Developing electric bus driving cycles with significant road gradient changes::A case study in Hong Kong

Battery electric buses have been increasingly being deployed to replace traditional diesel buses in providing urban public transport services. Accounted for over 30% of daily passenger trips, the franchised bus system in Hong Kong only retained a few battery electric buses after its trial programme. Under the unique bus driving environment in Hong Kong, more evaluations are anticipated for further deployment of electric buses. Driving cycle is a widely adopted platform for the assessment of vehicle fuel economy, energy consumption, emissions and driving range. Therefore, it is necessary to have a purposely developed driving cycle for battery electric buses. A comprehensive review of bus driving cycles developed elsewhere shows that the impacts of road gradients are seldom considered. Therefore, in this study, the only remaining battery electric bus route with significant gradient changes was selected for speed data collection and synthesis for a set of driving cycles. Results shown that driving characteristics of this route were comparable to urban bus cycles developed in other cities, but were slightly different from bus cycles developed for other conditions. It was also observed that battery electric buses appeared to be less responsive to drivers’ acceleration activities than that of a supercapacitor bus

A bottom-up clustering approach to identify bus driving patterns and to develop bus driving cycles for Hong Kong

Bus transport has been an important mode taking up a significant share of urban travel demand and thus the corresponding impacts on the environment are of great concerns. Use of driving cycles to evaluate the environmental impacts of buses has attracted much attention in recent years worldwide. The franchised bus service is currently playing important roles in the public transport system in Hong Kong; however, there is no driving cycle developed specifically for them. A set of bus driving cycle was therefore developed using a bottom-up approach where driving data on the bus network with mixed characteristics were collected. Using the Ward’s method for clustering, the collected data were then categorized into three clusters representing distinct franchised bus route patterns in Hong Kong. Driving cycles were then developed for each route pattern including (i) congested urban routes with closely spaced bus stops and traffic junctions; (ii) inter-district routes containing a number of stop-and-go activities and a significant portion of smoother high speed driving; and (iii) early morning express routes and mid-night routes connecting remote residential areas and urban areas. These cycles highlighted the unique low-speed and aggressive driving characteristics of bus transport in Hong Kong with frequent stop-and-go activities. The findings from this study would definitely be helpful in assessing the exhaust emissions, fuel consumptions as well as energy consumptions of bus transport. The bottom-up clustering approach adopted in this study would also be useful in identifying specific driving patterns based on vehicle speed trip data with mixed driving characteristics. It is believed that this approach is especially suitable for assessing fixed route public transport modes with mixed driving characteristics

Comparisons of Driving Characteristics between Electric and Diesel-Powered Bus Operations along Identical Bus Routes

The energy consumption profiles of conventional fuelled and electric vehicles are different due to the fundamental differences in the driving characteristics of these vehicles, which have been actively researched elsewhere but mostly on the basis of uncommon geographical contexts. This study, therefore, collected driving data on electric and conventional diesel buses running along exactly the same set of bus routes in Hong Kong during normal daily revenue operations. This enabled a fair comparison of driving characteristics for both types of bus under identical real-life, on-road driving conditions, which highlighted the originality and contributions of this study. A three-step approach was adopted to carry out detailed driving pattern analyses, which included key driving parameters, speed–acceleration probability distributions (SAPDs), and vehicle-specific power (VSP) distributions. Results found that route-based comparisons did highlight important differences in driving patterns between electric and diesel buses that might have been smoothed out by analyses with mixed-route datasets. In particular, the spread, intensity, and directions of these differences were found to be exaggerated at the route-based level. The differences in driving patterns varied across different routes, which has significant implications on vehicle energy consumption. Government agencies and/or bus operators should make references to these results in formulating electric bus deployment plans

A systematic review and recommendations on the use of plasma EBV DNA for nasopharyngeal carcinoma

