270 research outputs found

    New perspectives in pediatric dialysis technologies: the case for neonates and infants with acute kidney injury

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    Advancements in pediatric dialysis generally rely on adaptation of technology originally developed for adults. However, in the last decade, particular attention has been paid to neonatal extracorporeal therapies for acute kidney care, an area in which technology has made giant strides in recent years. Peritoneal dialysis (PD) is the kidney replacement therapy (KRT) of choice in the youngest age group because of its simplicity and effectiveness. However, extracorporeal blood purification provides more rapid clearance of solutes and faster fluid removal. Hemodialysis (HD) and continuous KRT (CKRT) are thus the most used dialysis modalities for pediatric acute kidney injury (AKI) in developed countries. The utilization of extracorporeal dialysis for small children is associated with a series of clinical and technical challenges which have discouraged the use of CKRT in this population. The revolution in the management of AKI in newborns has started recently with the development of new CKRT machines for small infants. These new devices have a small extracorporeal volume that potentially prevents the use of blood to prime lines and dialyzer, allow a better volume control and the use of small-sized catheter without compromising the blood flow amount. Thanks to the development of new dedicated devices, we are currently dealing with a true “scientific revolution” in the management of neonates and infants who require an acute kidney support

    The on-demand warehousing problem

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    Warehouses are key elements of supply chain networks, and great attention is paid to increase their efficiency. Highly volatile space requirements are enablers of innovative resource sharing concepts, where warehouse capacities are traded on online platforms. In this context, our paper introduces the on-demand warehousing problem from the perspective of platform providers. The objective prioritises demand–supply matching with maximisation of the number of transactions. If there is a tie, the secondary objective maximises the number of suppliers matched with at least one customer and the number of customers that have matches within a specific threshold with respect to the minimum achievable cost. Besides the mathematical integer programming formulation, a myopic list-based heuristic and an efficient matheuristic approach are presented and benchmarked against the performance of a commercial optimisation solver. The impact of several parameters on the platform's objective is analysed. A particularly relevant finding is that the pricing flexibility on the demand side does not necessarily imply higher payments to the supply side. All data instances are made available publicly to encourage more researchers to work on this timely and challenging topic

    Dynamic Collection Scheduling Using Remote Asset Monitoring: Case Study in the UK Charity Sector

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    Remote sensing technology is now coming onto the market in the waste collection sector. This technology allows waste and recycling receptacles to report their fill levels at regular intervals. This reporting enables collection schedules to be optimized dynamically to meet true servicing needs in a better way and so reduce transport costs and ensure that visits to clients are made in a timely fashion. This paper describes a real-life logistics problem faced by a leading UK charity that services its textile and book donation banks and its high street stores by using a common fleet of vehicles with various carrying capacities. Use of a common fleet gives rise to a vehicle routing problem in which visits to stores are on fixed days of the week with time window constraints and visits to banks (fitted with remote fill-monitoring technology) are made in a timely fashion so that the banks do not become full before collection. A tabu search algorithm was developed to provide vehicle routes for the next day of operation on the basis of the maximization of profit. A longer look-ahead period was not considered because donation rates to banks are highly variable. The algorithm included parameters that specified the minimum fill level (e.g., 50%) required to allow a visit to a bank and a penalty function used to encourage visits to banks that are becoming full. The results showed that the algorithm significantly reduced visits to banks and increased profit by up to 2.4%, with the best performance obtained when the donation rates were more variable

    Prostate Cancer Treatment-Related Toxicity: Comparison between 3D-Conformal Radiation Therapy (3D-CRT) and Volumetric Modulated Arc Therapy (VMAT) Techniques

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    Objective: This paper illustrates the results of a mono-institutional registry trial, aimed to test whether gastrointestinal (GI) and genitourinary (GU) toxicity rates were lower in localized prostate cancer patients treated with image-guided volumetric modulated arc therapy (IG-VMAT) compared to those treated with IG-3D conformal radiation therapy (IG-3DCRT). Materials and Methods: Histologically proven prostate cancer patients with organ-confined disease, treated between October 2008 and September 2014 with moderately hypofractionated radiotherapy, were reviewed. Fiducial markers were placed in the prostate gland by transrectal ultrasound guide. The prescribed total dose was 70 Gy in 28 fractions. The mean and median dose volume constraints for bladder and rectum as well as total volume of treatment were analyzed as potentially prognostic factors influencing toxicity. The Kaplan–Meier method was applied to calculate survival. Results: Overall, 83 consecutive patients were included. Forty-two (50.6%) patients were treated with 3D-CRT and 41 (49.4%) with the VMAT technique. The median follow-up for toxicity was 77.26 months for the whole cohort. The VMAT allowed for a dose reduction to the rectum and bladder for the large majority of the considered parameters; nonetheless, the only parameter correlated with a clinical outcome was a rectal dose limit V66 > 8.5% for late GI toxicity G ≄ 2 (p = 0.045). Rates of G ≄ 2 toxicities were low among the whole cohort of these patients treated with IGRT. The analysis for rectum dose volume histograms (DVHs) showed that a severe (grade ≄ 2) late GI toxicity was related with the rectal dose limit V66 > 8.5% (p = 0.045). Conclusions: This study shows that moderate hypofractionation is feasible and safe in patients with intermediate and high-risk prostate cancer. Daily IGRT may decrease acute and late toxicity to organs at risk and improve clinical benefit and disease control rate, cutting down the risk of PTV geographical missing. The adoption of VMAT allows for promising results in terms of OAR sparing and a reduction in toxicity that, also given the small sample, did not reach statistical significance

