**Wastewater Treatment: Current and Future Techniques**

Editors

**Amin Mojiri Mohammed J.K. Bashir**

MDPI • Basel • Beijing • Wuhan • Barcelona • Belgrade • Manchester • Tokyo • Cluj • Tianjin

*Editors* Amin Mojiri Hiroshima University Japan

Mohammed J.K. Bashir Universiti Tunku Abdul Rahman Malaysia

*Editorial Office* MDPI St. Alban-Anlage 66 4052 Basel, Switzerland

This is a reprint of articles from the Special Issue published online in the open access journal *Water* (ISSN 2073-4441) (available at: https://www.mdpi.com/journal/water/special issues/Wastewater Techniques).

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**3. Confronting COPD within different contexts**

The age of nihilism should also give way to a future of hope. Historical phenomena such as the stigmatization of smokers who develop COPD and denial of treatment options for those with the severe disease remain significant only as they are related to the responsibility of the present and the promises of the future. An appreciation of different contexts in the clinical presentation of COPD calls for earlier means of diagnosing COPD in an individual patient's lifetime, or at least the ability to predict which individuals are susceptible to COPD. From the newer theoretical understanding of the development of COPD also emanates anticipation of better preventive strategies in the future [4, 5].

In treating COPD, contextualization is crucial. Global guidelines formulated using evidence derived from restricted clinical trial formats are unlikely to be fully relevant to every clinical context in the real world. Clinicians in low-resource countries may be quite adept at managing COPD without the standard spirometry and other tests to rule out differential diagnoses as recommended by global practice guidelines. Recent developments in genomics, phenotyping, endotyping, and identifying treatable traits for the *telos* of personalized medicine may be impracticable in certain settings. Here again is where the universality of COPD, in that it is such a prevalent disease, must be balanced with the particularity of managing COPD within different contexts. Precision medicine does not always entail the use of proteomics and biomarkers, important as they are for the understanding and treatment of the disease, to guide therapeutic decisions. Neither does personalizing medicine mean forsaking the norm or whatever works for the whole, in favor of the quixotic or specific. More empirically, individualizing treatment requires reasoning and adaptation. When confronting COPD in extensive contexts, the clinician must be willing to apply powers of observation and reasoning: *deduction* (what works for the whole or in principle, should work for the individual), *induction* (observe what works for an individual to form a general conclusion), as well as *abduction* (to infer based on observation and assumption).


*2.3. Case Study Description*

Rijeka, Croatia, is a capital of the Coastal Mountain Region county in north-western Croatia, which partly corresponds to the territory of Liburnia and Kvarner. Road safety, especially for pedestrians, requires a lot of attention because out of 404 tra ffic deaths in Croatia in 2017, 60 were pedestrians (14.9%) and 27 in non-motorized vehicles (6.7%). Injuries were 10.5% for pedestrians and 7.3% for non-motorized vehicles (out of a total of 14,608). Regarding the road deaths, 16.9% were caused by pedestrians and 6.9% by cyclists. According to [68], almost 90% of pedestrian deaths in tra ffic are in the over 40 age group, showing a high importance of the age factor. Among the main causes of accidents are not only the conditions and the maintenance of infrastructure, but also the limited visibility and the behavior of pedestrians and drivers [12,13]. These data highlight the need to improve the infrastructure and spread a greater culture of road safety among the population. The document considers the comparison of di fferent routes with identical points of origin and destination, allowing walking as the only form of short distance travel.

The city was selected as a case study because it was named as the European Capital of Culture in 2020 and a good flow of tourists was observed in recent years, until the beginning of the pandemic. The center of the city is used by 160,000 pedestrians daily. Most of the pedestrians arrive to the center by vehicles, and 20% of them arrive by foot [68,69].

As the pedestrian mobility is becoming increasingly important, the City of Rijeka is planning several important enhancements: new pedestrian tra ffic spaces in the portual area, additional underpasses and overpasses related to railway structures, pedestrian access to healthcare services, and the creation of urban microcenters based on pedestrian mobility as residential centers which have a tertiary function (the pedestrian zones, such as squares and roads, are indicated for development). In some parts of the city, the sidewalks are planned with 2 m tree line division for the vehicles. In the center, pedestrian roads are planned with a 12 m section or roads with 6 m pedestrian corridors alongside. Moreover, the elements of mechanical vertical and horizontal mobility are planned in several parts of the city [69,70].