Introduction: Nasopharyngeal carcinoma (NPC) is an endemic malignancy in Southeast Asia, particularly Southern China. The classical non-keratinising cell type is almost unanimously associated with latent Epstein-Barr virus (EBV) infection. Circulating plasma EBV DNA can be a useful biomarker in various clinical aspects, but comprehensive recommendations and international guidelines are still lacking. We conducted a systematic review of all original articles on the clinical application of plasma EBV DNA for NPC; we further evaluated its strengths and limitations for consideration as standard recommendations. Methods: The search terms 'nasopharyngeal OR nasopharynx', and 'plasma EBV DNA OR cell-free EBV OR cfEBV' were used to identify full-length articles published up to December 2020 in the English literature. Three authors independently reviewed the article titles, removed duplicates and reviewed the remaining articles for eligibility. Results: A total of 81 articles met the eligibility criteria. Based on the levels of evidence and grades of recommendation assessed, it is worth considering the inclusion of plasma EBV DNA in screening, pre-treatment work-up for enhancing prognostication and tailoring of treatment strategy, monitoring during radical treatment, post-treatment surveillance for early detection of relapse, and monitoring during salvage treatment for recurrent or metastatic NPC. One major limitation is the methodology of measurement requiring harmonisation for consistent comparability. Conclusions: The current comprehensive review supports the inclusion of plasma EBV DNA in international guidelines in the clinical aspects listed, but methodological issues must be resolved before global application. 2021 Elsevier Ltd. All rights reserved

Roles of interactivity and usage experience in E-learning acceptance

The aim of this study is to investigate how interactivity with E-learning influence learners' consideration to use based on Malaysian settings and the effect relating to the learners' experiences in using e-learning over a period of time. This study uses a multiple regression for data analysis across a sample of 204 respondents. Based on the analysis, the interactivity factor such as two-way communication has significantly affected among Perceived Usefulness (PU), Perceived Ease of Use (PEOU) and Perceived Enjoyment (PE) while controllability and personalization affect towards PU and responsiveness on PEOU. Moreover, PE has directly affect the usage intention of e-learning system over time with increased usage experiences. The results could assist schools or universities enhancing the contents of e-learning system in order to encourage learners to strongly engage in utilizing the education materials that is provided, as well as improving the interactivity factors on the system

Cost-analysis of XELOX and FOLFOX4 for treatment of colorectal cancer to assist decision- making on reimbursement

Abstract Background: XELOX (capecitabine + oxaliplatin) and FOLFOX 4 (5-FU + folinic acid + oxaliplatin) have shown similar improvements in survival in patients with metastatic colorectal cancer (MCRC). A US cost-minimization study found that the two regimens had similar costs from a healthcare provider perspective but XELOX had lower costs than FOLFOX4 from a societal perspective, while a Japanese cost-effectiveness study found XELOX had superior cost-effectiveness. This study compared the costs of XELOX and FOLFOX4 in patients with MCRC recently treated in two oncology departments in Hong Kong. Methods: Cost data were collected from the medical records of 60 consecutive patients (30 received XELOX and 30 FOLFOX4) from two hospitals. Drug costs, outpatient visits, hospital days and investigations were recorded and expressed as cost per patient from the healthcare provider perspective. Estimated travel and time costs were included in a societal perspective analysis. All costs were classed as either scheduled (associated with planned chemotherapy and follow-up) or unscheduled (unplanned visits or admissions and associated tests and medicines). Costs were based on government and hospital sources and expressed in US dollars (US$). Results: XELOX patients received an average of 7.3 chemotherapy cycles (of the 8 planned cycles) and FOLFOX4 patients received 9.2 cycles (of the 12 planned cycles). The scheduled cost per patient per cycle was$2,046 for XELOX and $2,152 for FOLFOX4, while the unscheduled cost was$240 and $421, respectively. Total treatment cost per patient was$16,609 for XELOX and $23,672 for FOLFOX4; the total cost for FOLFOX4 was 37$17,836 for XELOX and $27,455 for FOLFOX4. Sensitivity analyses showed XELOX was still less costly than FOLFOX4 when using full drug regimen costs, incorporating data from a US model with costs and adverse event data from their clinical trial and with the removal of oxaliplatin from both treatment arms. Capecitabine would have to cost around four times its present price in Hong Kong for the total resource cost of treatment with XELOX to equal that of FOLFOX4

Current management of stage IV nasopharyngeal carcinoma without distant metastasis

