Stochastic hydrogeology's biggest hurdles analyzed and its big blind spot

This paper considers questions related to the adoption of stochastic methods in hydrogeology. It looks at factors affecting the adoption of stochastic methods including environmental regulations, financial incentives, higher education, and the collective feedback loop involving these factors. We begin by evaluating two previous paper series appearing in the stochastic hydrogeology literature, one in 2004 and one in 2016, and identifying the current thinking on the topic, including the perceived data needs of stochastic methods, the attitude in regulations and the court system regarding stochastic methods, education of the workforce, and the availability of software tools needed for implementing stochastic methods in practice. Comparing the state of adoption in hydrogeology to petroleum reservoir engineering allowed us to identify quantitative metrics on which to base our analysis. For impediments to the adoption of stochastic hydrology, we identified external factors as well as self-inflicted wounds. What emerges is a picture much broader than current views. Financial incentives and regulations play a major role in stalling adoption. Stochastic hydrology's blind spot is in confusing between uncertainty with risk and ignoring uncertainty. We show that stochastic hydrogeology comfortably focused on risk while ignoring uncertainty, to its own detriment and to the detriment of its potential clients. The imbalance between the treatment on risk on one hand and uncertainty on the other is shown to be common to multiple disciplines in hydrology that interface with risk and uncertainty.</p

2010 SSO John Wayne Clinical Research Lecture: Rectal Cancer Outcome Improvements in Europe: Population-Based Outcome Registrations will Conquer the World

During the past two decades, rectal cancer treatment has improved considerably in Europe. Clinical trials played a crucial role in improving surgical techniques, (neo)adjuvant treatment schedules, imaging, and pathology. However, there is still a wide variation in outcome after rectal cancer. In most western health care systems, efforts are made to reduce hospital variation by focusing on selective referral and encouraging patients to seek care in high-volume hospitals. On the other hand, the expertise for diagnosis and treatment of common types of cancer should be preferably widespread and easily accessible for all patients. As an alternative to volume-based referral, hospitals and surgeons can improve their results by learning from their own outcome statistics and those from colleagues treating a similar patient group. Several European surgical (colo)rectal audits have led to improvements with a greater impact than any of the adjuvant therapies currently under study. However, differences remain between European countries, which cannot be easily explained. To generate the best care for colorectal cancer in the whole of Europe and to meet political and public demands for transparency, the European CanCer Organisation (ECCO) initiated an international, multidisciplinary, outcome-based quality improvement program: European Registration of Cancer Care (EURECCA). The goal is to create a multidisciplinary European registration structure for patient, tumor, and treatment characteristics linked to outcome registration. Clinical trials will always play a major role in improving rectal cancer treatment. To further improve outcomes and diminish variation, EURECCA will establish the basis for a strong, multidisciplinary, international audit structure that can be used as a template for similar projects worldwide

A class of boron-rich solid-state neutron detectors

Real-time solid-state neutron detectors have been fabricated from semiconducting boron–carbon alloys, deposited by plasma-enhanced chemical vapor deposition. Single neutrons were detected and signals induced by gamma rays were determined to be insignificant. The source gas closo-1,2-dicarbadodecaborane (ortho-carborane) was used to fabricate the boron–carbon alloys with only the natural isotopic abundance of 10B. Devices made of thicker boron–carbon alloy layers enriched in 10B could lead to increased detection efficiency and active diodes could use the inherent micron scale spatial resolution, increasing the range of possible applications. © 2002 American Institute of Physics. [DOI: 10.1063/1.1477942

Regional Myocardial Temperature Variations with Asanguineous Potassium Cardioplegia

(J. Extra-Corpor. Technol. 19( 4) pp. 415-419 Winter 1987,) The temperature of the myocardium during cardioplegic arrest is an indication of the extent to which that area has received both hypothermic and chemical protection. Regional myocardial temperatures were examined during asanguineous cardioplegic arrest to assess differences in temperatures, examine regional rates of rewarming, and to identify maximum temperature gradients. Myocardial temperatures were measured at the left ventricular apex, the right ventricular free wall and the interventricular septum in twenty patients undergoing coronary artery bypass using multidose asanguineous cardioplegic arrest. Aortic root temperatures were measured to identify the temperature of the cardioplegia and left heart blood temperatures during venting. Temperatures in the left ventricular apex ranged from 13.9° to 21.3°, right ventricular free wall from 15.9° to 21.9°, and the interventricular septum from 13° to 23.6°. Temperature variations in the three areas were as great as 15 ° and as little as 2 °. Myocardial temperatures are 1) not predictable due to the nature of coronary artery disease, 2) variable despite optimal delivery technique, and 3) may vary due to cannulation and systemic blood temperature