Uncertainty modelling in multi-criteria analysis of water safety measures

Water utilities must assess risks and make decisions on safety measures in order to obtain a safe and sustainable drinking water supply. The World Health Organization emphasises preparation of Water Safety Plans, in which risk ranking by means of risk matrices with discretised probability and consequence scales is commonly used. Risk ranking enables prioritisation of risks but there is currently no common and structured way of performing uncertainty analysis and using risk ranking for evaluating and comparing water safety measures. To enable a proper prioritisation of safety measures and an efficient use of available resources for risk reduction, two alternative models linking risk ranking and multi-criteria decision analysis (MCDA) are presented and evaluated. The two models specifically enable uncertainty modelling in MCDA and they differ in terms of how uncertainties in risk levels are considered. The need of formal handling of risk and uncertainty in MCDA is emphasised in the literature and the suggested models provide innovations that are not dependent on the application domain. In the case study application presented here, possible safety measures are evaluated based on the benefit of estimated risk reduction, the cost of implementation and the probability of not achieving an acceptable risk level. Additional criteria such as environmental impact and consumer trust may also be included when applying the models. The case study shows how safety measures can be ranked based on preference scores or cost-effectiveness and how measures not reducing the risk enough can be identified and disqualified. Furthermore, the probability of each safety measure being ranked highest can be calculated. The two models provide a stepwise procedure for prioritising safety measures and enable a formalised handling of uncertainties in input data and results

Intrinsic differences between backward and forward vehicle simulation models

Two common methods for predicting the energy usage in vehicles through mathematical\ua0simulation, the `backward\u27 and the `forward\u27 schemes, are discussed and compared in terms\ua0of what longitudinal vehicle behaviour they predict. In the backward scheme, the input driving\ua0cycle is initially assumed to be followed perfectly and therefore the vehicle speed is not a dynamic\ua0state. In the forward scheme, a driver model controls the vehicle in an attempt to follow the\ua0input driving cycle, and the vehicle speed is intrinsically a dynamic state. A theoretical study is\ua0made with a simple mathematical vehicle model, where it is shown that the two methods neither\ua0predict the same expected energy use nor energy variation. Next, the simulation model that isused for the CO2 rating of heavy-duty trucks in Europe, VECTO, is used as an example of the\ua0backward method, and an equivalent implementation in a forward scheme is attempted. Two\ua0numerical experiments are made with these models: a detailed study of the longitudinal vehicle\ua0behaviour on a reference mission; and a study of the predicted CO2 emissions on a family of\ua0stochastically generated missions. The conclusion is that the backward method is easier to use\ua0but the forward method has a greater potential to predict realistic behaviour

Deactivation of a Vanadium-Based SCR Catalyst Used in a Biogas-Powered Euro VI Heavy-Duty Engine Installation

We have investigated how the exhaust gases from a heavy-duty Euro VI engine, powered with biogas impact a vanadium-based selective catalytic reduction (SCR) catalyst in terms of performance. A full Euro VI emission control system was used and the accumulation of catalyst poisons from the combustion was investigated for the up-stream particulate filter as well as the SCR catalyst. The NO(x)reduction performance in terms of standard, fast and NO2-rich SCR was evaluated before and after exposure to exhaust from a biogas-powered engine for 900 h. The SCR catalyst retains a significant part of its activity towards NO(x)reduction after exposure to biogas exhaust, likely due to capture of catalyst poisons on the up-stream components where the deactivation of the oxidation catalyst is especially profound. At lower temperatures some deactivation of the first part of the SCR catalyst was observed which could be explained by a considerably higher surface V4+/V(5+)ratio for this sample compared to the other samples. The higher value indicates that the reoxidation of V(4+)to V(5+)is partially hindered, blocking the redox cycle for parts of the active sites

Deactivation of a Pd/Pt Bimetallic Oxidation Catalyst Used in a Biogas-Powered Euro VI Heavy-Duty Engine Installation

