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Up to 10% of hospitalised patients are registered as penicillin allergic. However, 80-90% will tolerate penicillin after evaluation. New Danish guidelines suggest criteria for evaluation of patients based on risk stratification according to the severity of the index reaction. The allergy label can be removed immediately, if allergy can be ruled out using the criteria presented in this review, but all other patients should be referred for evaluation in a specialist allergy department. Specific IgE measurement should only be done in adult patients with an immediate reaction (onset less-than 2 h after intake of a tablet) or urticaria.

Background: Asthma is a common chronic disease worldwide without any known cure. Despite remarkable improvement in asthma treatment, better education and guideline implementation strategies, there is growing interest in using complementary and alternative medicine, like reflexology and homeopathy. However, evidence supporting the effectiveness of homeopathy and reflexology in asthma treatment is not available. Objective: The aim of this study was to evaluate the effect of reflexology and homeopathy as adjunctive therapies in asthma. Methods: In a single centre, randomised, investigator blinded, controlled study 86 asthma patients were enrolled. They were assigned to one of three study groups (conventional treatment alone or conventional treatment with addition of either homeopathy or reflexology). All patients received their asthma treatment during the study and were followed as usual by their general practitioner. The study assignment group of individual patients were blinded to the investigators, who made the clinical evaluation of asthma control. The primary outcome was the change in the asthma quality of life questionnaire (AQLQ) scores after 26 weeks. Secondary outcomes included asthma control questionnaire, EuroQol, forced expiratory volume in 1 sec, morning and evening peak expiratory flow, asthma symptoms, rescue medication use, and total medication score. Results: Minor improvements in the AQLQ score were observed in all three groups. However, no statistically significant changes in AQLQ scores were seen within or between groups. Likewise, secondary outcomes did not differ between groups. Conclusions: In this study, the addition of homeopathy or reflexology to conventional treatment did not result in improved quality of life in asthma.

The role of personalized ventilation (PV) in protecting against airborne disease transmission between occupants was evaluated by considering two scenarios with different PV alignments. The possibility that PV may facilitate the transport of exhaled pathogens was explored by performing experiments with droplets and applying PV to a source or/and a target manikin. The risk of direct and indirect exposure to droplets in the inhalation zone of the target was estimated, with these exposure types defined according to their different origins. The infection risk of influenza A, a typical disease transmitted via air, was predicted based on a dose-response model. Results showed that the flow interactions between PV and the infectious exhaled flow would facilitate airborne transmission between occupants in two ways. First, application of PV to the source caused more than 90% of indirect exposure of the target. Second, entrainment of the PV jet directly from the infectious exhalation increased direct exposure of the target by more than 50%. Thus, these scenarios for different PV application modes indicated that continuous exposure to exhaled influenza A virus particles for 2 h would correspond with an infection probability ranging from 0.28 to 0.85. These results imply that PV may protect against infection only when it is maintained with a high ventilation efficiency at the inhalation zone, which can be realized by reduced entrainment of infectious flow and higher clean air volume. Improved PV design methods that could maximize the positive effects of PV on disease control in the human microenvironment are discussed., Highlights • Role of personalized ventilation (PV) against airborne disease transmission is evaluated using droplets in terms of exposure risk and infection risk of influenza A. • Interactions between PV and infectious exhalation can facilitate the transport of exhaled pathogens. • PV used for the infector increases indirect exposure to the exposed occupant. • Direct entrainment of an infectious exhaled flow by PV should be strictly avoided. • Infection risk is lowered when PV delivers clean air to inhalation without direct entrainments from an infectious exhaled flow.

Refractories are indispensable for all high temperatures processes, such as the production of metals, cement, glass and ceramics. It is estimated that up to 28 million tons of spent refractories are generated every year. Despite these significant amounts, recycling of spent refractories has received little attention due to the abundance of low cost virgin raw materials and low disposal costs of the, largely inert, materials. In the last two decades, recycling of spent refractories has started to receive more attention due to environmental considerations and increasing costs for landfilling. However, recycling in applications such as road bed foundations or slag conditioners does not capture the full intrinsic value of the materials. Higher value recycling as refractory raw materials is much more limited, and estimated at only 7% of refractory raw material demand. Recently, rising prices and supply issues for high quality virgin raw materials have created a strong incentive for closed-loop refractory recycling. This review gives an overview of the history of refractory recycling and the main refractory recycling applications, with a particular focus on recycling in new refractories. Current spent refractory processing in view of raw material recycling is discussed, and an outlook is given to future trends and developments.

