Systems analysis approach to the design of efficient water pricing policies under the EU Water Framework Directive

Economic theory suggests that water pricing can contribute to efficient management of water scarcity. The European Union (EU) Water Framework Directive (WFD) is a major legislative effort to introduce the use of economic instruments to encourage efficient water use and achieve environmental management objectives. However, the design and implementation of economic instruments for water management, including water pricing, has emerged as a challenging aspect of WFD implementation. This study demonstrates the use of a systems analysis approach to designing and comparing two economic approaches to efficient management of groundwater and surface water given EU WFD ecological flow requirements. Under the first approach, all wholesale water users in a river basin face the same volumetric price for water. This water price does not vary in space or in time, and surface water and groundwater are priced at the same rate. Under the second approach, surface water is priced using a volumetric price, while groundwater use is controlled through adjustments to the price of energy, which is assumed to control the cost of groundwater pumping. For both pricing policies, optimization is used to identify optimal prices, with the objective of maximizing welfare while reducing human water use in order to meet constraints associated with EU WFD ecological and groundwater sustainability objectives. The systems analysis approach demonstrates the successful integration of economic, hydrologic, and environmental components into an integrated framework for the design and testing of water pricing policies. In comparison to the first pricing policy, the second pricing policy, in which the energy price is used as a surrogate for a groundwater price, shifts a portion of costs imposed by higher water prices from low-value crops to high-value crops and from small urban/domestic locations to larger locations. Because growers of low-value crops will suffer the most from water price increases, the use of energy costs to control groundwater use offers the advantage of reducing this burden.The authors would like to thank the Danish Research School of Water Resources (FIVA) for financial support. Three anonymous reviewers made helpful suggestions that were incorporated into the revised version.Riegels, N.; Pulido-Velazquez, M.; Doulgeris, C.; Sturm, V.; Jensen, R.; Moller, F.; Bauer-Gottwein, P. (2013). Systems analysis approach to the design of efficient water pricing policies under the EU Water Framework Directive. Journal of Water Resources Planning and Management. 139(5):574-582. doi:10.1061/(ASCE)WR.1943-5452.0000284S574582139

Soluble HLA in the aqueous humour of uveal melanoma is associated with unfavourable tumour characteristics

A high HLA expression in uveal melanoma (UM) is part of the prognostically unfavorable inflammatory phenotype. We wondered whether the presence of soluble HLA (sHLA) in the aqueous humour is associated with clinical, histopathological or genetic tumour characteristics, and represents tumour HLA expression and intratumoural inflammation. Aqueous humour from 108 UM patients was analysed for the presence of sHLA, using a Luminex assay specific for HLA Class I. Clinical and genetic parameters were compared between sHLA-positive and negative eyes. A qPCR analysis was performed on tumour tissue using a Fluidigm assay. In 19/108 UM-containing eyes, the sHLA level in the aqueous was above the detection limit. Tumours in sHLA-positive eyes were significantly larger, more frequently involved the ciliary body, and more often showed monosomy 3, gain of chromosome 8q and loss of BAP1 staining. Melanoma-related survival was worse in patients with sHLA-positive aqueous humour. sHLA in the aqueous did not represent the tumour's HLA expression and did not relate to immune cell infiltration in the tumour. We conclude that UM-containing eyes may contain sHLA in the aqueous humour, where it is a prognostically-unfavourable sign and may influence local immune responses

Health-related quality of life in transplant ineligible newly diagnosed multiple myeloma patients treated with either thalidomide or lenalidomide-based regimen until progression: a prospective, open-label, multicenter, randomized, phase 3 study

Data on the impact of long term treatment with immunomodulatory drugs (IMiD) on health-related quality of life (HRQoL) is limited. The HOVON-87/NMSG18 study was a randomized, phase 3 study in newly diagnosed transplant ineligible patients with multiple myeloma, comparing melphalan-prednisolone in combination with thalidomide or lenalidomide, followed by maintenance therapy until progression (MPT-T or MPR-R). The EORTC QLQ-C30 and MY20 questionnaires were completed at baseline, after three and nine induction cycles and six and 12 months of maintenance therapy. Linear mixed models and minimal important differences were used for evaluation. 596 patients participated in HRQoL reporting. Patients reported clinically relevant improvement in global quality of life (QoL), future perspective and role and emotional functioning, and less fatigue and pain in both arms. The latter being of large effect size

3D trunk orientation measured using inertial measurement units during anatomical and dynamic sports motions

