Search

New South Wales has the greatest burden of HIV in Australia, with 2012 and 2013 recording the highest rates of new diagnoses in 20 years. Concurrently, there has been significant changes in antiretroviral treatments and testing paradigms. We compiled a statewide resistance database to characterize changes in HIV-1 resistance mutations over time. Genotypic antiretroviral resistance testing (GART) was performed on request at three reference laboratories using commercial and in-house methods. In total, 7629 HIV-1 polymerase sequences obtained from GART from 2004 to 2013 were retrospectively collated, reformatted, de-identified, and analyzed using Stanford HIVdb program 7.0 and the 2009 World Health Organization (WHO) surveillance drug resistance mutations (SDRMs). Analyses were performed on subgroups of known treatment naives, treatment experienced, and seroconverters. There has been a decrease in overall rates of prevalent drug resistance mutations from 57.8% in 2004 to 21% in 2013. Dual and triple class resistance mutations have decreased from 32.7% in 2004 to 5.8% in 2013 and 16.4% to 1.2%, respectively. In treatment-naive individuals (

On behalf of the American Sexually Transmitted Diseases Association, we discuss benefits and challenges of direct-to-consumer test services for sexually transmitted infections and offer recommendations for future directions., Direct-to-consumer test services have gained popularity for sexually transmitted infections in recent years, with substantially increased use as a result of the SARS-CoV-2 (CoVID-19) global pandemic. This method of access has been variously known as “self-testing,” “home testing,” and “direct access testing.” Although these online services may be offered through different mechanisms, here we focus on those that are consumer-driven and require self-collected samples, and sample shipment to a centralized laboratory without involvement of health care providers and/or local health departments. We provide the American Sexually Transmitted Diseases Association's position on utilization of these services and recommendations for both consumers and health care providers.

Objectives The aim of this analysis was to characterize transmitted drug resistance (TDR) in Strategic Timing of Antiretroviral Treatment (START) study participants by next-generation sequencing (NGS), a sensitive assay capable of detecting low-frequency variants. Methods Stored plasma from participants with entry HIV RNA > 1000 copies/mL were analysed by NGS (Illumina MiSeq). TDR was based on the WHO 2009 surveillance definition with the addition of reverse transcriptase (RT) mutations T215N and E138K, and integrase strand transfer inhibitor (INSTI) surveillance mutations (Stanford HIVdb). Drug resistance mutations (DRMs) detected at three thresholds are reported: > 2%, 5% and 20% of the viral population. Results Between 2009 and 2013, START enrolled 4684 antiretroviral therapy (ART)-naive individuals in 35 countries. Baseline NGS data at study entry were available for 2902 participants. Overall prevalence rates of TDR using a detection threshold of 2%/5%/20% were 9.2%/5.6%/3.2% for nucleoside reverse transcriptase inhibitors (NRTIs), 9.2%/6.6%/4.9% for non-NRTIs, 11.4%/5.5%/2.4% for protease inhibitors (PIs) and 3.5%/1.6%/0.1% for INSTI DRMs and varied by geographic region. Using the 2% detection threshold, individual DRMs with the highest prevalence were: PI M46IL (5.5%), RT K103NS (3.5%), RT G190ASE (3.1%), T215ISCDVEN (2.5%), RT M41L (2.2%), RT K219QENR (1.7%) and PI D30N (1.6%). INSTI DRMs were detected almost exclusively below the 20% detection threshold, most commonly Y143H (0.4%), Q148R (0.4%) and T66I (0.4%). Conclusions Use of NGS in this study population resulted in the detection of a large proportion of low-level variants which would not have been detected by traditional Sanger sequencing. Global surveillance studies utilizing NGS should provide a more comprehensive assessment of TDR prevalence in different regions of the world.

