Exposure to Hyaluronan and Radon-Containing Water during the Treatment of Periodontal Pockets

Hyaluronic acid (HA) preparations have emerged as pivotal components in contemporary dentistry, gaining widespread recognition for their multifaceted roles in various biological functions. Extensive literature underscores the significance of HA in maintaining tissue water balance, fostering cell proliferation, promoting rapid cell migration, influencing cell differentiation during organism development, and facilitating tissue regeneration. Notably, HA’s interactions with cell surface receptors contribute to the viscosity of synovial fluid, activate the immune system, and enhance cartilage elasticity. Beyond these established functions, HA has also been investigated for its potential involvement in determining and studying the hormetic effects of radon water, adding a novel dimension to its applications in dental research. A thorough exploration of existing studies reveals a nuanced understanding of how HA interventions impact the outcomes of dental procedures. The comprehensive scope of these investigations allows for a more accurate assessment of the potential effectiveness of specific interventions and provides valuable insights into post-procedural prognoses for individual patients. This synthesis of literature serves as the foundation for elucidating the intricate interplay between HA, radon exposure, and their relevance in modern dental practices.

Performance of a Horizontal Flow Constructed Reed Bed Filter for Municipal Wastewater Treatment: The Case Study of the Prototype Installed at Gaston Berger University, Saint-Louis, Senegal

In Saint-Louis, Senegal, a constructed wetland with horizontal flow reed beds (FHa and FHb) has demonstrated significant efficacy in treating municipal wastewater. Analyzing various treatment stages, the system showed only a slight temperature variation, from an influent average of 26.3°C to an effluent of 24.7°C. Electrical conductivity decreased from 1331 mS/cm to 974.5 mS/cm post-primary treatment, with suspended solids (SS) dramatically reduced from 718.9 mg/L to 5.7 mg/L in the final effluent. Biochemical oxygen demand (BOD5) and chemical oxygen demand (COD) saw a notable decrease, from initial levels of 655.6 mg/L and 1240 mg/L to 2.3 mg/L and 71.3 mg/L, respectively. Nitrogenous compounds (N-TN) and phosphates () also decreased significantly, indicating the system’s nutrient removal capacity. Microbiological analysis revealed a reduction in fecal coliforms from 7.5 Ulog/100ml to 1.8 Ulog/100ml and a complete elimination of helminth eggs. The presence of Phragmites and Typha was instrumental in enhancing these reductions. The system’s compliance with the Senegalese standards for disposal into natural environments, WHO recommendations for unrestricted water reuse in irrigation, and the European legislation for water reuse was established. The effluent quality met the stringent criteria for various classes of agricultural reuse, illustrating the system’s potential for sustainable water management. This wetland model presents a robust solution for water-stressed regions, ensuring environmental protection while supporting agricultural needs. The study calls for ongoing research to further refine the system for optimal, reliable wastewater treatment and water resource sustainability.

Toxicity evaluation of produced formation waters after filtration treatment

During the last years many authors have char-acterized the produced formation waters (PFWs) with respect to chemical compounds and toxic-ity. Most of data are related to PFWs collected on offshore platform after treatment process. The available results showed that the particulate phase had an influence on PFW toxicity. As-suming the toxicity of PFWs treated on platform, the aim of this paper is to study the toxicity of these PFWs after a further filtration treatment carried out in laboratory. For this purpose PFWs were sampled from three natural gas platforms located in the Adriatic Sea (Italy) below treat-ment system. The eco-toxicological bioassays have been conducted on test-organisms be-longing to different trophic levels such as bac-teria, algae, crustaceans and fishes. The PFWs resulted toxic according to an overall assess-ment obtained through the bioassays. Further-more, it has been possible to identify the spe-cies that were more sensitive to the tested PFWs, namely Tigriopus fulvus, Dicentrarchus labrax and Vibrio fischeri. Besides, a chemical char-acterization was reported related to the con-taminants present in the PFWs to go with eco-toxicological assessment. Barium, zinc and manganese showed the most concentrations among the metals and the lower molecular weight components were common among the organic compounds. Some differences among PFWs were observed both for toxicity and chemical composition. The highest toxicity was recorded in PFWs (PFW1 and PFW2) containing the highest concentrations of some metals (Ba, Mn and Zn) and/or BTEX.

