Multi-level multi-criteria analysis of alternative fuels for waste collection vehicles in the United States

Historically, the U.S. waste collection fleet was dominated by diesel-fueled waste collection vehicles (WCVs); the growing need for sustainable waste collection has urged decision makers to incorporate economically efficient alternative fuels, while mitigating environmental impacts. The pros and cons of alternative fuels complicate the decisions making process, calling for a comprehensive study that assesses the multiple factors involved. Multi-criteria decision analysis (MCDA) methods allow decision makers to select the best alternatives with respect to selection criteria. In this study, two MCDA methods, Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) and Simple Additive Weighting (SAW), were used to rank fuel alternatives for the U.S. waste collection industry with respect to a multi-level environmental and financial decision matrix. The environmental criteria consisted of life-cycle emissions, tail-pipe emissions, water footprint (WFP), and power density, while the financial criteria comprised of vehicle cost, fuel price, fuel price stability, and fueling station availability. The overall analysis showed that conventional diesel is still the best option, followed by hydraulic-hybrid WCVs, landfill gas (LFG) sourced natural gas, fossil natural gas, and biodiesel. The elimination of the WFP and power density criteria from the environmental criteria ranked biodiesel 100 (BD100) as an environmentally better alternative compared to other fossil fuels (diesel and natural gas). This result showed that considering the WFP and power density as environmental criteria can make a difference in the decision process. The elimination of the fueling station and fuel price stability criteria from the decision matrix ranked fossil natural gas second after LFG-sourced natural gas. This scenario was found to represent the status quo of the waste collection industry. A sensitivity analysis for the status quo scenario showed the overall ranking of diesel and fossil natural gas to be more sensitive to changing fuel prices as compared to other alternatives

Health-care associated infections rates, length of stay, and bacterial resistance in an intensive care unit of Morocco: Findings of the International Nosocomial Infection Control Consortium (INICC)

<p>Abstract</p> <p>Background</p> <p>Most studies related to healthcare-associated infection (HAI) were conducted in the developed countries. We sought to determine healthcare-associated infection rates, microbiological profile, bacterial resistance, length of stay (LOS), and extra mortality in one ICU of a hospital member of the International Infection Control Consortium (INICC) in Morocco.</p> <p>Methods</p> <p>We conducted prospective surveillance from 11/2004 to 4/2008 of HAI and determined monthly rates of central vascular catheter-associated bloodstream infection (CVC-BSI), catheter-associated urinary tract infection (CAUTI) and ventilator-associated pneumonia (VAP). CDC-NNIS definitions were applied. device-utilization rates were calculated by dividing the total number of device-days by the total number of patient-days. Rates of VAP, CVC-BSI, and CAUTI per 1000 Device-days were calculated by dividing the total number of HAI by the total number of specific Device-days and multiplying the result by 1000.</p> <p>Results</p> <p>1,731 patients hospitalized for 11,297 days acquired 251 HAIs, an overall rate of 14.5%, and 22.22 HAIs per 1,000 ICU-days. The central venous catheter-related bloodstream infections (CVC-BSI) rate found was 15.7 per 1000 catheter-days; the ventilator-associated pneumonia (VAP) rate found was 43.2 per 1,000 ventilator-days; and the catheter-associated urinary tract infections (CAUTI) rate found was 11.7 per 1,000 catheter-days.</p> <p>Overall 25.5% of all <it>Staphylococcus aureus </it>HAIs were caused by methicillin-resistant strains, 78.3% of <it>Coagulase-negative-staphylococci </it>were methicillin resistant as well. 75.0% of <it>Klebsiella </it>were resistant to ceftriaxone and 69.5% to ceftazidime. 31.9% of <it>E. Coli </it>were resistant to ceftriaxone and 21.7% to ceftazidime. 68.4% of <it>Enterobacter sp </it>were resistant to ceftriaxone, 55.6% to ceftazidime, and 10% to imipenem; 35.6% of <it>Pseudomonas sp </it>were resistant to ceftazidime and 13.5% to imipenem.</p> <p>LOS of patients was 5.1 days for those without HAI, 9.0 days for those with CVC-BSI, 10.6 days for those with VAP, and 13.7 days for those with CAUTI.</p> <p>Extra mortality was 56.7% (RR, 3.28; P =< 0.001) for VAP, 75.1% (RR, 4.02; P = 0.0027) for CVC-BSI, and 18.7% (RR, 1.75; P = 0.0218) for CAUTI.</p> <p>Conclusion</p> <p>HAI rates, LOS, mortality, and bacterial resistance were high. Even if data may not reflect accurately the clinical setting of the country, programs including surveillance, infection control, and antibiotic policy are a priority in Morocco.</p

