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Knee adduction moment (KAM) is correlated with the progression of medial knee osteoarthritis (OA). Although a generic gait modification can reduce the KAM in some patients, it may have a reverse effect on other patients. We proposed the “decomposed ground reaction vector” (dGRV) model to 1) distinguish between the components of the KAM and their contribution to the first and second peaks and KAM impulse and 2) examine how medial knee OA, gait speed, and a brace influence these components. Using inverse dynamics as the reference, we calculated the KAM of 12 healthy participants and 12 patients with varus deformity and medial knee OA walking with/without a brace and at three speeds. The dGRV model divided the KAM into four components defined by the ground reaction force (GRF) and associated lever arms described with biomechanical factors related to gait modifications. The dGRV model predicted the KAM profile with a coefficient of multiple correlations of 0.98 ± 0.01. The main cause of increased KAM in the medial knee OA group, the second component (generated by the vertical GRF and mediolateral distance between the knee and ankle joint centers), was decreased by the brace in the healthy group. The first peak increased, and KAM impulse decreased with increasing velocity in both groups, while no significant change was observed in the second peak. The four-component dGRV model successfully estimated the KAM in all tested conditions. It explains why similar gait modifications produce different KAM reductions in subjects. Thus, more personalized gait rehabilitation, targeting elevated components, can be considered. more...

Stress has a negative impact on humans. Avoiding this impact requires good stress management, one of which is through reminiscence therapy. This therapy is an activity to reminisce about happy events in the past, which can be a coping mechanism to deal with stress. This research aims to determine the effect of reminiscence therapy on reducing stress levels in the elderly. This type of research uses a pre-experimental design with pre-test and post-test designs against one group. The place of research is at the Assalam nursing home for the elderly, Cirebon, Indonesia, in 2020. Sampling using a total sample of 20 respondents. The instrument used was a stress questionnaire (DASS). We collected data by interviewing and filling out a stress questionnaire. The technique of data analysis using T-test. This study's results indicate a significant effect of applying reminiscence therapy on stress levels in the elderly. The results of this study suggest that reminiscence therapy should be done frequently in nursing homes to reflect on feelings daily and reduce stress in the elderly. more...

Observational studies report a reduction of COPD exacerbations in patients treated with β-blockers. In contrast, the Beta-Blockers for the Prevention of Acute Exacerbations of Chronic Obstructive Pulmonary Disease (BLOCK COPD) randomised controlled trial which excluded COPD patients with cardiovascular conditions showed an increase in COPD exacerbations. It is unclear whether this discrepancy could be explained by underlying cardiovascular comorbidity. We examined whether the association between use of β-blockers and risk of COPD exacerbations differed between patients with and without a cardiovascular indication for β-blockers use. Within the Rotterdam Study, we followed COPD subjects until the first COPD exacerbation, or end of follow-up. Cardiovascular indication for β-blockers use was defined as a history of hypertension, coronary heart disease, atrial fibrillation and/or heart failure at baseline. The association between β-blockers use and COPD exacerbations was assessed using Cox proportional hazards models adjusted for age, sex, smoking, incident cardiovascular disease (i.e. heart failure, hypertension, atrial fibrillation and/or coronary heart disease during follow-up), respiratory drugs and nitrates. In total, 1312 COPD patients with a mean age of 69.7±9.2 years were included. In patients with a cardiovascular indication (n=755, mean age of 70.4±8.8 years), current use of cardioselective β-blockers was significantly associated with a reduced risk of COPD exacerbations (HR 0.69, 95% CI 0.57–0.85). In contrast, in subjects without a cardiovascular indication (n=557, mean age of 68.8±9.7 years), current use of cardioselective β-blockers was not associated with an altered risk of COPD exacerbations (HR 0.94, 95% CI 0.55–1.62). Use of cardioselective β-blockers reduced the risk of exacerbations in COPD patients with concomitant cardiovascular disease. Therefore, the potential benefits of β-blockers might be confined to COPD patients with cardiovascular disease., Use of cardioselective β-blockers reduces the risk of COPD exacerbations in patients with concomitant cardiovascular disease. The potential benefits of β-blockers might be restricted to COPD patients with cardiovascular disease. https://bit.ly/3bB1RGg more...

Objectives: To determine the prevalence of Potentially Inappropriate Medication (PIMs) and Potentially Omitted Medication (POMs) in older patients with cancer.Materials and Methods: In this prospective observational study (hospital) pharmacists conducted comprehensive medication reviews in older patients with cancer (aged >= 65 years) receiving parenteral chemotherapy and/or immunotherapy at the Deventer Hospital. PIMs and POMs were identified using the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP), the Screening Tool to Alert doctors to the Right Treatment (START), and pharmacists' expert opinion. Recommendations regarding PIMs and POMs were communicated to the patient's oncologist/haematologist and follow-up was measured. Associations between covariates and the prevalence of PIMs and POMs were statistically analysed.Results: For the 150 patients included, 180 PIMs and 86 POMs were identified with a prevalence of 78%. Using pharmacists' expert opinion in addition to only STOPP/START criteria contributed to 49% of the PIMs and 23% of the POMs. A follow-up action was required in 73% of the 266 PIMs and POMs. Number of medicines and Charlson Comorbidity Index score were both associated with having at least one PIM and/or POM (p = .031 and p = .016, respectively).Conclusion: The prevalence of PIMs and POMs and subsequent follow-up in older patients with cancer is high. A pharmacist-led comprehensive medication review is a good instrument to identify these PIMs and POMs and to optimize patients' treatment. A complete approach, including pharmacists' expert opinion, is recommended to identify all PIMs and POMs in clinical practice. (C) 2020 The Authors. Published by Elsevier Ltd. more...

Circular Economy (CE) has become one of the most recent ways to address environmental sustainability. CE activities focus exclusively on one of three levels (macro-level, meso-level, and micro-level). The majority of CE research has focused on the macro- and meso-levels, while research on the micro-level has been limited. This paper focusses on the latter by analysing how organisations have implemented the four Rs (reduction, repairing, remanufacturing, and recycling). A survey was sent to a database of 5,299 contacts from different organisations, from whom 256 complete responses were obtained. The results show that organisations focus on reducing and recycling more than repairing and remanufacturing, and in particular on internal CE efforts. Some organisations that engage with the 4Rs do not do it under the CE umbrella, whereas some that claim to apply CE have low levels of engagement with the 4Rs. The results indicate that organisations are using the four Rs to contribute to CE, but not all of them are aware that they are applying CE principles. The paper highlights that organisations need to improve their four Rs efforts to contribute more to CE by better linking its theory with practice. CE also has to be implemented outside the organisations, in a more holistic way, e.g. through better collaboration with stakeholders on CE efforts and activities. This research stresses that the gap between CE theory and practice needs to be closed to make Circular Economy circular. more...

