Central and Eastern Europe in transition: prospects for sustainable development

This dissertation seeks to describe and analyze the problem of environmental degradation in Central and Eastern Europe (CEE) in the context of international relations theory. Using the concepts of sustainable development and the theory of the commons, this analysis seeks to broaden understanding how the degradation occurred and how further degradation may be avoided in the future. It begins by explaining the global environmental debate, into which the states of CEE have not quite been incorporated. It then explains how, prior to the 1989 political changes in the Soviet bloc, the planned economies of CEE were characterized by an emphasis on heavy industry, high output, and the use of less energy-efficient fuels such as brown coal. The lack of a pricing mechanism to reflect relative scarcity of natural resources, along with the use of outdated industrial technology, both contributed to an overuse of natural resources. The effect on the environment has been significant. A survey of environmental pollution, as well as human health data which may be relevant, provides empirical evidence. Finally, a review of multilateral assistance to the region shows that the international community is taking a part in the attempt to set the region on a path to sustainable development, as well as to curb potential transboundary pollution and further degradation of "the commons.

Shop Scheduling In The Presence Of Batching, Sequence-dependent Setups And Incompatible Job Families Minimizing Earliness And Tardiness Penalties

The motivation of this research investigation stems from a particular job shop production environment at a large international communications and information technology company in which electro-mechanical assemblies (EMAs) are produced. The production environment of the EMAs includes the continuous arrivals of the EMAs (generally called jobs), with distinct due dates, degrees of importance and routing sequences through the production workstations, to the job shop. Jobs are processed in batches at the workstations, and there are incompatible families of jobs, where jobs from different product families cannot be processed together in the same batch. In addition, there are sequence-dependent setups between batches at the workstations. Most importantly, it is imperative that all product deliveries arrive on time to their customers (internal and external) within their respective delivery time windows. Delivery is allowed outside a time window, but at the expense of a penalty. Completing a job and delivering the job before the start of its respective time window results in a penalty, i.e., inventory holding cost. Delivering a job after its respective time window also results in a penalty, i.e., delay cost or emergency shipping cost. This presents a unique scheduling problem where an earlinesstardiness composite objective is considered. This research approaches this scheduling problem by decomposing this complex job shop scheduling environment into bottleneck and non-bottleneck resources, with the primary focus on effectively scheduling the bottleneck resource. Specifically, the problem of scheduling jobs with unique due dates on a single workstation under the conditions of batching, sequence-dependent iii setups, incompatible job families in order to minimize weighted earliness and tardiness is formulated as an integer linear program. This scheduling problem, even in its simplest form, is NP-Hard, where no polynomial-time algorithm exists to solve this problem to optimality, especially as the number of jobs increases. As a result, the computational time to arrive at optimal solutions is not of practical use in industrial settings, where production scheduling decisions need to be made quickly. Therefore, this research explores and proposes new heuristic algorithms to solve this unique scheduling problem. The heuristics use order review and release strategies in combination with priority dispatching rules, which is a popular and more commonly-used class of scheduling algorithms in real-world industrial settings. A computational study is conducted to assess the quality of the solutions generated by the proposed heuristics. The computational results show that, in general, the proposed heuristics produce solutions that are competitive to the optimal solutions, yet in a fraction of the time. The results also show that the proposed heuristics are superior in quality to a set of benchmark algorithms within this same class of heuristic

Accelerated Partial Breast Irradiation: Using the CyberKnife as the Radiation Delivery Platform in the Treatment of Early Breast Cancer

We evaluate the CyberKnife (Accuray Incorporated, Sunnyvale, CA, USA) for non-invasive delivery of accelerated partial breast irradiation (APBI) in early breast cancer patients. Between 6/2009 and 5/2011, nine patients were treated with CyberKnife APBI. Normal tissue constraints were imposed as outlined in the National Surgical Adjuvant Breast and Bowel Project B-39/Radiation Therapy Oncology Group 0413 (NSABP/RTOG) Protocol (Vicini and White, 2007). Patients received a total dose of 30 Gy in five fractions (group 1, n = 2) or 34 Gy in 10 fractions (group 2, n = 7) delivered to the planning treatment volume (PTV) defined as the clinical target volume (CTV) +2 mm. The CTV was defined as either the lumpectomy cavity plus 10 mm (n = 2) or 15 mm (n = 7). The cavity was defined by a T2-weighted non-contrast breast MRI fused to a planning non-contrast thoracic CT. The CyberKnife Synchrony system tracked gold fiducials sutured into the cavity wall during lumpectomy. Treatments started 4–5 weeks after lumpectomy. The mean PTV was 100 cm3 (range, 92–108 cm3) and 105 cm3 (range, 49–241 cm3) and the mean PTV isodose prescription line was 70% for groups 1 and 2, respectively. The mean percent of whole breast reference volume receiving 100 and 50% of the dose (V100 and V50) for group 1 was 11% (range, 8–13%) and 23% (range, 16–30%) and for group 2 was 11% (range, 7–14%) and 26% (range, 21–35.0%), respectively. At a median 7 months follow-up (range, 4–26 months), no acute toxicities were seen. Acute cosmetic outcomes were excellent or good in all patients; for those patients with more than 12 months follow-up the late cosmesis outcomes were excellent or good. In conclusion, the lack of observable acute side effects and current excellent/good cosmetic outcomes is promising. We believe this suggests the CyberKnife is a suitable non-invasive radiation platform for delivering APBI with achievable normal tissue constraints

