Optimizing Sustainable Transit Bus Networks in Smart Cities

Urban mobility has been facing several challenges in the recent years due to the increasing populations and private vehicles ownership, which led to several negative environmental and social impacts in big cities. In this dissertation, we investigate how decision support systems can enhance the role of transit bus networks in the transition to more sustainable and convenient urban mobility

Enabling Sustainable Public Transport in Smart Cities through Real-time Decision Support

The growing consumption of fossil fuels and its negative environmental consequences have been a major concern during the last few decades. In line with that, public transport operators face global pressure to replace diesel buses by battery-electric buses (BEBs) in many countries. However, BEBs need to be recharged several times throughout the day to avoid running out of energy due to their limited driving range and slow charging rate. Accordingly, operating BEBs is substantially more sensitive to unanticipated delays and excess energy consumption, which raises serious challenges with respect to charging schedules. Moreover, BEBs are only a truly sustainable alternative if they are powered by renewable energy generators (REGs), which have intermittent and uncertain generation. Thus, we design and propose a real-time decision support system to overcome these uncertainties and maximize the utilization of REGs and minimize the impact on the grid while guaranteeing a feasible operation for the BEBs

Prescriptive Analytics in Urban Policing Operations

Problem definition: We consider the case of prescriptive policing, that is, the data-driven assignment of police cars to different areas of a city. We analyze key problems with respect to prediction, optimization, and evaluation as well as trade-offs between different quality measures and crime types. Academic/practical relevance: Data-driven prescriptive analytics is gaining substantial attention in operations management research, and effective policing is at the core of the operations of almost every city in the world. Given the vast amounts of data increasingly collected within smart city initiatives and the growing safety challenges faced by urban centers worldwide, our work provides novel insights on the development and evaluation of prescriptive analytics applications in an urban context. Methodology: We conduct a computational study using crime and auxiliary data on the city of San Francisco. We analyze both strong and weak prediction methods along with two optimization formulations representing the deterrence and response time impact of police vehicle allocations. We analyze trade-offs between these effects and between different crime types. Results: We find that even weaker prediction methods can produce Pareto-efficient outcomes with respect to deterrence and response time. We identify three different archetypes of combinations of prediction methods and optimization objectives that constitute the Pareto frontier among the configurations we analyze. Furthermore, optimizing for multiple crime types biases allocations in a way that generally decreases single-type performance along one outcome metric but can improve it along the other. Managerial implications: Although optimization integrating all relevant crime types is theoretically possible, it is practically challenging because each crime type requires a collectively consistent weight. We present a framework combining prediction and optimization for a subset of key crime types with exploring the impact on the remaining types to support implementation of operations-focused smart city solutions in practice

Evaluation of Rezum therapy as a minimally invasive modality for management of Benign Prostatic Hyperplasia: A prospective observational study

Objective: To evaluate safety and efficacy of Rezum therapy as a minimally invasive modality for management of benign prostatic hyperplasia in patients with prostate volume 80cc. Methods: Between June 2020 and February 2023, A total of 98 patients diagnosed with BPH and managed by Rezum were included in this study. Patients were divided based on their prostate volume of either less than 80 cc or greater than 80 cc. We evaluated several parameters related to their condition, including prostate volume, post-voiding residual (PVR) before and after surgery, number of treatments received, maximum urine flow rate (Qmax) before and after surgery and mean follow- up periods. Results: The mean age was 68 years (SD 11.2). The median prostatic volume was 62 cc (IQR 41, 17). A maximum of 9 treatments were administered. Six months was determined to be the average post-operative follow-up period (IQR: 3.5-7.2). The mean preoperative total PSA was 2.7 (IQR 1, 2), preoperative mean PVR was 79.8 cm3, preoperative mean Qmax was 8.2 ml/s (IQR 4.7-10.5), and median post-operative days until catheter removal was four days (IQR 3,1). Post-operative PVR was 24.7 cm3 (IQR 18.2, 29.4) and the mean post-operative Qmax was 18.3 ml/s (SD 6.3). Qmax levels significantly increased, by an average of 8.2 ml/s (SD 7.13) (p < 0.001). Similarly, a decrease of average PVR of 97.28 cm3 (SD 95.85) (p < 0.001) was detected, which is a substantial reduction. Between prostates less 80cc and those over 80cc, there were no appreciable differences in Qmax or PVR (p-values: 0.435 and 0.431, respectively). Conclusions: From our study, we conclude that Rezum water vapor thermal therapy, as a minimally invasive modality, is an effective and safe surgical option for management of benign prostatic hyperplasia of men with moderate to severe lower urinary tract symptoms (LUTS). This procedure has been shown to be effective in patients with varying larger prostate volumes

Safety and efficacy of percutaneous nephrolithotripsy in comorbid patients: A 3 years prospective observational study