Clinical Features and Differential Diagnoses in Laryngeal Mucoepidermoid Carcinoma

Mucoepidermoid carcinoma is the most common malignant tumor of salivary glands. However, it is a rare entity in larynx. Laryngeal cases are frequently misdiagnosed with other malignancies and they are under-reported. So, recognizing the clinical and histological features of this tumor is essential. Laryngeal mucoepidermoid carcinoma can arise in supraglottis, glottis and subglottis. Generally, it presents as a submucosal mass; therefore, progressive symptoms without any identifiable lesion in laryngoscopy must be well considered. The prognosis is somehow dependent on the histological features. In high-grade tumors, recurrence is more common and radical surgery with radiotherapy is recommended. In this paper, we provide a thorough literature review on mucoepidermoid carcinoma in the larynx. The most important distinguishing features of mucoepidermoid carcinoma and its two major differential diagnoses (squamous cell carcinoma and adenosquamous carcinoma) are clearly stated and pitfalls in true diagnosis of this tumor are discussed

Understanding Drought Dynamics during Dry Season in Eastern Northeast Brazil

Eastern Northeast Brazil (ENEB) generally experiences a high variability in precipitation in the dry season, with amplitudes that can overcome 500mm. The understanding of this variability can help in mitigating the socio-economic issues related to the planning and management of water resources this region, which is highly vulnerable to drought. This work aims to assess spatio-temporal variability of precipitation during the dry season and investigate the relationships between climate phenomena and drought events in the ENEB, using univariate (Spearman correlation) and multivariate statistical techniques, such as Principal Component Analysis, Cluster Analysis, and Maximum Covariance Analysis. The results indicate that the variability of precipitation in the dry season can be explained mainly (62%) by local physical conditions and climate conditions have a secondary contribution. Further analysis of the larger anomalous events suggests that the state of Atlantic and Pacific oceans can govern the occurrence of those events, and the conditions of Atlantic Ocean can be considered a potential modulator of anomalous phenomena of precipitation in ENEB

Geomagnetic Disturbances (GMD) Impacts on Protection Systems

This paper provides background and historical events of Geomagnetic Disturbances (GMD), and reviews GMD impacts on power systems equipment, and associated protection and control systems, mitigating measures, and Geomagnetic Induced Current (GIC) monitoring methods. This paper is a summary of the IEEE PES-TR72 report, titled, GMD Impacts on Protection Systems, prepared by the K17 Working Group of the IEEE Power System Relaying and Control committee

STRATEGI GURU AGAMA ISLAM DALAM MENGATASI KESULITAN SISWA MEMBACA AL-QUR’AN DI MADRASAH ALIYAH AL AYUBI DESA MARIGEH KECAMATAN BATHIN III ULU KABUPATEN MUARO BUNGO

Skripsi ini membahas tentang Strategi Guru Agama Islam Dalam Mengatasi Kesulitan Siswa Membaca Al Qur‟an Di Madrasah Aliyah Al Ayubbi Desa Marigeh Kecamatan Bathin III Ulu Kabupaten Muaro Bungo. Penelitian ini merupakan penelitian kualitatif, sedangkan pengumpulan data menggunakan metode observasi, metode wawancara, dan metode dokumentasi. Penelitian ini menemukan bahwa strategi guru agama islam dalam mengatasi kesulitan siswa membaca Al Qur‟an ini sangat berpengaruh sekali terhadap proses belajar mengajar di Madrasah Aliyah Al Ayubbi Desa Marigeh Kecamatan Bathin III Ulu Kabupaten Muaro Bungo. Hasil penelitian ini menyarankan agar guru Agama Islam hendaknya perlu memahami kesulitan-kesulitan yang di alami oleh siswa dalam membaca Al Qur‟an, sehingga dengan demikian dapat membuat siswa dapat memahamibacaan Al Quran