Bacterial Infections Change Natural History of Cirrhosis Irrespective of Liver Disease Severity

OBJECTIVES: We assessed the prognostic significance of infections in relation to current prognostic scores and explored if infection could be considered per se a distinct clinical stage in the natural history of cirrhosis. METHODS: We included consecutive patients with cirrhosis admitted to a tertiary referral liver unit for at least 48 h over a 2-year period. Diagnosis of infection was based on positive cultures or strict established criteria. We used competing risk analysis and propensity score matching for data analysis. RESULTS: 501 patients (63% male, 48% alcoholic liver disease, median Model of End-stage Liver Disease (MELD)=17) underwent 781 admissions over the study period. Portal hypertensive bleeding and complicated ascites were the commonest reasons of admission. The incidence of proven bacterial infection was 25.6% (60% community acquired and 40% nosocomial). Survival rates at 3, 6, 12, and 30 months were 83%, 77%, 71%, and 62% in patients without diagnosis of infection, vs. 50%, 46%, 41%, and 34% in patients with diagnosis of infection. Overall survival was independently associated with MELD score (hazards ratio (HR) 1.099), intensive care (ITU) stay (HR 1.967) and bacterial infection (HR 2.226). Bacterial infection was an independent predictor of survival even when patients who died within the first 30 days were excluded from the analysis in Cox regression (HR 2.013) and competing risk Cox models in all patients (HR 1.46) and propensity risk score-matched infected and non-infected patients (HR 1.67). CONCLUSIONS: Infection most likely represents a distinct prognostic stage of cirrhosis, which affects survival irrespective of disease severity, even after recovery from the infective episode

Exploring specific features of Transport Interchange Hubs (TIH) design, taking into account the climatic conditions of the Russian Arctic

This paper provides a more detailed analysis of the context of designing Transport Interchange Hubs (TIHs) in the Arctic Zone of the Russian Federation (AZRF). It uses a design framework proposed by another paper also presented in this conference by the same authors [1] to discuss how green spaces can be inte-grated to TIHs in extreme climates to enhance the qualities of different types of spaces inside terminals considering implications of these in the overall assess-ment of building performance. It also discusses, the way pedestrian flow and movement is modelled and simulated in Russia in relation to the different simula-tion techniques used in other countries (mainly the West) and what are the ad-vantages these different models offer in the assessment of design decisions for TIHs in the AZRF considering how these could potentially be integrated with parametric design tools, finishing by highlighting complexities involved in de-signing compact buildings, a necessary requirement to reduce heat losses and the impact of building footprint on the permafrost. As the AZRF is now experiencing unprecedented economic development and completely lacks transport integrated facilities (TIHs) this paper attempts to review and discuss specific features of these buildings so new developments currently planned for the Russian Arctic can be better designed and assessed mainly in relation to pedestrian flow and their integration with opportunity spaces to improve the quality of passengers’ waiting time

A user-centred approach to design Transport Interchange Hubs (TIH): A discussion illustrated by a case study in the Russian Arctic

This paper proposes a user-centred approach to design Transport In-terchange Hubs (TIH). It is based on a literature review of existing information related to TIHs outside the domain of transport engineering, so the focus is on the building and the usage of it by its main customers: the travellers. A literature review is used to extract high level information on travellers’ needs, technical and functional requirements of TIHs, constraints and design parameters. A prod-uct development approach is used to classify and combine this data so a proper set of design specifications to better address users’ needs is proposed. The method is illustrated through an example in the Russian Arctic, an area with un-der-developed transport facilities for travellers which would benefit from high-level design specifications to address complex needs, requirements and parame-ters involved in designing for extreme climate conditions. A proof of concept, using Axiomatic Design, to develop design specifications and manage constraints is applied and discussed considering major needs involved in building in the Rus-sian Arctic including how different types of simulation tools, essential to assess performance of complex buildings, can be integrated in the early stages of the design workflow. Robust specifications, despite being part of parametric design methods, are underexplored in the architecture design domain, meaning this work can contribute to further research in how to define common design targets and objectives for different stakeholders as well as to manage the collaborative work of consultants involved in designing complex buildings

Gender Impact on Transit Quality of Service Importance and Performance Assessment