Manufacturing enterprises today have to face the volatility of markets, characterized by a decreasing production volume and an increasing number of product variants to meet customer expectations. Traditional dedicated manufacturing lines (DML) have been replaced by flexible manufacturing systems (FMS) and, recently, by the systems that combine features of DML and FMS, i.e., by reconfigurable manufacturing systems (RMS). Appropriate manufacturing support and optimization systems for FMS and RMS will advance the quality and effectiveness of reconfigurable manufacturing. This paper proposes an original mixed integer linear programming (MILP) model for decision support in configuration and reconfiguration of the manufacturing system. The modeled problem is a certain development of the known machine loading problem MLP. In this approach, we generate a highly parameterized model based on a set of constraints and a set of questions. Different mathematical programming (MP) - based solvers are proposed to solve this model.

Two kinds of intertwined decisions: the routing decisions, which determine the set of sequences of stations visited by each tugger train’s route, and the scheduling decisions, which plan congestion-free movements of tugger train fleets, are considered. The problem under study can be seen as extension of the pick-up and delivery problem with time windows in which different profiles of separately executed delivery and pick-up operations are assumed. The NP-hard character of the problem considered follows from its roots derived from the vehicle routing and the deadlock-avoidance problems. In this regard, a constraint programming paradigm allowing the further integration of multi-period, multi-trip and multi-commodity flows with various customers’ demands as well as distribution network topology constraints is applied. Consequently, a recursive formulation of a well-known constraint satisfaction problem is proposed. The computer experiments provided illustrate the possibility of using the approach presented in systems of real-life scale.

In this paper, a depth-first search strategy to cope with the problem of multi-trip unmanned aerial vehicle (UAV) fleet mission planning is proposed. The considered UAVs delivery problem aims at a trajectory planning issue addressed for UAVs operating in a hostile environment while considering battery and payload weight as well as vehicles reuse. Employed UAVs fly on a 3D plane matching a distribution network while servicing customers and ensuring collision avoidance among team members. The objective is to get a sequence of submissions that ensures delivery to customers satisfying the requested amount and demands within a given time horizon. The method proposed in this paper offers solutions to several questions related to the multistage mission planning that could be applied to solve problems such as minimizing energy consumption, conducting the mission in the shortest possible time, just-in-time replenishing of supplies, and so on. The computational experiment illustrates possibilities of the proposed method.

Deriving a detailed schedule for an unmanned aerial vehicle (UAV) deployment involves a wide range of scheduling problems, where solving them as a whole is intractable. Moreover, uncertainties in operational environments of the UAV deployment bring a gap between models assumed for the scheduling problems and an actual system. Motivated by the facts, we propose a conceptual design of a scheduling system for a UAV deployment. Specifically we first introduce fundamental scheduling problems for UAV deployments and specify dependencies between them. A design for a scheduling system, which sequentially solves the scheduling problems and evaluates the solutions using a simulation model, is then proposed. Finally, a prototype of the scheduling system implemented to demonstrate the feasibility of the design is described.

In order to deal with unexpected events such as employee absenteeism and/or a demand for personnel that is higher or lower than expected, organizations need to adopt proactive and reactive scheduling strategies to protect the personnel roster and to respond to this operational variability, respectively. In this paper, we propose a preemptive programming approach to construct a personnel shift roster that maximizes the employee substitutability. A proactive approach builds in a certain degree of robustness in the original roster. This built-in robustness improves both the absorption and adjustment capability of the original roster during the operational allocation phase when unexpected events occur. With a view to developing a DSS-driven method dedicated to competence allocation planning robust to unexpected staff absenteeism, we present a methodology, based on constraints programming and robust employee competence structure concepts. Introduced approach allows to find an employee competence structure robust to a given set of disruptions while guaranteeing an admissible personnel allocation to the assumed set of tasks. Potential applications of the proposed solution are discussed using examples.

