Expert survey and classification of tools for modeling and simulating hybrid energy networks

Sector coupling is expected to play a key role in the decarbonization of the energy system by enabling the integration of decentralized renewable energy sources and unlocking hitherto unused synergies between generation, storage and consumption. Within this context, a transition towards hybrid energy networks (HENs), which couple power, heating/cooling and gas grids, is a necessary requirement to implement sector coupling on a large scale. However, this transition poses practical challenges, because the traditional domain-specific approaches struggle to cover all aspects of HENs. Methods and tools for conceptualization, system planning and design as well as system operation support exist for all involved domains, but their adaption or extension beyond the domain they were originally intended for is still a matter of research and development. Therefore, this work presents innovative tools for modeling and simulating HENs. A categorization of these tools is performed based on a clustering of their most relevant features. It is shown that this categorization has a strong correlation with the results of an independently carried out expert review of potential application areas. This good agreement is a strong indicator that the proposed classification categories can successfully capture and characterize the most important features of tools for HENs. Furthermore, it allows to provide a guideline for early adopters to understand which tools and methods best fit the requirements of their specific applications

Development and evaluation of tools and an intervention to improve patient- and carer-centred outcomes in Longer-Term Stroke care and exploration of adjustment post stroke: the LoTS care research programme

Background: Evidence-based care pathways are required to support stroke patients and their carers in the longer term. Aims: The twofold aim of this programme of four interlinking projects was to enhance the care of stroke survivors and their carers in the first year after stroke and gain insights into the process of adjustment. Methods and results: We updated and further refined a purposely developed system of care (project 1) predicated on a patient-centred structured assessment designed to address areas of importance to patients and carers. The structured assessment is linked to evidence-based treatment algorithms, which we updated using a structured protocol: reviewing available guidelines, Cochrane reviews and randomised trials. A pragmatic cluster randomised controlled trial evaluation of the clinical effectiveness and cost-effectiveness of this system of care was undertaken in 29 community-based UK stroke care co-ordinator services (project 2). In total, 15 services provided the system of care and 14 continued with usual practice. The primary objective was to determine whether the intervention improved patient psychological outcomes (General Health Questionnaire-12) at 6 months; secondary objectives included functional outcomes for patients, outcomes for carers and cost-effectiveness, as measured through self-completed postal questionnaires at 6 and 12 months. A total of 800 patients and 208 carers were recruited; numbers of participants and their baseline characteristics were well balanced between intervention and control services. There was no evidence of statistically significant differences in primary or secondary end points or adverse events between the two groups, nor evidence of cost-effectiveness. Intervention compliance was high, indicating that this is an appropriate approach to implement evidence into clinical practice. A 22-item Longer-term Unmet Needs after Stroke (LUNS) questionnaire was developed and robustly tested (project 3). A pack including the LUNS questionnaire and outcome assessments of mood and social activity was posted to participants 3 or 6 months after stroke to assess acceptability and validity. The LUNS questionnaire was re-sent 1 week after return of the first pack to assess test–retest reliability. In total, 850 patients were recruited and the acceptability, validity and test–retest reliability of the LUNS questionnaire as a screening tool for post-stroke unmet need were confirmed. This tool is now available for clinical use. An in-depth qualitative investigation was undertaken with 22 patients (and carers) at least 1 year after stroke (project 4) to gain further insights into the experience of adjustment. This included initial semistructured interviews, limited observations and solicited diaries with a follow-up interview 3–4 months after the initial interview and highlighted a range of different trajectories for post-stroke recovery. Conclusions: The programme has been completed as planned, including one of the largest ever stroke rehabilitation trials. This work highlights that successfully addressing the needs of a heterogeneous post-stroke population remains problematic. Future work could explore stratifying patients and targeting services towards patients (and carers) with specific needs, leading to a more specialised bespoke service. The newly developed LUNS questionnaire and the qualitative work will help inform such services

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Cues adopted by consumers in examining corporate website favorability: an empirical study of financial institutions in the UK and Russia

The purpose of this paper is to explore, reconcile and depict corporate website favorability (CWF), its antecedents and consequences in the financial setting in the UK and Russia context. To achieve the goals of this study, the research adopted a mixed method research design by using a survey, which is supported by insights from in-depth interviews and focus group discussions. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and Structural equation modeling (SEM) were applied to gain insight into the various influences and relationships. The paper develops and empirically validates the framework of CWF antecedents and consequences. The paper indicates essential guidance for cross-functional managers and designers regarding the integrated and holistic utilization of building favorable corporate websites as part of the corporate identity management. The paper adds to the understanding of CWF and discusses the antecedents of CWF by drawing upon the existing literature. Furthermore, it offers possible consequences of CWF and provides a framework for future testing