Some Indicators of the Water Regime in Some Varieties Belonging to the Monarda didyma L. Genus in the Conditions of Tashkent (Uzbekistan)

In this article, the names of 3 varieties of Monarda didyma L., which are considered to be introduced species, some indicators of the water regime in the climatic conditions of Uzbekistan: the amount of water in the leaves, water deficit, water storage capacity were studied in spring and summer, and seasonal changes were determined. According to these indicators of the water regime, the studied varieties belong to the labile water regime, high green mass (centner), seed yield (how many grams), resistance to diseases and pests have been determined, which shows that it is promising for introduction in the conditions of our republic. Therefore, it is recommended to breed these varieties in the foothills and hilly regions of Uzbekistan, where the amount of precipitation is more than 400 - 500 mm.

KELEA: A Natural Energy That Seemingly Reduces Intermolecular Hydrogen Bonding in Water and Other Liquids

The alternative cellular energy (ACE) pathway was initially identified as a non-immunological defense mechanism against virus infections. It is particularly relevant to the suppression of stealth adapted viruses, which are not normally recognized by the cellular immune system. Many of the methods able to enhance the ACE pathway are consistent with the transfer of a natural energy to the body’s fluids. Additional support for this premise is provided in this paper. The vapor pressure and rate of evaporation of activated water, ethanol and gasoline increase to beyond atmospheric pressure over time. The term KELEA (kinetic energy limiting electrostatic attraction) is proposed for a natural energy that increases the volatility of fluids, seemingly through the loosening of intermolecular hydrogen bonding. KELEA activated fluids have many potential health, agricultural and industrial applications, as well as providing the opportunity for fundamental research.

Photosynthetic Water Use Efficiency of Heritage and Modern Potatoes under Limited and Unlimited Water Environments

Photosynthetic capacity for heritage (Taewa) and modern potato cultivars were compared at different water and nitrogenregimes in the glasshouse and field. The glasshouse was 2*2*4 factorial design with two irrigation: 100% ET and 60% ET;two applied N: 50 kg N ha-1 and 200 kg N ha-1, two Taewa (Moe Moe, Tutaekuri) and two modern potatoes (Moonlight, Agria). The 2009/2010 field experiment was a split-plot, with irrigation and rain-fed regimes as the main treatments: four potatoes above were sub-treatments. The 2010/2011 field experiment was a split-split-plot, with three water regimes as the main treatments: three cultivars (Moe Moe, Tutaekuri, and Agria) were subplots;two N rates were sub-sub-treatments. Gaseous exchange was measured by CIRAS-2 at different days from emergence. Leaf water potential was measured using pressure chamber method. Taewa achieved high photosynthetic WUE in glasshouse and 2010/2011 experiment by maintaining high An, low gs and low Ci compared to modern cultivars (p The An, gs and T increased with irrigation and N increase while decreasing Ci (p < 0.01). Water stress significantly increased VPD resulting in low An and photosynthetic WUE in Moonlight in the glasshouse. The leaf water potential for Taewa was very tolerant while modern potatoes were weakened by water stress. The study indicated that Taewa can be scheduled at partial irrigation without more detrimental effects on photosynthetic capacity while modern potatoes need full irrigation to avoid detrimental effects on photosynthetic capacity.

Hydrochemical characteristics of surface water in Hengduan mountain region of Eastern Tibet and its response to human activities:A case study of Duoqu Basin,Jinsha River