This observational study assessed trends in abdominal aortic aneurysm (AAA) death rates in European Union (EU) 15+ countries for the years 1990 to 2017.Age-standardized death rates (ASDRs) were extracted from the Global Burden of Disease Study Global Health Data Exchange. Trends were analysed using joinpoint regression analysis.Between 1990 and 2017, ASDRs from AAA decreased in all 19 EU15+ countries for women, and in 18 of 19 countries for men. Increasing AAA mortality was observed only for men in Greece (+5·3 per cent). The largest relative decreases in ASDR between 1990 and 2017 were observed in Australia (men -65·6 per cent, women -50·4 per cent) and Canada (men -60·8 per cent, women -48·6 per cent). Over the 28-year interval, the smallest decreases in ASDR for women were noted in Greece (-2·3 per cent) and in Italy (-2·5 per cent). In 2017, the highest mortality rates were observed in the UK for both men and women (7·5 per 100 000 and 3·7 per 100 000 respectively). The lowest ASDR was observed in Portugal for men (2·8 per 100 000) and in Spain for women (1·0 per 100 000). ASDRs for AAA in 2017 were higher for men than women in all 19 EU15+ countries. The most recent trends demonstrated increasing AAA ASDRs in 14 of 19 countries for both sexes; the increases were relatively small compared with the improvements in the preceding years.This observational study identified decreasing mortality from AAA across EU15+ countries since 1990. The most recent trends demonstrated relatively small increases in AAA mortality across the majority of EU15+ countries since 2012.Este estudio observacional evalúa las tendencias en las tasas de mortalidad del aneurisma de aorta abdominal (abdominal aortic aneurysm, AAA) en los 19 países integrantes del acrónimo conocido como EU15+ en los aóos 1990-2017. MÉTODOS: Se obtuvieron las tasas de mortalidad estandarizadas por la edad del Global Burden of Disease Study Global Health Data Exchange. Las tendencias se analizaron utilizando el análisis de regresión por puntos de inflexión (joinpoint).Entre 1990 y 2017, las tasas de muerte estandarizadas por edad (age-standardized death rates, ASDR) del AAA disminuyeron en todos los 19 EU15+ países para las mujeres, y en 18 de los 19 países para los varones. Solamente se observó un incremento de la mortalidad del AAA para los varones en Grecia (+5,3%). El mayor descenso relativo de ASDR entre 1990-2017 se observó en Australia (varones -65,6%, mujeres -50,4%) y Canadá (varones -60,8%, mujeres -48,6%). A lo largo del periodo de 28 aóos, en el caso de las mujeres, los menores descensos en ASDR se observaron en Grecia (-2,3%) y en Italia (-2,5%). En 2017, las tasas de mortalidad más elevadas se observaron en el Reino Unido tanto para varones como para mujeres (7,5/100.000 y 3,7/100.000 para varones y mujeres, respectivamente). La ASDR más baja se observó en Portugal para varones (2,8/100.000) y Espaóa para mujeres (1,0/100.000). Las ASDRs para AAA en 2017 fueron más altas para varones que para mujeres en todos los 19 países EU15+. Las tendencias más recientes demostraron aumentos de las ASDRs por AAA en 14 de 19 países para varones y mujeres; los aumentos fueron relativamente pequeóos cuando se compararon con las mejorías observadas dentro de los aóos precedentes. CONCLUSIÓN: En este estudio observacional de los países EU15+, se ha identificado una disminución en la mortalidad de los AAA entre los países integrantes de EU15+ desde 1990. Las tendencias más recientes demuestran aumentos relativamente pequeóos de la mortalidad del AAA en la mayoría de los países EU15+ desde 2012. more...

Máster en Ingeniería Química

Using insoles to modify walking biomechanics is of keen interest for the treatment of medial-compartment knee osteoarthritis. So far, insole interventions have focused on reducing the peak of the knee adduction moment (pKAM) and have led to inconsistent clinical outcomes. This study aimed to evaluate the changes in other gait variables related to knee osteoarthritis when patients walk with different insoles to provide insights into the necessity to enlarge the biomechanical analyses to other variables. Walking trials were recorded for 10 patients in four insole conditions. Changes among conditions were computed for six gait variables, including the pKAM. The associations between the changes in pKAM and the changes in the other variables were also assessed individually. Walking with different insoles had noticeable effects on the six gait variables, with high heterogeneity among patients. For all variables, at least 36.67% of the changes were of medium-to-large effect size. The associations with the changes in pKAM varied among variables and patients. In conclusion, this study showed that varying the insole could globally influence ambulatory biomechanics and that limiting measurement to the pKAM could lead to an important loss of information. Beyond the consideration of additional gait variables, this study also encourages personalized interventions to address inter-patient variability. more...

BackgroundLow-value care provides minimal or no benefit for the patient, wastes resources, and can cause harm. Explicit do-not-do recommendations in clinical guidelines are a first step in reducing low-value care. The aim of this study was to identify and prioritize do-not-do recommendations in general practice guidelines with priority for implementation.MethodsWe used a mixed method design in Dutch primary care. First, we identified do-not-do recommendations through a systematic assessment of 92 Dutch guidelines for general practitioners (GPs), resulting in 385 do-not-do recommendations. Second, we selected 146 recommendations addressing high prevalent conditions. Third, a random sample of 5000 Dutch GPs was invited for an online survey to prioritize recommendations based on the prevalence of the condition and low-value care practice, potential harm, and potential cost reduction on a scale from 1 to 5/6. Total scores could range from 4 to 22. Recommendations with a median score > 12 were included. In total, 440 GPs completed the survey.ResultsThe selection process led to 30 prioritised recommendations. These covered drug treatments (n = 12), diagnostics (n = 10), referral to other healthcare professions (n = 5), and non-drug treatment (n = 3).ConclusionDutch clinical guidelines include many do-not-do recommendations that are perceived as highly relevant by the GPs. The list of 30 high-priority do-not-do recommendations can be used to raise awareness of low-value care among GPs. As the recommendations are supported with the latest evidence from international studies, primary healthcare professionals and policy makers worldwide can use the list for further validating the list in their local context and designing strategies to reduce low-value care. more...

El aumento de las actividades de construcción en el AMB en los últimos años ha llevado al incremento de los residuos de construcción y demolición (RCD). Estos residuos no han tenido un manejo adecuado y el aprovechamiento de estos es nulo, por ende, existe un gran desafío por la adopción de la economía circular en la gestión de los RCD. El objetivo de este trabajo era realizar un análisis a la gestión de los RCD en el AMB a través del principio de las 3R (Reducir, Reutilizar, Reciclar), todo ello, mediante una revisión exhaustiva de las políticas y reglamentos existentes. Los resultados arrojaron que para reducir los RCD el principal obstáculo es la falta de educación, capacitación y socialización a los que son generadores de RCD. Para la reutilización es la falta de separación de residuos en la fuente y, para el reciclaje es que no se evidencian las distintas alternativas para los materiales reciclados. Además, se realizan propuestas para mejorar esta situación basadas también en el principio de las 3R. The increase in construction activities in the AMB in recent years has led to an increase in construction and demolition waste (CDW). These wastes have not been adequately managed and the use of these wastes is null, therefore, there is a great challenge for the adoption of the circular economy in the management of CDW. The objective of this work was to analyze the management of CDW in the AMB through the principle of the 3Rs (Reduce, Reuse, Recycle), by means of an exhaustive review of existing policies and regulations. The results show that the main obstacle to reducing CDW is the lack of education, training and socialization of CDW generators. For reuse it is the lack of separation of waste at the source and for recycling, it is that the different alternatives for recycled materials are not evident. Alternatives are proposed to improve this situation based also on the 3R principle. Ingeniero Civil http://www.ustabuca.edu.co/ustabmanga/presentacion Pregrado more...