Up to one in four patients with nasopharyngeal carcinoma present with non-metastatic stage IV disease (i.e. T4 or N3). Distinct failure patterns exist, despite the routine adoption of contemporary treatment modalities such as intensity modulated radiotherapy and systemic chemotherapy. Concurrent chemoradiotherapy (CCRT) followed by adjuvant chemotherapy or induction chemotherapy followed by CCRT are commonly employed in this setting, with the latter emerging as the preferred option. Additionally, emerging radiation technologies like proton therapy has become available offering new opportunities for prevention of radiation-induced side effects. This article reviews not only the current treatment strategies, but also discusses novel ways to tackle this challenging disease with respect to the patterns of failure

Preliminary results of trial NPC-0501 evaluating the therapeutic gain by changing from concurrent-adjuvant to induction-concurrent chemoradiotherapy, changing from fluorouracil to capecitabine, and changing from conventional to accelerated radiotherapy fractionation in patients with locoregionally advanced nasopharyngeal carcinoma

© 2014 American Cancer Society. BACKGROUND A current recommendation for locoregionally advanced nasopharyngeal carcinoma (NPC) is conventional fractionated radiotherapy with concurrent cisplatin plus adjuvant cisplatin and fluorouracil (PF). In this randomized trial, the authors evaluated the potential therapeutic benefit from changing to an induction-concurrent chemotherapy sequence, replacing fluorouracil with oral capecitabine, and/or using accelerated rather than conventional radiotherapy fractionation. METHODS Patients with stage III through IVB, nonkeratinizing NPC were randomly allocated to 1 of 6 treatment arms. The protocol was amended in 2009 to permit confining randomization to the conventional fractionation arms. The primary endpoint was progression-free survival. Secondary endpoints included overall survival and safety. RESULTS In total, 803 patients were accrued, and 706 patients were randomly allocated to all 6 treatment arms. Comparisons of induction PF versus adjuvant PF did not indicate a significant improvement. Unadjusted comparisons of induction cisplatin and capecitabine (PX) versus adjuvant PF indicated a favorable trend in progression-free survival for the conventional fractionation arm (P = .045); analyses that were adjusted for other significant factors and fractionation reflected a significant reduction in the hazards of disease progression (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.36-0.80) and death (HR, 0.42; 95% CI, 0.25-0.70). Unadjusted comparisons of induction sequences versus adjuvant sequences did not reach statistical significance, but adjusted comparisons indicated favorable improvements by induction sequence. Comparisons of induction PX versus induction PF revealed fewer toxicities (neutropenia and electrolyte disturbance), unadjusted comparisons of efficacy were statistically insignificant, but adjusted analyses indicated that induction PX had a lower hazard of death (HR, 0.57; 95% CI, 0.34-0.97). Changing the fractionation from conventional to accelerated did not achieve any benefit but incurred higher toxicities (acute mucositis and dehydration). CONCLUSIONS Preliminary results indicate that the benefit of changing to an induction-concurrent sequence remains uncertain; replacing fluorouracil with oral capecitabine warrants further validation in view of its convenience, favorable toxicity profile, and favorable trends in efficacy; and accelerated fractionation is not recommended for patients with locoregionally advanced NPC who receive chemoradiotherapy.postprin

Management of locally recurrent nasopharyngeal carcinoma

As a consequence of the current excellent loco-regional control rates attained using the generally accepted treatment paradigms involving intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC), only 10-20% of patients will suffer from local and/or nodal recurrence after primary treatment. Early detection of recurrence is important as localized recurrent disease is still potentially salvageable, but this treatment often incurs a high risk of major toxicities. Due to the possibility of radio-resistance of tumors which persist or recur despite adequate prior irradiation and the limited tolerance of adjacent normal tissues to sustain further additional treatment, the management of local failures remains one of the greatest challenges in this disease. Both surgical approaches for radical resection and specialized re-irradiation modalities have been explored. Unfortunately, available data are based on retrospective studies, and the majority of them are based on a small number of patients or relatively short follow-up. In this article, we will review the different salvage treatment options and associated prognostic factors for each of them. We will also propose a treatment algorithm based on the latest available evidence and discuss the future directions of treatment for locally recurrent NPC.Peer reviewe