Metaheuristics are known to be strong in solving large-scale instances of computationally hard problems. However, their efficiency still needs exploration in the context of instance structure, scale and numerical properties for many of these problems. In this paper, we present an in-depth computational study of two local search metaheuristics for the classical uncapacitated facility location problem. We investigate four problem instance models, studied for the same problem size, for which the two metaheuristics exhibit intriguing and contrasting behaviours. The metaheuristics explored include a local search (LS) algorithm that chooses the best moves in the current neighbourhood, while a randomised local search (RLS) algorithm chooses the first move that does not lead to a worsening. The experimental results indicate that the right choice between these two algorithms depends heavily on the distribution of coefficients within the problem instance. This is also put further into context by finding optimal or near-optimal solutions using a mixed-integer linear programming problem solver. Since the facility location problem is a relatively simple example of a choice-and-assignment problem, similar phenomena are likely to be discovered in a number of other, possibly more complex computational problems in science and engineering.

Following the massive interests in unmanned aerial vehicles (UAVs), various optimization algorithms have been proposed for a path planning problem that allow the units to navigate in a region filled with threats such as a radar detection in air defence systems. Among the algorithms, we address Dijkstra’s algorithm and a heuristic algorithm for the path planning of a UAV. The algorithms are compared under various configurations of a region to navigate with respect to the optimality and the computational complexity of the algorithms.

Objective:We evaluated processing-speed and shift-cost measures in adults with depression or attention-deficit hyperactivity disorder (ADHD) and monitored the effects of treatment. We hypothesised that cognitive-speed and shift-cost measures might differentiate diagnostic groups.Methods:Colour, form, and colour–form stimuli were used to measure naming times. The shift costs were calculated as colour–form-naming time minus the sum of colour- and form-naming times. Measurements were done at baseline and end point for 42 adults with depression and 42 with ADHD without depression. Patients with depression were treated with transcranial pulsed electromagnetic fields and patients with ADHD with methylphenidate immediate release.Results:During depression treatment, reductions in naming times were recorded weekly. One-way analysis of variance indicated statistical between-group differences, with effect sizes in the medium range for form and colour–form. In both groups, naming times were longer before than after treatment. For the ADHD group, shift costs exceeded the average–normal range at baseline but were in the average–normal range after stabilisation with stimulant medication. For the depression group, shift costs were in the average–normal range at baseline and after treatment. Baseline colour–form-naming times predicted reductions in naming times for both groups, with the largest effect size and index of forecasting efficiency for the ADHD group.Conclusions:The cognitive-processing-speed (colour–form) and shift-cost measures before treatment proved most sensitive in differentiating patients with depression and ADHD. Reductions in naming times for the depression group were suggested to reflect improved psychomotor skills rather than improved cognitive control.

Inhalation exposure to indoor particulate contaminants contributes as one of the leading threats to public health. Most existing airway morphometry models are either theoretical or semi-empirical; these are developed for predicting deposition fractions for an averaged general population subgroup. It is difficult to customize a fast and accurate prediction on individual basis. This study aims to analyse the regional particle deposition along an anatomically correct airway model, which is developed from a healthy volunteer’s computer tomography images. Computational fluid dynamics simulation results show that the majority of particles are deposited in the bronchi. Accumulation particles (0.1–2.0 μm) have the smallest deposition fraction in the lower airways. An increase in the aerodynamic diameter >2.0 μm of the particles elevated the deposition fraction. These findings inspire future investigations into control methods that minimize the negative health impact of indoor emissions.

The condition of the sea surface and seabed boundaries of the ocean often significantly affect the characteristics of acoustic signal propagation, reverberation and noise particularly in shallow water. A series of collaborative experiments were conducted from 2000 to 2009 to better understand the impact of ocean boundary characteristics on ocean acoustic signals in the frequency range of 100 – 5000 Hz. Acoustic measurements included long-range (waveguide) propagation, reverberation, and clutter as well as measurements of local boundary reflection and scattering. These were supported by oceanographic, geophysical and geologic measurements. Experimental locations included the Tyrrhenian Sea, Straits of Sicily, the New Jersey shelf, and the Scotian shelf with collaborators from NATO-STO CMRE and national laboratories and institutions from Italy, Canada, France, and the US. This talk will provide an overview of some of the main results from these experiments. [Research sponsored by CMRE(NATO), ONR(US), NUWC(US), INGV(IT), SHOM(FR), DRDC(CA), Italian Navy(IT).]