Background & Aims of the Study: Solid waste management is one of the most daunting environmental challenges. The present study aimed to investigate the awareness and practice of people about household waste management in Kermanshah, Iran. Materials and Methods: This cross-sectional descriptive-analytical study was carried out on 150 Kermanshah citizens in 2017. Cluster sampling was performed and the data were collected using a researcher-made questionnaire, including awareness, practice, and resources of education for waste management. Finally, the data were analyzed in SPSS software (version18) using ANOVA and t-test at α = 0.05. Results: Citizens' awareness of waste-related diseases and the impact of waste on the environment, the benefits of recycling and reduction in origin were assessed as moderate up to favorable. Nonetheless, the public's performance in relation to the Recycling Agency and the municipality was not favorable. Citizens demonstrated poor practice in terms of household waste management. Conclusion: From the results of the present study, it can be concluded that conducting training courses, increasing the level of general knowledge and culture in the field of household waste management can improve public awareness and practice. more...

The typical voyage of a barge transporting maritime containers inland, consists of visiting a set of terminals where loading/unloading operations occur. The required stowage plans must meet stability requirements during all transport phases and avoid costly re-handling operations. In this paper, we formalize this problem and consider a typical dry-port transport system. We propose a comprehensive mathematical model that seeks to maximize stowed containers. To solve it, we develop a hybrid metaheuristic approach, based on local search and an industrial solver. Numerical experiments, based on real-world data, provide insights into the performances of the proposed framework and current stowage practices. more...

CV C-Maxi Alloycast is an industry engaged in the manufacture of household appliances (pans) made of aluminum which is located in Yogyakarta. The aim of the study was to identify the potential application of clean production principles in CV C-Maxi Alloycast. The methods used were production process mapping, waste analysis through liquid waste testing and potential analysis of clean production principles. The results obtained for the production process were smelting aluminum and scrap, pouring molten metal into molds, lifting molds and providing coolant, lifting castings, turning, filing, quality control, storage and distribution. Based on the laboratory test, the characteristics of the liquid waste produced by the CV C-Maxi Alloycast were pH 8.9; COD 52.1 mg/L; BOD 21.4 mg/L; TSS 6660 mg/L; Fe 4,2440 mg/L; Cu 0.0130 mg/L; and Zn 0.0893 mg/L. All parameters indicate that the value meets the quality standard, but the TSS content did not meet the NAB (Threshold Value) which refers to the Regulation of the Minister of the Environment of the Republic of Indonesia No. 5 of 2014 and the Regulation of the Special Region of Yogyakarta (DIY) No. 7 of 2016. Clean production opportunities were: good housekeeping, application of 3R (Reduce, Reuse, Recycle) on solid waste, construction of B3 Waste TPS and capacity building of human resources. Environmental performance had increased based on the Green Industry Standard (SIH) from level 1 to level 2 with a value of 53% to 65% with the implementation of clean production. The economic performance of implementing clean production gains a profit of Rp. 77,412,000,-/year, then the second alternative, namely recycling aluminum scrap is an economical alternative to clean technology with a 5-year NPV value of Rp. 37,853,056,558,- Implementing clean production can have a positive impact on the environment and the economy. more...

The breaching of planetary boundaries and excessive extraction of natural resources requires a revisited approach to consumption and production. The concept of sufficiency, which advocates meeting human needs within the planetary limits by curbing excessive consumption levels, is gaining increasing attention. Businesses are drivers of consumption, yet they have been largely overlooked as potential leaders towards a sufficiency-based economy and research on businesses driving sustainable consumption strategically is still a niche. The methods applied here are a literature and practice review and interviews to understand the state-of-the-art in sufficiency-orientated business strategies and develop a framework for future research and practice. Merging English- and German-language research, a base matrix of the waste hierarchy and the four lessens is presented. This matrix is populated with business sufficiency strategies, condensing existing work and creating the ‘Business for Sufficiency’ (BfS) framework. Empirical research with businesses already employing sufficiency strategies refines and validates the framework and sheds light on the viability, desirability, feasibility and sustainability of such offers, highlighting barriers and opportunities. The most prevalent strategies fall into the Rethink framework dimension which require the least radical changes. In addition, interviewees highlighted obstacles in reconciling more radical strategies such as Moderating sales with their financial sustainability. Yet, all interviewees stressed the need for reduced consumption and the role that business should play in enabling sufficiency, demonstrating the relevance of this topic for future research and practice. more...

Earned value management (EVM) and earned duration management (EDM) are established methodologies to monitor the project performance during execution. These methods serve as a basis to forec...

Nearly 460 million individuals are affected by sensorineural hearing loss (SNHL), one of the most common human sensory disorders. In mammals, hearing loss is permanent due to the lack of efficient regenerative capacity of the sensory epithelia and spiral ganglion neurons (SGN). Sphere-forming progenitor cells can be isolated from the mammalian inner ear and give rise to inner ear specific cell types in vitro. However, the self-renewing capacities of auditory progenitor cells from the sensory and neuronal compartment are limited to few passages, even after adding powerful growth factor cocktails. Here, we provide phenotypical and functional characterization of a new pool of auditory progenitors as sustainable source for sphere-derived auditory neurons. The so-called phoenix auditory neuroprogenitors, isolated from the A/J mouse spiral ganglion, exhibit robust intrinsic self-renewal properties beyond 40 passages. At any passage or freezing–thawing cycle, phoenix spheres can be efficiently differentiated into mature spiral ganglion cells by withdrawing growth factors. The differentiated cells express both neuronal and glial cell phenotypic markers and exhibit similar functional properties as mouse spiral ganglion primary explants and human sphere-derived spiral ganglion cells. In contrast to other rodent models aiming at sustained production of auditory neurons, no genetic transformation of the progenitors is needed. Phoenix spheres therefore represent an interesting starting point to further investigate self-renewal in the mammalian inner ear, which is still far from any clinical application. In the meantime, phoenix spheres already offer an unlimited source of mammalian auditory neurons for high-throughput screens while substantially reducing the numbers of animals needed. more...

Transition toward circular-economy model is a must to sustain the planet resources. Under circular economy model wastewater is transformed from a waste into a resource. Therefore, a comprehensive circular economy index; the Circonomics Index, is proposed to measure circularity of wastewater industry. The component indicators of the index are linked directly to the three Rs; reduce, reuse and recycle, of circular economy. The novelty of the proposed Index is that it uses objectively constructed weights that reflect the environmental benefits of the treatment process, and the index captures the reuse and recycling efficiency of an WWTP, which reflect the specific nature of wastewater. The findings show that treatment technology is a major factor in determining the production efficiency, reuse rate and recycling performance of a WWTP. The results of using the Circonomics Index have profound implication for policy makers to speed up the process of moving to a circular economy. more...