The reduction of anthropogenic greenhouse gas emissions is crucial to avoid further warming of the planet. We investigated how effluent gases from a biogas powered Euro VI heavy-duty engine impact the performance of a bimetallic (palladium and platinum) oxidation catalyst. Using synthetic gas mixtures, the oxidation of NO, CO, and CH4\ua0before and after exposure to biogas exhaust for 900 h was studied. The catalyst lost most of its activity for methane oxidation, and the activity loss was most severe for the inlet part of the aged catalyst. Here, a clear sintering of Pt and Pd was observed, and higher concentrations of catalyst poisons such as sulfur and phosphorus were detected. The sintering and poisoning resulted in less available active sites and hence lower activity for methane oxidation

Mutation update and genotype-phenotype correlations of novel and previously described mutations in TPM2 and TPM3 causing congenital myopathies

Mutations affecting skeletal muscle isoforms of the tropomyosin genes may cause nemaline myopathy, cap myopathy, core-rod myopathy, congenital fiber-type disproportion, distal arthrogryposes, and Escobar syndrome. We correlate the clinical picture of these diseases with novel (19) and previously reported (31) mutations of the TPM2 and TPM3 genes. Included are altogether 93 families: 53 with TPM2 mutations and 40 with TPM3 mutations. Thirty distinct pathogenic variants of TPM2 and 20 of TPM3 have been published or listed in the Leiden Open Variant Database (http://www.dmd.nl/). Most are heterozygous changes associated with autosomal-dominant disease. Patients with TPM2 mutations tended to present with milder symptoms than those with TPM3 mutations, DA being present only in the TPM2 group. Previous studies have shown that five of the mutations in TPM2 and one in TPM3 cause increased Ca2+ sensitivity resulting in a hypercontractile molecular phenotype. Patients with hypercontractile phenotype more often had contractures of the limb joints (18/19) and jaw (6/19) than those with nonhypercontractile ones (2/22 and 1/22), whereas patients with the non-hypercontractile molecular phenotype more often (19/22) had axial contractures than the hypercontractile group (7/19). Our in silico predictions show that most mutations affect tropomyosin–actin association or tropomyosin head-to-tail binding

Ab initio van der Waals interactions in simulations of water alter structure from mainly tetrahedral to high-density-like

The structure of liquid water at ambient conditions is studied in ab initio molecular dynamics simulations using van der Waals (vdW) density-functional theory, i.e. using the new exchange-correlation functionals optPBE-vdW and vdW-DF2. Inclusion of the more isotropic vdW interactions counteracts highly directional hydrogen-bonds, which are enhanced by standard functionals. This brings about a softening of the microscopic structure of water, as seen from the broadening of angular distribution functions and, in particular, from the much lower and broader first peak in the oxygen-oxygen pair-correlation function (PCF), indicating loss of structure in the outer solvation shells. In combination with softer non-local correlation terms, as in the new parameterization of vdW-DF, inclusion of vdW interactions is shown to shift the balance of resulting structures from open tetrahedral to more close-packed. The resulting O-O PCF shows some resemblance with experiment for high-density water (A. K. Soper and M. A. Ricci, Phys. Rev. Lett., 84:2881, 2000), but not directly with experiment for ambient water. However, an O-O PCF consisting of a linear combination of 70% from vdW-DF2 and 30% from experiment on low-density liquid water reproduces near-quantitatively the experimental O-O PCF for ambient water, indicating consistency with a two-liquid model with fluctuations between high- and low-density regions

Enhanced external counter pulsation in treatment of refractory angina pectoris: two year outcome and baseline factors associated with treatment failure