International audience; Background: Global HIV-1 genetic diversity and evolution form a major challenge to treatment and prevention efforts. An increasing number of distinct HIV-1 recombinants have been identified worldwide, but their contribution to the global epidemic is unknown. We aimed to estimate the global and regional distribution of HIV-1 recombinant forms during 1990-2015.Methods: We assembled a global HIV-1 molecular epidemiology database through a systematic literature review and a global survey. We searched the PubMed, Embase (Ovid), CINAHL (Ebscohost), and Global Health (Ovid) databases for HIV-1 subtyping studies published from Jan 1, 1990, to Dec 31, 2015. Unpublished original HIV-1 subtyping data were collected through a survey among experts in the field who were members of the WHO-UNAIDS Network for HIV Isolation and Characterisation. We included prevalence studies with HIV-1 subtyping data collected during 1990-2015. Countries were grouped into 14 regions and analyses were done for four time periods (1990-99, 2000-04, 2005-09, and 2010-15). The distribution of circulating recombinant forms (CRFs) and unique recombinant forms (URFs) in individual countries was weighted according to the UNAIDS estimates of the number of people living with HIV in each country to generate regional and global estimates of numbers and proportions of HIV-1 recombinants in each time period. The systematic review is registered with PROSPERO, CRD42017067164.Findings: Our global data collection yielded an HIV-1 molecular epidemiology database of 383 519 samples from 116 countries in 1990-2015. We found that the proportion of recombinants increased over time, both globally and in most regions, reaching 22·8% (7 978 517 of 34 921 639) of global HIV-1 infections in 2010-15. Both the proportion and the number of distinct CRFs detected increased over time to 16·7% and 57 CRFs in 2010-15. The global and regional distribution of HIV-1 recombinants was diverse and evolved over time, and we found large regional variation in the numbers (0-44 CRFs), types (58 distinct CRFs), and proportions (0-80·5%) of HIV-1 recombinants. Globally, CRF02_AG was the most prevalent recombinant, accounting for 33·9% (2 701 364 of 7 978 517) of all recombinant infections in 2010-15. URFs accounted for 26·7% (2 131 450 of 7 978 517), CRF01_AE for 23·0% (1 838 433), and other CRFs for 16·4% (1 307 270) of all recombinant infections in 2010-15. Although other CRFs accounted for small proportions of infections globally (

Significance We developed a strategy to avoid human subjectivity by assessing the quality of red blood cells using imaging flow cytometry and deep learning. We successfully automated traditional expert assessment by training a computer with example images of healthy and unhealthy morphologies. However, we noticed that experts disagree on ∼18% of cells, so instead of relying on experts’ visual assessment, we taught a deep-learning network the degradation phenotypes objectively from images of red blood cells sampled over time. Although training with diverse samples is needed to create and validate a clinical-grade model, doing so would eliminate subjective assessment and facilitate research. The time-based deep-learning strategy may also prove useful for other biological progressions, such as development and disease progression., Stored red blood cells (RBCs) are needed for life-saving blood transfusions, but they undergo continuous degradation. RBC storage lesions are often assessed by microscopic examination or biochemical and biophysical assays, which are complex, time-consuming, and destructive to fragile cells. Here we demonstrate the use of label-free imaging flow cytometry and deep learning to characterize RBC lesions. Using brightfield images, a trained neural network achieved 76.7% agreement with experts in classifying seven clinically relevant RBC morphologies associated with storage lesions, comparable to 82.5% agreement between different experts. Given that human observation and classification may not optimally discern RBC quality, we went further and eliminated subjective human annotation in the training step by training a weakly supervised neural network using only storage duration times. The feature space extracted by this network revealed a chronological progression of morphological changes that better predicted blood quality, as measured by physiological hemolytic assay readouts, than the conventional expert-assessed morphology classification system. With further training and clinical testing across multiple sites, protocols, and instruments, deep learning and label-free imaging flow cytometry might be used to routinely and objectively assess RBC storage lesions. This would automate a complex protocol, minimize laboratory sample handling and preparation, and reduce the impact of procedural errors and discrepancies between facilities and blood donors. The chronology-based machine-learning approach may also improve upon humans’ assessment of morphological changes in other biomedically important progressions, such as differentiation and metastasis.

There has been a growing interconnection across the world owing to various multimedia applications and services. Fixed wireless access (FWA) is an attractive wireless solution for delivering multimedia services to different homes. With the fifth-generation (5G) and beyond mobile networks, the FWA performance can be enhanced significantly. However, their implementation will present different challenges on the transport network due to the incessant increase in the number of required cell-sites and the subsequent increase in the per-site requirements. This paper presents a comprehensive tutorial on the enabling technologies, design considerations, requirements, and prospects of broadband schemes. Furthermore, the related technical challenges of FWA are reviewed, and we proffer potential solutions to address them. Besides, we review various transport network options that can be employed for FWA deployment. In this regard, we offer an in-depth discussion on their related requirements for different use cases. Moreover, we give an insight into the 3GPP RAN functional split implementations and implications on the 5G FWA transport network solutions. The concepts of virtualized RANs for attending flexibly to the dynamic nature of different use cases are also presented.

Continuous-variable quantum key distribution (CV-QKD) provides a theoretical unconditionally secure solution to distribute symmetric keys among users in a communication network. However, the practical devices used to implement these systems are intrinsically imperfect, and, as a result, open the door to eavesdropper attacks. In this work, we show the impact of receiver device imperfections on the estimated channel parameters, performance and security of a CV-QKD system. The presented results show that, due to the erroneously estimated channel parameters, non-monitored imbalances can pose a security risk or even reduce the system’s performance. Our results show the importance of monitoring these imbalances and hint at the possibility of compensating for some receiver imbalances by tuning other components.