In order for land managers and policy makers to manage excessive soil phosphorus (P) concentrations and reduce the risk of this particular source of P from impacting water bodies, models of soil P decline under various scenarios are needed. We modelled the decrease in calcium chloride-extractable P (CaCl2-P), and sodium bicarbonate-extractable P (Olsen-P and Colwell-P) using data from six Australian grazed pasture soils with contrasting P sorption properties, over a period of 4.5 years. Each soil had four initial soil P concentrations (Pinit), each of which received four on-going rates of P fertiliser (Pfert). The model predicts the final P concentration (Pfinal) by taking into account the P concentration previously measured (CaCl2-P, Olsen-P or Colwell-P), Pfert applied since measurement, and time since previous measurement: Final P concentration = (previously measured P concentration + ep x P fertiliser applied) exp (-dp x years since previous P concentration measurement). Where ep is the increase in soil P for each unit of applied P and dp is the decay constant representing how quickly the soil P decreased. The greatest decreases in proportion to Pinit occurred for CaCl2-P, followed by Olsen-P, and then Colwell-P. The model tended to fit the dataset well for Olsen-P and Colwell-P, with mean overestimation (modelled Pfinal concentration greater than actual Pfinal) of the Pfinal concentrations of 6.1 (32%) and 4.3 mg/kg (10%), respectively. Although there was less CaCl2-P data, the model successfully described it, with a mean overestimation of Pfinal CaCl2 of 3.1 mg/kg (26%). The overestimation of Pfinal CaCl2 was possibly due to the high CaCl2-P concentrations of the low P buffering index soils. The model predicted an average of 32 years (ranging from 26 to 49 years) for Olsen-P concentrations of between 55 and 96 mg/kg to decrease to an agronomic optimum of 17 mg/kg. Agronomic optimum was not a reliable indicator of environmental risk as some soils did not exceed the CaCl2-P environmental threshold until Olsen-P concentrations were twice the agronomic optimum, whereas low P sorbing soils tended to exceed the threshold before reaching agronomic optimum. Further work with more soils is required to examine the influence of soil properties – such as P sorption – on decreases in soil P. more...

Kristiina Rönö,1 Beata Stach-Lempinen,2 Johan Gunnar Eriksson,3,4 Maritta Pöyhönen-Alho,1 Miira Marjuska Klemetti,1,2,5 Risto Paavo Roine,6,7 Emilia Huvinen,1 Sture Andersson,8 Hannele Laivuori,6,9–11 Anita Valkama,3,4 Jelena Meinilä,3,4 Hannu Kautiainen,3,12 Aila Tiitinen,1 Saila Birgitta Koivusalo1 1Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Women’s Hospital, Helsinki, Finland; 2Department of Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland; 3Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 4Public Health Research Program, Folkhälsan Research Center, Helsinki, Finland; 5Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 6Department of Health and Social Management, Research Centre for Comparative Effectiveness and Patient Safety, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland; 7Group Administration, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 8University of Helsinki and Helsinki University Hospital, Children’s Hospital, Pediatric Research Center, Helsinki, Finland; 9Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland; 10Department of Obstetrics and Gynecology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland; 11Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland; 12Department of General Practice and Primary Health Care, University of Eastern Finland, Kuopio, Finland Purpose: Lifestyle intervention studies performed during pregnancy have shown inconsistent results in relation to prevention of gestational diabetes mellitus (GDM). Therefore, the aim of this study was to assess the effect of an intervention initiated already before pregnancy in prevention of GDM in high-risk women.Patients and methods: A randomized controlled trial was conducted in four Finnish maternity hospitals between the years 2008 and 2014. Altogether 228 high-risk women planning pregnancy were randomized to an intervention (n=116) or a control group (n=112). The risk factors were body mass index ≥30kg/m2 (n=46), prior GDM (n=120), or both (n=62), without manifest diabetes at study inclusion. Trained study nurses provided individualized lifestyle counseling every 3months in addition to a group session with a dietician. The control group received standard antenatal care. GDM was defined as one or more pathological glucose values in a 75g 2-hour oral glucose tolerance test, performed between 12 and 16weeks of gestation and if normal repeated between 24 and 28weeks of gestation.Results: Within 12months, 67% of the women (n=72) in the intervention group and 63% of the women (n=71) in the control group (p=0.84) became pregnant. The cumulative incidence of GDM among the women available for the final analyses was 60% (n=39/65) in the intervention group and 54% (n=34/63) in the control group (p=0.49). GDM was diagnosed already before 20weeks of gestation in 60% (n=44/73) of the cases.Conclusion: The preconceptional lifestyle intervention applied in the present study did not reduce the incidence of GDM. Keywords: preconception, pregnancy, obesity, nutrition, physical activity more...

In the context of globalization, with a rapid drop in natural resources and an increase in the amount of waste an effective tool for boosting business competitiveness is the bioeconomy. The purpose of the article is to review the standpoint of scientists and different institutions towards the concept of bioeconomy and evaluate the use of circular economy in industry. The study proposed a production logistics model that is based on the use of the circular economy and the 3Rs principle. Based on the results of the research, the potential benefits of using the circular economy have been identified, which will encourage resource conservation and waste reduction. Santrauka Globalizacijos kontekste sparčiai senkant gamtiniams ištekliams ir didėjant atliekų kiekiui, efektyvi priemonė verslo konkurencingumui didinti yra bioekonomika. Straipsnio tikslas– apžvelgti mokslininkų ir skirtingų institucijų požiūrį į bioekonomikos sampratą ir įvertinti žiedinės ekonomikos naudojimą pramonėje. Tyrimo metu buvo pasiūlytas gamybos logistikos modelis, grindžiamas žiedinės ekonomikos ir 3Rs principo taikymu. Remiantis tyrimų rezultatais buvo nustatyti žiedinės ekonomikos naudojimo pranašumai, kurie skatins tausoti išteklius ir mažinti atliekas. Reikšminiai žodžiai:gamybos logistika, žiedinė ekonomika, bioekonomika, 3Rs, sumažinimas, pakartotinas naudojimas, perdirbimas, baltoji biotechnologija. &nbsp more...

School Safety Zone (ZoSS) is a road area in front of school where vehicles must reduce speed in time basis. The purpose of SSZ is to ensure students safety during school hours, especially when school started and ended. Kota Langsa is one district in Aceh Province where applied city administrative sistem since 2001. It is developing in every sector, including transportation infrastructure. However, the ZoSS is not applied optimally thus, this zone is not well known to the public. This paper aims to study whether the zone will change the street users’ behavior and vehicles reduce speed when going through the school zone. The research uses Z-score testing method from norm standard distribution for ZoSS application requirements. The test is done in 8 (eight) roads in front school yard with no school zone facilities. Furthermore, one school is selected to develop minimum ZoSS facilities. The evaluation of the street users from both conditions (with and without ZoSS) shows changing from unsafe to safety. That means the ZoSS gives a positive changes to the street users behavior. Keywords : Behavior, Safety, School, Speed, Street Users, Reduce Abstrak : Zona Selamat Sekolah (ZoSS) adalah ruas jalan di depan sekolah yang mengatur kendaraan yang melewatinya harus mengurangi kecepatan berbasis waktu, dan kemudian peraturan itu enjadi aturan etika bagi pengguna jalan. Namun demikian, masih banyak pengendara yang tidak memahami etika tersebut. Kota Langsa adalah salah satu Kota di Provinsi Aceh yang menerapkan sistem Kota Administrasi sejak tahun 2001. Kota ini terus berkembang di berbagai sektor, termasuk dalam pembangunan infrastruktur transportasinya. Akan tetapi ZoSS masih belum diaplikasikan secara optimal sehingga tidak terlalu dikenal oleh masyarakat. Artikel ini bertujuan untuk mempelajari apakah jika ZoSS diterapkan di Kota Langsa ini akan merubah perilaku pengendara yang lewat di depan sekolah dengan mengurangi kecepatan kendaraannya atau tidak. Penelitian ini menggunakan metode uji Z-Score pada standar distribusi normal untuk kebutuhan ZoSS. Uji Z ini dilakukan di 8 wilayah sekolah yang belum terdapat fasilitas ZoSS. Selanjutnya pada salah satu sekolah dilakukan eksperimen dengan membangun fasilitas minimum sementara. Hasil dari evaluasi menunjukkan perubahan perilaku pengguna jalan dari belum selamat menjadi selamat. Artinya fasilitas ZoSS memberikan pengaruh positive terhadap perilaku pengguna jalan. Kata kunci : Perilaku, Pengguna jalan, Selamat, Sekolah, Pengurangan, Kecepatan. more...

