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

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

CO2 budgeting at the regional scale using a Lagrangian experimental strategy and meso-scale modeling

An atmospheric Lagrangian experiment for regional CO2 budgeting with aircraft measurements took place during the CarboEurope Regional Experiment Strategy campaign (CERES) in south-west France, in June 2005. The atmospheric CO2 aircraft measurements taken upstream and downstream of an active and homogeneous pine forest revealed a CO2 depletion in the same air mass, using a Lagrangian strategy. This field experiment was analyzed with a meteorological meso-scale model interactively coupled with a surface scheme, with plant assimilation, ecosystem respiration, anthropogenic CO2 emissions and sea fluxes. First, the model was carefully validated against observations made close to the surface and in the atmospheric boundary layer. Then, the carbon budget was evaluated using the numerous CERES observations, by upscaling the surface fluxes observations, and using the modeling results, in order to estimate the relative contribution of each physical process. A good agreement is found between the two methods which use the same vegetation map: the estimation of the regional CO2 surface flux by the Eulerian meso-scale model budget is close to the budget deduced from the upscaling of the observed surface fluxes, and found a budget between −9.4 and −12.1μmol.m−2.s−1, depending on the size of the considered area. Nevertheless, the associated uncertainties are rather large for the upscaling method and reach 50%. A third method, using Lagrangian observations of CO2 estimates a regional CO2 budget a few different and more scattered, (−16.8μmol.m−2.s−1 for the small sub-domain and −8.6μmol.m−2.s−1 for the larger one). For this budgeting method, we estimate a mean of 31% error, mainly arising from the time of integration between the two measurements of the Lagrangian experiment. The paper describes in details the three methods to assess the regional CO2 budget and the associated error

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

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

Integrating agri-environmental indicators, ecosystem services assessment, life cycle assessment and yield gap analysis to assess the environmental sustainability of agriculture

Agriculture's primary function is the production of food, feed, fibre and fuel for the fast-growing world population. However, it also affects human health and ecosystem integrity. Policymakers make policies in order to avoid harmful impacts. How to assess such policies is a challenge. In this paper, we propose a conceptual framework to help evaluate the impacts of agricultural policies on the environment. Our framework represents the global system as four subsystems and their interactions. These four components are the cells of a 2 by 2 matrix [Agriculture, Rest of the word]; [Socio-eco system, Ecological system]. We then developed a set of indicators for environmental issues and positioned these issues in the framework. To assess these issues, we used four well-known existing approaches: Life Cycle Assessment, Ecosystem Services Analysis, Yield Gap Analysis and Agro-Environmental Indicators. Using these four approaches together provided a more holistic view of the impacts of a given policy on the system. We then applied our framework on existing cover crop policies using an extensive literature survey and analysing the different environmental issues mobilised by the four assessment approaches. This demonstration case shows that our framework may be of help for a full systemic assessment. Despite their differences (aims, scales, standardization, data requirements, etc.), it is possible and profitable to use the four approaches together. This is a significant step forward, though more work is needed to produce a genuinely operational tool. © 2022 The Author

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

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

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

This paper demonstrates that atmospheric inversions of CO₂ 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 CO₂ 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

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

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