<p>Abstract</p> <p>Background</p> <p>Enhanced external counter pulsation (EECP) is a non-invasive treatment option for patients with refractory angina pectoris ineligible to further traditional treatment. The aim of this study was to evaluate the effect of EECP on patients at a Scandinavian medical centre and to investigate if outcome can be predicted by analysing baseline factors.</p> <p>Methods</p> <p>86 consecutive patients (70 male, 16 female) were treated with EECP and followed for two years post treatment. Canadian cardiovascular society (CCS) class was analysed, and medication and adverse clinical events were researched prior to EECP, at the end of the treatment, and at six, 12 and 24 months thereafter. Patients responding to therapy by improving at least one CCS class were compared with those who failed to respond. Any differences in background factors were recorded and analysed.</p> <p>Results</p> <p>79% of the patients responded to therapy by improving at least one CCS class. In general, the CCS class improved by one class after EECP treatment (3.05 before versus 2.14 after treatment). A total of 61.5% of the initial responders showed sustained improvement at the 12 month follow-up while 29% presented sustained improvement after 24 months. Treatment was most effective among patients suffering from CCS class III-IV angina pectoris, while patients suffering from CCS class II angina pectoris improved transiently but failed to show sustained improvement after the 12 month follow-up. Diabetes mellitus and calcium channel antagonists were more common among the non-responders (<it>p </it>< 0.05).</p> <p>Conclusion</p> <p>This study confirms the safety and efficiency of EECP as a treatment option for patients suffering from refractory angina pectoris. The therapy is most beneficial in patients suffering from severe angina (CCS III-IV) while sustained response to therapy could not be verified among patients suffering from CCS class II angina pectoris.</p

Results of matching valve and root repair to aortic valve and root pathology

ObjectiveFor patients with aortic root pathology and aortic valve regurgitation, aortic valve replacement is problematic because no durable bioprosthesis exists, and mechanical valves require lifetime anticoagulation. This study sought to assess outcomes of combined aortic valve and root repair, including comparison with matched bioprosthesis aortic valve replacement.MethodsFrom November 1990 to January 2005, 366 patients underwent modified David reimplantation (n = 72), root remodeling (n = 72), or valve repair with sinotubular junction tailoring (n = 222). Active follow-up was 99% complete, with a mean of 5.6 ± 4.0 years (maximum 17 years); follow-up for vital status averaged 8.5 ± 3.6 years (maximum 19 years). Propensity-adjusted models were developed for fair comparison of outcomes.ResultsThirty-day and 5-, 10-, and 15-year survivals were 98%, 86%, 74%, and 58%, respectively, similar to that of the US matched population and better than that after bioprosthesis aortic valve replacement. Propensity-score–adjusted survival was similar across procedures (P > .3). Freedom from reoperation at 30 days and 5 and 10 years was 99%, 92%, and 89%, respectively, and was similar across procedures (P > .3) after propensity-score adjustment. Patients with tricuspid aortic valves were more likely to be free of reoperation than those with bicuspid valves at 10 years (93% vs 77%, P = .002), equivalent to bioprosthesis aortic valve replacement and superior after 12 years. Bioprostheses increasingly deteriorated after 7 years, and hazard functions for reoperation crossed at 7 years.ConclusionsValve preservation (rather than replacement) and matching root procedures have excellent early and long-term results, with increasing survival benefit at 7 years and fewer reoperations by 12 years. We recommend this procedure for experienced surgical teams

One year follow-up of patients with refractory angina pectoris treated with enhanced external counterpulsation

BACKGROUND: Enhanced external counterpulsation (EECP) is a non-invasive technique that has been shown to be effective in reducing both angina and myocardial ischemia in patients not responding to medical therapy and without revascularization alternatives. The aim of the present study was to assess the long-term outcome of EECP treatment at a Scandinavian centre, in relieving angina in patients with chronic refractory angina pectoris. METHODS: 55 patients were treated with EECP. Canadian cardiovascular society (CCS) class, antianginal medication and adverse clinical events were collected prior to EECP, at the end of the treatment, and at six and 12 months after EECP treatment. Clinical signs and symptoms were recorded. RESULTS: EECP treatment significantly improved the CCS class in 79 ± 6% of the patients with chronic angina pectoris (p < 0.001). The reduction in CCS angina class was seen in patients with CCS class III and IV and persisted 12 months after EECP treatment. There was no significant relief in angina in patients with CCS class II prior to EECP treatment. 73 ± 7% of the patients with a reduction in CCS class after EECP treatment improved one CCS class, and 22 ± 7% of the patients improved two CCS classes. The improvement of two CCS classes could progress over a six months period and tended to be more prominent in patients with CCS class IV. In accordance with the reduction in CCS classes there was a significant decrease in the weekly nitroglycerin usage (p < 0.05). CONCLUSION: The results from the present study show that EECP is a safe treatment for highly symptomatic patients with refractory angina. The beneficial effects were sustained during a 12-months follow-up period