Approximately one out of two cancer patients should receive radiotherapy at least once in the course of their disease in Europe [1] and elsewhere [2]. Particle therapy is an expensive anti-cancer t... more...

A paradigm shift from a linear economy to a circular economy is crucial to reduce pressure on the environment and to improve the security of supply of primary raw materials. Under this new paradigm, governed by the imperatives of “reduce, reuse, and recycle”, the extraction of primary resources is minimised by extending the useful life of existing resources and materials. This paper seeks to identify the drivers and barriers of this circularisation and provide guidance for effective policies to hasten the transition to it. The innovative contribution made by this paper to this area of research is the empirical evidence it provides on the role played by economic, social, and environmental factors in the transition to a circular economy. To achieve this, yearly data from 2010 to 2019, for a panel of 19 European Union countries were analysed employing a Panel-Corrected Standard Errors estimator, which was shown to be an appropriate estimator for the data's characteristics. The circular material use rate was used as a proxy for the circular economy. The main findings suggest that the age distribution of a country is a significant predictor of a circular economy. Older people tend to be reluctant to change their behaviour, while young people are more inclined to move away from the so-called ‘take-make-waste’ extractive industrial model. Policies directed to older people to sensibilize them on the benefits and importance of a circular economy are thus required. When per capita income increases, the propensity to accept products containing recycled materials decreases. This finding merits the particular attention of policymakers. In turn, income inequality makes moving toward a circular economy more difficult. Those in the middle-income bracket are more likely to exhibit green behaviour, which implies that they are more aware of environmental issues. more...

Waste management conserves human health, ownership, environment, and keeps valuable natural resources. Lean-green waste of an organization’s operations can be decreased through implementation 3R (Reduce, Reuse, and Recycling) techniques by reduction of manufacturing system wastes. This research aims to integrate lean-green waste of the manufacturing system throughout employing 3R techniques and weighted properties method in order to manage waste. Al-Kufa cement plant is employed as a case study. Results are generated using Edraw Max Version 7 and Excel. Overall results show reduce technique of lean-green waste management has major contribution of 55 % and recycling technique has minor contribution 18 %. Defects waste has major integration of lean-green waste, while air emissions waste has minor integration of lean-green waste. more...

Gait retraining is gaining in interest to reduce loading associated to knee osteoarthritis (OA) progression. So far, interventions focused on reducing the peak knee adduction moment (pKAM) and it remains unclear if this can be done individually without increasing the peak knee flexion moment (pKFM). Additionally, while modifying foot progression angle (FPA) and step width (SW) is common, little is known about modifications in stride length (SL). This study aimed at characterizing the feasibility of a dual kinetic change, consisting in reducing the pKAM by at least 10% without increasing the pKFM. It also aimed to evaluate the added value of SL modifications in achieving the dual kinetic change. Gait trials with modifications in FPA, SW and SL were recorded for 11 young healthy subjects in a laboratory equipped with an augmented-reality system displaying instruction footprints on the floor. All participants achieved the dual kinetic change with at least one of the modifications. Seven participants achieved it with FPA modification, three with SW modification, and seven with SL modification. In conclusion, this study showed that it is feasible to achieve the dual kinetic change individually through subject-specific modifications in footprint parameters, suggesting that, in the future, gait retraining could aim for more specific kinetic changes than simply pKAM reductions. Modifying SL allowed achieving the dual kinetic change, stressing out the value of this parameter for gait retraining, in addition to FPA and SW. Finally, an augmented-reality approach was introduced to help footprint parameter modifications in the framework of knee OA. (C) 2020 The Author(s). Published by Elsevier Ltd. more...

Background Anastomotic leakage (AL) is still a common and feared complication after low anterior resection (LAR) for rectal cancer. The multifactorial pathophysiology of AL and lack of standardised treatment options requires a multi-modal approach to improve long-term anastomotic integrity. The objective of the IMARI-trial is to determine whether the one-year anastomotic integrity rate in patients undergoing LAR for rectal cancer can be improved using a multi-interventional program. Methods IMARI is a multicentre prospective clinical effectiveness trial, whereby current local practice (control cohort) will be evaluated, and subsequently compared to results after implementation of the multi-interventional program (intervention cohort). Patients undergoing LAR for rectal cancer will be included. The multi-interventional program includes three preventive interventions (mechanical bowel preparation with oral antibiotics, tailored full splenic flexure mobilization and intraoperative fluorescence angiography using indocyanine green) combined with a standardised pathway for early detection and active management of AL. The primary outcome is anastomotic integrity, confirmed by CT-scan at one year postoperatively. Secondary outcomes include incidence of AL, protocol compliance and association with AL, temporary and permanent stoma rate, reintervention rate, quality of life and functional outcome. Microbiome analysis will be conducted to investigate the role of the rectal microbiome in AL. In a Dutch nationwide study, the AL rate was 20%, with anastomotic integrity of 90% after one year. Based on an expected reduction of AL due to the preventive approaches of 50%, and increase of anastomotic integrity by a standardised pathway for early detection and active management of AL, we hypothesised that the anastomotic integrity rate will increase from 90 to 97% at one year. An improvement of 7% in anastomotic integrity at one year was considered clinically relevant. A total number of 488 patients (244 per cohort) are needed to detect this difference, with 80% statistical power. Discussion The IMARI-trial is designed to evaluate whether a multi-interventional program can improve long-term anastomotic integrity after rectal cancer surgery. The uniqueness of IMARI lies in the multi-modal design that addresses the multifactorial pathophysiology for prevention, and a standardised pathway for early detection and active treatment of AL. Trial registration Trialregister.nl (NL8261), January 2020. more...

