the Lagos partners and first implemented in November 2016. This program trained community-nominated health educators in adult, low-literacy, knowledge exchange approaches, utilizing information identified by communities as a priority. After a second training in March 2017, these educators will teach community-based groups and will support and facilitate behavior change models and peer-support methods around basic issues like hand washing and disease transmission. They will be supported by community paralegals who will help ensure that newly trained community groups can act on education around access, such as receiving free vaccinations, maternal health care, and HIV/AIDS medicines. Materials will continue to be updated as needs and issues arise, with a focus on identifying best practices around health improvements that can be shared across these partner communities. Conclusion: These materials are the first of their kind, and address a void of health information and understanding pervasive in informal-urban Lagos communities. Initial feedback indicates high levels of commitment and interest, as well as investment by communities in these materials, largely because they are responsive, targeted, and build community capacity. This methodology is an important step in dignity-based health justice solutions, albeit in the process of refinement.

Keywords: community health educators, interdisciplinary and cross cultural partnerships, health justice and access, Nigeria

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Authors: Filippo Verre

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This paper explores Turkey’s role as an influential waterpower in the Middle East, emphasizing the Peace Water Pipeline Project (PWPP) as a paradigm of hydro solidarity rather than conventional water diplomacy. Hydro solidarity transcends the strategic and often competitive nature of water diplomacy, highlighting cooperative, inclusive, and mutually beneficial approaches to water resource management. The PWPP, which aimed to transport freshwater from Turkey’s Manavgat River to several water-scarce nations in the Middle East, exemplifies this ethos. By providing a reliable water supply to address the chronic shortages in the region, the project underscored Turkey’s commitment to fostering regional cooperation, stability, and collective well-being through shared water resources. This paper provides an in-depth analysis of the Peace Water Pipeline Project, examining its technical specifications, environmental impact, and political implications. It discusses how the project’s foundation on principles of hydro solidarity could facilitate stronger regional ties, mitigate water-related conflicts, and promote sustainable development. By prioritizing collective benefits over unilateral gains, Turkey’s approach exemplified a transformative model of resource sharing that could inspire similar initiatives globally. This paper argues that the Peace Water Pipeline Project serves as a crucial case study in demonstrating how shared natural resources can be leveraged to build trust, enhance cooperation, and achieve common goals in a geopolitically volatile region. The findings emphasize the importance of adopting hydro solidarity as a guiding principle for future transboundary water projects, showcasing how collaborative water management can play a pivotal role in fostering peace, security, and sustainable development in the Middle East and beyond. This research is based on a mixed methodological approach combining qualitative and quantitative methods. The most relevant qualitative methods will involve Case Studies and Content Analysis. Concretely, the Friendship Dam Project (FDP) between Turkey and Syria will be mentioned to underline the importance of hydro solidarity approaches as opposed to water diplomacy. Analyzing this case aims to identify factors that contribute to successful hydro solidarity agreements, such as effective communication channels, trust-building measures, and adaptive management practices. Concerning Content Analysis, reviewing and analyzing policy documents, treaties, media reports, and public statements will help identify the official narratives and discourses surrounding the PWPP. This method fully comprehends how different stakeholders frame the issues and what solutions they propose. The quantitative methodology used in this research, which complements the qualitative approaches, involves economic valuation, which quantifies the PWPP’s economic impacts on Turkey and the Middle Eastern region. This includes assessing the cost of construction and maintenance and the financial benefits derived from improved water access and reduced conflict. Hydrological modelling will also be used as a quantitative research method. Using hydrological models to simulate the water flow and distribution scenarios helps quantify the pipeline’s potential impacts on water resources. By assessing the sustainability of water extraction and predicting how changes in water availability might affect different regions, these models play a crucial role in this research, shedding light on the impact of transboundary infrastructures on water management.

Keywords: hydro-solidarity, Middle East, transboundary water management, peace water pipeline project, water scarcity