This chapter describes the digital competencies that have become essential in the workforce and how higher education institutions (HEIs) are trying to keep up in a moment in which faculty members have been acquiring digital skills alongside students. A field study was conducted with faculty from HEIs in Mexico to identify the differences between the digital skills that faculty possessed previous to the pandemic and those acquired as a result of remote work. It also analyzes the digital tools they have been provided with to perform their jobs, the training they have received, and the digital skills that they still lack to help students acquire the digital competencies demanded in the workforce. The objective is to identify areas of opportunity and create general guidelines that will help develop critical digital skills. A literature review of the most relevant aspects of digital dexterity and digital competence in higher education (HE) is presented. An analysis of the current context and how it is producing changes faster than before is also included.

Continuous-variable quantum key distribution (CV-QKD) provides a theoretical unconditionally secure solution to distribute symmetric keys among users connected through a communication channel. However, polarization drift in standard optical fibres can pose a considerable impairment, as it will degrade the efficiency of the coherent detection scheme if not compensated. In this work, we present a novel receiver configuration for CV-QKD that allows for passive polarization drift compensation. The presented results show that our detection system can effectively compensate random polarization drift even in very adverse scenarios.

There has been significant research interest in various computing-based paradigms such as cloud computing, Internet of Things, fog computing, and edge computing, due to their various associated advantages. In this chapter, we present a comprehensive review of these architectures and their associated concepts. Moreover, we consider different enable technologies that facilitate computing paradigm evolution. In this context, we focus mainly on fog computing considering its related fundamental issues and recent advances. Besides, we present further research directions toward the sixth generation fog computing paradigm.

Acute acalculous cholecystitis (AAC) is an infrequently encountered clinical condition associated with high morbidity and mortality. Viral infection associated AAC is rare, but it is most commonly associated with Epstein-Barr virus, cytomegalovirus, dengue virus, hepatitis A, hepatitis B, human immunodeficiency virus, disseminated visceral varicella-zoster virus infection, Zika virus, and hepatitis C. We report on a patient who was first diagnosed with a chronic hepatic C infection and subsequently with acalculous cholecystitis.

OBJECTIVE To assess the impact of immediate vs. deferred antiretroviral therapy (ART) on CD4 recovery among individuals early in HIV infection. DESIGN Using serologic markers of early infection together with self-reported dates of infection and HIV diagnosis, ART-naive participants who were randomized to immediate vs. deferred ART in the Strategic Timing of Antiretroviral Treatment trial were classified into subgroups of duration of HIV infection at baseline. CD4 cell count recovery over follow-up according to duration of HIV infection was investigated. METHODS Three subgroups were defined: first, infected 6 months or less (n = 373); second, infected 6-24 months (n = 2634); and third, infected 24 months or longer (n = 1605). Follow-up CD4, CD8, and CD4 : CD8 ratio for the immediate and deferred ART groups were compared by subgroup using linear models. For the deferred ART group, decline to CD4 less than 350 cells/μl or AIDS according to infection duration was compared using time-to-event methods. RESULTS Follow-up CD4 cell count differences (immediate minus deferred) were greater for those recently infected (+231 cells/μl) compared with the two other subgroups (202 and 171 cells/μl; P

Nowadays, humanity is consuming unsustainably the planet’s resources. In the scope of energy resource consumption, e.g., the intense use of fossil fuels has contributed to the acceleration of climate changes on the planet, and the overriding need to increase energy efficiency in all sectors is now widely recognized, aiming to reduce greenhouse gases (GHG) emissions by 69% in 2030. Largely due to climate changes, water has also become a critical resource on the planet and hydric stress risk will rise significantly in the coming decades. Accordingly, several countries will have to apply measures to increase water efficiency in all sectors, including at the building level. These measures, in addition to reducing water consumption, will contribute to the increase of energy efficiency and to the decrease of GHG emissions, especially of CO2. Therefore, the nexus water energy in buildings is relevant because the application of water efficiency measures can result in a significant contribution to improve buildings’ energy efficiency and the urban water cycle (namely in abstraction, treatment, and pumping). For Mediterranean climate, there are few studies to assess the extent and impact of this nexus. This study presents the assessment of water-energy nexus performed in a university building located in a mainland Portugal central region. The main goals are to present the results of the water and energy efficiency measures implemented and to assess the consequent reduction of water, above 37%, and energy (30%) consumption, obtained because of the application of water-efficient devices and highly efficient light systems in the building. The water efficiency increase at the building level represents at the urban level an energy saving in the water supply system of 406 kWh/year, nearly 0.5% of the building energy consumption, with a consequent increase in the energy efficiency and in the reduction of GHG emissions. Complementarily, other energy-efficient measures were implemented to reduce the energy consumption. As the building under study has a small demand of domestic hot water with no hydro pressure pumps and has a small water-energy nexus, it was concluded that the significant reduction of the building energy consumption did not influence the indoor comfort.

