Analysis of High-Speed Rail Implementation Alternatives in the Northeast Corridor: the Role of Institutional and Technological Flexibility

In this paper, an engineering systems framework using the CLIOS Process, scenario analysis, and flexibility analysis is used to study the implementation of a high-speed rail corridor in the Northeast Corridor of the United States. Given the tremendous uncertainty that characterizes high-speed rail projects, the implementation of the alternatives proposed, which are very similar to other commonly accepted ways to implement high-speed rail in the corridor, are analyzed under different scenarios. The results motivate incorporation of flexibility into the alternatives to allow decision makers to adapt as situations evolve. While designing-in this flexibility has a cost, it may facilitate the implementation of the alternatives by enabling adaptation to uncertain outcomes, thereby improving performance

NEC FUTURE Tier I Scoping Process: Public Comment

Utilizing its special expertise, the Regional Transportation Planning and High Speed Rail Research Group at the Massachusetts Institute of Technology (MIT) sought to provide input via public comment to the NEC FUTURE Tier I scoping process. Earlier in 2012, we completed a comprehensive look at the complexities and challenges associated with mobility in the NEC. This submittal is based on a report prepared for and funded by the Institute for Transportation Policy Studies (ITPS) in Tokyo, Japan, entitled Transportation in the Northeast Corridor of the U.S.: A Multimodal and Intermodal Conceptual Framework. We applied novel combinations of system analysis methods to seek new insights for planning in this corridor. With the lessons learned from this account, we seek to provide input to the NEC FUTURE scoping process, and enrich the NEC FUTURE Tier I EIS study. We recognize that the Purpose and Need and a comprehensive and carefully articulated range of alternatives are of utmost importance for the EIS process, and we are focusing our comments in these two areas. With our lessons learned, we hope to offer insights useful in formulating and refining the project’s Purpose and Need, and as well in defining the alternatives to be considered

NEC FUTURE Preliminary Alternatives Report: Public Comment

The United States Department of Transportation's Federal Railroad Administration (FRA) is currently in the early stages of a planning process to define a 30-year passenger rail investment plan for the Northeast Corridor (NEC), between Boston and Washington, D.C. In the Spring of 2013, NEC FUTURE (the name of the planning process), released a Preliminary Alternatives Report, containing 15 possible alternatives for passenger rail infrastructure investment. This working paper contains a memo from the Regional Transportation Planning and High Speed Rail Research Group at the Massachusetts Institute of Technology (MIT) responding to the Preliminary Alternatives Report, as well as following up on the group's previous public comments to NEC FUTURE (ESD-WP-2012-27 NEC FUTURE Tier I Scoping Process: Public Comment). The memo focuses on the group's reactions in three areas: “goals and objectives, and evaluation of the alternatives,” “planning under uncertainty and flexible alternatives,” and “institutional assumptions.” These comments also build on the knowledge gained from report prepared for and funded by the Institute for Transportation Policy Studies (ITPS) in Tokyo, Japan, entitled Transportation in the Northeast Corridor of the U.S.: A Multimodal and Intermodal Conceptual Framework

BIM deletion polymorphisms in Hispanic patients with non-small cell lung cancer carriers of EGFR mutations

BACKGROUND: Germline alterations in the proapoptotic protein Bcl-2-like 11 (BIM) can have a crucial role in diverse tumors. To determine the clinical utility of detecting BIM deletion polymorphisms (par4226 bp/ par363 bp) in EGFR positive non-small-cell lung cancer (NSCLC) we examined the outcomes of patients with and without BIM alterations. RESULTS: BIM deletion was present in 14 patients (15.7%). There were no significant differences between patients with and without BIM-del in clinical characteristics or EGFR mutation type; however, those with BIM-del had a worse overall response rate (ORR) to erlotinib (42.9% vs. 73.3% in patients without BIM-del; p=0.024) as well as a significantly shorter progression-free survival (PFS) (10.8 BIM-del+ vs. 21.7 months for patients without BIM-del; p=0.029) and overall survival (OS) (15.5 BIM-del+ vs. 34.0 months for patients without BIM-del; p=0.035). Multivariate Cox regression analysis showed that BIM-del+ was an independent indicator of shorter PFS (HR 3.0; 95%CI 1.2-7.6; p=0.01) and OS (HR 3.4; 95%CI 1.4-8.3; p=0.006). METHODS: We studied 89 NSCLC Hispanic patients with EGFR mutation who were treated with erlotinib between January 2009 and November 2014. BIM deletion polymorphisms (BIM-del) was analyzed by PCR in formalin-fixed paraffin-embedded (FFPE) tissues of tumor biopsies. We retrospectively analyzed clinical characteristics, response rate, toxicity, and outcomes among patients with and without BIM-del. CONCLUSIONS: The incidence of BIM-del found in Hispanic patients is similar to that previously described in Asia. This alteration is associated with a poor clinical response to erlotinib and represents an independent prognostic factor for patients who had NSCLC with an EGFR mutation

BJS commission on surgery and perioperative care post-COVID-19

Background: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues experiences and published evidence. Methods: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. Results: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. Conclusion: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era

BJS commission on surgery and perioperative care post-COVID-19

Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues' experiences and published evidence