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Authors: Isabelle Barrett

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Natural watercourses provide a range of vital ecosystem services, notably freshwater provision. They also offer highly heterogeneous habitat which supports an extreme diversity of aquatic life. Exploitation of rivers, changing land use and flood prevention measures have led to habitat degradation and subsequent biodiversity loss; indeed, freshwater species currently face a disproportionate rate of extinction compared to their terrestrial and marine counterparts. Large woody debris (LWD) encompasses the trees, large branches and logs which fall into watercourses, and is responsible for important habitat characteristics. Historically, natural LWD has been removed from streams under the assumption that it is not aesthetically pleasing and is thus ecologically unfavourable, despite extensive evidence contradicting this. Restoration efforts aim to replace lost LWD in order to reinstate habitat heterogeneity. This paper aims to assess the current state of such restoration schemes for improving fluvial ecological health in the UK. A detailed review of the scientific literature was conducted alongside a meta-analysis of 25 UK-based projects involving LWD restoration. Projects were chosen for which sufficient information was attainable for analysis, covering a broad range of budgets and scales. The most effective strategies for river restoration encompass ecological success, stakeholder engagement and scientific advancement, however few projects surveyed showed sensitivity to all three; for example, only 32% of projects stated biological aims. Focus tended to be on stakeholder engagement and public approval, since this is often a key funding driver. Consequently, there is a tendency to focus on the aesthetic outcomes of a project, however physical habitat restoration does not necessarily lead to direct biodiversity increases. This highlights the significance of rivers as highly heterogeneous environments with multiple interlinked processes, and emphasises a need for a stronger scientific presence in project planning. Poor scientific rigour means monitoring is often lacking, with varying, if any, definitions of success which are rarely pre-determined. A tendency to overlook negative or neutral results was apparent, with unjustified focus often put on qualitative results. The temporal scale of monitoring is typically inadequate to facilitate scientific conclusions, with only 20% of projects surveyed reporting any pre-restoration monitoring. Furthermore, monitoring is often limited to a few variables, with biotic monitoring often fish-focussed. Due to their longer life cycles and dispersal capability, fish are usually poor indicators of environmental change, making it difficult to attribute any changes in ecological health to restoration efforts. Although the potential impact of LWD restoration may be positive, this method of restoration could simply be making short-term, small-scale improvements; without addressing the underlying symptoms of degradation, for example water quality, the issue cannot be fully resolved. Promotion of standardised monitoring for LWD projects could help establish a deeper understanding of the ecology surrounding the practice, supporting movement towards adaptive management in which scientific evidence feeds back to practitioners, enabling the design of more efficient projects with greater ecological success. By highlighting LWD, this study hopes to address the difficulties faced within river management, and emphasise the need for a more holistic international and inter-institutional approach to tackling problems associated with degradation.

Keywords: biological monitoring, ecological health, large woody debris, river management, river restoration

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Authors: Roven Tumaneng, Angelica Kristina Monzon, Ralph Sedricke Lapuz, Jose Don De Alban, Jennica Paula Masigan, Joanne Rae Pales, Laila Monera Pornel, Dennis Tablazon, Rizza Karen Veridiano, Jackie Lou Wenceslao, Edmund Leo Rico, Neil Aldrin Mallari

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Most protected area management plans in the Philippines, particularly the smaller and more remote islands suffer from insufficient baseline data, which should provide the bases for formulating measureable conservation targets and appropriate management interventions for these protected areas. Attempts to synthesize available data particularly on cultural and socio-economic characteristic of local peoples within and outside protected areas also suffer from the lack of comprehensive and detailed inventories, which should be considered in designing adaptive management interventions to be used for those protected areas. Mt Guiting-guiting Natural Park (MGGNP) located in Sibuyan Island is one of the poorly studied protected areas in the Philippines. In this study, we determined the highly biologically important areas of the protected area using Maximum Entropy approach (MaxEnt) from environmental predictors (i.e., topographic, bioclimatic,land cover, and soil image layers) derived from global remotely sensed data and point occurrence data of species of birds and trees recorded during field surveys on the island. A total of 23 trigger species of birds and trees was modeled and stacked to generate species richness maps for biological high conservation value areas (HCVAs). Forest habitat change was delineated using dual-polarised L-band ALOS-PALSAR mosaic data at 25 meter spatial resolution, taken at two acquisition years 2007 and 2009 to provide information on forest cover ad habitat change in the island between year 2007 and 2009. Determining the livelihood guilds were also conducted using the data gathered from171 household interviews, from which demographic and livelihood variables were extracted (i.e., age, gender, number of household members, educational attainment, years of residency, distance from forest edge, main occupation, alternative sources of food and resources during scarcity months, and sources of these alternative resources).Using Principal Component Analysis (PCA) and Kruskal-Wallis test, the diversity and patterns of forest resource use by people in the island were determined with particular focus on the economic activities that directly and indirectly affect the population of key species as well as to identify levels of forest resource use by people in different areas of the park.Results showed that there are gaps in the area occupied by the natural park, as evidenced by the mismatch of the proposed HCVAs and the existing perimeters of the park. We found out that subsistence forest gathering was the possible main driver for forest degradation out of the eight livelihood guilds that were identified in the park. Determining the high conservation areas and identifyingthe anthropogenic factors that influence the species richness and abundance of key species in the different management zone of MGGNP would provide guidance for the design of a protected area management plan and future monitoring programs. However, through intensive communication and consultation with government stakeholders and local communities our results led to setting conservation targets in local development plans and serve as a basis for the reposition of the boundaries and reconfiguration of the management zones of MGGNP.