The evolution in the Information and Communications Technologies industry results in excessive energy consumption and carbon dioxide emission in the wireless networks. In this context, energy efficiency in mobile networks has been attracting considerable attention as green communications and operational expenditures reduction depend on it. Although the Internet of Things is to be supported by devices that are low-energy consuming, the power consumption of the huge number to be connected for several applications and services demand significant attention. To offer insights into green communications, this paper reviews various energy efficiency improvement techniques. Also, we consider a hybrid model in which the main grid power and dynamically harvested green energy from renewable energy sources can be leveraged to support the energy demand of the radio access network. In this regard, we reformulate the energy consumption model and consider an energy-efficient power allocation algorithm for green energy optimization. Numerical results show that with resource allocation algorithm exploitation, the energy efficiency can be enhanced. Besides, the amount of the grid energy consumption can be considerably minimized, resulting in the greenhouse gas emissions reduction in the wireless networks.

Introduction This study evaluates the impact of the COVID-19 pandemic on testing for common sexually transmitted infections. Specifically, changes are measured in chlamydia and gonorrhea testing and case detection among patients aged 14–49 years during the COVID-19 pandemic. Methods U.S. chlamydia and gonorrhea testing and positivity were analyzed on the basis of >18.6 million tests (13.6 million tests for female patients and 4.7 million tests for male patients) performed by a national reference clinical laboratory from January 2019 through June 2020. Results Chlamydia and gonorrhea testing reached a nadir in early April 2020, with decreases (relative to the baseline level) of 59% for female patients and 63% for male patients. Declines in testing were strongly associated with increases in weekly positivity rates for chlamydia (R2=0.96) and gonorrhea (R2=0.85). From March 2020 through June 2020, an expected 27,659 (26.4%) chlamydia and 5,577 (16.5%) gonorrhea cases were potentially missed. Conclusions The COVID-19 pandemic impacted routine sexually transmitted infection services, suggesting an increase in syndromic sexually transmitted infection testing and missed asymptomatic cases. Follow-up analyses will be needed to assess the long-term implications of missed screening opportunities. These findings should serve as a warning for the potential sexual and reproductive health implications that can be expected from the overall decline in testing and potential missed cases.

This chapter presents virtual collaboration in remote project management as a way to develop sustainable business practices. As temporary organizations, virtual projects have grown substantially, mainly because of the confinement conditions of the COVID-19 pandemic. A study was conducted to identify the main issues that employees working in virtual projects in the state of Tamaulipas in Mexico have faced. A survey based on the remote work and its effects scale was used. The most relevant tools and techniques that have been applied in virtual collaboration in remote project management are briefly described. The objective is to shed light on the importance of technology, time and task management, team collaboration and integration, communication, and trust to develop successful projects.

This chapter presents the Avocado metaphor for advanced value organizations (AVOs) based on emergent, hybrid, and self-maturing temporary organizational theories. The metaphor was constructed through bricolage, bringing in concepts and ideas from different areas. AVOs develop as a response to ever-changing business environments, which are more and more often transiting towards new ways of working, primarily projects. Avocado organizations reflect the global trend of smaller organizational designs creating organizations within organizations and teams of teams. Research is theoretical. It includes a general view on metaphors and their importance in organizational theory. Special attention is given to the definition of advanced value organizations, emergent theories, hybrid organizational designs, organizational lifecycles, and maturing processes, as well as temporary organizations and new working arrangements based mainly on projects. The avocado metaphor is explained in every section allowing a better understanding of how it can be used to describe modern-day organizations.

The current 5G network deployment is anticipated to support a massive number of connections and offer a very high-data-rate to ensure enhanced mobile broadband with ultra-reliable and low-latency services. However, the full connectivity requirements by the future digital society may be challenging for 5G. Consequently, for effective support of future demands, research attention is towards beyond 5G wireless communications. This chapter presents in-depth studies on the envisage use cases, network architectures, deployment scenarios, and technology-driven paradigm shifts for the sixth generation (6G) networks. Beyond 5G connectivity will be based on digital twin worlds for accurate representation and unification of the physical and biological worlds. To realize this, innovative ideas will emerge to define 6G system requirements and technologies. Besides, the swift advancement in artificial intelligence makes it one of the viable solutions for 6G networks. Moreover, key technical areas and technology advances such as new spectrum bands, cognitive spectrum sharings, photonics-based cognitive radio, innovative architecture models, terahertz communications, holographic radio, advanced duplex, and advanced modulation schemes are envisaged to define the 6G radio access network (RAN). Consequently, the 6G RAN is anticipated to be an exceptionally dynamic, inherently intelligent ultra-dense heterogeneous network with effective support for all things.

