973 research outputs found
A methodology and toolkit for the assessment and selection of LZC technologies in the building design process
The advent of environmentally driven building regulations, rising energy costs, and heightened client awareness of energy-related issues has increased the demand for the assessment of building integrated low-carbon (LZC) energy supply systems. However, it is seldom the case that any one software tool fulfils the needs for an appraisal of these types of systems. Therefore, there is a clear need for an effective methodology for the use of a range of software tools in LZC technology analysis. This paper describes a practitioner-driven project within which such a methodology and supporting software (termed a 'toolkit') has been developed. The application of this toolkit to a real design problem is described and the results from the analysis are discussed. The paper also addresses the means by which the results from the analysis can be presented to clients and other stakeholders in the design process
A system for patient management based discrete-event simulation and hierarchical clustering
Hospital Accident and Emergency (A&E) departments in England have a 4 hour target to treat 98% of patients from arrival to discharge, admission or transfer. Managing resources to meet the target and deliver care across the range of A&E services is a huge challenge for A&E managers. This paper develops an intelligent patient management tool to help managers and clinicians better understand patient length of stay and resources within an A&E area. The developed discrete-event simulation model gives a highlevel representation of ambulance arrivals into A&E. The model facilitates analysis in the following ways: visually interactive software showing patient length of stay in the A&E area; patient activity broken down into sub-groups so that intelligence might be gathered on how sub-groups affect the overall length of stay; understanding the number of patient treatment places and nurse resources required. To support ease of inputs for scenario and sensitivity testing, data is entered into the simulation model (Simul8) via Excel spreadsheets. The model discussed in this paper used patient length of stay grouped by A&E diagnosis codes and was limited to ambulance arrivals. The analysis was derived from A&E attendance in 2004 from an English hospital
Refining pathological evaluation of neoadjuvant therapy for adenocarcinoma of the esophagus
AIM: To assess tumour regression grade (TRG) and lymph node downstaging to help define patients who benefit from neoadjuvant chemotherapy.METHODS: Two hundred and eighteen consecutive patients with adenocarcinoma of the esophagus or gastro-esophageal junction treated with surgery alone or neoadjuvant chemotherapy and surgery between 2005 and 2011 at a single institution were reviewed. Triplet neoadjuvant chemotherapy consisting of platinum, fluoropyrimidine and anthracycline was considered for operable patients (World Health Organization performance status ? 2) with clinical stage T2-4 N0-1. Response to neoadjuvant chemotherapy (NAC) was assessed using TRG, as described by Mandard et al. In addition lymph node downstaging was also assessed. Lymph node downstaging was defined by cN1 at diagnosis: assessed radiologically (computed tomography, positron emission tomography, endoscopic ultrasonography), then pathologically recorded as N0 after surgery; ypN0 if NAC given prior to surgery, or pN0 if surgery alone. Patients were followed up for 5 years post surgery. Recurrence was defined radiologically, with or without pathological confirmation. An association was examined between t TRG and lymph node downstaging with disease free survival (DFS) and a comprehensive range of clinicopathological characteristics.RESULTS: Two hundred and eighteen patients underwent esophageal resection during the study interval with a mean follow up of 3 years (median follow up: 2.552, 95%CI: 2.022-3.081). There was a 1.8% (n = 4) inpatient mortality rate. One hundred and thirty-six (62.4%) patients received NAC, with 74.3% (n = 101) of patients demonstrating some signs of pathological tumour regression (TRG 1-4) and 5.9% (n = 8) having a complete pathological response. Forty four point one percent (n = 60) had downstaging of their nodal disease (cN1 to ypN0), compared to only 15.9% (n = 13) that underwent surgery alone (pre-operatively overstaged: cN1 to pN0), (P < 0.0001). Response to NAC was associated with significantly increased DFS (mean DFS; TRG 1-2: 5.1 years, 95%CI: 4.6-5.6 vs TRG 3-5: 2.8 years, 95%CI: 2.2-3.3, P < 0.0001). Nodal down-staging conferred a significant DFS advantage for those patients with a poor primary tumour response to NAC (median DFS; TRG 3-5 and nodal down-staging: 5.533 years, 95%CI: 3.558-7.531 vs TRG 3-5 and no nodal down-staging: 1.114 years, 95%CI: 0.961-1.267, P < 0.0001).CONCLUSION: Response to NAC in the primary tumour and in the lymph nodes are both independently associated with improved DFS
Quantitative assessment of the relative risk of ship strike to humpback whales in the Great Barrier Reef
There is global recognition that ship strike represents a significant risk to some populations of whales around the world. Analysis of ship strike records worldwide demonstrates that humpback whales are the second most frequently reported whale species to be struck by a ship. In Australia, both the east and west coast populations of humpback whales are strongly recovering from commercial whaling during the mid-20th century which resulted in populations nearing extinction. On the east coast of Australia the main breeding ground for humpback whales is within the Great Barrier Reef World Heritage Area (GBRWHA). Both the east and west coast of Australia have also in the past decade experienced considerable coastal and port development associated with an increase in natural resource projects. It is due to substantial coastal development and port expansions related to the mining industry that UNESCO were considering listing the GBRWHA on the 'List of World Heritage in Danger' and are currently monitoring Australia's commitment to its sustainability. Along with considerable port expansion along the GBRWHA coastline to meet increasing global demands for coal and liquefied natural gas (LNG), there is projected to be substantial increases in shipping traffic. Conservative estimates are predicting a doubling of shipping traffic by 2025, albeit not for all Queensland ports. Considering the rapid rate of increase of the east Australian population of humpback whales (approximately 10.9% increase per annum), there is potential for increased interaction between humpback whales and shipping traffic and increased risk of ship strikes to the whales on their breeding ground. To understand the risk of ship strike to humpbacks in the GBRWHA, it is necessary to understand the distribution and densities for both whales and shipping. This report uses current knowledge on the distribution of humpback whales within the GBRWHA from aerial survey data from 2012 and 2014 and contemporary (2012-2014) shipping traffic data of ships travelling within the GBR to provide estimates of relative risk of ship strike to humpback whales within the GBR