Diving in at the deep end : the value of alternative in-situ approaches for systematic library search

OPAC interfaces, still the dominant access point to library catalogs, support systematic search but are problematic for open-ended exploration and generally unpopular with visitors. As a result, libraries start subscribing to simplified search paradigms as exemplified by web-search systems. This is a problem considering that systematic search is a crucial skill in the light of today’s abundance of digital information. Inspired by novel approaches to facilitating search, we designed CollectionDiver, an installation for supporting systematic search in public libraries. The CollectionDiver combines tangible and large display direct-touch interaction with a visual representation of search criteria and filters. We conducted an in-situ qualitative study to compare participants’ search approaches on the CollectionDiver with those on the OPAC interface. Our findings show that while both systems support a similar search process, the CollectionDiver (1) makes systematic search more accessible, (2) motivates proactive search approaches by (3) adding transparency to the search process, and (4) facilitates shared search experiences. We discuss the CollectionDiver’s design concepts to stimulate new ideas toward supporting engaging approaches to systematic search in the library context and beyond.Postprin

The characteristics of cognitive neuroscience tests in a schizophrenia cognition clinical trial: Psychometric properties and correlations with standard measures.

In comparison to batteries of standard neuropsychological tests, cognitive neuroscience tests may offer a more specific assessment of discrete neurobiological processes that may be aberrant in schizophrenia. However, more information regarding psychometric properties and correlations with standard neuropsychological tests and functional measures is warranted to establish their validity as treatment outcome measures. The N-back and AX-Continuous Performance Task (AX-CPT) are two promising cognitive neuroscience tests designed to measure specific components of working memory and contextual processing respectively. In the current study, we report the psychometric properties of multiple outcome measures from these two tests as well as their correlations with standard neuropsychological measures and functional capacity measures. The results suggest that while the AX-CPT and N-back display favorable psychometric properties, they do not exhibit greater sensitivity or specificity with functional measures than standard neurocognitive tests

Evaluation of Risk for Late Language Emergence after In Utero Antiretroviral Drug Exposure in HIV-exposed Uninfected Infants

This is not the published version.BACKGROUND Combination antiretroviral (cARV) regimens are recommended for pregnant women with HIV to prevent perinatal HIV transmission. Safety is a concern for infants who were HIV-exposed but uninfected (HEU), particularly for neurodevelopmental problems, such as language delays. METHODS We studied late language emergence (LLE) in HEU children enrolled in a US-based prospective cohort study. LLE was defined as a caregiver-reported score ≤ 10th percentile in any of 4 domains of the MacArthur-Bates Communicative Development Inventory for one-year-olds and as ≥1 standard deviation below age-specific norms for the Ages and Stages Questionnaire for two-year-olds. Logistic regression models were used to evaluate associations of in utero cARV exposure with LLE, adjusting for infant, maternal, and environmental characteristics. RESULTS 1,129 language assessments were conducted among 792 one- and two-year-olds (50% male, 62% black, and 37% Hispanic). Overall, 86% had in utero exposure to cARV and 83% to protease inhibitors. LLE was identified in 26% of one-year-olds and 23% of two-year-olds, with higher rates among boys. In adjusted models, LLE was not associated with maternal cARV or ARV drug classes in either age group. Among cARV-exposed one-year-olds, increased odds of LLE was observed for those exposed to atazanavir (aOR=1.83, 95% CI=1.10-3.04), particularly after the first trimester (aOR=3.56, p=0.001), compared to atazanavir-unexposed infants. No associations of individual ARV drugs with LLE were observed among two-year-olds. CONCLUSIONS In utero cARV exposure showed little association with LLE, except for a higher risk of language delay observed in one-year-old infants with atazanavir exposure

Healing built-environment effects on health outcomes: environment–occupant–health framework