The analysis of hydrochemical characteristics and influencing factors of surface river on plateau is helpful to study water hydrological cycle and environmental evolution,which can scientifically guide rational development and utilization of water resources and planning of ecological environment protection.With the expansion and diversification of human activities,the quality of surface rivers will be more directly affected.Therefore,it is of great significance to pay attention to the hydrochemical characteristics of plateau surface rivers and the influence of human activities on their circulation and evolution.In this study,surface water in the Duoqu basin of Jinsha River located in Hengduan mountain region of Eastern Tibet was selected as the representative case.Twenty-three groups of surface water samples were collected to analyze the hydrochemical characteristics and ion sources based on correlation analysis,piper trigram,gibbs model,hydrogen and oxygen isotopic techniques.The results suggest the following:(1)The pH showed slight alkalinity with the value ranged from 7.25 to 8.62.Ca^(2+),Mg^(2+)and HCO_(3)^(–)were the main cations and anions.HCO_(3)^(-)Ca and HCO_(3)^(-)Ca·Mg were the primary hydrochemical types for the surface water of Duoqu River.The correlation analysis showed that TDS had the most significant correlation with Ca^(2+),Mg^(2+)and HCO_(3)^(–).Analysis on hydrogen and oxygen isotopes indicated that the surface rivers were mainly recharged by atmospheric precipitation and glacial melt water in this study area.(2)The surface water had a certain reverse cation alternating adsorption,and surface water ions were mainly derived from rock weathering,mainly controlled by weathering and dissolution of carbonates,and secondly by silicates and sodium rocks.(3)The influence of human activities was weak,while the development of cinnabar minerals had a certain impact on the hydrochemistry characteristics,which was the main factor for causing the increase of SO_(4)^(2–).The densely populated county towns and temples with frequent incense burning activities may cause some anomalies of surface water quality.At present,the Duoqu River watershed had gone through a certain influence of mineral exploitation,so the hydrological cycle and river eco-environment at watershed scale will still bound to be change.The results could provide basic support for better understanding water balance evolution as well as the ecological protection of Duoqu River watershed.

Estimation and mapping of water erosion and soil loss:Application of Gavrilovic erosion potential model(EPM)using GIS and remote sensing in the Assif el mal Watershed,Western high Atlas

Water erosion is a serious problem that leads to soil degradation,loss,and the destruction of structures.Assessing the risk of erosion and determining the affected areas has become crucial in order to understand the main factors influencing its evolution and to minimize its impacts.This study focuses on evaluating the risk of erosion in the Assif el mal watershed,which is located in the High Atlas Mountains.The Erosion Potential Model(EPM)is used to estimate soil losses depending on various parameters such as lithology,hydrology,topography,and morphometry.Geographic information systems and remote sensing techniques are employed to map areas with high erosive potential and their relationship with the distribution of factors involved.Different digital elevation models are also used in this study to highlight the impact of data quality on the accuracy of the results.The findings reveal that approximately 59%of the total area in the Assif el mal basin has low to very low potential for soil losses,while 22%is moderately affected and 19.9%is at high to very high risk.It is therefore crucial to implement soil conservation measures to mitigate and prevent erosion risks.

Optimization of water-urban-agricultural-ecological land use pattern:A case study of Guanzhong Basin in the southern Loess Plateau of Shaanxi Province,China

Extensive land use will cause many environmental problems.It is an urgent task to improve land use efficiency and optimize land use patterns.In recent years,due to the flow decrease,the Guanzhong Basin in Shaanxi Province is confronted with the problem of insufficient water resources reserve.Based on the Coupled Ground-Water and Surface-Water Flow Model(GSFLOW),this paper evaluates the response of water resources in the basin to changes in land use patterns,optimizes the land use pattern,improves the ecological and economic benefits,and the efficiency of various spatial development,providing a reference for ecological protection and high-quality development of the Yellow River Basin.The research shows that the land use pattern in the Guanzhong Basin should be further optimized.Under the condition of considering ecological and economic development,the percentage change of the optimum area of farmland,forest,grassland,water area,and urban area compared with the current land use area ratio is+2.3,+2.4,-6.1,+0.2,and+1.6,respectively.The economic and ecological value of land increases by14.1%and 3.1%,respectively,and the number of water resources can increase by 2.5%.

How Water-Development Nexus Can Reunite Central Asia?

The following article has been retracted due to the fact that it cannot be accepted by the author’s university as a scientific peer-reviewed publication. The Editorial Board takes a very strong respect to the author’s situation on this matter. This paper published in World Journal of Engineering and Technology Vol.2 No.3B, September 2014, has been removed from this site.

Innovative Technologies for Large-Scale Water Production in Arid Regions: Strategies for Sustainable Development

Water scarcity in arid regions poses significant challenges to sustainable development and human well-being. This article explores both existing and innovative technologies and methods to produce large amounts of water to address these challenges effectively. Key approaches include atmospheric water generation, advanced desalination techniques, innovative water collection methods such as fog nets and dew harvesting, geothermal water extraction, and water recycling and reuse. Each method is evaluated for its feasibility with existing technology, potential time of implementation, required investments, and specific challenges. By leveraging these technologies and combining them into a multifaceted water management strategy, it is possible to enhance water security, support agricultural and industrial activities, and improve living conditions in arid regions. Collaborative efforts between governments, private sector entities, and research institutions are crucial to advancing these technologies and ensuring their sustainable implementation. The article provides a comprehensive overview of the current state of these technologies, their potential for large-scale application, and recommendations for future research and development.