Quantifying ship strike risk to breeding whales in a multiple-use marine park: The Great Barrier Reef
Spatial risk assessments are an effective management tool used in multiple-use marine parks to balance the needs for conservation of natural properties and to provide for varying socio-economic demands for development. The multiple-use Great Barrier Reef Marine Park (GBRMP) has recently experienced substantial increases in current and proposed port expansions and subsequent shipping. Globally, large whale populations are recovering from commercial whaling and ship strike is a significant threat to some populations and a potential welfare issue for others. Within the GBRMP, there is spatial conflict between the main breeding ground of the east Australian humpback whale population and the main inner shipping route that services several large natural resource export ports. The east coast humpback whale population is one of the largest humpback whale populations globally, exponentially increasing (11% per annum) close to the maximum potential rate and estimated to reach pre-exploitation population numbers in the next 4-5 years. We quantify the relative risk of ship strike to calving and mating humpback whales, with areas of highest relative risk coinciding with areas offshore of two major natural resource export ports. We found females with a dependent calf had a higher risk of ship strike compared to groups without a calf when standardized for group size and their inshore movement and coastal dependence later in the breeding season increases their overlap with shipping, although their lower relative abundance decreases risk. The formalization of a two-way shipping route has provided little change to risk and projected risk estimates indicate a three- to five-fold increase in risk to humpback whales from ship strike over the next 10 years. Currently, the whale Protection Area in the GBRMP does not cover the main mating and calving areas, whereas provisions within the legislation for establishment of a Special Management Area during the peak breeding season in high-risk areas could occur. A common mitigation strategy of re-routing shipping lanes to reduce risk is not a viable option for the GBRMP due to physical spatial limitations imposed by the reef, whereas speed restrictions could be the most feasible based on current ship speeds
PCN158 Determinants for guideline appropriate care among Elderly Women with stage I-III Breast Cancer in a Seer-Medicare Population
Follow The Leader: Some Thoughts on Leadership
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68818/2/10.1177_107179199500200115.pd
Microplastics Detected in Groundwater
Low concentrations of microplastics are present in Illinois’ karst groundwater, according to a preliminary study completed in spring 2018. This is the first time that microplastics have been detected in groundwater. The study was conducted in collaboration with scientists at the Illinois State Geological Survey, Illinois State Water Survey, Loyola University Chicago, and ISTC. Full study results published in Panno, S.V., Kelly, W.R., Scott, J., Zheng, W., McNeish, R.E., Holm, N., Hoellein, T.J. and Baranski, E.L. (2019), Microplastic Contamination in Karst Groundwater Systems. Groundwater, 57: 189-196. doi:10.1111/gwat.12862.League of Women Voters of Jo Daviess County; Illinois State Geological Survey; Illinois State Water Survey; Illinois Sustainable Technology Center (Hazardous Waste Research Fund);. Illinois-Indiana Sea Grant (National Oceanic and Atmospheric Administration ; 074483-15907); National Science Foundation (CAREER 1553835).Ope
Summer CO2 evasion from streams and rivers in the Kolyma River basin, north-east Siberia
Inland water systems are generally supersaturated in carbon dioxide (CO2) and are increasingly recognized as playing an important role in the global carbon cycle. The Arctic may be particularly important in this respect, given the abundance of inland waters and carbon contained in Arctic soils; however, a lack of trace gas measurements from small streams in the Arctic currently limits this understanding.We investigated the spatial variability of CO2 evasion during the summer low-flow period from streams and rivers in the northern portion of the Kolyma River basin in north-eastern Siberia. To this end, partial pressure of carbon dioxide (pCO2) and gas exchange velocities (k) were measured at a diverse set of streams and rivers to calculate CO2 evasion fluxes.
We combined these CO2 evasion estimates with satellite remote sensing and geographic information system techniques to calculate total areal CO2 emissions. Our results show that small streams are substantial sources of atmospheric CO2 owing to high pCO2 and k, despite being a small portion of total inland water surface area. In contrast, large rivers were generally near equilibrium with atmospheric CO2. Extrapolating our findings across the Panteleikha-Ambolikha sub-watersheds demonstrated that small streams play a major role in CO2 evasion, accounting for 86% of the total summer CO2 emissions from inland waters within these two sub-watersheds. Further expansion of these regional CO2 emission estimates across time and space will be critical to accurately quantify and understand the role of Arctic streams and rivers in the global carbon budget
The Value of Information for Populations in Varying Environments
The notion of information pervades informal descriptions of biological
systems, but formal treatments face the problem of defining a quantitative
measure of information rooted in a concept of fitness, which is itself an
elusive notion. Here, we present a model of population dynamics where this
problem is amenable to a mathematical analysis. In the limit where any
information about future environmental variations is common to the members of
the population, our model is equivalent to known models of financial
investment. In this case, the population can be interpreted as a portfolio of
financial assets and previous analyses have shown that a key quantity of
Shannon's communication theory, the mutual information, sets a fundamental
limit on the value of information. We show that this bound can be violated when
accounting for features that are irrelevant in finance but inherent to
biological systems, such as the stochasticity present at the individual level.
This leads us to generalize the measures of uncertainty and information usually
encountered in information theory
- …