Main factors of Kota Kinabalu residents tend to use public transport

Transportation and movement of goods are one of the essential human needs, and special attention is placed on the planning of a large city. It has always played an essential role in the development of society, initially concerning trade routes and harbor, but more recently about land and air-based systems. Therefore, in a particular area where the population growth keeps increasing as in Kota Kinabalu, there is a need to implement a good transportation system to ensure proper traffic flow. This paper surveys the reaction of 450 respondents towards the existing public transportation provided in Kota Kinabalu city through a questionnaire distributed via online form. The main aim of this research is to find out the main factor of Kota Kinabalu residents tends to use public transport. Based on the Chi-square analysis, the age and gender of Kota Kinabalu residents have a significant influence on the frequency of public transport usage in Kota Kinabalu. The results of the study also showed that the main factor of Kota Kinabalu tend to use public transports are the reliability of public transport and its drop-off consistency. Meanwhile, the most factors which need to be enhanced are the cleanliness and comfort of the existing public transport in Kota Kinabalu, Sabah

Main factors of Kota Kinabalu residents tend to use the private vehicle

Kota Kinabalu is the capital city of Sabah which acts as economic and administration centre and fondly known as KK. The migration of people due to wide opportunities has enhanced the population growth drastically. Unexpectedly, this led to the increase of the travel demand. This has been proven as the number of vehicles travelling in and out of the city grows by 8.3% annually by the number of roads grows at a slower rate, causing worst traffic congestion mainly during peak hours. Hence, this study has been conducted in order to determine the relationship between variables and car ownership in Kota Kinabalu, the relationship between variables with the type of vehicles use for travelling in Kota Kinabalu City as well as to study the factor of Kota Kinabalu residents tend to use the private vehicles in Kota Kinabalu City. An online survey being conducted via Google Form to obtain the findings and chi-square test has been done to analyse the data. It is found that the most factors that encourage people to use private vehicles in Kota Kinabalu City are security concerns, hygiene as well as the time and destinations flexibility

Pilot study for the modelling of congestion pricing in Kota Kinabalu, Sabah

Congestion pricing is a policy at which road users being charged with certain amount for using particular road during peak hours. It is as much about meeting the demand of car drivers for road space as allocating road space between road users. It has been successfully implemented in some other countries such as Stockholm, London and Singapore with various scheme of congestion pricing. Hence, the main aim of this pilot study is to evaluate and create model based on the willingness of the Kota Kinabalu City residents’ to shift to public transport due to the implementation of congestion pricing. A total of 60 respondents were randomly chosen within Kota Kinabalu City. Data collection is being conducted using stated preference survey and analysed with Microsoft Office Excel 2010 in order to conduct regression analysis and develop a logistic transport model analysis. It is found that the number of people who willing to shift to public transport is parallel with the congestion charge amount. The results from this pilot study indicate that 71.67% of respondents are willing to shift to public transport when the congestion charge price is RM4.00. This study can give contribution for further transportations planning in order to achieve sustainable transportations in Kota Kinabalu, Sabah

An overview of the transportation issues in Kota Kinabalu, Sabah

The explosive growth of population in Sabah has caused the rise of private vehicle ownership and utilizations which give significant defects on transportation and environmental conditions, especially in the central city of Sabah, Kota Kinabalu. As the demand in transportation increased, traffic congestion occurs due to the abundance of a private vehicle on the road while the improvement of traffic facilities is weak and slow. Traffic congestion is an urban mobility problem that worsens traffic flow and eventually, causing economic hindrance to happen. In order to overcome this problem, a good plan, systematic and safe transportation system should be developed. Hence, the purpose of this paper is to study and understand the transportation system in Kota Kinabalu and the feasibility of existing transportation plans for Kota Kinabalu. This paper outlines an overview of the existing transportation system available in Kota Kinabalu, Sabah, the issues encountered, as well as the impacts regarding the current city transport system. In summary, urban transportation relies on proper planning by experts based on passenger experience to find proper solutions to complex urban transport issues in Kota Kinabalu

Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

PURPOSE: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. MATERIALS AND METHODS: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. RESULTS: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). CONCLUSIONS: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial

Artificial intelligence in andrology: From Semen Analysis to Image Diagnostics

Artificial intelligence (AI) in medicine has gained a lot of momentum in the last decades and has been applied to various fields of medicine. Advances in computer science, medical informatics, robotics, and the need for personalized medicine have facilitated the role of AI in modern healthcare. Similarly, as in other fields, AI applications, such as machine learning, artificial neural networks, and deep learning, have shown great potential in andrology and reproductive medicine. AI-based tools are poised to become valuable assets with abilities to support and aid in diagnosing and treating male infertility, and in improving the accuracy of patient care. These automated, AI-based predictions may offer consistency and efficiency in terms of time and cost in infertility research and clinical management. In andrology and reproductive medicine, AI has been used for objective sperm, oocyte, and embryo selection, prediction of surgical outcomes, cost-effective assessment, development of robotic surgery, and clinical decision-making systems. In the future, better integration and implementation of AI into medicine will undoubtedly lead to pioneering evidence-based breakthroughs and the reshaping of andrology and reproductive medicine

Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

Purpose: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. Materials and Methods: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. Results: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. Conclusions: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians

Technical aspects and clinical limitations of sperm DNA fragmentation testing in male infertility: A global survey, current guidelines, and expert recommendations

Purpose Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. Materials and Methods Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. Results The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). Conclusions This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial

Controversy and consensus on the management of elevated sperm DNA fragmentation in male infertility: A global survey, current guidelines, and expert recommendations

Purpose Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition. Materials and Methods An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method. Results A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4–6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated. Conclusions This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians

Best practices across the continuum of care for the treatment of opioid use disorder.

People living with an opioid use disorder in Canada should have access to comprehensive treatment options that meet all their needs. Best Practices across the Continuum of Care for the Treatment of Opioid Use Disorder presents services that should be available to individuals experiencing or at risk of experiencing harms from opioid use. This report, developed to inform Health Canada’s Federal, Provincial and Territorial Treatment Task Group, outlines the standard of service that should implemented to provide person-centred care to all people experiencing harms from opioids. The report includes a summary of actions taking place across Canada at multiple levels of government to help people experiencing harms from opioids and to stop the deaths occurring from opioid poisonings