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Rational planning is essential for infrastructure transitions in network industries due to the substantial investment costs involved. This study evaluates the economic feasibility of transitioning to a centralised wastewater treatment paradigm. We propose a hybrid Wastewater Infrastructure Transition Optimisation and Evaluation (WWITOE) framework that integrates mathematical optimisation and Cost-Benefit Analysis (CBA), explicitly accounting for geographic, topographic, and hydraulic cost uncertainties. The transition strategy explored involves cascading consolidations of Wastewater Treatment Plants (WWTPs), whereby small-scale facilities are closed, and their flows redirected to larger, centralised hubs. While economies of scale at these hubs are expected to reduce treatment costs, the construction of extended collection networks may offset these savings-necessitating a balanced, cost-effective approach. We formulate the optimisation model as an Uncapacitated Transportation and Facility Location Problem (UNCAP-TFLP) using integer Linear Programming (LP), and solve it through a Nearest Neighbour Search Algorithm (NNS-A) supported by GIS tools to address spatial feasibility and routing. The WWITOE framework is applied to a real-world case study of 63 WWTPs operated by Anglian Water Services Ltd (AWS) in Lincolnshire, UK. Over a 25-year planning horizon, the Benefit-to-Cost Ratios (BCRs) from the CBA reveal that fully centralised consolidation does not deliver economic advantages in this flat, semi-rural region. The findings demonstrate that WWITOE provides a practical decision-support tool for evaluating wastewater infrastructure transitions, with scalability to other contexts. However, the results reinforce that optimal degrees of centralisation are highly context-dependent, warranting further research into hybrid and adaptive transition pathways.
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http://dx.doi.org/10.1016/j.watres.2025.124424 | DOI Listing |
Resour Conserv Recycl Adv
September 2025
Institute for Environmental Studies, VU Amsterdam, De Boelelaan 1111, 1091 HV Amsterdam, the Netherlands.
Shifting towards a circular economy in the built environment is considered an important step toward fostering environmentally sustainable and socially resilient cities. Housing cooperatives, established to provide affordable and democratically governed housing, may offer structural advantages for embedding circularity - but their role in circular transitions remains underexplored. This study investigates how cooperative governance may influence the implementation of circular strategies, including circular design, product-service systems, and shared resource models, across different housing types.
View Article and Find Full Text PDFWomen Birth
September 2025
Department of nursing, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. Electronic address:
Background: Although home births have been largely discontinued in contemporary China, traditional birth attendants (TBAs) historically played a pivotal role in enhancing maternal and child health, particularly in rural areas.
Aim: This study explored the transformation of TBAs in China from the 1950s to the 1970s, focusing on their gradual shift from traditional to modern midwifery practices. By drawing on oral histories from TBAs, the research seeks to enrich the historical understanding of midwifery development in China.
Crit Rev Clin Lab Sci
September 2025
Laboratory Medicine Program, University Health Network, Toronto, Canada.
Implementing DP on a large scale is a complex, multi-dimensional process that requires strategic planning, technological adaptation, and change management. We provide a detailed account of the full-scale implementation of DP at the University Health Network (UHN), a multi-site tertiary clinical center in Canada, highlighting practical lessons learned, ongoing challenges, and mitigation strategies. A phased implementation approach was adopted, involving pre-implementation planning, procurement, infrastructure development, and optimized validation protocols.
View Article and Find Full Text PDFStroke
September 2025
Hospital Israelita Albert Einstein, São Paulo, Brazil (J.B.C.d.A., G.S.S.).
The global transition to digital health offers a critical opportunity to transform health care delivery, particularly in low- and middle-income countries. Stroke care exemplifies the need for timely, coordinated, and longitudinal management across health systems. Although substantial progress has been achieved, low- and middle-income countries continue to encounter persistent challenges, including infrastructural deficiencies, digital inequity, fragmented governance structures, and limitations within the health care workforce.
View Article and Find Full Text PDFGlob Health Promot
September 2025
TeenSmart International, Zapote, San José, Costa Rica.
Digital health platforms hold promise for addressing youth health inequalities; however, the factors that enable their successful expansion remain to be explored in depth. This study examines the scaling process of JovenSalud.net, a nonprofit digital platform for adolescent health promotion in Central America, led by TeenSmart International, as part of the 18-month 'Transition to Scale' initiative (2022-2023).
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