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Increasing urbanization and its implication for human health, outdoor thermal comfort, air quality or energy consumption necessitate a need for high-resolution urban modelling. In this study, we evaluate uSINGV, a coupled urban-atmosphere research model used by the Singapore Meteorological Service, for four clear-day over Singapore using two different spatial resolutions of 300 and 100 m, respectively. The model is modified to incorporate urban morphology and land use/land cover datasets which are based on European Space Agency climate change initiative data (ESA CCI) at 300 and local datasets at 100 m spatial resolution. The evaluation is carried out for near-surface variables such as temperature, specific humidity, wind speed, and turbulent surface fluxes using Kling-Gupta efficiency (KGE'), root mean square error (RMSE) and mean absolute error (MAE) as model evaluation metrics. Results suggest that temperature and specific humidity are similar for 300 m and 100 m spatial resolution. On the other hand, for 100 m (300 m), the 10 m wind speed has a KGE’ of 0.45 (0.15), RMSE of 0.69 (1.42) m/s, and MAE of 0.55 (1.26) m/s, hence showing improvements from 300 to 100 m spatial resolution. In addition, sensible heat flux for 100 m resolution simulations is closer to observations, while latent heat flux is overestimated. Overall, uSINGV is able to produce reliable simulations at 100 m spatial resolution, thereby showing promise for improved understanding of detailed urban climate processes.

This paper studies the features of metabolic parameters, diabetic complications and drug therapy of a single-centre cohort of patients with type 1 diabetes (T1DM) or type 2 diabetes (T2DM) in secondary care and tertiary care over a 15-year period. Methods: Retrospective cross-sectional analysis of four single-centre cohorts between 2004 and 2019. All patients with T1DM or T2DM in secondary care (n = 5571) or tertiary care (n = 2001) were included. Statistical analyses were performed using linear mixed models. Results: Diabetes duration increased in both patients with T1DM and T2DM in secondary care and tertiary care (p < 0.001). Patients in secondary care consistently showed good glycaemic control, while patients in tertiary care showed inadequate glycaemic control. All four cross-sectional cohorts showed a significant increase in the prevalence of nephropathy over time and three out of four cohorts (T1DM and T2DM in secondary care and T2DM in tertiary care) showed an increase in the prevalence of neuropathy (all p < 0.001). The incidence of severe hypoglycaemia was consistently low. The use of insulin pumps and insulin analogues in the therapy of T1DM increased significantly. Conclusions: The increased prevalence of complications is likely due to older age and longer diabetes duration. Low rates of hypoglycaemia, lower limb amputations and good glycaemic control in secondary care patients indicate a good structure of patient care.

A total of 20 urban neighbourhood-scale eddy covariance flux tower datasets are made openly available after being harmonized to create a 50 site–year collection with broad diversity in climate and urban surface characteristics. Variables needed as inputs for land surface models (incoming radiation, temperature, humidity, air pressure, wind and precipitation) are quality controlled, gap-filled and prepended with 10 years of reanalysis-derived local data, enabling an extended spin up to equilibrate models with local climate conditions. For both gap filling and spin up, ERA5 reanalysis meteorological data are bias corrected using tower-based observations, accounting for diurnal, seasonal and local urban effects not modelled in ERA5. The bias correction methods developed perform well compared to methods used in other datasets (e.g. WFDE5 or FLUXNET2015). Other variables (turbulent and upwelling radiation fluxes) are harmonized and quality controlled without gap filling. Site description metadata include local land cover fractions (buildings, roads, trees, grass etc.), building height and morphology, aerodynamic roughness estimates, population density and satellite imagery. This open collection can help extend our understanding of urban environmental processes through observational synthesis studies or in the evaluation of land surface environmental models in a wide range of urban settings. These data can be accessed from https://doi.org/10.5281/zenodo.7104984 (Lipson et al., 2022).

Simulations of five November months (2010–2014) using the urban version of the numerical weather prediction system of the Meteorological Service Singapore (uSINGV) are used to analyse the urban effect on convective precipitation over Singapore and Johor Bahru (Malaysia). The model is able to closely predict locations where rainfall peaks occur, but rainfall totals are overestimated compared to radar data. The temporal variability of rainfall in the region shows that urban areas increase the frequency and severity of rainfall events and that such impact increases with the rainfall intensity. Results show that low-level moisture advection is enhanced in this coastal conurbation as a result of the strengthening of wind convergence. The latter is likely caused by increasing sea-breeze strength due to lower surface pressure over the urban area, and higher urban surface roughness, respectively. As a consequence, more precipitable water is available in the region, enhancing convection and increasing the probability of heavy rainfall over the centre and north of Singapore island and Johor Bahru. Stronger convection further increases moisture advection from the vicinity. By studying the temporal variability and the spatial distribution of rainfall events, the present study provides new insights on the urban impact on heavy rainfall in tropical areas. The conclusions are only valid for the November inter-monsoon period, when local forcing, rather than large-scale influences, dominates rainfall generation. National Environment Agency - Singapore, R-109-000-338 236-490