For the last 30 years, the Department of Defense (DoD) has been asked in various ways to measure the effectiveness of the DoD counterdrug mission. In this thesis, I advance the idea of using the drug purity data as the best and only stand-alone metric to determine if drug interdiction efforts are reducing the amount of illicit drugs available in the United States. I also present a cost-benefit equation the DoD can utilize to determine the cost effectiveness of the counterdrug mission. The intangible benefits and unintended consequences of the DoD counterdrug mission are relayed and include developing partner nation relations and building partner capacity, positive and negative impacts on military readiness, and promoting the incorrect idea that the military can and should be used to solve any national problem. I conclude that the DoD cannot measure the outcomes of the counterdrug mission; however, it can combine counterdrug mission data already collected with key performance indicators inside of a pattern and trend methodology to better correlate the DoD counterdrug mission and supply-side outcome goals. http://archive.org/details/departmentofdefe1094564072 Major, United States Air Force Approved for public release; distribution is unlimited. more...

Persons with mental health problems and/or substance addictions (MHPSA) are stigmatised more than persons with physical conditions. This includes stigmatisation by care professionals. Stigma is considered one of the most important barriers for recovery from these conditions. There is an ongoing debate that use of language can exacerbate or diminish stigmatisation. Therefore, we conducted an experiment examining how four different ways of referring to a person with (a) alcohol addiction, (b) drug addiction, (c) depression and (d) schizophrenia are related to stigmatising attitudes by care professionals in the Netherlands. We partially replicated two studies performed in the United States and used surveys with vignettes containing either ‘disorder‐first’, ‘person‐first’, ‘victim’ and ‘recovery’ language, which were randomly assigned to participants (n = 361). No significant differences between language conditions were found for any of the vignettes. Our findings suggest that subtle differences in language to refer to persons with mental health problems or substance addictions have no effect on stigmatising attitudes by care professionals in the Netherlands. However, more research is needed to determine the effect of language use on other groups, such as individuals with MHPSA. more...

A standardized interface for different CubeSat missions is one of the keys to reduce costs and delivery time. A backplane interface approach, proposed by the University of Wuerzburg in Germany as UWE-3, was implemented in three CubeSat projects at the Kyushu Institute of Technology (Kyutech) in Japan to shorten the development and assembly times. The backplane approach also helped to reduce the risk of workmanship errors associated with the harness. The proposed standard interface board, however, needed changes in every CubeSat project to comply with the mission requirements. To obtain more flexibility especially for data connections, this work introduces a novel idea of a software-configurable bus interface with the backplane board. A Complex Programmable Logic Device (CPLD) was used instead of the hardware routing so that we can reconfigure the bus interface by reprogramming the CPLD. The concept was validated by a functional test with a breadboard module. A radiation test verified that the selected CPLD has enough strength to survive total ionization dozes of more than 2 years in low Earth orbit. A new backplane board with CPLD have been integrated with Engineering Model and Flight Model of the fourth CubeSat project at Kyutech, BIRDS-3 project, and system level verification was conducted. The flight model is now ready for delivery to JAXA in February 2019 for a planned launch to International Space Station in April 2019. The initial on-orbit data will be obtained by the time of the conference in August 2019 and will be presented to the audience. more...

This work presents a generalization of the Slot Planning Problem which raises when the liner shipping industry needs to plan the placement of containers within a vessel (stowage planning). State-of-the-art stowage planning relies on a heuristic decomposition where containers are first distributed in clusters along the vessel. For each of those clusters a specific position for each container must be found. Compared to previous studies, we have introduced two new features: the explicit handling of rolled out containers and the inclusion of separations rules for dangerous cargo. We present a novel integer programming formulation and a Greedy Randomized Adaptive Search Procedure (GRASP) to solve the problem. The approach is able to find high-quality solution within 1 s. We also provide comparison with the state-of-the-art on an existing and a new set of benchmark instances. (C) 2016 Elsevier Ltd. All rights reserved. more...

This study aims to determine the community's response to waste management based on 3 R (Reduce, Reuse and Recycle) in the residential environment of Moronge Village, Moronge District. A descriptive quantitative research method was used by determined 25% of the population sample from 30 families. The result shows, The reducing of waste by 80% of respondents think that the condition of waste in the residential environment of Moronge Village, Moronge District is very concerning, an attempt to reuse waste that can still be used for the same or different functions from 83.3% of respondents agree if there is a part of the waste that can still be used and The activity to reprocess or recycle that 86.7% of respondents agree to utilize waste that can still be used in the form of recycling. more...

Background: The increase in pharmaceutical waste medicines is a global phenomenon and financial burden. The Circular Economy, as a philosophy within the pharmaceutical supply chain, aims to promote waste reduction, maximise medicines value, and enable sustainability within this supply chain (increasing circularity). Circularity strategies for pharmaceuticals are not currently implemented in many countries, due to quality and safety barriers. The aim of this study was to determine whether the application of circular economy principles can minimise pharmaceutical waste and support sustainability in the pharmaceutical supply chain; Methods: a detailed narrative literature review was conducted in order to examine pharmaceutical waste creation, management, disposal, and the application of circular economy principles; Results: the literature scrutinised revealed that pharmaceutical waste is created by multiple routes, each of which need to be addressed by pharmacists and healthcare bodies through the Circular Economy 9R principles. These principles act as a binding mechanism for disparate waste management initiatives. Medicines, or elements of a pharmaceutical product, can be better managed to reduce waste, cost, and reduce negative environmental impacts through unsafe disposal. Conclusions: the study findings outline a Circular Pharmaceutical Supply Chain and suggests that it should be considered and tested as a sustainable supply chain proposition. more...

Delayed antibiotic prescription in primary care has been shown to reduce antibiotic consumption, without increasing risk of complications, yet is not widely used in the UK. We sought to quantify the relative importance of factors affecting the decision to give a delayed prescription, using a stated-choice survey among UK general practitioners. Respondents were asked whether they would provide a delayed or immediate prescription in fifteen hypothetical consultations, described by eight attributes. They were also asked if they would prefer not to prescribe antibiotics. The most important determinants of choice between immediate and delayed prescription were symptoms, duration of illness, and the presence of multiple comorbidities. Respondents were more likely to choose a delayed prescription if the patient preferred not to have antibiotics, but consultation length had little effect. When given the option, respondents chose not to prescribe antibiotics in 51% of cases, with delayed prescription chosen in 21%. Clinical features remained important. Patient preference did not affect the decision to give no antibiotics. We suggest that broader dissemination of the clinical evidence supporting use of delayed prescription for specific presentations may help increase appropriate use. Establishing patient preferences regarding antibiotics may help to overcome concerns about patient acceptance. Increasing consultation length appears unlikely to affect the use of delayed prescription. more...