The current 5G and data-center services as well as the associated applications are imposing stringent requirements on the optical communication systems due to the ever-increasing network traffic. Based on this, there is significant need to enhance per wavelength data rate beyond 100 Gb/s. Meeting the current and future requirements for a highspeed system demands novel coding schemes, advanced modulation formats, and high-performance DSP algorithms. This paper presents our recent investigations on the optimization of the DSP subsystems for simplified coherent receivers, including the conventional Kramers Kronig (KK) scheme, upsampling free KK, and iterative linear filter architectures. published

The construction sector high energy consumption and GHG emissions lead to the development of easier methodologies to achieve low carbon buildings. Currently, the use of Building Information Modeling (BIM) is growing in the Architecture, Engineering, Construction and Operation (AECO) sector, and it assumes relevance in buildings energy simulation. Therefore, this work aims to explore the potential and limitations of applying BIM to energy management and simulation in the operation life cycle phase of a service building, and comparing it with a specific and customized tool for energy efficiency assessment of public buildings. A service building BIM model was developed in Autodesk Revit showing its utility when used as an asset for storing and organize energy-related data. The add-in Energy Analysis for Autodesk Revit allowed automatically generating the Building Energy Model (BEM) from the BIM model and performing a cloud-based simulation in Autodesk Green Building Studio (GBS). The energy consumption results obtained in GBS were compared with the results obtained with the energy simulation tool ECO.AP developed in the Portuguese National Laboratory of Civil Engineering (LNEC). It was possible to infer that the input limitations of GBS, mainly in HVAC systems customization, compromise the representation and energy performance evaluation of the building under actual operating conditions, making GBS more adequate for early buildings life cycle stages where energy simulation results may support decisions that aim to improve the buildings energy performance during the operation phase.

We present a quantum enabled secure multiparty computation service able to perform private recognition of composite signals. This system is based on the generation and distribution of quantum oblivious keys. The engineered system is going to be tested in the Madrid Quantum Network.

Over the last decades, the geographical distribution of species, as well as its associated patterns have been at the core of the macroecology research program. Gradients in geographic range size and shape, as well as range overlap (species richness), reveal broad-scale patterns that may help to infer underlying ecological processes, mainly related to climatic and environmental variation. However, it is clear now that evolutionary processes are at least equally important, demanding the inclusion of an evolutionary dimension to better understand such patterns. In this review, we discuss recent macroecological approaches to study evolutionary patterns at the geographical scale, and exemplify some of these approaches with data from a model group of Neotropical birds, the Furnariides.

Australia has maintained a low prevalence of HIV, with a mainly concentrated epidemic and successful public health response. With the widespread availability of HIV genotyping for resistance testing, and development of phylogenetic methodologies, the field of molecular epidemiology has evolved a deeper understanding of diversity and transmission dynamics of HIV. Studies combining HIV genotype with epidemiological data have allowed insights to be gained into the changing subtype diversity, rates of transmitted drug resistance and transmission networks of HIV in Australia. This review provides an overview of HIV molecular epidemiology studies in Australia.

Objective: To assess Central Pennsylvania health-care professional and student knowledge, beliefs, and awareness of human trafficking.Methods: An anonymous online public survey URL was distributed ...

We present an optimized dual-stage CPR method based on pilot symbols and a blind phase search algorithm (BPS) for M-QAM coherent optical transmission systems, targeting an efficient hardware implementation. A comprehensive optimization of the key CPR parameters is performed, including, pilot-rate, number of test phases, angle interval and moving average filter size. The optimization process is validated through numerical assessment of the optical communication system performance using 16-QAM, 64-QAM, and 256-QAM modulation formats at 64 GBaud. The optimized dual-stage CPR is demonstrated to operate with a very low number of test phases in the second stage BPS algorithm. In addition, it supports more than 10× higher laser linewidth than the standard CPR based on pilot symbols. Besides, a reduction of more than 90%, in terms of hardware complexity is achieved with respect to the standalone application of the BPS algorithm. The optimized dual-stage CPR is also validated through hardware implementation based on VHDL, and its gate-level complexity is assessed for a commercial off-the-shelf Xilinx Virtex-7 FPGA.

The carrier contribution factor (CCF) is used in the DC-value method to assure the minimum phase condition (MPC) at the transmitter. We analyze the impact of the CCF estimation accuracy at the receiver on the DC-value system performance. We found that the CCF estimation accuracy at the receiver should be within ±5% to exploit all advantages of the DC-value method. We propose an accurate method to estimate the CCF at the receiver that works effectively with both direct current (DC) and alternating current (AC) coupled photodetectors. We experimentally validate the proposed method employing a 24 GBaud 16QAM signal. The experimental results show that the minimum BER value can be approached within ±5% offset of the estimated CCF value almost independently of the carrier to signal power ratio (CSPR) value. The proposed method can also be used to reconstruct the DC component in other minimum phase signal self-coherent techniques, such as the Kramers-Kronig receiver.