Congenital hyperinsulinism (CHI) is a rare glucose metabolism disorder characterized by unregulated secretion of insulin that leads to hyperinsulinemic hypoglycemia (HH). Most cases are caused by mutations in the KATP-channel genes ABCC8 and KCNJ11. We report 2 patients that experienced severe HH from the first day of life. Patient 1 developed midgut volvulus after initiating diazoxide and required intestinal resection. He was subsequently managed with a high-dose octreotide and glucose-enriched diet. Consistent with diffuse type CHI by 18F-dihydroxyphenylalanine positron emission tomography-computed tomography, genetic testing revealed a homozygous ABCC8 variant, c.1801G>A, p.(Val601Ile). The rare variant was previously reported to be diazoxide-responsive, and the patient responded well to diazoxide monotherapy, with clinical remission at 2 years of age. Patient 2 responded to diazoxide with spontaneous clinical remission at 15 months of age. However, an oral glucose tolerance test at 7 years of age revealed hyperinsulinism. Genetic testing revealed that the proband and several seemingly healthy family members harbored a novel, heterozygous ABCC8 variant, c.1780T>C, p.(Ser594Pro). Genetic findings identified previously unrecognized HH in the proband's mother. The proband's uncle had been diagnosed with monogenic ABCC8-diabetes and was successfully transitioned from insulin to glibenclamide therapy. We report findings of intestinal malrotation and volvulus occurring 2 days after initiation of diazoxide treatment. We also report a novel, heterozygous ABCC8 variant in a family that exhibited cases of CHI in infancy and HH and monogenic diabetes in adult members. The cases demonstrate the importance and clinical utility of genetic analyses for informing and guiding treatment and care.

Model-based solutions for monitoring and control of chemical batch processes have been of interest in research for many decades. However, unlike in continuous processes, in which model-based tools such as Model Predictive Control (MPC) have become a standard in the industry, the reported use of models for batch processes, either for monitoring or control, is rather scarce. This limited use is attributed partly to the inherent complexity of the batch processes (e. g., dynamic, nonlinear, multipurpose) and partly to the lack of appropriate commercial tools in the past. In recent years, algorithms and commercial tools for model-based monitoring and control of batch processes have become more mature and in the era of Industry 4.0 and digitalization they are slowly but steadily gaining more interest in real-word batch applications. This contribution provides a practical example in this application field. Specifically, the use of a grey-box modeling approach, in which a multiway Projection to Latent Structure (PLS) model is combined with a first-principles model, to monitor the evolution of a batch polymerization process and predict in real-time the final batch quality is reported. The modeling approach is described, and the experimental results obtained from an industrial batch laboratory reactor are presented.

In this paper, modeling of storage constraints and material transfer are considered for short-term batch scheduling. The key features of storage and quality checks are inspired from a case study of a multiproduct batch plant. The case study presents two strategies for assigning batch orders to each individual storage tank during batch production, which are modeled in the proposed scheduling formulations as two scenarios of storage policies. A continuous-time MILP formulation is applied for the assignment and sequencing of batches in the multistage processes. The proposed approach is tested using the case study problems, and the computational results illustrate the performance of the scheduling formulations.

Understanding the response of extreme precipitation (EP) at a city scale to global warming is critical to reducing the respective risk of urban flooding. Yet, current knowledge on this issue is limited. Here, focusing on an urban agglomeration in the tropics, Singapore, we reveal that future global warming enhances both frequency and intensity of EP, based on simulations with a state-of-the-art convection-permitting regional climate model. EP intensification can reach maximum "super" Clausius-Clapeyron rate (>= $\ge $+7% per K warming) rate, implying a "new normal" of "extreme events get more extreme," which is consistently for both Representative Concentration Pathways 8.5 and 4.5. The intensification is lower for moderate and light precipitation. Also, global warming was found to dampen the urban effect on EP events. The EP enhancement is attributed to the increased atmospheric moisture and convective inhibition due to enhanced low-level stratification that delays a convection to develop until it becomes more intense., Earth's Future, 10 (6), ISSN:2328-4277

