43 research outputs found

    Analysing Port Community System Network Evolution

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    Ports have played an important role in facilitating exchanges among countries since the day when inland transportation was poor. As ports become hubs for global supply chain, they have to maintain their competitiveness not only by reassuring their efficiency, reliability, accessibility to hinterland, and sustainability. In addition, there is a constant challenge from all operational parties of the port to acquire needed information or to trust information received, due to multiple legacy systems and platforms that do not integrate with each other, and to the lack of real time updates. There are differing agendas between parties and, sometimes, distrust within the multi-stakeholder ecosystem leads to working in silos. This jeopardises seamless data exchange and cooperation across the port value chain, resulting in significant inefficiencies. Port community system (PCS) can enhance communication and simplify administrative process resulting economic and environmental benefit for actors in the supply chain. The invisibility of the benefit, actors’ heterogeneity and significant investment to develop the system resulting a reluctance in implementing PCS. This chapter aims to study the evolution mechanism behind the process of PCS network development using lessons learned from industrial symbiosis network development and network trajectories theory. The PCS network development follows a serendipitous and goal-oriented process that can be categorised into three stages: pre-PCS network, PCS network emergence, and PCS network expansion. This chapter contributes to the exploration of network evolution and documents lesson learned to foster PCS implementation.© 2020 Springer. This is a post-peer-review, pre-copyedit version of an article published in European Port Cities in Transition: Moving Towards More Sustainable Sea Transport Hubs. The final authenticated version is available online at: http://dx.doi.org/10.1007/978-3-030-36464-9_10fi=vertaisarvioitu|en=peerReviewed

    Has Selection for Improved Agronomic Traits Made Reed Canarygrass Invasive?

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    Plant breeders have played an essential role in improving agricultural crops, and their efforts will be critical to meet the increasing demand for cellulosic bioenergy feedstocks. However, a major concern is the potential development of novel invasive species that result from breeders' efforts to improve agronomic traits in a crop. We use reed canarygrass as a case study to evaluate the potential of plant breeding to give rise to invasive species. Reed canarygrass has been improved by breeders for use as a forage crop, but it is unclear whether breeding efforts have given rise to more vigorous populations of the species. We evaluated cultivars, European wild, and North American invader populations in upland and wetland environments to identify differences in vigor between the groups of populations. While cultivars were among the most vigorous populations in an agricultural environment (upland soils with nitrogen addition), there were no differences in above- or below-ground production between any populations in wetland environments. These results suggest that breeding has only marginally increased vigor in upland environments and that these gains are not maintained in wetland environments. Breeding focuses on selection for improvements of a specific target population of environments, and stability across a wide range of environments has proved elusive for even the most intensively bred crops. We conclude that breeding efforts are not responsible for wetland invasion by reed canarygrass and offer guidelines that will help reduce the possibility of breeding programs releasing cultivars that will become invasive

    Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

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    IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570
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