Discrete modulation continuous variable quantum key distribution (DM-CV-QKD) is highly considered in real implementations to avoid the complexity of Gaussian modulation (GM), which is optimum in terms of the key rate. DM-CV-QKD systems usually consider M-symbol phase shift keying (M-PSK) constellations. However, this type of constellation cannot reach transmission distances and key rates as high as GM, limiting the practical implementation of CV-QKD systems. Here, by considering M-symbol amplitude and phase shift keying (M-APSK) constellations, we can approximate GM. Indeed, considering finite-size effects, 4 ring 64-APSK can reach 52.0 km, only 7.2 km less than GM and 282% the maximum achievable transmission distance for 8-PSK.

This paper reviews recent progress on different high-speed optical short- and medium-reach transmission systems. Furthermore, a comprehensive tutorial on high-performance, low-cost, and advanced optical transceiver (TRx) paradigms is presented. In this context, recent advances in high-performance digital signal processing algorithms and innovative optoelectronic components are extensively discussed. Moreover, based on the growing increase in the dynamic environment and the heterogeneous nature of different applications and services to be supported by the systems, we discuss the reconfigurable and sliceable TRxs that can be employed. The associated technical challenges of various system algorithms are reviewed, and we proffer viable solutions to address them.

Geothermal energy production consists of two main types: low temperature or low enthalpy for temperatures below 150oC, and high temperature or high enthalpy systems for temperatures over than 150oC. In mainland Portugal the most common ground temperature varies from 20 to 40oC, depending on the place where the geothermal boreholes are placed, which means that low enthalpy systems can be considered. Currently the increased development of ground source heat pumps (GSHP) lead to a continuous development and innovation of ground heat exchangers (GHE). The geothermal systems can contribute with savings between 25-75% of the energy demands of buildings’ HVAC systems, making it a very appealing solution mainly in northern and central Europe. The goal of this paper is to analyse the performance of a geothermal system installed in a department of the University of Aveiro, in the center of Portugal. Firstly, an introduction about different GHE systems is done and after a real case study is described and the methodology applied. To achieve the goal established, the building was analysed, audit and modeled, and an energy simulation was carried out with EnergyPlus® 8.6 (EP) software. After the results obtained it can be concluded that even in regions with mild climate as Aveiro, the geothermal system contributes with 34% of savings of the annual global primary energy needs.

Five and four stars’ hotels to guarantee high comfort and quality of their services lead to high energy and water consumption per user. A great part of it is for the guestś baths which include a great energy expenditure for hot water production, pumping and distribution. Efficient showers installation entail at the building level to the decrease of water use and of the energy for its heating and distribution. At the urban level the decrease of the water consumption implies also the energy reduction needed for its abstraction, treatment, pumping and distribution and also for sewage pumping and treatment. This study encompass the measurement of the energy consumption associated with the water use (including pressurization, recirculation, storage and heating), and the laboratory assessment of the hydric efficiency of different showers from the hotels under study and a simplified methodology to assess the nexus between water and energy. It also includes the study of the relation between the consumption and the installation's features depicting the respective models. It was concluded: 1) is essential to increase the showers’ hydric efficiency to decrease the energy consumption by each hotel user; 2) there is no linear relation between the water and energy consumption; 3) in the pumping and in the thermal insulation pipes there is a potential of improvement of the energy efficiency to effectively diminish the carbon footprint and the building vulnerabilities under climate changes.

Resume Les equipes de reanimation pour adultes sont rarement confrontees a la prise en charge de patients mineurs. Les objectifs de notre travail etaient d’evaluer la qualite de la formation pediatrique des unites de reanimation pour adultes, la charge de travail representee par l’activite de reanimation pediatrique et d’identifier les difficultes rencontrees lors de l’approche de patients mineurs. Une enquete prospective a ete conduite en Basse Normandie entre le 4 avril et le 1 er septembre 2012 aupres des professionnels medicaux et paramedicaux, exercant dans un des 9 services de reanimation pour adultes. Un questionnaire evaluant leur experience pediatrique, leur activite pediatrique quotidienne et les difficultes rencontrees leur a ete adresse. Cent neuf reponses (26 medecins seniors, 18 internes, 38 infirmieres et 27 aides-soignantes) ont ete recues. Les trois-quarts (76 %) ont signale ne jamais avoir exerce dans une unite de pediatrie. Quarante-deux pour cent pensaient que la limite d’âge de la pediatrie etait officiellement de 15 ans et 3 mois, mais plus de 50 % souhaitaient voir cette limite a 16 ans ou au-dela. Quatre-vingt-treize participants (85 %) estimaient avoir une activite pediatrique dans leur pratique courante mais celle-ci restait rare. Des difficultes ont ete rapportees par 73 soignants (67 %). Il y a peu d’evaluations recentes de la qualite de la formation des reanimateurs pour adultes dans le domaine de la pediatrie et peu de donnees concernant le ressenti que ces equipes ont de la charge de travail et des difficultes que represente l’activite pediatrique dans leur pratique quotidienne.