    Mesoscale modelling of the CO2 interactions between the surface and the atmosphere applied to the April 2007 CERES field experiment

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    This paper describes a numerical interpretation of the April 2007, CarboEurope Regional Experiment Strategy (CERES) campaign, devoted to the study of the CO2 cycle at the regional scale. Four consecutive clear sky days with intensive observations of CO2 concentration, fluxes at the surface and in the boundary layer have been simulated with the Meso-NH mesoscale model, coupled to ISBA-A-gs land surface model. The main result of this paper is to show how aircraft observations of CO2 concentration have been used to identify surface model errors and to calibrate the CO2 driving component of the surface model. In fact, the comparisons between modelled and observed CO2 concentrations within the Atmospheric Boundary Layer (ABL) allow to calibrate and correct not only the parameterization of respired CO2 fluxes by the ecosystem but also the Leaf Area Index (LAI) of the dominating land cover. After this calibration, the paper describes systematic comparisons of the model outputs with numerous data collected during the CERES campaign, in April 2007. For instance, the originality of this paper is the spatial integration of the comparisons. In fact, the aircraft observations of CO2 concentration and fluxes and energy fluxes are used for the model validation from the local to the regional scale. As a conclusion, the CO2 budgeting approach from the mesoscale model shows that the winter croplands are assimilating more CO2 than the pine forest, at this stage of the year and this case study

    Bridging the gap between atmospheric concentrations and local ecosystem measurements

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    This paper demonstrates that atmospheric inversions of CO<sub>2</sub> are a reliable tool for estimating regional fluxes. We compare results of an inversion over 18 days and a 300 x 300 km 2 domain in southwest France against independent measurements of fluxes from aircraft and towers. The inversion used concentration measurements from 2 towers while the independent data included 27 aircraft transects and 5 flux towers. The inversion reduces the mismatch between prior and independent fluxes, improving both spatial and temporal structures. The present mesoscale atmospheric inversion improves by 30% the CO<sub>2</sub> fluxes over distances of few hundreds of km around the atmospheric measurement locations. Citation: Lauvaux, T., et al. (2009), Bridging the gap between atmospheric concentrations and local ecosystem measurements, Geophys. Res. Lett., 36, L19809, doi: 10.1029/2009GL039574

    The Smc5/6 complex is required for dissolution of DNA-mediated sister chromatid linkages

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    Mitotic chromosome segregation requires the removal of physical connections between sister chromatids. In addition to cohesin and topological entrapments, sister chromatid separation can be prevented by the presence of chromosome junctions or ongoing DNA replication. We will collectively refer to them as DNA-mediated linkages. Although this type of structures has been documented in different DNA replication and repair mutants, there is no known essential mechanism ensuring their timely removal before mitosis. Here, we show that the dissolution of these connections is an active process that requires the Smc5/6 complex, together with Mms21, its associated SUMO-ligase. Failure to remove DNA-mediated linkages causes gross chromosome missegregation in anaphase. Moreover, we show that Smc5/6 is capable to dissolve them in metaphase-arrested cells, thus restoring chromosome resolution and segregation. We propose that Smc5/6 has an essential role in the removal of DNA-mediated linkages to prevent chromosome missegregation and aneuploidy

    "You have to get wet to learn how to swim" applied to bridging the gap between research into personnel scheduling and its implementation in practice

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    Personnel scheduling problems have attracted research interests for several decades. They have been considerably changed over time, accommodating a variety of constraints related to legal and organisation requirements, part-time staff, flexible hours of staff, staff preferences, etc. This led to a myriad of approaches developed for solving personnel scheduling problems including optimisation, meta-heuristics, artificial intelligence, decision-support, and also hybrids of these approaches. However, this still does not imply that this research has a large impact on practice and that state-of-the art models and algorithms are widely in use in organisations. One can find a reasonably large number of software packages that aim to assist in personnel scheduling. A classification of this software based on its purpose will be proposed, accompanied with a discussion about the level of support that this software offers to schedulers. A general conclusion is that the available software, with some exceptions, does not benefit from the wealth of developed models and methods. The remaining of the paper will provide insights into some characteristics of real-world scheduling problems that, in the author’s opinion, have not been given a due attention in the personnel scheduling research community yet and which could contribute to the enhancement of the implementation of research results in practice. Concluding remarks are that in order to bridge the gap that still exists between research into personnel scheduling and practice, we need to engage more with schedulers in practice and also with software developers; one may say we need to get wet if we want to learn how to swim

    Sources and Sinks of Greenhouse Gases from European Grasslands and Mitigation Options: The ‘GreenGrass’ Project

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    Adapting the management of grasslands may be used to enhance carbon sequestration into soil, but could also increase N2O and CH4 emissions. In support of the European post-Kyoto policy, the European \u27GreenGrass\u27 project (EC FP5, EVK2-CT2001-00105) has three main objectives: i) to reduce the large uncertainties concerning the estimates of CO2, N2O and CH4 fluxes to and from grassland plots under different climatic conditions and assess their global warming potential, ii) to measure net greenhouse gas (GHG) fluxes for different management which reflect potential mitigation options, iii) to construct a model of the controlling processes to quantify the net fluxes and to evaluate mitigation scenarios by up-scaling to a European level
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