Leaf Tissue Water Relations Are Associated with Drought-Induced Leaf Shedding in Tropical Montane Habitats

In tropical montane areas, water limitation is a common occurrence, and both pioneer and forests species experience water stress during the dry season. Adjustments of leaf area during periods of drought allow for the maintenance of the water supply and physiological functions of the remaining leaves. Here, we compared leaf blade water relations between pioneer and forest tree species. Leaf pressure-volume (P-V) curves were determined from samples taken prior to the dry season, to assess how leaves of the different species were adapted to prepare for and endure water deficits. The following parameters were calculated: osmotic potential at full (Ψπ(100)) and zero (Ψπ(0)) turgor, relative water content at zero turgor (RWC0), volumetric elastic modulus (&#949) as well as apoplasm (A) and symplasm (S) water content and their ratio (A/S). Although the pioneer and forest species occupied contrasting habitats, and both groups were clearly differentiated with respect to their water transport capability and water use efficiency, their leaf tissue water relations showed clear differences across species but not between the groups. Some species underwent leaf shedding and accumulated xylem embolisms during the dry season, and their leaves had high cell elasticity. Consequently, these species presented large cell volume changes with turgor loss. Conversely, species with rigid leaves were able to undergo lower leaf turgor with only small changes in cell volume during drought, which might aid to preserve leaf cell function, maintain water uptake, and consequently avoid accelerated leaf senescence and shedding during the dry season.

Review on the Impact of Climate Change on Great Lakes Region’s Agriculture and Water Resources

This study investigates the multifaceted impacts of climate change on the Midwest region of the United States, particularly the rising temperatures and precipitation brought about by hot weather activities and technological advances since the 19th century. From 1900 to 2010, temperatures in the Midwest rose by an average of 1.5 degrees Fahrenheit, which would also lead to an increase in greenhouse gas emissions. Precipitation is also expected to increase due to increased storm activity and changes in regional weather patterns. This paper explores the impact of these changes on urban and agricultural areas. In urban areas such as the city of Chicago, runoff from the increasing impervious surface areas poses challenges to the drainage system, and agriculture areas are challenged by soil erosion, nutrient loss, and fewer planting days due to excessive rainfall. Sustainable solutions such as no-till agriculture and the creation of grassland zones are discussed. Using historical data, recent climate studies and projections, the paper Outlines ways to enhance the Midwest’s ecology and resilience to climate change.

Linkage between precipitation isotopes and water vapor sources in the monsoon margin:Evidence from arid areas of Northwest China

The isotope composition in precipitation has been widely considered as a tracer of monsoon activity.Compared with the coastal region,the monsoon margin usually has limited precipitation with large fluctuation and is usually sensitive to climate change.The water resource management in the monsoon margin should be better planned by understanding the composition of precipitation isotope and its influencing factors.In this study,the precipitation samples were collected at five sampling sites(Baiyin City,Kongtong District,Maqu County,Wudu District,and Yinchuan City)of the monsoon margin in the northwest of China in 2022 to analyze the characteristics of stable hydrogen(δD)and oxygen(δ18O)isotopes.We analyzed the impact of meteorological factors(temperature,precipitation,and relative humidity)on the composition of precipitation isotope at daily level by regression analysis,utilized the Hybrid Single-Particle Lagrangian Integrated Trajectory(HYSPLIT)-based backward trajectory model to simulate the air mass trajectory of precipitation events,and adopted the potential source contribution function(PSCF)and concentration weighted trajectory(CWT)to analyze the water vapor sources.The results showed that compared with the global meteoric water line(GMWL),the slope of the local meteoric water line(LMWL;δD=7.34δ^(18)O-1.16)was lower,indicating the existence of strong regional evaporation in the study area.Temperature significantly contributed toδ18O value,while relative humidity had a significant negative effect onδ18O value.Through the backward trajectory analysis,we found eight primary locations that were responsible for the water vapor sources of precipitation in the study area,of which moisture from the Indian Ocean to South China Sea(ITSC)and the western continental(CW)had the greatest influence on precipitation in the study area.The hydrogen and oxygen isotopes in precipitation are significantly influenced by the sources and transportation paths of air mass.In addition,the results of PSCF and CWT analysis showed that the water vapor source areas were primarily distributed in the south and northwest direction of the study area.

