Development of a procedure and tool for retrofit hydropower evaluation at South African dams

South Africa is in a critical power situation and is in dire need of additional generation capacity. Thus, renewable energy sources such as wind, solar and hydropower should be evaluated to identify highpotential and cost-effective sites. Rivers in South Africa, as a water-scarce country, are already heavily impounded, meaning that there are limited sites available for conventional hydropower generation. Instead, novel solutions such as retrofitting hydropower installations to existing infrastructure, like existing dams, are required. To estimate the retrofit hydropower potential at dams, a set of five tools was developed using Python 3, known as the University of Pretoria Retrofit Hydropower Evaluation Software (UP-RHES). The UP-RHES screens potential sites where historic flow records are available, then downloads the required flow records from the national database and performs a first-order hydraulic assessment of the site, as well as a first-order life cycle cost analysis. By applying the UP-RHES to 118 dams operated by the Department of Water and Sanitation (DWS), it was found that a total estimated hydropower potential of 128 MW with an annual energy output of between 385 and 469 GWh exists at South African dams. The Vaal, Pongolapoort, Goedertrouw and Blyderivierpoort Dams were found to be feasible sites with a combined capacity of 77 GWh/annum.https://www.watersa.netCivil Engineerin

The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the "Delirium Day 2015"

Backround: Use of indwelling urinary catheter (IUC) in older adults has negative consequences, including delirium. Aim: This analysis, from the "Delirium Day 2015", a nationwide multicenter prevalence study, aim to evaluate the association of IUC with delirium in hospitalized and Nursing Homes (NHs) patients. Methods: Patients underwent a comprehensive geriatric assessment, including the presence of IUC; inclusion criteria were age > 65 years, being Italian speaker and providing informed consent; exclusion criteria were coma, aphasia, end-of-life status. Delirium was assessed using the 4AT test (score ≥ 4: possible delirium; scores 1-3: possible cognitive impairment). Results: Among 1867 hospitalized patients (mean age 82.0 ± 7.5 years, 58% female), 539 (28.9%) had IUC, 429 (22.9%) delirium and 675 (36.1%) cognitive impairment. IUC was significantly associated with cognitive impairment (OR 1.60, 95% CI 1.19-2.16) and delirium (2.45, 95% CI 1.73-3.47), this latter being significant also in the subset of patients without dementia (OR 2.28, 95% CI 1.52-3.43). Inattention and impaired alertness were also independently associated with IUC. Among 1454 NHs residents (mean age 84.4 ± 7.4 years, 70.% female), 63 (4.3%) had IUC, 535 (36.8%) a 4AT score ≥ 4, and 653 (44.9%) a 4AT score 1-3. The multivariate logistic regression analysis did not show a significant association between 4AT test or its specific items with IUC, neither in the subset of patients without dementia. Discussion: We confirmed a significant association between IUC and delirium in hospitalized patients but not in NHs residents. Conclusion: Environmental and clinical factors of acute setting might contribute to IUC-associated delirium occurrence

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

The effect of the muscarinic M-1 receptor antagonist biperiden on cognition in medication free subjects with psychosis

The acetylcholine muscarinic M-1 receptor has been implicated in both psychosis and cognition. Post-mortem research has shown reduced muscarinic M-1 receptor density in 25% of chronic patients with schizophrenia. It is unknown whether reduced M-1 receptor density is related to cognitive symptoms of psychosis. We investigated the role of the M-1 receptor in separate cognitive domains in subjects with a psychotic disorder using a muscarinic M-1 antagonist as an acute pharmacological challenge. 33 young subjects with a psychotic disorder and 30 gender, age and IQ matched healthy controls were enrolled. All participants completed a comprehensive cognitive test battery twice: once after placebo and once after oral administration of 4 mg. biperiden (M-1 antagonist). The order of drug administration was counterbalanced. Biperiden significantly negatively influenced both verbal (p&lt;0.001 and p=0.032) and visual learning and memory (p = 0.028) in both groups. A medication x group interaction effect was found for reasoning and problem solving (p=0.005). No main or interaction effects were found for other cognitive domains. These results provide further in-vivo evidence that the M-1 receptor is involved in cognitive functioning, particularly verbal and visual memory processes. Lack of differential effects of biperiden between psychotic subjects and healthy controls may suggest that decreased M-1 receptor density is only present in chronic, older schizophrenia patients. However, it remains possible that differential effects of biperiden would be present in more severe cognitive impaired subjects with psychosis after several doses of biperiden instead of a single administration. (C) 2017 Elsevier B.V. and ECNP. All rights reserved.</p

Accuracy of Environmental Monitoring in China: Exploring the Influence of Institutional, Political and Ideological Factors

Environmental monitoring data are essential to informing decision-making processes relevant to the management of the environment. Their accuracy is therefore of extreme importance. The credibility of Chinese environmental data has been long questioned by domestic and foreign observers. This paper explores the potential impact of institutional, political, and ideological factors on the accuracy of China’s environmental monitoring data. It contends that the bureaucratic incentive system, conflicting agency goals, particular interests, and ideological structures constitute potential sources of bias in processes of environmental monitoring in China. The current leadership has acknowledged the issue, implementing new measures to strengthen administrative coordination and reinforce the oversight of the central government over local authorities. However, the failure to address the deeper political roots of the problem and the ambivalence over the desirability of public participation to enhance transparency might jeopardize Beijing’s strive for environmental data accuracy.Environmental monitoring data are essential to informing decision-making processes relevant to the management of the environment. Their accuracy is therefore of extreme importance. The credibility of Chinese environmental data has been long questioned by domestic and foreign observers. This paper explores the potential impact of institutional, political, and ideological factors on the accuracy of China's environmental monitoring data. It contends that the bureaucratic incentive system, conflicting agency goals, particular interests, and ideological structures constitute potential sources of bias in processes of environmental monitoring in China. The current leadership has acknowledged the issue, implementing new measures to strengthen administrative coordination and reinforce the oversight of the central government over local authorities. However, the failure to address the deeper political roots of the problem and the ambivalence over the desirability of public participation to enhance transparency might jeopardize Beijing's strive for environmental data accuracy