Resilient Power Project Case Study: Sterling Municipal Light Department

Sterling Municipal Light Department (SMLD) is a municipal utility serving the small New England town of Sterling, Massachusetts, with 3,700 residential, commercial, municipal, and industrial customers. In 2013, with a total of 3.2 megawatts (MW) of solar PV installed, SMLD became the number one utilityin the country for solar watts per customer. Solar accounted for approximately 30 percent of SMLD's peak load. At this high level of penetration, the variable nature of solar generation bagan to cause problems. Additionally, the costs of capacity and transmission services, based on SMLD"s peak demand for power purchased from the grid operator, were rising dramatically. These costs increased from $500,000 in 2010 to$1.2 million in 2017. SMLD needed a new strategy to firm the output of its solar generation and control rising costs linked to the utility's share of regional demand peak.The town of Sterling was considering adding a natural gas peaker plant to avoid rising capacity costs at its Municipal Light Department. But this idea was abandoned when the option of energy storage presented itself in the form of a state grant program offered through the Massachusetts Department of Energy Resources (DOER), called the Community Clean Energy Resiliency Initiative (CCERI). The grant program, initiated after Superstorm Sandy devastated the Northeast,w as designed to support municipal resilient clean energy systems. The town had also been hit by an ice storm in 2008, which had left residents without power for up to 14 days; thus, reciliency had been a longtime conern for the town. Energy storage presented an attractive means to firm the town's solar resources, add reciliency for critical infrastructure, and control rising costs

Eating and drinking interventions for people at risk of lacking decision-making capacity: who decides and how?

Abstract Background Some people with progressive neurological diseases find they need additional support with eating and drinking at mealtimes, and may require artificial nutrition and hydration. Decisions concerning artificial nutrition and hydration at the end of life are ethically complex, particularly if the individual lacks decision-making capacity. Decisions may concern issues of life and death: weighing the potential for increasing morbidity and prolonging suffering, with potentially shortening life. When individuals lack decision-making capacity, the standard processes of obtaining informed consent for medical interventions are disrupted. Increasingly multi-professional groups are being utilised to make difficult ethical decisions within healthcare. This paper reports upon a service evaluation which examined decision-making within a UK hospital Feeding Issues Multi-Professional Team. Methods A three month observation of a hospital-based multi-professional team concerning feeding issues, and a one year examination of their records. The key research questions are: a) How are decisions made concerning artificial nutrition for individuals at risk of lacking decision-making capacity? b) What are the key decision-making factors that are balanced? c) Who is involved in the decision-making process? Results Decision-making was not a singular decision, but rather involved many different steps. Discussions involving relatives and other clinicians, often took place outside of meetings. Topics of discussion varied but the outcome relied upon balancing the information along four interdependent axes: (1) Risks, burdens and benefits; (2) Treatment goals; (3) Normative ethical values; (4) Interested parties. Conclusions Decision-making was a dynamic ongoing process with many people involved. The multiple points of decision-making, and the number of people involved with the decision-making process, mean the question of ‘who decides’ cannot be fully answered. There is a potential for anonymity of multiple decision-makers to arise. Decisions in real world clinical practice may not fit precisely into a model of decision-making. The findings from this service evaluation illustrate that within multi-professional team decision-making; decisions may contain elements of both substituted and supported decision-making, and may be better represented as existing upon a continuum

Genomic Imprinting Mediates Social Interactions Within Honeybee (Apis mellifera) Colonies.

Patient centeredness means providing care that is respectful of and responsive to individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions’.The concept assumes that both physicians and patients are experts; physicians in diagnostic and therapeutic procedures, patients by their personal experience. Van der Eijk examined how patient-centeredness could be defined, measured and improved in Parkinson care. Patients with Parkinson's disease(PD) become progressively disabled due to a mixture of cognitive, emotional and motor symptoms. Given the complex nature of the disease, delivering patient-centered care to PD patients is challenging. Preferably, Parkinson care is provided by a collaborative team of physicians, nurses, psychosocial caregivers and allied health experts. 'Patient-centeredness' implies that patients are invited to participate within this team. PD patients currently assume a passive role in healthcare, partially because this is the traditional approach, but also because they lack the tools to self-manage their condition. Van der Eijk found out that PD patients experience a lack of collaboration between their healthcare professionals. Additionally, patients urgently call for more and personally tailored information as well as emotional support to cope better with their disease. Van der Eijk collected patient-experiences in the Netherlands, Canada and the United States and evaluated regional multidisciplinary healthcare networks and online health communities. These innovations may improve the patient-centeredness of care and enhance communication among health professionals and patients, and support coordination of care across institutions. A personal health community is a private community governed by individual patients. Apart from the patient, participants include the caregiver and one or more (ideally all) health professionals involved. Patients favor the possibility to interact with their health professionals for emotional support and to obtain medical information. When technically well facilitated, the concept stimulates active patient involvement in their own health and healthcare

Oceanography of Cowichan Bay: A background view for early marine survival of Chinook and Coho salmon

