Factors For Success In Rural Tourism: A Case Study Of Eastern Kentucky

This research study examines the variables of tourism that influence a traveler’s decision when traveling in Eastern Kentucky, specifically Morehead, Kentucky. Morehead is a destination with great potential to be built into a prominent location for tourism in Kentucky. To best understand the potential of the area, the resources available and the existing tourism locations were accessed to build the foundation of this project. Successful tourism destinations around the state of Kentucky have been assessed to determine what factors contribute to their success as well as what tactics/resources the businesses use to draw people in. In comparison to successful tourism destinations in the Lexington, Red River Gorge, Louisville, Bowling Green, and Newport areas, Morehead is lacking in the attractions that draw guests in to stay for longer than one day. Upon further study, Morehead was found to be an ideal location due to the college presence and the natural attractions such as Cave Run Lake and the Daniel Boone National Forrest as well as Morehead’s easy access to the interstate. Morehead is lacking in hotel room availability, night life, extended store hours, and access to services such as Uber and Lyft

Economic Feasibility of Rainwater Harvesting:A Case Study at Morehead State University

Rainwater harvesting (RWH) was primarily considered as a source for freshwater supply or a conservation practice for over coming water shortages in drought prone areas. By retaining storm-water run-off for on site use, harvesting systems reduce the runoff volumes and pollutant masses entering waterways. Consequently, using roof-top RWH as a best management practice has been encouraged by many state and local governments. Some of the most interesting aspects of RWH are the methods of capture, storage, and the use of this natural resource at the place it occurs.https://scholarworks.moreheadstate.edu/celebration_posters_2022/1042/thumbnail.jp

Economic Analysis of Solar Panel Installation: A Case Study at Derrickson Agriculture Complex

https://scholarworks.moreheadstate.edu/student_scholarship_posters/1224/thumbnail.jp

Economic and Financial Analysis of Rainwater Harvesting Pond: A Case Study at Morehead State University

Rainwater harvesting (RWH) was primarily considered as a source for fresh water supply or a conservation practice for overcoming water shortages in drought prone areas. By retaining storm-water run-off for onsite use, harvesting systems reduce the runoff volumes and pollutant masses entering waterways. Some of the most interesting aspects of RWH are the methods of capture, storage, and the use of this natural resource at the place it occurs.https://scholarworks.moreheadstate.edu/celebration_posters_2023/1045/thumbnail.jp

Nonlinearly consistent schemes for coupled problems in reactor analysis

Conventional coupling paradigms used nowadays to couple various physics components in reactor analysis problems can be inconsistent in their treatment of the nonlinear terms. This leads to usage of smaller time steps to maintain stability and accuracy requirements thereby increasing the computational time. These inconsistencies can be overcome using better approximations to the nonlinear operator in a time stepping strategy to regain the lost accuracy. This research aims at finding remedies that provide consistent coupling and time stepping strategies with good stability properties and higher orders of accuracy. Consistent coupling strategies, namely predictive and accelerated methods, were introduced for several reactor transient accident problems and the performance was analyzed for a 0-D and 1-D model. The results indicate that consistent approximations can be made to enhance the overall accuracy in conventional codes with such simple nonintrusive techniques. A detailed analysis of a monoblock coupling strategy using time adaptation was also implemented for several higher order Implicit Runge-Kutta (IRK) schemes. The conclusion from the results indicate that adaptive time stepping provided better accuracy and reliability in the solution fields than constant stepping methods even during discontinuities in the transients. Also, the computational and the total memory requirements for such schemes make them attractive alternatives to be used for conventional coupling codes

High Resolution Numerical Methods for Coupled Non-linear Multi-physics Simulations with Applications in Reactor Analysis

The modeling of nuclear reactors involves the solution of a multi-physics problem with widely varying time and length scales. This translates mathematically to solving a system of coupled, non-linear, and stiff partial differential equations (PDEs). Multi-physics applications possess the added complexity that most of the solution fields participate in various physics components, potentially yielding spatial and/or temporal coupling errors. This dissertation deals with the verification aspects associated with such a multi-physics code, i.e., the substantiation that the mathematical description of the multi-physics equations are solved correctly (both in time and space). Conventional paradigms used in reactor analysis problems employed to couple various physics components are often non-iterative and can be inconsistent in their treatment of the non-linear terms. This leads to the usage of smaller time steps to maintain stability and accuracy requirements, thereby increasing the overall computational time for simulation. The inconsistencies of these weakly coupled solution methods can be overcome using tighter coupling strategies and yield a better approximation to the coupled non-linear operator, by resolving the dominant spatial and temporal scales involved in the multi-physics simulation. A multi-physics framework, KARMA (K(c)ode for Analysis of Reactor and other Multi-physics Applications), is presented. KARMA uses tight coupling strategies for various physical models based on a Matrix-free Nonlinear-Krylov (MFNK) framework in order to attain high-order spatio-temporal accuracy for all solution fields in amenable wall clock times, for various test problems. The framework also utilizes traditional loosely coupled methods as lower-order solvers, which serve as efficient preconditioners for the tightly coupled solution. Since the software platform employs both lower and higher-order coupling strategies, it can easily be used to test and evaluate different coupling strategies and numerical methods and to compare their efficiency for problems of interest. Multi-physics code verification efforts pertaining to reactor applications are described and associated numerical results obtained using the developed multi-physics framework are provided. The versatility of numerical methods used here for coupled problems and feasibility of general non-linear solvers with appropriate physics-based preconditioners in the KARMA framework offer significantly efficient techniques to solve multi-physics problems in reactor analysis