Objective To assess patent ductus arteriosus treatment variation between Swiss perinatal centers and to determine its effect on outcome in a population-based setting. Study design This was a retrospective cohort study of infants born less than 28 weeks of gestation between 2012 and 2017. Outcomes between surgically ligated and pharmacologically treated infants as well as infants born in centers performing ≤10% ligation (“low” group) and >10% (“high” group) were compared using logistic regression and 1:1 propensity score matching. Matching was based on case-mix and preligation confounders: intraventricular hemorrhages grades 3-4, necrotizing enterocolitis, sepsis, and ≥28 days’ oxygen supply. Results Of 1389 infants, 722 (52%) had pharmacologic treatment and 156 (11.2%) received surgical ligation. Compared with infants who received pharmacologic treatment, ligated infants had greater odds for major morbidities (OR 2.09, 95% CI 1.44-3.04) and 2-year neurodevelopmental impairment (OR 1.81, 95% CI 1.15-2.84). Mortality was comparable after restricting the cohort to infants surviving at least until day 10 to avoid survival bias. In the “low” group, 34 (4.9%) of 696 infants were ligated compared with 122 (17.6%) of 693 infants in the “high” group. Infants in the “high” group had greater odds for major morbidities (OR 1.49, 95% CI 1.11-2.0). Conclusions Our analysis identified a burden on infants receiving surgical ligation vs pharmacologic treatment in a population-based setting where there was no agreed-on common procedure. These results may guide a revision of patent ductus arteriosus treatment practice in Switzerland.

Our aim was to develop and validate a predictive risk score for bronchopulmonary dysplasia (BPD), according to two clinically used definitions: 1. Need for supplementary oxygen during ≥ 28 cumulative days, BPD28, 2. Need for supplementary oxygen at 36 weeks postmenstrual age (PMA), BPD36. Logistic regression was performed in a national cohort (infants born in Switzerland with a birth weight < 1501 g and/or between 23 0/7 and 31 6/7 weeks PMA in 2009 and 2010), to identify predictors of BPD. We built the score as the sum of predicting factors, weighted according to their ORs, and analysed its discriminative properties by calculating the area under the ROC (receiver operating characteristic) curves (AUCs). This score was then applied to the Swiss national cohort from the years 2014–2015 to perform external validation. The incidence of BPD28 was 21.6% in the derivation cohort (n= 1488) and 25.2% in the validation cohort (n= 2006). The corresponding numbers for BPD36 were 11.3% and 11.1%, respectively. We identified gestational age, birth weight, antenatal corticosteroids, surfactant administration, proven infection, patent ductus arteriosus and duration of mechanical ventilation as independent predictors of BPD28. The AUCs of the BPD risk scores in the derivation cohort were 0.90 and 0.89 for the BPD28 and BPD36 definitions, respectively. The corresponding AUCs in the validation cohort were 0.92 and 0.88, respectively.Conclusion: This score allows for predicting the risk of a very low birth weight infant to develop BPD early in life and may be a useful tool in clinical practice and neonatal research.What is Known:• Many studies have proposed scoring systems to predict bronchopulmonary dysplasia (BPD).• Such a risk prediction may be important to identify high-risk patients for counselling parents, research purposes and to identify candidates for specific treatment.What is New:• A predictive risk score for BPD was developed and validated in a large national multicentre cohort and its performance assessed by two indices of accuracy.• The developed scoring system allows to predict the risk of BPD development early but also at any day of life with high validity.

Water storage plays an important role in mitigating heat and flooding in urban areas. Assessment of the capacity of cities to store water remains challenging due to the extreme heterogeneity of the...

A snapshot of web pages describing the site location informationand observations used in the Urban-PLUMBER model evaluation projectfor urban areas. Observational data files themselves are NOT included. Access to observational data files must be separately negotiated with data owners. Webpage available at:https://urban-plumber.github.io/sites

In the process industry, various types of degradation occur in processing plants, resulting in significant economic losses. Modeling of degradation is important because it provides quantitative insights for consideration of degradation impacts in the operations of process manufacturing. This paper studies batch processes that show a periodic pattern for the evolution of degradation. A new data structure, the campaign, is applied for data-driven modeling of the periodic batch-to-batch evolution of degradation using a new multiway partial least squares approach, and it is further employed to predict the evolution of degradation in a series of batch runs. The proposed approach is illustrated and applied in a comprehensive industrial case study. The example illustrates the efficacy of the proposed model and presents a fair potential for applications of degradation prediction. © 2019 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license. (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Degradation such as fouling has significant negative impact on the efficiency of process manufacturing. Creating transparency about degradation is essential in the operations of the plants. This paper focuses on the state estimation of fouling in a multipurpose batch process, and the problem is formulated using an industrial case study. Due to the lack of a good model of fouling, the state estimation is integrated with parameter estimation using the expectation maximization (EM) algorithm, where the variational approximation method is employed for the intermediate robust state estimation in the E-step. The proposed state estimation is applied in the case study, which demonstrates the efficacy of the estimation of a recipe-independent key performance indicator for the batch-to-batch fouling. © 2019, IFAC (International Federation of Automatic Control) Hosting by Elsevier Ltd. All rights reserved.