Crown Copyright © 2019 Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the Open Government License (OGL) (http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/).; International audience; BackgroundCatheter-associated urinary tract infection (CAUTI) and bloodstream infection (CABSI) are leading causes of healthcare-associated infection in England's National Health Service (NHS), but health-economic evidence to inform investment in prevention is lacking.AimsTo quantify the health-economic burden and value of prevention of urinary-catheter-associated infection among adult inpatients admitted to NHS trusts in 2016/17.MethodsA decision-analytic model was developed to estimate the annual prevalence of CAUTI and CABSI, and their associated excess health burdens [quality-adjusted life-years (QALYs)] and economic costs (£ 2017). Patient-level datasets and literature were synthesized to estimate population structure, model parameters and associated uncertainty. Health and economic benefits of catheter prevention were estimated. Scenario and probabilistic sensitivity analyses were conducted.FindingsThe model estimated 52,085 [95% uncertainty interval (UI) 42,967–61,360] CAUTIs and 7529 (UI 6857–8622) CABSIs, of which 38,084 (UI 30,236–46,541) and 2524 (UI 2319–2956) were hospital-onset infections, respectively. Catheter-associated infections incurred 45,717 (UI 18,115–74,662) excess bed-days, 1467 (UI 1337–1707) deaths and 10,471 (UI 4783–13,499) lost QALYs. Total direct hospital costs were estimated at £54.4M (UI £37.3–77.8M), with an additional £209.4M (UI £95.7–270.0M) in economic value of QALYs lost assuming a willingness-to-pay threshold of £20,000/QALY. Respectively, CABSI accounted for 47% (UI 32–67%) and 97% (UI 93–98%) of direct costs and QALYs lost. Every catheter prevented could save £30 (UI £20–44) in direct hospital costs and £112 (UI £52–146) in QALY value.ConclusionsHospital catheter prevention is poised to reap substantial health-economic gains, but community-oriented interventions are needed to target the large burden imposed by community-onset infection. more...

Task scheduling for MapReduce jobs has been an active area of research with the objective of decreasing the amount of data transferred during the shuffle phase via exploiting data locality. In the literature, generally only the scheduling of reduce tasks is considered with the assumption that scheduling of map tasks is already determined by the input data placement. However, in cloud or HPC deployments of MapReduce, the input data is located in a remote storage and scheduling map tasks gains importance. Here, we propose models for simultaneous scheduling of map and reduce tasks in order to improve data locality and balance the processors' loads in both map and reduce phases. Our approach is based on graph and hypergraph models which correctly encode the interactions between map and reduce tasks. Partitions produced by these models are decoded to schedule map and reduce tasks. A two-constraint formulation utilized in these models enables balancing processors' loads in both map and reduce phases. The partitioning objective in the hypergraph models correctly encapsulates the minimization of data transfer when a local combine step is performed prior to shuffle, whereas the partitioning objective in the graph models achieve the same feat when a local combine is not performed. We show the validity of our scheduling on the MapReduce parallelizations of two important kernel operations - sparse matrix-vector multiplication (SpMV) and generalized sparse matrix-matrix multiplication (SpGEMM) - that are widely encountered in big data analytics and scientific computations. Compared to random scheduling, our models lead to tremendous savings in data transfer by reducing data traffic from several hundreds of megabytes to just a few megabytes in the shuffle phase and consequently leading up to 2.6x and 4.2x speedup for SpMV and SpGEMM, respectively. (C) 2018 Elsevier B.V. All rights reserved. more...

ObjectivesAs well as debridement and irrigation, soft-tissue coverage, and osseous stabilization, systemic antibiotic prophylaxis is considered the benchmark in the management of open fractures and considerably reduces the risk of subsequent fracture-related infections (FRI). The direct application of antibiotics in the surgical field (local antibiotics) has been used for decades as additional prophylaxis in open fractures, although definitive evidence confirming a beneficial effect is scarce. The purpose of the present study was to review the clinical evidence regarding the effect of prophylactic application of local antibiotics in open limb fractures.MethodsA comprehensive literature search was performed in PubMed, Web of Science, and Embase. Cohort studies investigating the effect of additional local antibiotic prophylaxis compared with systemic prophylaxis alone in the management of open fractures were included and the data were pooled in a meta-analysis.ResultsIn total, eight studies which included 2738 patients were eligible for quantitative synthesis. The effect of antibiotic-loaded poly(methyl methacrylate) beads was investigated by six of these studies, and two studies evaluated the effect of local antibiotics applied without a carrier. Meta-analysis showed a significantly lower infection rate when local antibiotics were applied (4.6%; 91/1986) than in the control group receiving standard systemic prophylaxis alone (16.5%; 124/752) (p ConclusionThis meta-analysis suggests a risk reduction in FRI of 11.9% if additional local antibiotics are given prophylactically for open limb fractures. However, due to limited quality, heterogeneity, and considerable risk of bias, the pooling of data from primary studies has to be interpreted with caution. Cite this article: M. Morgenstern, A. Vallejo, M. A. McNally, T. F. Moriarty, J. Y. Ferguson, S. Nijs, WJ. Metsemakers. Bone Joint Res 2018;7:447–456. The effect of local antibiotic prophylaxis when treating open limb fractures: A systematic review and meta-analysis. DOI: 10.1302/2046-3758.77.BJR-2018-0043.R1 more...

peer-reviewed This study uses a national farm survey which is part of the European Union (EU) Farm Accountancy Data Network (FADN) to develop environmental sustainability indicators in the use of nitrogen (N) and phosphorus (P) across a range of farm systems in the Republic of Ireland. Farm level micro data were used to calculate all inputs and outputs of N and P that cross the farm gate and to derive balances (kg ha-1) and overall use efficiencies across 827 farms in 2012. The sample is populated weighted to represents 71,480 farms nationally. Results indicated an average N balance of 71.0 kg ha-1 and use efficiency of 36.7% across the nationally representative sample. Nitrogen balances were between two and four times higher across specialist dairy farms compared to livestock rearing and specialist tillage systems. Nitrogen use efficiency was generally lowest across milk producing systems compared to livestock rearing and tillage systems. Phosphorus balance and use efficiency averaged 4.7 kg ha-1 and 79.6% respectively across the sample. Specialist tillage and dairying farms had higher average P balances compared to other livestock based systems. The approach developed in this analysis will form the benchmark for temporal analysis across these indicators for future nutrient balance and efficiency trends and could assist other members of the EU FADN to develop similar nationally representative indicators. Department of Agriculture, Food and the Marine more...

Non-pharmacological interventions are increasingly being acknowledged as valuable treatment options to overcome or reduce functional problems in patients with Parkinson's disease (PD). There is a wide range of such non-pharmacological treatments for which the supportive evidence is emerging. Physiotherapy is one good example in this domain. However, there are also several promising non pharmacological treatment strategies that have thus far received less research attention. Here, we describe two relatively new, but encouraging approaches. First, we focus on a hitherto largely overseen subgroup of PD, namely those with late-stage disease, a population that is often excluded from clinical studies. Importantly, the aims and therapeutic strategies in late-stage PD differ considerably from those in early-stage PD, and an emphasis on non-pharmacological management is particularly important for this vulnerable subgroup. Second, we focus on computer-based cognitive training, as an example of a relatively new intervention that includes innovative elements such as personalized training, artificial intelligence, and virtual reality. We review the latest evidence, practical considerations and future research perspectives, both for non-pharmacological approaches in late-stage PD and for computer based cognitive training. (C) 2017 Published by ElSevier Ltd. more...

Efforts towards a circular economy are accelerating and gaining more attention. Since product's lifecycle is mostly determined during early product development phases, it is crucial to support those phases with explicit strategic directions. This paper examines the possibility to aggregate various definitions of end-of-life (EoL) strategies in a visually compelling way. We propose a taxonomy for communication between multidisciplinary product development teams using ReX, an abbreviation for alternative EoL strategies starting with prefix 'Re', such as reduce, reuse, repurpose, repair, remanufacture, recycle, and recover. We construct our taxonomy based on a) EU Waste Directive, b) a systematic literature review, and c) relevant theoretical constructs. Then we discuss whether ReX allows assessing potential EoL alternatives, and steering the product development efforts. Finally, we suggest ReX for supporting decision-making when several stakeholders are involved, common language is sought for, and significant EoL related decisions are made at the early phases. more...