Severe Asthma Standard-of-Care Background Medication Reduction With Benralizumab: ANDHI in Practice Substudy

Background: The phase IIIb, randomized, parallel-group, placebo-controlled ANDHI double-blind (DB) study extended understanding of the efficacy of benralizumab for patients with severe eosinophilic asthma. Patients from ANDHI DB could join the 56-week ANDHI in Practice (IP) single-arm, open-label extension substudy. Objective: Assess potential for standard-of-care background medication reductions while maintaining asthma control with benralizumab. Methods: Following ANDHI DB completion, eligible adults were enrolled in ANDHI IP. After an 8-week run-in with benralizumab, there were 5 visits to potentially reduce background asthma medications for patients achieving and maintaining protocol-defined asthma control with benralizumab. Main outcome measures for non-oral corticosteroid (OCS)-dependent patients were the proportions with at least 1 background medication reduction (ie, lower inhaled corticosteroid dose, background medication discontinuation) and the number of adapted Global Initiative for Asthma (GINA) step reductions at end of treatment (EOT). Main outcomes for OCS-dependent patients were reductions in daily OCS dosage and proportion achieving OCS dosage of 5 mg or lower at EOT. Results: For non-OCS-dependent patients, 53.3% (n = 208 of 390) achieved at least 1 background medication reduction, increasing to 72.6% (n = 130 of 179) for patients who maintained protocol-defined asthma control at EOT. A total of 41.9% (n = 163 of 389) achieved at least 1 adapted GINA step reduction, increasing to 61.8% (n = 110 of 178) for patients with protocol-defined EOT asthma control. At ANDHI IP baseline, OCS dosages were 5 mg or lower for 40.4% (n = 40 of 99) of OCS-dependent patients. Of OCS-dependent patients, 50.5% (n = 50 of 99) eliminated OCS and 74.7% (n = 74 of 99) achieved dosages of 5 mg or lower at EOT. Conclusions: These findings demonstrate benralizumab's ability to improve asthma control, thereby allowing background medication reduction

Effect of surgical experience and spine subspecialty on the reliability of the {AO} Spine Upper Cervical Injury Classification System

OBJECTIVE The objective of this paper was to determine the interobserver reliability and intraobserver reproducibility of the AO Spine Upper Cervical Injury Classification System based on surgeon experience (< 5 years, 5–10 years, 10–20 years, and > 20 years) and surgical subspecialty (orthopedic spine surgery, neurosurgery, and "other" surgery). METHODS A total of 11,601 assessments of upper cervical spine injuries were evaluated based on the AO Spine Upper Cervical Injury Classification System. Reliability and reproducibility scores were obtained twice, with a 3-week time interval. Descriptive statistics were utilized to examine the percentage of accurately classified injuries, and Pearson’s chi-square or Fisher’s exact test was used to screen for potentially relevant differences between study participants. Kappa coefficients (κ) determined the interobserver reliability and intraobserver reproducibility. RESULTS The intraobserver reproducibility was substantial for surgeon experience level (< 5 years: 0.74 vs 5–10 years: 0.69 vs 10–20 years: 0.69 vs > 20 years: 0.70) and surgical subspecialty (orthopedic spine: 0.71 vs neurosurgery: 0.69 vs other: 0.68). Furthermore, the interobserver reliability was substantial for all surgical experience groups on assessment 1 (< 5 years: 0.67 vs 5–10 years: 0.62 vs 10–20 years: 0.61 vs > 20 years: 0.62), and only surgeons with > 20 years of experience did not have substantial reliability on assessment 2 (< 5 years: 0.62 vs 5–10 years: 0.61 vs 10–20 years: 0.61 vs > 20 years: 0.59). Orthopedic spine surgeons and neurosurgeons had substantial intraobserver reproducibility on both assessment 1 (0.64 vs 0.63) and assessment 2 (0.62 vs 0.63), while other surgeons had moderate reliability on assessment 1 (0.43) and fair reliability on assessment 2 (0.36). CONCLUSIONS The international reliability and reproducibility scores for the AO Spine Upper Cervical Injury Classification System demonstrated substantial intraobserver reproducibility and interobserver reliability regardless of surgical experience and spine subspecialty. These results support the global application of this classification system

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries