Simulation-Based Evolutionary Optimization of Air Traffic Management

In the context of aerospace engineering, the optimization of processes may often require to solve multi-objective optimization problems, including mixed variables, multi-modal and non-differentiable quantities, possibly involving highly-expensive objective function evaluations. In Air Traffic Management (ATM), the optimization of procedures and protocols becomes even more complicated, due to the involve-ment of human controllers, which act as final decision points in the control chain. In this article, we propose the use of computational intelligence techniques, such as Agent-Based Modelling and Simulation (ABMS)and Evolutionary Computing (EC), to design a simulation-based distributed architecture to optimize control plans and procedures in the context of ATM. We rely on Agent-Based fast-time simulations to carry out offline what-if analysis of multiple scenarios, also taking into account human-related decisions, during the strategic or pre-tactical phases. The scenarios are constructed using real-world traffic data traces, while multiple optimization variables governed by an EC algorithm allow to explore the search space to identify the best solutions. Our optimization approach relies on ad-hoc multi-objective performance metrics which allow to assess the goodness of the control of aircraft and air traffic regulations. We present experimental results which prove the viability of our approach, comparing them with real-world data traces, and proving their meaningfulness from an Air Traffic Control perspective

Simulation-Based Evolutionary Optimization of Air Traffic Management

In the context of aerospace engineering, the optimization of processes may often require to solve multi-objective optimization problems, including mixed variables, multi-modal and non-differentiable quantities, possibly involving highly-expensive objective function evaluations. In Air Traffic Management (ATM), the optimization of procedures and protocols becomes even more complicated, due to the involve-ment of human controllers, which act as final decision points in the control chain. In this article, we propose the use of computational intelligence techniques, such as Agent-Based Modelling and Simulation (ABMS)and Evolutionary Computing (EC), to design a simulation-based distributed architecture to optimize control plans and procedures in the context of ATM. We rely on Agent-Based fast-time simulations to carry out offline what-if analysis of multiple scenarios, also taking into account human-related decisions, during the strategic or pre-tactical phases. The scenarios are constructed using real-world traffic data traces, while multiple optimization variables governed by an EC algorithm allow to explore the search space to identify the best solutions. Our optimization approach relies on ad-hoc multi-objective performance metrics which allow to assess the goodness of the control of aircraft and air traffic regulations. We present experimental results which prove the viability of our approach, comparing them with real-world data traces, and proving their meaningfulness from an Air Traffic Control perspective

Epidemiology, Diagnosis and Management of Penile Cancer: Results from the Spanish National Registry of Penile Cancer

Introduction: Penile cancer (PC) is a rare malignancy with an overall incidence in Europe of 1/100,000 males/year. In Europe, few studies report the epidemiology, risk factors, clinical presentation, and treatment of PC. The aim of this study is to present an updated outlook on the aforementioned factors of PC in Spain. Materials and Methods: A multicentric, retrospective, observational epidemiological study was designed, and patients with a new diagnosis of PC in 2015 were included. Patients were anonymously identified from the Register of Specialized Care Activity of the Ministry of Health of Spain. All Spanish hospitals recruiting patients in 2015 were invited to participate in the present study. We have followed a descriptive narration of the observed data. Continuous and categorical data were reported by median (p25th–p75th range) and absolute and relative frequencies, respectively. The incidence map shows differences between Spanish regions. Results: The incidence of PC in Spain in 2015 was 2.55/100,000 males per year. A total of 586 patients were identified, and 228 patients from 61 hospitals were included in the analysis. A total of 54/61 (88.5%) centers reported ≤ 5 new cases. The patients accessed the urologist for visually-assessed penile lesions (60.5%), mainly localized in the glans (63.6%). Local hygiene, smoking habits, sexual habits, HPV exposure, and history of penile lesions were reported in 48.2%, 59.6%, 25%, 13.2%, and 69.7%. HPV-positive lesions were 18.1% (28.6% HPV-16). The majority of PC was squamous carcinoma (95.2%). PC was ≥cT2 in 45.2% (103/228) cases. At final pathology, PC was ≥pT2 in 51% of patients and ≥pN1 in 17% of cases. The most common local treatment was partial penectomy (46.9% cases). A total of 47/55 (85.5%) inguinal lymphadenectomies were open. Patients with ≥pN1 disease were treated with chemotherapy in 12/39 (40.8%) of cases. Conclusions: PC incidence is relatively high in Spain compared to other European countries. The risk factors for PC are usually misreported. The diagnosis and management of PC are suboptimal, encouraging the identification of referral centers for PC management

Functional recovery of secondary tropical forests

One-third of all Neotropical forests are secondary forests that regrow naturally after agricultural use through secondary succession. We need to understand better how and why succession varies across environmental gradients and broad geographic scales. Here, we analyze functional recovery using community data on seven plant characteristics (traits) of 1,016 forest plots from 30 chronosequence sites across the Neotropics. By analyzing communities in terms of their traits, we enhance understanding of the mechanisms of succession, assess ecosystem recovery, and use these insights to propose successful forest restoration strategies. Wet and dry forests diverged markedly for several traits that increase growth rate in wet forests but come at the expense of reduced drought tolerance, delay, or avoidance, which is important in seasonally dry forests. Dry and wet forests showed different successional pathways for several traits. In dry forests, species turnover is driven by drought tolerance traits that are important early in succession and in wet forests by shade tolerance traits that are important later in succession. In both forests, deciduous and compound-leaved trees decreased with forest age, probably because microclimatic conditions became less hot and dry. Our results suggest that climatic water availability drives functional recovery by influencing the start and trajectory of succession, resulting in a convergence of community trait values with forest age when vegetation cover builds up. Within plots, the range in functional trait values increased with age. Based on the observed successional trait changes, we indicate the consequences for carbon and nutrient cycling and propose an ecologically sound strategy to improve forest restoration success

Functional recovery of secondary tropical forests

One-third of all Neotropical forests are secondary forests that regrow naturally after agricultural use through secondary succession. We need to understand better how and why succession varies across environmental gradients and broad geographic scales. Here we present data on functional recovery, using community data on seven plant characteristics (traits) of 1016 forest plots from 30 chronosequence sites across the Neotropics. By analyzing communities in terms of their traits one can enhance understanding of the mechanisms of succession and assess ecosystem recovery

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status