Purpose: To report the result of percutaneous nephrolithotripsy (PCNL) via standard nephrostomy tract in a single training institution. The perioperative complications in relation to the comorbid state are particularly assessed. Patients and methods: A prospective interventional study between January 2019 to November 2022, included 210 patients scheduled for PCNL. The average age was 40.3 ± 11.8 years (range 18- 67 years). Patients were categorized into two groups. The first group comprised 146 cases (69 .5%) with no associated co-morbidities while the second group 64 (30.5%) had co-morbidities such as obesity in 4 cases (1.9%), hypertension (HTN) in 24 cases (11.4%) cases, diabetes mellitus (DM) in 17 (8.1%) cases, history of recurrent stone surgery in 11 (5.2%) cases and more than one in 8 cases (3.8%). Co-morbidities, stone burden, location of stone, time of surgery, stay in the hospital, further operations, and negative events were among the reported data. Complications and the stone-free rate were the main outcome indicators. Results: Intraoperative complications were reported in 40 (18.8%) patients (18 group 1 and 22 group 2) during PCNL. Bleeding occurred in 22 (10.5%) patients (9 group 1 and 13 group 2), blood transfusions were needed in 4 (1.9%) (2 group 1 and 2 group 2), extravasation was observed in 11 patients (5.2%) (6 group 1 and 5 group 2) and cardiac arrhythmia in 3 (1.4%) (1 group 1 and 2 group 2) patients. Postoperative complications occurred in 61 patients (29%) (24 group 1 and 37 group 2) in the form of fever in 10 patients (4.8 %) (3 group 1 and 7 group 2) and prolonged leakage in 50 patients (23.8%) (21 group 1 and 29 group 2). One patient of group 2 died from postoperative sepsis. Extravasation and postoperative leakage were higher in diabetic patients than in non-diabetics. Stonefree rate was 60.5% (127 of 210). Clinically significant residual fragments (CSRFs) found in 70 cases (33.3%) (33 group 1 and 37 group 2). In 13 cases (6.2%) (5 group 1 and 8 group 2), clinically insignificant residual fragments (CIRFs) were found. In 8 (3 group 1 and 5 group 2) of the 13 cases, spontaneous stone passage was observed within 4-6 weeks of surgery. Residual stones in three cases (1 group 1 and 2 group 2) were asymptomatic and 4 mm or less, whereas stones increased in two cases of group 2. Among all factors studied, stone burden was significantly correlated to both intraoperative and postoperative complications. The occurrence of postoperative fever increased with large stone burden. Conclusions: PCNL is a therapeutic modality that is effective, feasible, and safe for a wide range of patients with concurrent medical issues. A steep curve is required to reduce intraoperative and postoperative complications

HER2/neu expression status of post BCG recurrent non-muscle-invasive bladder urothelial carcinomas in relation to their primary ones

Background: Transurethral resection (TUR) followed by adjuvant therapy is still the treatment of choice of Non-Muscle-Invasive Bladder Urothelial Carcinoma (NMIBUC). However, recurrence is one of the most troublesome features of these lesions. Early second resection and adjuvant BCG therapy has been shown to improve the outcome. Objective: To evaluate the prognostic value of C-erbB-2 (HER2/neu) expression status in Non-Muscle-Invasive Bladder Urothelial Carcinoma cases, before and after intravesical Bacillus Calmette Guerin (BCG immunotherapy). Materials and methods: HER2/neu expression was studied in 120 (Ta-T1) Non-Muscle-Invasive Urothelial Carcinoma cases. The expression was evaluated and compared to the expression after Bacillus Calmette Guerin (BCG) immunotherapy. Results: HER2/neu expression in low and high grade of the Non- Muscle-Invasive Urothelial Carcinoma was (38%) and (83%) respectively. The difference of the expression rates by tumor grade was statistically significant. In recurring lesions post BCG therapy, C-erbB-2 expression was markedly decreased (31.6%) when compared to its expression before therapy (65%). Conclusions: The HER2/neu expression increased as the tumor grade rose. The reduction in expression following BCG treatment in Non-Invasive transitional cell carcinoma cases could reflect a reduction of the potential malignancy of the tumor

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Optimizing Sustainable Transit Bus Networks in Smart Cities

Urban mobility has been facing several challenges in the recent years due to the increasing populations and private vehicles ownership, which led to several negative environmental and social impacts in big cities. In this dissertation, we investigate how decision support systems can enhance the role of transit bus networks in the transition to more sustainable and convenient urban mobility

DG Allocation Based on Reliability, Losses and Voltage Sag Considerations: an expert system approach

<p align="left">Expert System (ES) as a branch of Artificial Intelligence (AI) methodology can potentially help in solving complicated power system problems. This may be more appropriate methodology than conventional optimization techniques when contradiction between objectives appears in reaching the optimum solution. When this contradiction is the hindrance in reaching the required system operation through the application of traditional methods ES can give a hand in such case.</p><p class="Abstract" align="left"> In this paper, the  knowledge- based ES technique is proposed to reach near-optimum solution which is further directed to the optimum solution through particle swarm optimization (PSO) technique. This idea is known as Hybrid-Expert-System (HES). The proposed idea is used in getting the optimum allocation of a number of distributed generation (DG) units on Distribution System (DS) busbars taking into consideration three issues; reliability, voltage sag, and line losses. Optimality is assessed on the economic basis by calculating money benefits (or losses) resulting from DG addition considering the three aforementioned issues. The effectiveness of the proposed technique is ascertained through example.</p