Early Marine Survival (EMS) of Chinook and Coho salmon in the Salish Sea has plummeted over the past decades, and both bottom-up and top-down mechanisms for decline have been proposed. As a background for an ecosystem-based assessment of EMS, a pilot study on the basic oceanography of a small sub-component of the system was launched in spring and early summer, 2013. A repeat sampling grid covering Cowichan Bay and immediately connected waters was established, and then sampled on weekly intervals for temperature, salinity, chlorophyll fluorescence, nutrients and zooplankton. Oceanographic studies were carried out concurrently with fisheries assessments. A longer section was carried out at monthly intervals, with the purpose of connecting Cowichan Bay to the Strait of Georgia. This talk will present findings from this study, identify key shortcoming and suggest an approach to expand the pilot study to the scale of the Salish Sea

Rational vector design and multi-pathway modulation of HEK 293E cells yield recombinant antibody titers exceeding 1 g/l by transient transfection under serum-free conditions

Transient transfection allows for fast production of recombinant proteins. However, the current bottlenecks in transient transfection are low titers and low specific productivity compared to stable cell lines. Here, we report an improved transient transfection protocol that yields titers exceeding 1 g/l in HEK293E cells. This was achieved by combining a new highly efficient polyethyleneimine (PEI)-based transfection protocol, optimized gene expression vectors, use of cell cycle regulators p18 and p21, acidic Fibroblast Growth Factor, exposure of cells to valproic acid and consequently the maintenance of cells at high cell densities (4 million cells/ml). This protocol was reproducibly scaled-up to a working volume of 2 l, thus delivering >1 g of purified protein just 2 weeks after transfection. This is the fastest approach to gram quantities of protein ever reported from cultivated mammalian cells and could initiate, upon further scale-up, a paradigm shift in industrial production of such proteins for any application in biotechnology

Library preparation and MiSeq sequencing for the genotyping-by-sequencing of the Huntington disease HTT exon one trinucleotide repeat and the quantification of somatic mosaicism [Protocol]

Huntington disease (HD) is an autosomal dominant neurodegenerative disorder caused by the expansion of a CAG repeat in the first exon of the HTT gene. Affected individuals inherit more than 40 repeats and the CAG repeat is genetically unstable in both the germline and soma. Molecular diagnosis and genotyping of the CAG repeat is traditionally performed by estimation of PCR fragment size. However, this approach is complicated by the presence of an adjacent polymorphic CCG repeat and provides no information on the presence of variant repeats, flanking sequence variants or on the degree of somatic mosaicism. To overcome these limitations, we have developed an amplicon-sequencing protocol that allows the sequencing of hundreds of samples in a single MiSeq run. The composition of the HTT exon one trinucleotide repeat locus can be determined from the MiSeq sequencing reads generated. With sufficient sequencing depth, such MiSeq data can also be used to quantify the degree of somatic mosaicism of the HTT CAG repeat in the tissue analysed

One-year mortality of colorectal cancer patients: development and validation of a prediction model using linked national electronic data.

Funder: The National Bowel Cancer Audit is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme, and funded by NHS England and the Welsh Government (www.hqip.org.uk/national-programmes).BACKGROUND: The existing literature does not provide a prediction model for mortality of all colorectal cancer patients using contemporary national hospital data. We developed and validated such a model to predict colorectal cancer death within 90, 180 and 365 days after diagnosis. METHODS: Cohort study using linked national cancer and death records. The development population included 27,480 patients diagnosed in England in 2015. The test populations were diagnosed in England in 2016 (n = 26,411) and Wales in 2015-2016 (n = 3814). Predictors were age, gender, socioeconomic status, referral source, performance status, tumour site, TNM stage and treatment intent. Cox regression models were assessed using Brier scores, c-indices and calibration plots. RESULTS: In the development population, 7.4, 11.7 and 17.9% of patients died from colorectal cancer within 90, 180 and 365 days after diagnosis. T4 versus T1 tumour stage had the largest adjusted association with the outcome (HR 4.67; 95% CI: 3.59-6.09). C-indices were 0.873-0.890 (England) and 0.856-0.873 (Wales) in the test populations, indicating excellent separation of predicted risks by outcome status. Models were generally well calibrated. CONCLUSIONS: The model was valid for predicting short-term colorectal cancer mortality. It can provide personalised information to support clinical practice and research

Long-term ocean and resource dynamics in a hotspot of climate change

Unidad de excelencia María de Maeztu CEX2019-000940-MThe abundance, distribution, and size of marine species are linked to temperature and nutrient regimes and are profoundly affected by humans through exploitation and climate change. Yet little is known about long-term historical links between ocean environmental changes and resource abundance to provide context for current and potential future trends and inform conservation and management. We synthesize >4000 years of climate and marine ecosystem dynamics in a Northwest Atlantic region currently undergoing rapid changes, the Gulf of Maine and Scotian Shelf. This period spans the late Holocene cooling and recent warming and includes both Indigenous and European influence. We compare environmental records from instrumental, sedimentary, coral, and mollusk archives with ecological records from fossils, archaeological, historical, and modern data, and integrate future model projections of environmental and ecosystem changes. This multidisciplinary synthesis provides insight into multiple reference points and shifting baselines of environmental and ecosystem conditions, and projects a near-future departure from natural climate variability in 2028 for the Scotian Shelf and 2034 for the Gulf of Maine. Our work helps advancing integrative end-to-end modeling to improve the predictive capacity of ecosystem forecasts with climate change. Our results can be used to adjust marine conservation strategies and network planning and adapt ecosystem-based management with climate change