The impact of optical amplification on the achievable information rate (AIR) is evaluated, considering continuous and discrete modulation formats. The theoretical model for the AIR considers the optical amplification noise, the nonlinear optical noise, and the coherent receiver shot and thermal noise sources. Two different scenarios for the AIR are analyzed. First, we admit that the gain of each optical amplifier under or over compensate the previous fiber span loss. After that, we consider the case where we remove optical amplifiers from the transmission link. Results show that for the first scenario, when we under or over compensate the span loss the AIR tends to decrease. Nevertheless, for low cardinality constellations the AIR is not primarily limited by the gain of the optical amplifiers. In the second scenario, results show that it is possible to remove amplification stages from the end to the beginning of the transmission link without decreasing the AIR. We observe that for a polarization multiplexing (PM) 4-PSK constellation the plateau of 4 bits/symbol is preserved even if we remove the last two amplifiers from the transmission link.

This work aims to apply Life Cycle Assessment (LCA) methodology to evaluate the potential environmental impacts of three structural solutions (mixed, steel and reinforced concrete) of a building in Aveiro University (Portugal), comparing two life spans for the building: 50 and 100 years. Designing a 100-year life span building requires structural materials with higher resistance and higher environmental impacts in construction phase than a 50-year design. Therefore, a detailed assessment of materials and environmental impacts for those two different life spans was performed. Data were collected on the amounts of materials consumed in each alternative and on the environmental impacts associated with the production of each material. The work concludes that the concrete alternative is environmentally more sustainable than the other two structural solutions. A sensitivity analysis can show whether the 100-year design could compensate for the 50-year design, particularly when the first one needs maintenance once, while the second one requires maintenance twice. Moreover, the sensitivity analysis helped finding out the reasons for uncertainty of LCA results, highlighting the need for a treatment and more sufficient maintenance actions avoiding using materials with high environmental impacts.

The oblivious transfer primitive is sufficient to implement secure multiparty computation. However, secure multiparty computation based only on classical cryptography is severely limited by the security and efficiency of the oblivious transfer implementation. We present a method to efficiently and securely generate and distribute oblivious keys by exchanging qubits and by performing commitments using classical hash functions. With the presented hybrid approach, quantum and classical, we obtain a practical and high-speed oblivious transfer protocol, secure even against quantum computer attacks. The oblivious distributed keys allow implementing a fast and secure oblivious transfer protocol, which can pave the way for the widespread of applications based on secure multiparty computation., 11 pages, 5 figures

We present a digital technique able to monitor and compensate for the mode-dependent losses (MDL) in space-division multiplexing (SDM) transmission systems. The working principle of the technique is based on the analysis of the received signal samples in the higher-order Poincaré spheres (HoPs). When an arbitrary pair of tributaries is represented in the respective HoPs, the effect of the MDL can be modeled as a simple shift of the constellation points in a such sphere. Therefore, the MDL can be estimated by computing those shifts over all the HoPs and the induced signal distortions can be compensated by re-centering all the constellations in the respective HoPs. It should be highlighted that the proposed technique is scalable with an arbitrary number of spatial channels, modulation format agonistic and free of training sequences. The HoPs-based MDL monitoring (compensation) technique allows the MDL estimation (compensation) up to values of ≈ 6 dB. The proposed technique can partially compensate the MDL distortion, making a MDL sensitive algorithm in an insensitive one. When the proposed technique assists a HoPs-based space-demultiplexing algorithm, it provides signal-to-noise ratio (SNR) enhancements of 2, 4 and 8 dB for PM-QPSK, PM-16QAM and PM-64QAM signals, respectively, for the particular case of a SDM-based transmission system with a spatial diversity of 2 and 2 dB of MDL. published

Introduction and objectives Drug provocation tests (DPTs) are the gold-standard method to diagnose non-immediate hypersensitivity reactions (NIHSR) to beta-lactam antibiotics (BL) in children. Our aim was to compare the negative predictive value (NPV) of one-day (short) DPT versus 3–7 days (extended) DPT for the diagnosis of NIHSR to BL in paediatric age. A secondary aim was to compare confidence on drug re-exposure after short and extended negative DPTs. Methods The occurrence of HSR on drug re-exposure and drug refusal after negative diagnostic DPTs were evaluated in children/adolescents with a history of NIHSR to BL using a questionnaire performed six months to ten years after DPT. Patients were divided into two groups according to the protocol performed: short DPT vs. extended DPT. Results We enrolled 212 children and adolescents (86 females, 126 males, mean age at DPT 5.52 years, p25 = 3 years, p75 = 7.25 years): 69 tested with short DPT, and 143 with extended DPT. The NPV of both types of DPT together was 95.2%. The NPV of short DPT was 97.5% and the NPV of extended DPT was 93.8% (p = 0.419). After negative DPT, beta-lactams were refused by carers in 14.75% of the children requiring subsequent treatment, 6.98% in the short DPT group and 18.99% in the extended DPT group (p = 0.074). Conclusions In our paediatric sample, prolonging drug administration did not increase the NPV of diagnostic DPT for NIHSR to BL or reduce drug refusal. Altogether, the data here reported suggest that, however intuitive, prolonging DPT is not beneficial in the parameters analysed.