An investigation examined the structured scientific evidence on healthcare facilities (the healing built environment – HBE) and its impact on patients’ health outcomes under a holistic conceptual evaluative framework. The integrative review considered 127 papers (of which 59 were review papers). It found there was no adequate framework that could integrate existing research findings holistically. Such a holistic framework needs to demonstrate the cumulative and interactive effects of various HBE characteristics on patients’ health outcomes and wellbeing. An environment–occupant–health (E-O-H) framework is proposed, taking a holistic perspective to identify and evaluate different HBE characteristics. The E-O-H framework should support future research by (1) identifying the HBE characteristics that affect health outcomes; (2) defining appropriate future research designs; and (3) understanding the need for holistic analysis of the integrated effects of diverse HBE characteristics on health outcomes

Language Impairment in Children Perinatally Infected with HIV Compared to Children Who Were HIV-Exposed and Uninfected

Objective - To investigate risk for language impairment in children perinatally infected or exposed to HIV. Methods - We evaluated the prevalence of language impairment (LI) in 7–16 year old children with perinatal HIV infection (HIV+) compared to children HIV-exposed and uninfected (HEU), using a comprehensive standardized language test (CELF-4). LI was classified as primary LI (Pri-LI) (monolingual English exposure and no cognitive or hearing impairment), concurrent LI (Con-LI) (cognitive or hearing impairment), or no LI. Associations of demographic, caregiver, HIV disease and antiretroviral treatment (ART) factors with LI category were evaluated using univariate and multivariable logistic regression models. Results - Of 468 children with language assessments, 184 (39%) had LI. No difference was observed by HIV infection status for overall LI or for Pri-LI or Con-LI; mean (SD) CELF-4 scores were 88.5 (18.4) for HIV+ vs 87.5 (17.9) for HEU. After adjustment, Black children had higher odds of Pri-LI vs no LI (aOR=2.43, p=0.03). Children who were Black, Hispanic, had a caregiver with low education or low IQ, or a non-biological parent as caregiver had higher odds of Con-LI vs no LI. Among HIV+ children, viral load \u3e400 copies/ml (aOR=3.04, pp=0.02) and ART initiation (aOR=2.12, p=0.02) were associated with higher odds of Con-LI vs. no LI. Conclusions - Children perinatally exposed to HIV are at high risk for LI, but such risk was not increased for youth with HIV. Risk factors differed for Pri-LI and Con-LI

Ethnic inequalities in positive SARS-CoV-2 tests, infection prognosis, COVID-19 hospitalisations, and deaths : analysis of two years of a record linked national cohort study in Scotland

Funding: Economics and Social Research Council (ESRC) ES/W000849/1, Medical Research Council (MRC) MC_UU_00022/2, Scottish Government Chief Scientist Office SPHSU17.BACKGROUND: This study aims to estimate ethnic inequalities in risk for positive SARS-CoV-2 tests, COVID-19 hospitalisations and deaths over time in Scotland. METHODS: We conducted a population-based cohort study where the 2011 Scottish Census was linked to health records. We included all individuals≥16 years living in Scotland on 1 March 2020. The study period was from 1 March 2020 to 17 April 2022. Self-reported ethnic group was taken from the census and Cox proportional hazard models estimated HRs for positive SARS-CoV-2 tests, hospitalisations and deaths, adjusted for age, sex and health board. We also conducted separate analyses for each of the four waves of COVID-19 to assess changes in risk over time. FINDINGS: Of the 4 358 339 individuals analysed, 1 093 234 positive SARS-CoV-2 tests, 37 437 hospitalisations and 14 158 deaths occurred. The risk of COVID-19 hospitalisation or death among ethnic minority groups was often higher for White Gypsy/Traveller (HR 2.21, 95% CI (1.61 to 3.06)) and Pakistani 2.09 (1.90 to 2.29) groups compared with the white Scottish group. The risk of COVID-19 hospitalisation or death following confirmed positive SARS-CoV-2 test was particularly higher for White Gypsy/Traveller 2.55 (1.81-3.58), Pakistani 1.75 (1.59-1.73) and African 1.61 (1.28-2.03) individuals relative to white Scottish individuals. However, the risk of COVID-19-related death following hospitalisation did not differ. The risk of COVID-19 outcomes for ethnic minority groups was higher in the first three waves compared with the fourth wave. INTERPRETATION: Most ethnic minority groups were at increased risk of adverse COVID-19 outcomes in Scotland, especially White Gypsy/Traveller and Pakistani groups. Ethnic inequalities persisted following community infection but not following hospitalisation, suggesting differences in hospital treatment did not substantially contribute to ethnic inequalities.Publisher PDFPeer reviewe