This paper examines the impact of gender on transit travelers’ quality assessment considering 26 indicators’ importance and performance ratings. Through an online survey and using a 5 point Likert scale, transit travelers were asked to rate both the importance and the performance they recognize for the examined quality indicators. The online survey was distributed to a list of contacts, organizations, businesses, universities and operations’ websites in three Greek cities (Athens, Thessaloniki and Volos), aiming to cover all modes and quality conditions someone may face in Greek transit operations. In total, 211 PT users (96 male and 116 female transit travelers) provided their feedback that was further analyzed, aiming to underline the impact of their gender on transit quality importance and performance assessments. Research results, showed that women attribute a higher importance than men on route and service related characteristics, cleanliness and safety and security related indicators, along with the availability of shelter and benches at stops, the ease of purchasing ticket and the use of ecological vehicles. Similarly, women recognize a higher performance for the ease of purchasing ticket. Research results explicitly analyze the gender impact on transit quality assessment, providing useful knowledge and insights for decision makers planning and operations. © 2021, The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG

Guidance Provision for Increasing Quality of Service of Public Transport

Travellers formulate their optimal strategyto follow for their trip, every time they may shift to another mode. Trip generalized cost is perceived based on quality of service aspects and type of traveller. One of the most known models to assess service quality is the GAP model, proposed by Parasuramanet al. (1985), which considersboth consumer and provider beliefs, expectations, perceptions and standards. The present paper deals with the fifth GAP of the model, known as the quality GAP, thus expected versus perceived quality of service, for the assessment of the transit service quality. This GAP has been estimated for the case of the transit system in Greece. An internet based questionnaire was used to collect user expectations and perceptions of 26 selected transit quality indicators, based on a 5 point likert scale. Then, a decision tree was developed, using the J48 algorithm, which linked user perceptions and expectations with the overall service quality assessment. The decision tree analysis depicts the importance of various quality components in the generalized cost estimation. Findings showed that the performance indicator "Availability of information by phone, mail", was the most crucial parameter for the overall assessment of the service, while both performance and importance variables participated in the tree formulation. Tree paths provide guidance for transit operators and/or decision makers for increasing the quality of their services and at the same time enhance performance efficiency and operation profitability. © 2017 The Authors

Examining travelers "optimal strategies" in transit trip choices, applying a classification tree approach on transit quality of service indicators

According to Spiess and Florian (1989) [1], at each transfer point passengers may shape the "optimal" for them strategy taking into account minimum generalized travel cost. The generalized cost of trip choices is formulated based on objective and subjective criteria of travelers that reflect their perception of the generalized cost of their trip. Quality of Service (QS) parameters affect users?perceptions and may influence the formulation of the perceived cost and furthermore may influence travel choices. This paper examines the transit QS formulation by analyzing 26 quality indicators which have been assessed by transit users through a Customer Satisfaction Survey (CSS). The survey took place in the city of Thessaloniki, Greece in the summer of 2012. This paper examines travelers optimal strategies based on transit QS by applying two classification trees on transit quality of service indicators. A Classification and Regression tree has been used to classify the important quality indicators among male and female travelers and a J48 classification algorithm has been applied to classify all quality attributes based on their importance in the general assessment formulation of transit QS. Research pointed out that stop location is the most important attribute to a gender classification of transit QS attributes, followed by the indicator of information by phone, internet. For the general assessment of the transit QS as perceived by transit users, the root node of the classification tree is the security against crimes on bus, which denotes the most important predictor in such an analysis

Model NSR catalysts:Fabrication and reactivity of barium oxide layers on Cu(1 1 1)

The growth of barium oxide on a Cu(1 1 1) substrate, formed by the deposition of barium and its subsequent oxidation, yields stable BaO films which expose predominantly the BaO(1 0 0) surface. The interaction of the oxide films with common components of motor-vehicle exhaust gases (CO2, H2O, NOx) has been studied using surface analytical techniques, including X-ray photoelectron spectroscopy (XPS), temperature programmed desorption (TPD) and reflection IR spectroscopy (RAIRS). The spectroscopic identification of Ba(OH)2, BaCO3 and Ba(NO2)2 phases is discussed, and the relative stabilities and decomposition mechanisms of these materials when supported on Cu(1 1 1) is revealed by a combination of TPD and XPS. BaO is shown to be resistant to reaction with pure NO and NO/O2 mixtures, but exposure to NO2 leads to the rapid formation of barium nitrite. The formation of the nitrite is proposed to be the first-step in the production of barium nitrate, which has previously been shown to be the main phase involved in NOx storage and reduction (NSR) catalysis.</p