We investigated the intracellular dynamics of calcite and sulfur in the large sulfur-oxidizing, calcite-accumulating bacterium Achromatium, with an emphasis on oxygen exposure as a physiological control. For this purpose, morphological changes and possible accretion mechanisms of calcite granules in cells that were freshly collected from natural Achromatium-containing sediment were compared to cells from the same source after prolonged exposure to atmospheric oxygen. Intracellular sulfur is oxidized and removed in response to oxygen exposure. Calcite granules also undergo distinct oxygen-related dynamics; they alternate between tightly packaged, smooth granules with narrow but sharply defined interstitial spaces in atmospheric oxygen-exposed cells, and more loosely packaged granules with irregular, bumpy surface texture and larger interstitial spaces in cells that were not artificially exposed to oxygen. These results suggest that morphological changes of the calcite granules reflect their changing physiological role inside the cell. Sulfur oxidation and calcite dissolution appear to be linked in that proton generation during sulfur oxidation is buffered by gradual calcite erosion, visible in the smooth, rounded surface morphology observed after oxygen exposure. Our results support the hypothesis that calcite dynamics buffer the intracellular pH fluctuations linked to electron acceptor limitation during proton-consuming sulfide oxidation to sulfur, and electron acceptor abundance during proton-generating sulfur oxidation to sulfate.

The study considers the generation of surface water waves by wind through pressure and shear stress acting on the surface. The situations of temporal growth of an infinitely long uniform wave train and of down-wind growth of a stationary non-uniform wave field are treated. The mechanisms of energy and momentum transfer between the wind and the waves are considered and it is explained how the ‘wave Reynolds stress’ and the wave set-down are contributing to a force balance over the water column. The role of the wind forcing for the wave drift and a mean current is shown. The analogy between energy dissipation by wave breaking and wave generation by a harmonic surface shear stress is discussed together with the transfer of momentum to the ocean currents by breaking waves.

An analytical model is presented for the 2DV flow-structure, bed shear stress and surface shape of the tips of dam-break waves, tsunami- or wave run-up. This model differs from previous analytical models, which have taken the usual ‘hydraulics approach’, describing bed-parallel velocities only and expressing the bed shear stress, τ in terms of a friction factor from steady, uniform flow and an ad-hoc velocity. The 2DV model presented here gives a simple, rational explanation for the fact that the boundary layer is very thin at the contact point. In turn, this explains the measurements of bed shear stresses, which decay with distance s from the tip, or at a fixed point, with time t since passage of the tip. The manner of τ−decay depends on the growth of the boundary layer thickness δ with distance from the tip. The details of this boundary layer growth depend on challenging turbulence features for unsteady, non-uniform flows over rough and usually mobile beds. For illustrative purposes, details are given for the simple example of δ = (vtt)1/2 = (vts/c)1/2, where vt is the nominal eddy-viscosity and c is the speed of the tip, assumed to progress with constant form. With this variation of δ, the model gives τ ∼ t−1/2 = (s/c)−1/2, which is in good qualitative agreement with measurements. Subsequently, this quasi-steady model gives h ∼ s1/4 for the depth on a horizontal bed, also in good agreement with experiments. The 2DV flow pattern includes surface particles drifting towards the tip and eventually impacting on the bed at the contact point with full forward momentum and large bed-normal velocity. As well as large local bed shear stresses, this tip-flow pattern involves large vertical accelerations and associated large localized pressures, which are likely to be important for the sediment entrainment under the tip. The eddy viscosity is the only tuning parameter in this simple initial model. Based on shear-stress and depth measurements from laboratory settings, with tip propagation speeds of the order 2 m/s, one finds that the required eddy viscosity is in the range 1 × 10−6 - 18 × 10−6 m2/s increasing with increasing bed roughness in the range from smooth beds to beds of 2.85 mm fixed sand-grains.