The selected area is the most crowded area of the city by pedestrians due to the tourist attractions and the commercial and tertiary activities present. The analysis was conducted in the city of Rijeka where about 130,000 inhabitants live. Over 19.7% of the resident population is made up of people over the age of 65 years [70] who have a habit of moving on foot or using the public transport. The city is recently characterized by a strong attendance of tourists. The area, which is located closest to the historic center and the port, is fairly flat and allows pedestrians and cyclists to move easily. The city faces the sea and is characterized by large areas that can be easily traveled on foot and characterized by numerous tourist and commercial attractions, as in Figure 4.

**Figure 4.** Geolocation of the study area and photos of the outdoor market area in Rijeka (map source: https://www.openstreetmap.org/).

Other parts of the city are on sloped terrain. Traffic lights exist in every intersection in the center of the city. These intersections provide very long pedestrian crossings. The traffic light cycle, however, does not provide times of more than 25 s and therefore people, especially the elderly and other vulnerable users, find themselves in difficulty during the crossing and are forced to stop in the middle of their route, waiting for the next green [22]. Almost all of the crossings do not have pedestrian areas that can protect them.

This study involves in an area between the pedestrian center and the outdoor market. These two areas are connected by different itineraries that can be travelled on foot or by car. The work focuses on four pedestrian itineraries characterized by different infrastructural elements.

The area is delimited by two main roads for vehicular flows called Adimi´ceva (near the open market define by photos n◦2 and 6 on Figure 4) and Ivana Zajca (near the Korzo, the main pedestrian only street defined by photo n◦3,4 and 5 on Figure 4). They are covered in one way, and today they represent the main transit corridors to and from the city.

The presence of numerous sidewalks allows users to move easily anywhere. The presence of an underpass that connects the two areas analyzed (origin and destination of the movements) reduces this type of potential collision. Specifically, it was considered appropriate to define the main pedestrian area called Korzo as the origin of the four itineraries (yellow area) and the open market (blue area) was instead selected as the final destination, as shown in Figure 5.

**Figure 5.** Evaluated area of Rijeka (Croatia) [22] (map source: https://www.openstreetmap.org/).

The two areas, of the Korzo and the open air market, constitute the two centroids of the exemplified traffic network covered in this study. They are characterized by a high flow of pedestrians during the various hours of the day for both business and pleasure reasons. In addition, the origin node is also characterized by the presence of numerous offices while the destination node is characterized by the presence of the historic covered market and the municipal theater, as well as by numerous restaurants and pubs that attract many tourists. The monitored area was recently embellished with numerous artistic installations and Rijeka finally defined as the European capital of culture 2020.

The questionnaire was given to the citizens of Rijeka who have a good knowledge of the city. The PAPI method was applied in order to acquire the sensations perceived by pedestrians as they travel through the various selected itineraries.

The survey was administered considering the same environmental conditions for all users, i.e., the same period of the day with similar sunlight and similar traffic conditions near the area which is under investigation. Therefore, the sample was limited precisely because of the finding of the same external conditions during the administration of the questionnaire. Among the different sensations experienced by the users during the walk, particular attention was paid to the feeling of safety [71], comfort, and confusion [72,73].

In particular, the area is described in Figure 6. It has been analyzed, proposing the comparison of four itineraries represented in Figure 6 and thus defined:

The analysis also considered the presence of a railway track dedicated to a train for the transport of goods to and from the logistics port area which interrupts the pedestrian crossings of the various routes. The Euclidean measure, which is the one taken between origin and destination, is 135 m, and is similar to the length of itinerary IT4. Itineraries 1 and 2 are characterized by lengths of 340 and 300 m while IT3 is 168 m. Since the itineraries are less than 500 m (defined as short-haul journeys), they can be easily walked on.

**Figure 6.** Different itineraries selected for Analytical Hierarchy Process (AHP) analysis [22] (map source: https://www.openstreetmap.org/).

### *2.4. Data acquisition. Sample and Survey definition*

The sample was randomly selected by carrying out PAPI method at the end of 2019. The survey templates were organized in such a way to ensure unambiguous interpretation of questions and answers. The variables investigated are summarized in Table 1. In particular, they have been included in (socio-demographic data with closed answers), Section 2 (travel habits and road network judgment with closed answers and answers on a scale Likert 1–5), and Section 3 (travel perception with AHP comparison method on a scale of judgment 0–4).