Impact of climate change and human activities on the spatiotemporal dynamics of surface water area in Gansu Province, China

Understanding the dynamics of surface water area and their drivers is crucial for human survival and ecosystem stability in inland arid and semi-arid areas.This study took Gansu Province,China,a typical area with complex terrain and variable climate,as the research subject.Based on Google Earth Engine,we used Landsat data and the Open-surface Water Detection Method with Enhanced Impurity Control method to monitor the spatiotemporal dynamics of surface water area in Gansu Province from 1985 to 2022,and quantitatively analyzed the main causes of regional differences in surface water area.The findings revealed that surface water area in Gansu Province expanded by 406.88 km2 from 1985 to 2022.Seasonal surface water area exhibited significant fluctuations,while permanent surface water area showed a steady increase.Notably,terrestrial water storage exhibited a trend of first decreasing and then increasing,correlated with the dynamics of surface water area.Climate change and human activities jointly affected surface hydrological processes,with the impact of climate change being slightly higher than that of human activities.Spatially,climate change affected the'source'of surface water to a greater extent,while human activities tended to affect the'destination'of surface water.Challenges of surface water resources faced by inland arid and semi-arid areas like Gansu Province are multifaceted.Therefore,we summarized the surface hydrology patterns typical in inland arid and semi-arid areas and tailored surface water'supply-demand'balance strategies.The study not only sheds light on the dynamics of surface water area in Gansu Province,but also offers valuable insights for ecological protection and surface water resource management in inland arid and semi-arid areas facing water scarcity.

Progress and prospects of EOR technology in deep,massive sandstone reservoirs with a strong bottom-water drive

The Triassic massive sandstone reservoir in the Tahe oilfield has a strong bottom-water drive and is characterized by great burial depth,high temperature and salinity,a thin pay zone,and strong heterogeneity.At present,the water-cut is high in each block within the reservoir;some wells are at an ultrahigh water-cut stage.A lack of effective measures to control water-cut rise and stabilize oil production have necessitated the application of enhanced oil recovery(EOR)technology.This paper investigates the development and technological advances for oil reservoirs with strong edge/bottom-water drive globally,and compares their application to reservoirs with characteristics similar to the Tahe oilfield.Among the technological advances,gas injection from the top and along the direction of structural dip has been used to optimize the flow field in a typical bottom-water drive reservoir.Bottom-water coning is restrained by gas injection-assisted water control.In addition,increasing the lateral driving pressure differential improves the plane sweep efficiency which enhances oil recovery in turn.Gas injection technology in combination with technological measures like channeling prevention and blocking,and water plugging and profile control,can achieve better results in reservoir development.Gas flooding tests in the Tahe oilfield are of great significance to identifying which EOR technology is the most effective and has the potential of large-scale application for improving development of deep reservoirs with a strong bottomwater drive.

Strategy &Techniques for Restoration of Healthy Aquaecosystem from Toxic Super Eutrophic Water Body

There are complex river-lake systems in the Taihu Lake catchment with total water surface area of 6174.7 km2, and population density of 1079/km2, including Taihu Lake water surface area of 2338 km2. The water systems in this catchment have healthy aquaecosystems during long history. However, in some riverlets in this catchment the water quality was estimated as “acute toxicity for higher organisms” and over standards for many heavy metal elements content;there were no any living plants and macro organisms in the water body, because there were developed a series of industry with abundant release of heavy metals and difficult decomposition organic chemical components along the riverlets during last decades. The even more serious situation was observed in sediments of the riverlets. How to restore such riverlet into a healthy aquaeosystem with abound plants and higher organisms? The main strategy and techniques are described in this paper as summarizing a report of engineering in a riverlet in Wuxi New District during last years, which leads to restore the aquaecosystem into a healthy one with abundant surface plant cultured on floating islands and observed living fish, lobster, frog, toad, mollusk and others in the riverlet. The main techniques are: 1) softwall buffer technic;2) floating eco-island technic by using which can culture any plant which can be cultured in solution;3) immobilized nitrogen cycle bacteria (INCB) technic;4) tattering esters and other big-molecule organic chemicals by using electronic pulse technic and photosensitization technic;5) mist spray facility technic for improving dissolved oxygen in deep water layers;6) technic for buffering and suppressing H2S release from water;7) the appropriate portion of surface with cultured plant to the total water surface area is about 1/3;8) Cress [Oenanthe Ljavanica (Bl.) DC.] and Myriophyllum verticilatum L. may be cultured in Taihu Lake catchment during the whole year as main plants with mosaic combination of other supplement plants in different seasons.