Rising sea levels are expected to cause widespread coastal recession over the course of the next century. In this work, new insight into the response of sandy beaches to sea level rise is obtained through a series of comprehensive experiments using monochromatic and random waves in medium scale laboratory wave flumes. Beach profile development from initially planar profiles, and a 2/3 power law profile, exposed to wave conditions that formed barred or bermed profiles and subsequent profile evolution following rises in water level and the same wave conditions are presented. Experiments assess profile response to a step-change in water level as well as the influence of sediment deposition above the still water level (e.g. overwash). A continuity based profile translation model (PTM) is applied to both idealised and measured shoreface profiles, and is used to predict overwash and deposition volumes above the shoreline. Quantitative agreement with the Bruun Rule (and variants of it) is found for measured shoreline recession for both barred and bermed beach profiles. There is some variability between the profiles at equilibrium at the two different water levels. Under these idealised conditions, deviations between the original Bruun Rule, the modification by Rosati et al. (2013) and the PTM model predictions are of the order of 15% and all these model predictions are within ±30% of the observed shoreline recession. Measurements of the recession of individual contour responses, such as the shoreline, may be subject to local profile variability; therefore, a measure of the mean recession of the profile is also obtained by averaging the recession of discrete contours throughout the active profile. The mean recession only requires conservation of volume, not conservation of profile shape, to be consistent with the Bruun Rule concept, and is found to be in better agreement with all three model predictions than the recession measured at the shoreline.

Flammable gases and vapours are widely used in industrial field, which brings up the explosion risk in the large premises. In this paper, several transient experiments have been conducted in a newly built large space chamber. Sulfur hexafluoride (SF6) was released in a specific place in each experiment while the space was ventilated throughout each experiment. The concentrations were measured and recorded at several points. Several parameters have been changed, namely air distribution pattern, air change rate, contaminant gas emission rate and contaminant source releasing method. The approximate accessibility of contaminant source (ACS) in different experiment conditions have been yielded with experimental data and compared. The dimensionless number ( g ' q V / D ) 1 / 3 / U i n l e t has been proposed on the basis of the passive gas criterion of ( g ' q V / D ) 1 / 3 / U to represent the magnitude of the gas gravity effect. The experiment results show obvious correlations between ACS and ( g ' q V / D ) 1 / 3 / U i n l e t at different locations.

BackgroundThe optimal pulmonary revascularisation strategy in high-risk pulmonary embolism (PE) requiring implantation of extracorporeal membrane oxygenation (ECMO) remains controversial.MethodsWe conducted a systematic review and meta-analysis of evidence comparing mechanical embolectomy and other strategies, including systemic thrombolysis, catheter-directed thrombolysis or ECMO as stand-alone therapy, with regard to mortality and bleeding outcomes.ResultsWe identified 835 studies, 17 of which were included, comprising 327 PE patients. Overall, 32.4% were treated with mechanical pulmonary reperfusion (of whom 85.9% had surgical embolectomy), while 67.6% received other strategies. The mortality rate was 22.6% in the mechanical reperfusion group and 42.8% in the “other strategies” group. The pooled odds ratio for mortality with mechanical reperfusion was 0.439 (95% CI 0.237–0.816) (p=0.009; I2=35.2%)versusother reperfusion strategies and 0.368 (95% CI 0.185–0.733) (p=0.004; I2=32.9%) for surgical embolectomyversusthrombolysis. The rate of bleeding in patients under ECMO was 22.2% in the mechanical reperfusion group and 19.1% in the “other strategies” group (OR 1.27, 95% CI 0.54–2.96; I2=7.7%). The meta-regression model did not identify any relationship between the covariates “more than one pulmonary reperfusion therapy”, “ECMO implantation before pulmonary reperfusion therapy”, “clinical presentation of PE” or “cancer-associated PE” and the associated outcomes.ConclusionsThe results of the present meta-analysis and meta-regression suggest that mechanical reperfusion, notably by surgical embolectomy, may yield favourable results regardless of the timing of ECMO implantation in the reperfusion timeline, independent of thrombolysis administration or cardiac arrest presentation.

Since requirements of service demands are becoming increasingly complex and diversified, one of the success factors of a multimodal service system is its capability to design a specific service instance satisfying a specific set of requirements. This capability is further highlighted in Ad Hoc Multimodal Service Systems (AHMSSs), where service instances rarely follow a standard form of service delivery and exist only for a limited time. However, due to the increasing scale and frequency of services in many business and public sectors, meeting the desired level of capability has become troublesome. A well-designed Artificial Intelligence (AI) approach can be a solution to the difficulty by addressing the underlying complexity and uncertainty of the AHMSS design process. To conceptualize and foster AI applications to an AHMSS, this study identifies key decision-making problems in the AHMSS design process and discusses the role of AI in the process. The results will form the basis for AI development and implementation for an AHMSS and relevant service systems.