Most deforested lands in Brazil are occupied by low-productivity cattle ranching. Brazil is the second biggest meat producer worldwide and is projected to increase its agricultural output more than any other country. Biochar has been shown to improve soil properties and agricultural productivity when added to degraded soils, but these effects are context-dependent. The impact of biochar, fertilizer and inoculant on the productivity of forage grasses in Brazil (Brachiaria spp. and Panicum spp.) was investigated from environmental and socio-economic perspectives. We showed a 27% average increase in Brachiaria production over two years but no significant effects of amendment on Panicum yield. Biochar addition also increased the contents of macronutrients, soil pH and CEC. Each hectare amended with biochar saved 91 tonnes of CO2eq through land sparing effect, 13 tonnes of CO2eq sequestered in the soil, equating to U$455 in carbon payments. The costs of biochar production for smallholder farmers, mostly because of labour cost, outweighed the potential benefits of its use. Biochar is 617% more expensive than common fertilizers. Biochar could improve productivity of degraded pasturelands in Brazil if investments in efficient biochar production techniques are used and biochar is subsidized by low emission incentive schemes.

Contains fulltext : 177598.pdf (Publisher’s version ) (Closed access) OBJECTIVES: Excessive fluid therapy in patients with sepsis may be associated with risks that outweigh any benefit. We investigated the possible influence of early fluid balance on outcome in a large international database of ICU patients with sepsis. DESIGN: Observational cohort study. SETTING: Seven hundred and thirty ICUs in 84 countries. PATIENTS: All adult patients admitted between May 8 and May 18, 2012, except admissions for routine postoperative surveillance. For this analysis, we included only the 1,808 patients with an admission diagnosis of sepsis. Patients were stratified according to quartiles of cumulative fluid balance 24 hours and 3 days after ICU admission. MEASUREMENTS AND MAIN RESULTS: ICU and hospital mortality rates were 27.6% and 37.3%, respectively. The cumulative fluid balance increased from 1,217 mL (-90 to 2,783 mL) in the first 24 hours after ICU admission to 1,794 mL (-951 to 5,108 mL) on day 3 and decreased thereafter. The cumulative fluid intake was similar in survivors and nonsurvivors, but fluid balance was less positive in survivors because of higher fluid output in these patients. Fluid balances became negative after the third ICU day in survivors but remained positive in nonsurvivors. After adjustment for possible confounders in multivariable analysis, the 24-hour cumulative fluid balance was not associated with an increased hazard of 28-day in-hospital death. However, there was a stepwise increase in the hazard of death with higher quartiles of 3-day cumulative fluid balance in the whole population and after stratification according to the presence of septic shock. CONCLUSIONS: In this large cohort of patients with sepsis, higher cumulative fluid balance at day 3 but not in the first 24 hours after ICU admission was independently associated with an increase in the hazard of death.

We report an optimized hardware scheme for carrier frequency and phase recovery algorithms based on Mth-order power schemes for flexible intradyne coherent receivers. The phase recovery is based on the traditional Viterbi & Viterbi algorithm with a feedforward architecture, which requires an Mth-order power nonlinear operation. The output of such operation is also used in the differential phase-based approach for frequency offset estimation by means of a feedback loop. Hence, by using a single Mth-order operation, the reported architecture saves approximately half of the hardware resources for quadrature phase shift keying (QPSK) in the frequency recovery stage compared with fully independent phase and frequency algorithms. The evaluation of the accuracy of the proposed method is performed with digital signal processing in real-time using a field-programmable gate array (FPGA) for differential QPSK and 8PSK modulation formats. No significant performance penalty is observed when compared with an implementation featuring independent algorithms.

We experimentally characterize a bidirectional 2.5 Gb/s UDWDM-PON system based on Nyquist shaped DQPSK with digital signal processing in real time. The optical distribution network power budget of this system is evaluated and in coexistence of UDWDM channels with upstream TWDM-PON and RF video overlay signals, a set of optimum parameters and their impact on the network operation is driven. Additionally, we report the first field-trial of bidirectional coherent Nyquist UDWDM-PON using commercial real-time FPGA-based transceivers, coexisting with the deployed GPON, RF video overlay, and NG-PON2 technologies. A −44.5 dBm receiver sensitivity is achieved for 64 × 2.5 Gb/s DQPSK downstream channels and a 17 dB tolerance in dynamic power range of upstream channels is performed.