Soil water resources use limit in the loess plateau of China

Soil water is a key factor limiting plant growth in water-limited regions. Without limit of soil water used by plants, soil degradation in the form of soil desiccation is easy to take place in the perennial forestland and grassland with too higher density or productivity. Soil water resources use limit (SWRUL) is the lowest control limit of soil water resources which is used by plants in those regions. It can be defined as soil water storage within the maximum infiltration depth in which all of soil layers belong to dried soil layers. In this paper, after detailed discussion of characteristics of water resources and the relationship between soil water and plant growth in the Loess Plateau, the definition, quantitative method, and practical applications of SWRUL are introduced. Henceforth, we should strengthen the study of SWRUL and have a better understanding of soil water resources. All those are of great importance for designing effective restoration project and sustainable management of soil water resources in water- limited regions in the future.

Characteristics of In-Situ Soil Water Hysteresis Observed through Multiple-Years Monitoring

A soil water retention curve (SWRC) is an essential soil physical property for analyzing transport and retention of water in a soil layer. A SWRC is often described as a single-valued function that relates the soil water potential ψ to volumetric water content θ of the soil. However, an in-situ ψ − θ relation should show soil water hysteresis, though this fact is often neglected in analyses of field soil water regimes while long-term in-situ soil water hysteresis is not well characterized. This study aimed at probing and characterizing in-situ ψ − θ relations. The developments of large hysteresis in the in-situ ψ − θ relations were observed only a few times during the study period of 82 months. Any of the large hysteretic behaviors in the ψ − θ relations began with an unusually strong continual reduction in ψ. The completion of a hysteresis loop required a recorded maximum rainfall. Because the study field had very small chances to meet such strong rainfall events, it took multiple years to restore the fraction of soil water depleted by the unusually strong continual reduction in ψ. While wetting-drying cycles had occurred within a certain domain of ψ, hysteretic behaviors tended to be so small that the in-situ ψ − θ relation can be approximated as a single-valued function of θ(ψ). These observed patterns of the in-situ ψ − θ relations were characterized by kinds of difference in dθ/dψ between a drying process and a wetting process at a given ψ. Thus, more amounts of experimental facts about wetting SWRCs in parallel with drying SWRCs should be needed for correct modelling, analyzing, and predicting soil water regimes in fields. It is also necessary to increase our understandings about the long-term trends of occurrences of extreme weather conditions associated with possible change in climate.

A Triple Nexus Water-Energy-Housing (WEH) Framework Modelling towards Improved Decision-Making in Humanitarian Operations

Given the challenges facing most humanitarian operations worldwide, a change of approach is needed to ensure greater sustainability of humanitarian settlements right from the planning stage. Some studies attribute unsustainability to inadequate provision of basic resources and highlight the apparent bottlenecks that prevent access to the meaningful data needed to plan and remedy problems. Most operations have relied on an “ad hoc ism” approach, employing parallel and disconnected data processing methods, resulting in a wide range of data being collected without subsequent prioritization to optimize interconnections that could enhance performance. There have been little efforts to study the trade-offs potentially at stake. This work proposes a new framework enabling all subsystems to operate in a single system and focusing on data processing perspective. To achieve this, this paper proposes a Triple Nexus Framework as an attempt to integrate water, energy, and housing sector data derived from a specific sub-system within the overall system in the application of Model-Based Systems Engineering. Understanding the synergies between water, energy, and housing, Systems Engineering characterizes the triple nexus framework and identifies opportunities for improved decision-making in processing operational data from these sectors. Two scenarios illustrate how an integrated platform could be a gateway to access meaningful operational data in the system and a starting point for modeling integrated human settlement systems. Upon execution, the model is tested for nexus megadata processing, and the optimization simulation yielded 67% satisfactory results, demonstrating that an integrated system could improve sustainability, and that capacity building in service delivery is more than beneficial.