Keywords: conservation gaps, livelihood guilds, MaxEnt, protected area

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Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

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Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

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Authors: Arthur Müller

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The study treats human dimensions of hunting by conducting statistical data analysis and providing decision-making support by examples of good prefectural governance and successful wildlife management, crucial to reduce pest species and sustain a stable hunter population in the future. Therefore it analyzes recent revision of wildlife legislation, reveals differences in administrative management structures, as well as socio-demographic characteristics of hunters in correlation with harvest trends of sika deer and wild boar in 47 prefectures in Japan between 1990 and 2013. In a wider context, Japan’s decentralized license hunting system might take the potential future role of a regional pioneer in East Asia. Consequently, the study contributes to similar issues in premature hunting systems of South Korea and Taiwan. Firstly, a quantitative comparison of seven mainland regions was conducted in Hokkaido, Tohoku, Kanto, Chubu, Kinki, Chugoku, and Kyushu. Example prefectures were chosen by a cluster analysis. Shifts, differences, mean values and exponential growth rates between trap and gun hunters, age classes and common occupation types of hunters were statistically exterminated. While western Japan is characterized by high numbers of aged trap-hunters, occupied in agricultural- and forestry, the north-eastern prefectures show higher relative numbers of younger gun-hunters occupied in the field of production and process workers. With the exception of Okinawa island, most hunters in all prefectures are 60 years and older. Hence, unemployed and retired hunters are the fastest growing occupation group. Despite to drastic decrease in hunter population in absolute numbers, Hunting Recruitment Index indicated that all age classes tend to continue their hunting activity over a longer period, above ten years from 2004 to 2013 than during the former decade. Associated with a rapid population increase and distribution of sika deer and wild boar since 1978, a number of harvest from hunting and culling also have been rapidly increasing. Both wild boar hunting and culling is particularly high in western Japan, while sika hunting and culling proofs most successful in Hokkaido, central and western Japan. Since the Wildlife Protection and Proper Hunting Act in 1999 distinct prefectural hunting management authorities with different power, sets apply management approaches under the principles of subsidiarity and guidelines of the Ministry of Environment. Additionally, the Act on Special Measures for Prevention of Damage Related to Agriculture, Forestry, and Fisheries Caused by Wildlife from 2008 supports local hunters in damage prevention measures through subsidies by the Ministry of Agriculture and Forestry, which caused a rise of trap hunting, especially in western Japan. Secondly, prefectural staff in charge of wildlife management in seven regions was contacted. In summary, Hokkaido serves as a role model for dynamic, integrative, adaptive “feedback” management of Ezo sika deer, as well as a diverse network between management organizations, while Hyogo takes active measures to trap-hunt wild boars effectively. Both prefectures take the leadership in institutional performance and capacity. Northern prefectures in Tohoku, Chubu and Kanto region, firstly confronted with the emergence of wild boars and rising sika deer numbers, demand new institution and capacity building, as well as organizational learning.

Keywords: hunting and culling harvest trends, hunter socio-demographics, regional comparison, wildlife management approach

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Authors: Mazlum Çelik, Burcu Gürkan Ercan, Ahmet Ayaz, Hilal Yakut İpekoğlu, Furkan Baltacı, Mustafa Kurtoğlu, Bilge Kalkavan, Sinem Küçükyılmaz, Hikmet Çağrı Yardımcı, Şeyma Sevgican, Cemile Gökçe Elkovan, Bilal Çayır, Mehmet Emin Düzcan

