Dynamic integrated water quality modelling: A case study of the Lambro River, northern Italy

In this paper an integrated modelling approach is presented and applied to a 26km stretch of the Lambro River downstream of the Merone Wastewater Treatment Plant in northern Italy. The sub-models used (ASM1 for the treatment plant and RWQM1 for the river) have been implemented in the WEST® simulator. Hydraulics and quality processes of the Lambro River have been modelled with a ‘tanks in series’ approach. The purpose of this study is to model the effect on river water quality of an insufficient treatment capacity of the WWTP. The plant was constantly operating at its maximum hydraulic capacity, leading to a daily bypass of dry weather wastewater, which imposed a marked diurnal cycle on pollutant concentrations in the river. The assessment of the actual WWTP upgrade has confirmed its beneficial effect on the river water quality.Keywords: ASM1, integrated modelling, LAS, model interfaces, RWQM

Hospital admissions, transfers and costs of guillain-Barré syndrome

Background Guillain-Barré syndrome (GBS) has a highly variable clinical course, leading to frequent transfers within and between hospitals and high associated costs. We defined the current admissions, transfers and costs in relation to disease severity of GBS. Methods Dutch neurologists were requested to report patients diagnosed with GBS between November 2009 and November 2010. Information regarding clinical course and transfers was obtained via neurologists and general practitioners. Results 87 GBS patients were included with maximal GBS disability score of 1 or 2 (28%), 3 or 4 (53%), 5 (18%) and 6 (1%). Four mildly affected GBS patients were not hospital admitted. Of the 83 hospitalized patients 68 (82%) were initially admitted at a neurology department, 4 (5%) at an ICU, 4 (5%) at pediatrics, 4 (5%) at pediatrics neurology and 3 (4%) at internal medicine. Median hospital stay was 17 days (IQR 11-26 days, absolute range 1-133 days). Transfers between departments or hospitals occurred in 33 (40%) patients and 25 (30%) were transferred 2 times or more. From a cost-effectiveness perspective 21 (25%) of the admissions was suboptimal. Median costs for hospital admission of GBS patients were 15,060 Euro (IQR 11,226-23,683). Maximal GBS disability score was significantly correlated with total length of stay, number of transfers, ICU admission and costs. Conclusions Hospital admissions for GBS patients are highly heterogeneous, with frequent transfers and higher costs for those with mo

Simulation Of The Integrated Urban Wastewater System Using Mechanistic Surrogate Models

INTRODUCTION The integrated urban wastewater system (sewers, treatment plants and receiving water) has a major impact on the quality of the receiving water, due to discharges of combined sewer overflows (CSO) during storms and due to effluents of the treatment plants. An integrated model, which takes into account the quality of the receiving water, is a useful tool to study these effects. Moreover, a parallel simulation of the integrated urban wastewater system has been asked for since the last few years (Rauch et al., 1998; Schtze et al., 1998). A problem encountered when creating an integrated model is the fact the existing models are quite complex and require sophisticated integration algorithms to solve them. This results in long calculation times, making these models impractical to use, especially within optimisation problems where a lot of simulations need to be performed. These complex models need hence to be replaced by faster surrogate models