Trunk motion is related to the performance and risk of injuries during dynamic sports motions. Optical motion capture is traditionally used to measure trunk motion during dynamic sports motions, but these systems are typically constrained to a laboratory environment. Inertial measurement units (IMUs) might provide a suitable alternative for measuring the trunk orientation during dynamic sports motions. The objective of the present study was to assess the accuracy of the three-dimensional trunk orientation measured using IMUs during dynamic sports motions and isolated anatomical trunk motions. The motions were recorded with two IMUs and an optical motion capture system (gold standard). Ten participants performed a total of 71 sports motions (19 golf swings, 15 one-handed ball throws, 19 tennis serves, and 18 baseball swings) and 125 anatomical trunk motions (42, 41, and 42 trials of lateral flexion, axial rotation, and flexion/extension, respectively). The root-mean-square differences between the IMU- and optical motion capture-based trunk angles were less than 5 degrees, and the similarity between the methods was on average across all trials “very good” to “excellent” (R ≥ 0.85; R2 ≥ 0.80). Across the dynamic sports motions, even higher measures of similarity were found (R ≥ 0.90; R2 ≥ 0.82). When aligned to the relevant segment, the current IMUs are a promising alternative to optical motion capture and previous presented IMU-based systems for the field-based measurement of the three-dimensional trunk orientation during dynamic sports motions and the anatomical trunk motions

A systematic review and meta-analysis of the protective effects of metformin in experimental myocardial infarction

Contains fulltext : 177026.pdf (publisher's version ) (Open Access)Metformin improves cardiovascular prognosis in patients with diabetes mellitus, compared to alternative glucose-lowering drugs, despite similar glycemic control. Direct cardiovascular protective properties have therefore been proposed, and studied in preclinical models of myocardial infarction. We now aim to critically assess the quality and outcome of these studies. We present a systematic review, quality assessment and meta-analysis of the effect of metformin in animal studies of experimental myocardial infarction. Through a comprehensive search in Pubmed and EMBASE, we identified 27 studies, 11 reporting on ex vivo experiments and 18 reporting on in vivo experiments. The primary endpoint infarct size as percentage of area at risk was significantly reduced by metformin in vivo (MD -18.11[-24.09,-12.14]) and ex vivo (MD -18.70[-25.39, -12.02]). Metformin improved the secondary endpoints left ventricular ejection fraction (LVEF) and left ventricular end systolic diameter. A borderline significant effect on mortality was observed, and there was no overall effect on cardiac hypertrophy. Subgroup analyses could be performed for comorbidity and timing of treatment (infarct size and mortality) and species and duration of ischemia (LVEF), but none of these variables accounted for significant amounts of heterogeneity. Reporting of possible sources of bias was extremely poor, including randomization (reported in 63%), blinding (33%), and sample size calculation (0%). As a result, risk of bias (assessed using SYRCLE's risk of bias tool) was unclear in the vast majority of studies. We conclude that metformin limits infarct-size and improves cardiac function in animal models of myocardial infarction, but our confidence in the evidence is lowered by the unclear risk of bias and residual unexplained heterogeneity. We recommend an adequately powered, high quality confirmatory animal study to precede a randomized controlled trial of acute administration of metformin in patients undergoing reperfusion for acute myocardial infarction

Muscle-level analysis of trunk mechanics via musculoskeletal modeling and high-density electromyograms

Back-support (BS) exoskeletons aim at preventing or minimizing low-back pain in workers within occupational environments. Currently, there is no consensus on the optimal controller for BS exoskeletons. We propose a controller based on electromyography (EMG)-informed musculoskeletal modeling that estimates back muscle-tendon forces and moments. In this study, we validate an EMG-driven trunk model to estimate flexion-extension moments at the lumbar L5/S1 joint, during symmetric lifting tasks. In a first experimental session, ground reaction forces, subject kinematics and bipolar EMG activity from abdominal and lumbar muscles were recorded to estimate L5/S1 moments using both, inverse dynamics (ID) and EMG-driven modeling approaches. One subject performed squatting and stooping lifting tasks with three weight conditions (0, 5 and 15 kg). Correlation coefficients, R2, between reference moments (from ID) and corresponding EMG-driven estimates ranged between 0.94 and 0.98, with root mean squared errors between 10.23 and 20.30 Nm. In a second experimental session,}4 high-density EMG (HDEMG) grids (256 channels) were used to generate high-fidelity topographical activation maps of thoracolumbar muscles during lifting tasks. These maps revealed that lifting objects using the squatting technique, underlay a shift of activation from caudal muscle trunk regions to cranial areas while lowering the weights. Muscle forces derived from EMG-driven modeling altogether with HDEMG activation maps are here proposed as a new framework to understand trunk neuromechanics during complex lifting tasks