Background Stress during ambulance transportation has been described in adult healthy volunteers where indicators of stress such as heart rate, blood pressure, and cortisol increased significantly. In neonates, a few studies have described stress in ambulance with behavioural scales. However, there is no study in neonates assessing both behavioural and physiological indicators of stress simultaneously during ambulance transportation. Objective To assess the feasibility of a study aiming at identifying stress in clinically stable neonates during ambulance transportation in non-emergency situations. Methods Stable neonates transported by ambulance from September 2015 to January 2016 were eligible. Physiological and behavioural parameters of stress were measured during the entire transfer procedure, starting on the ward of departure until hospitalisation at destination. Physiological parameters included salivary cortisol concentration, heart rate, respiratory rate, and oxygen saturation. Behavioural parameters were measured with the Comfort Behavior and the Premature Infant Pain Profile-Revised scales. Results Twenty neonates were included. The study proved to be feasible, but collection of saliva for cortisol measurement was problematic. To reach a sufficient amount of saliva, the collection time had to be extended from 90 to 300 s. Physiological parameters demonstrated heterogeneous patterns of stress. Behavioural scores increased during the entire transfer procedure and did not return to baseline values, indicating discomfort, specifically during transfer from the cot into the transport incubator. Conclusions Salivary cortisol values were variable. Behavioural measurement of stress provided a more sensitive measure to detect low level of stress, as shown in our sample of stable neonates, during non-emergency transportation.

The objective of this study was to identify risk factors and study the causes of neonatal mortality of LBW newborns referred to the Institute of Nutrition and Child Health. Material and Methods: This is a prospective descriptive and analytical study from March 1 to August 31, 2015, involving 250 newborns referred to the Neonatology Department of the Institute of Child Nutrition and Health (INSE). Results: During our study period, we recorded 1169 newborns, 250 of whom were referred, representing a referral frequency of 21.38%. The overall mortality rate for transferring newborns was 46.8%. Risk factors associated with neonatal mortality were gravidity (p = 0.0019), parity (p = 0.0323), occupational activities requiring physical effort (p = 0.0257), birth weight (p = 0.0008) and prematurity (p = 0.0039). Conclusion: Neonatal mortality associated with referrals is a major health problem in developing countries. There is currently no doubt that it is possible to significantly reduce perinatal mortality and morbidity rates by organizing the identification of “mother-child” couples at risk, to refer them intently to centres better equipped with technical and human resources to care for them.

Two neonates were presented at the Neonatology Department of the Institute of Child Nutrition and Health in Conakry, Guinea, with tension pneumothoraces as confirmed by chest X-ray. They were initially managed with needle thoracentesis but required continuous thoracic drainage. Due to scarce resources in the public health sector, no prepacked and dedicated pleural drainage systems were available as is the case in many developing countries. Therefore, we fabricated an improvised underwater seal drain out of a plastic infusion bottle and a Heimlich valve out of a vicryl fingerstall. Both devices have shown to be effective. Pneumothorax is a common and potentially life-threatening disease in neonates that often requires prompt treatment. This case series demonstrates how tension pneumothorax in two newborns was successfully managed by improvising different chest drainage systems. The depicted techniques shall serve as an instruction manual to healthcare professionals working in low-resource settings and facing similar challenges.

Large spatial differences in canopy-layer air temperature are found across the city as a consequence of distinct urban morphologies and anthropogenic activities throughout the urban landscape. Model-based studies investigating the spatial and temporal variability of air temperature are commonly employed to assess heat mitigation strategies in cities. It is therefore important that models are capable to accurately predict air temperature variability across the city to account for the local climate context. This study explores the sensitivity of the Weather Research and Forecasting (WRF) model coupled with a multi-layer urban scheme (BEP-BEM) to simulate intra-urban variations of 2-m air temperature during different synoptic conditions in a tropical city, Singapore. An accurate representation of the real heterogeneous urban morphology of Singapore is implemented in the model. Two one-month long simulations are conducted for distinct synoptic weather conditions: (a) a relatively wet period during the SW monsoon and (b) a very dry period during the NE monsoon. The performance of the model is firstly evaluated against micrometeorological data collected by a tall eddy covariance flux tower in a representative low-rise residential neighbourhood. Overall good performance is obtained for wind speed and direction, turbulence parameters and surface energy balance components, in particular during dry conditions. Some difficulties are found in predicting intermittent cloud cover, which results in an overestimation of net radiation increasing model errors during the wetter period. Hence the comparison of 2-m air temperatures against observations results in slightly higher errors during the latter period (RMSE