Waste management in schools continues to generate thoughts, interest and research because of the huge amount of the refuse that schools generation which include papers, cartons, cans, broken bottles, polymers which can be recycled but are rather turned out as rubbish to be collected as refuse. These refuse from schools are collected alongside other household refuses and heaped on streets or refuse dump with it antecedent health challenges which include unsightly heap of refuse, the odour emanating from such heap and the heap being a breeding ground for disease vectors like mosquitoes, cockroaches, rodents, reptiles among others. Among all the significant contributors of environmental waste, schools have been chosen for this write up since the waste generation rate and its corresponding composition has not been reported or has been underestimated. Hence, the present paper is an attempt to fill up this gap in knowledge. The objective of this paper specifically is to raise awareness among educators, learners and their families of the cause and effect of poor waste management and the benefits of recycling, reuse and reduce as waste management strategies. Also, to provide environmental tools to enhance quality of life and assist schools with portfolio development and waste minimization projects. more...

The use of 5α-reductase inhibitors (5α-RIs) as prostate cancer chemoprevention agents is controversial. Two large randomized trials, the Prostate Cancer Prevention Trial (PCPT) and the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) Trial, have both shown a decreased incidence of prostate cancer in patients administered with 5α-RIs. Both studies showed, however, an increased risk of higher-grade prostate cancer. Numerous studies have since analyzed the inherent biases in these landmark studies and have used mathematical modeling to estimate the true incidence of prostate cancer and the risk for high-grade prostate cancer in patients undergoing 5α-RI treatment. All primary publications associated with the PCPT and REDUCE studies were reviewed in detail. Pertinent references from the above publications were assessed and a literature search of all published articles associated with PCPT, REDUCE or 5α-RIs as chemopreventative agents through October 2013 was performed using Pubmed/Medline. PCPT and REDUCE both showed a significant decrease in the incidence of prostate cancer following the administration of 5α-reductase inhibitor, as compared with placebo, suggesting that 5α-RIs may be effective agents for prostate cancer chemoprevention. Inherent biases in the design of these two studies may have caused an artificial increase in the number of high-grade cancers reported. Mathematical models, that integrated data from these trials, revealed neither an increased nor decreased risk of high-grade disease when taking these biases into consideration. Moderately strong evidence exists that 5α-RIs may reduce the risk of prostate cancer. PCPT and REDUCE showed a decreased prevalence of prostate cancer in patients taking 5α-RIs. Urologists should have a working knowledge of these studies and discuss with patients the risks and benefits of 5α-RI treatment. Further studies to evaluate the cost-effectiveness of chemoprevention with 5α-RIs and appropriate patient selection are warranted. more...

Households’ energy consumption has received a lot of attention in debates on urban sustainability and housing policy due to its possible consequences for climate change. In Europe, the residential sector accounts for roughly one third of the energy consumption and is responsible for 16% of total CO2 emissions. Households have been progressively highlighted as the main actor that can play a substantial in the reduction of this energy use. Their behavior is a complex and hard to change process that combines numerous determinants. These determinants have already been extensively studied in the literature from a variety of thematic domains (psychology, sociology, economics, and engineering), however, each approach is limited by its own assumptions and often omit important energy behavioral components. Therefore, energy behavior studies require an integration of disciplines through interdisciplinary approaches. Based on that knowledge, this paper introduces a conceptual framework to capture and understand households’ energy consumption. The paper aims at connecting objective (physical and technical) with subjective (human) aspects related to energy use of households. This combination provide the answers to the ‘what’, the ‘how’ and most importantly the ‘why’ questions about people’s behavior regarding energy use. It allows clarifying the numerous internal and external factors that act as key determinants, as well as the need to take into account their interactions. By doing so, we conclude the paper by discussing the value of the conceptual framework along with valuable insights for researchers, practitioners and policymakers. more...

Sustainable mobility and smart mobility management play important roles in achieving smart cities’ goals. In this context we investigate the role of smartphones as mobility behavior sensors and evaluate the responsivity of different attitudinal profiles towards personalized route suggestion incentives delivered via mobile phones. The empirical results are based on mobile sensed data collected from more than 3400 people’s real life over a period of six months. The findings show which user profiles are most likely to accept such incentives and how likely they are to result in more sustainable mode choices. In addition we provide insights into tendencies towards accepting more sustainable route options for different trip purposes and illustrate smart city platform potential (for collection of mobility behavior data and delivery of incentives) as a tool for development of personalized mobility management campaigns and policies. more...

International audience; We discuss the implementation of a minimalist parallel library in OCaml. The library provides parallel map and fold (reduce) higher order functions and targets standard cache coherent shared memory multi-cores. Our Parmap.parmap and Parmap.parfold functions may be used to seamlessly replace OCaml List map and fold standard functions preserving their full functional semantics while achieving nearly optimal speedup on standard multi-core architectures. We discuss the design of the Parmap module, the main implementation features and we present some experimental results assessing the effciency of the Parmap parallel functions. Overall, Parmap represents a perfect incarnation of the "propagate the concept with minimal disruption" principle introduced in Cole's algorithmic skeleton manifesto. more...

This study summarizes the reducing principle of design of corrugated box used in the goods packaging. Then it makes a term-by-term analysis on the selection of raw materials for paper boxes, the optimization of prism types, and the overall design of paper box, with special emphasis on the method to realize moderate packaging of goods. more...

Within the REACH regulatory framework in the EU, quantitative structure-activity relationships (QSAR) models are expected to help reduce the number of animals used for experimental testing. The objective of this study was to develop QSAR models to describe the acute toxicity of organothiophosphate pesticides to aquatic organisms. Literature data sets for acute toxicity data of organothiophosphates to fish and one data set from experiments with 15 organothiophosphates on Daphnia magna performed in the present study were used to establish QSARs based on quantum mechanically derived molecular descriptors. The logarithm of the octanol/water partition coefficient, log K-ow. the energy of the lowest unoccupied molecular orbital, E-lumo, and the energy of the highest occupied molecular orbital, E-homo were used as descriptors. Additionally, it was investigated if toxicity data for the invertebrate D. magna could be used to build a QSAR model to predict toxicity to fish. Suitable QSAR models (0.80 more...

Google’s MapReduce programming model serves for processing large data sets in a massively parallel manner. We deliver the first rigorous description of the model including its advancement as Google’s domain-specific language Sawzall. To this end, we reverse-engineer the seminal papers on MapReduce and Sawzall, and we capture our findings as an executable specification. We also identify and resolve some obscurities in the informal presentation given in the seminal papers. We use typed functional programming (specifically Haskell) as a tool for design recovery and executable specification. Our development comprises three components: (i) the basic program skeleton that underlies MapReduce computations; (ii) the opportunities for parallelism in executing MapReduce computations; (iii) the fundamental characteristics of Sawzall’s aggregators as an advancement of the MapReduce approach. Our development does not formalize the more implementational aspects of an actual, distributed execution of MapReduce computations. more...