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The earthquake research literature generally examines emotional, cognitive, and behavioral responses after an earthquake. Studies concerning the behavioral responses to earthquakes reveal that after the earthquake, people either flee in a panic or do not act according to the stereotype that they act irrationally and anti-socially and sometimes give rational and adaptive reactions. However, the rareness of research dealing with human behavior experiencing the earthquake moment makes it necessary to pay particular attention to these behavior patterns. In this direction, this study aims to examine human behavior indoors in case of rising earthquake intensity. In Turkey, located on geography in the earthquake zone, devastating earthquakes took place, such as in "Istanbul" with a magnitude of 7.4 in 1999 and in "Elazığ" with a magnitude of 6.8 in 2020. Occurred recently, the "Kahramanmaraş" earthquake affected 11 provinces, with a magnitude of 7.7 and 7.6 in 2023. In addition, there is expected to be a devastating earthquake in Istanbul, experts warn. For this reason, it is essential to understand human behavior for disaster risk. Management and pre-disaster preparedness to be effective and efficient and to take realistic measures to protect human life. Mazlum Çelik, Burcu Gürkan Ercan, Ahmet Ayaz, Hilal Yakut İpekoğlu, Furkan Baltacı, Mustafa Kurtoğlu, Bilge Kalkavan, Sinem Küçükyılmaz, Hikmet Çağrı Yardımcı, Şeyma Sevgican, Cemile Gökçe Elkovan, Bilal Çayır, Mehmet Emin Düzcan. In this study, which is currently part of a project supported by The Scientific and Technological Council of Turkey (TUBITAK), the indoor recordings during the earthquakes in Elazig on January 24, 2020, and in İzmir on October 30, 2020, are examined, and the people's behavior during the earthquake is analyzed. In this direction, video recordings taken from the YouTube archives of İzmir and Elazığ Disaster and Emergency Management Presidency (AFAD) Directorates and metropolitan municipalities are examined. The researchers have created an observation form in line with the information in the relevant literature to classify people's behavior during an earthquake. It is intended to determine the behavioral patterns by classifying according to the form and video analysis of the people heading toward the door, remaining stable, taking protective measures, turning to people, and engaging in "other" behaviors outside of these behaviors during the earthquake. A total of 60 video analyzes are carried out from Elazığ and İzmir. The descriptive statistic has been used with the SPSS 23.0 package program in the data analysis. It is found that in the event of an increase in the severity of the earthquake, unlike Elazığ, in İzmir, protective action is preferred to the act of remaining stable. In addition, it is observed that with the increase in the earthquake's intensity, women attempt to take more protective action while men head toward the door. In contrast, a rise is observed in the behavior of young people heading toward the door and taking protective actions, while there is a decrease in their behavior directing to people. These findings, unlike the literature, reveal that human behavior during earthquakes cannot be reduced to a single behavior pattern, such as drop-cover-hold-on. The results show that it is necessary to understand the behaviors of individuals during the earthquake and to develop practical policy proposals for combating earthquakes by considering sociocultural, geographical, and demographic variables.

Keywords: descriptive analysis, earthquake, human behaviour, disaster policy.

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Authors: Nahashon Mwirigi

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The management of HIV/AIDS is a global challenge, demanding precise tools to predict disease progression and guide tailored treatment. CD4 cell count dynamics, a crucial immune function indicator, play an essential role in understanding HIV/AIDS progression and enhancing patient care through effective modeling. While several models assess disease progression, existing methods often fall short in capturing the complex, non-linear nature of HIV/AIDS, especially across diverse demographics. A need exists for models that balance predictive accuracy with clinical applicability, enabling individualized care strategies based on patient-specific progression rates. This study utilizes patient data from Kenyatta National Hospital (2003–2014) to model HIV/AIDS progression across six CD4-defined states. The Exponential, 2-Parameter Weibull, and 3-Parameter Weibull models are employed to analyze failure rates and explore progression patterns by age and gender. Model selection is based on Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) to identify models best representing disease progression variability across demographic groups. The 3-Parameter Weibull model emerges as the most effective, accurately capturing HIV/AIDS progression dynamics, particularly by incorporating delayed progression effects. This model reflects age and gender-specific variations, offering refined insights into patient trajectories and facilitating targeted interventions. One key finding is that older patients progress more slowly through CD4-defined stages, with a delayed onset of advanced stages. This suggests that older patients may benefit from extended monitoring intervals, allowing providers to optimize resources while maintaining consistent care. Recognizing slower progression in this demographic helps clinicians reduce unnecessary interventions, prioritizing care for faster-progressing groups. Gender-based analysis reveals that female patients exhibit more consistent progression, while male patients show greater variability. This highlights the need for gender-specific treatment approaches, as men may require more frequent assessments and adaptive treatment plans to address their variable progression. Tailoring treatment by gender can improve outcomes by addressing distinct risk patterns in each group. The model’s ability to account for both accelerated and delayed progression equips clinicians with a robust tool for estimating the duration of each disease stage. This supports individualized treatment planning, allowing clinicians to optimize antiretroviral therapy (ART) regimens based on demographic factors and expected disease trajectories. Aligning ART timing with specific progression patterns can enhance treatment efficacy and adherence. The model also has significant implications for healthcare systems, as its predictive accuracy enables proactive patient management, reducing the frequency of advanced-stage complications. For resource limited providers, this capability facilitates strategic intervention timing, ensuring that high-risk patients receive timely care while resources are allocated efficiently. Anticipating progression stages enhances both patient care and resource management, reinforcing the model’s value in supporting sustainable HIV/AIDS healthcare strategies. This study underscores the importance of models that capture the complexities of HIV/AIDS progression, offering insights to guide personalized, data-informed care. The 3-Parameter Weibull model’s ability to accurately reflect delayed progression and demographic risk variations presents a valuable tool for clinicians, supporting the development of targeted interventions and resource optimization in HIV/AIDS management.

Keywords: HIV/AIDS progression, 3-parameter Weibull model, CD4 cell count stages, antiretroviral therapy, demographic-specific modeling

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