Natural ventilation enables personal control, and occupant behaviors in window opening play a decisive role on natural ventilation performance, indoor air quality (IAQ), and/or airborne infection risk in a hospital setting. The occupant behaviors differ significantly from different building types with different functions and living habits. Based on a one-year field measurement in two general hospital wards in Nanjing, China, the effects of air quality (i.e. indoor CO2 concentration and outdoor PM2.5 concentration) and the climatic parameters (i.e. indoor/outdoor temperature, relative humidity, and outdoor wind speed, wind direction and rainfall) on window opening/closing behaviors are analyzed. Indoor air temperature or relative humidity is found to be a dominant factor for window opening behaviors. Seasonal differences are observed for the different influences of physical factors. The outdoor temperature is found to be associated with the window opening probability negatively during the cooling season, but positively during the transition and heating seasons. The indoor relative humidity positively affects the window opening probability during the transition season while a negative impact appears during the cooling and heating seasons. Based on the seasonal variation of window opening behaviors, Logistic regression models in different seasons (cooling, transition and heating seasons) are developed to predict the window opening/closing state and are verified to be promisingly adaptable with results of accuracy bigger than 70%., Highlights • Influences of different thermal-driven factors on occupant behaviors in window opening vary with seasons. • The indoor temperature or relative humidity is a dominant factor for window opening behaviors in hospital wards in seasons. • Logistic regression models in different seasons are developed and verified with results of accuracy bigger than 70%.

Graphical abstract, In the context of COVID-19, new requirements are occurring in ventilation systems to mitigate airborne transmission risk in indoor environment. Personalized ventilation (PV) which directly delivers clean air to the occupant’s breathing zone is considered as a promising solution. To explore the potentials of PV in preventing the spread of infectious aerosols between closely ranged occupants, experiments were conducted with two breathing thermal manikins with three different relative orientations. Nebulized aerosols were used to mimic exhaled droplets transmitted between the occupants. Four risk assessment models were applied to evaluate the exposure or infection risk affected by PV with different operation modes. Results show that PV was effective in reducing the user’s infection risk compared with mixing ventilation alone. Relative orientations and operation modes of PV significantly affected its performance in airborne risk control. The infection risk of SARS-CoV-2 was reduced by 65% with PV of 9 L/s after an exposure duration of 2 h back-to-back as assessed by the dose–response model, indicating effective protection effect of PV against airborne transmission. While the side-by-side orientation was found to be the most critical condition for PV in airborne risk control as it would accelerate diffusion of infectious droplets in lateral diffusion to occupants by side. Optimal designs of PV for closely ranged occupants were hereby discussed. The four risk assessment models were compared and validated by experiments with PV, implying basically consistent rules of the predicted risk with PV among the four models. The relevance and applicability of these models were discussed to provide a basis for risk assessment with non-uniformly distributed pathogens indoor.

Accelerated carbonation is a rapidly developing technology that is attracting attention as it uses CO2 as a binder to make construction materials. Originally stemming from geochemical and environmental research into CO2 sequestration or waste remediation, accelerated carbonation has been developed into a technology that enables to transform alkaline precursors into products that meet technical requirements for use as aggregates or shaped blocks. Alkaline precursors can be manufactured from primary resources or derived from industrial residues: a.o. metallurgical slags, incineration ashes and concrete recycling residues are prone to carbonate under controlled conditions. Moist carbonation of shaped Ca-silicate rich precursors at elevated curing temperature and CO2 concentration or pressure has delivered the most promising results so far. This letter presents an overview of current accelerated carbonation approaches to make carbonate bonded construction materials from alkaline residues. The general carbonation mechanism is explained and two application routes are exemplified: i.e. production of lightweight aggregates and compact blocks by accelerated moist carbonation.

Novel series of experiments are presented that demonstrate morphological hysteresis in the evolution to equilibrium of beach profiles under sequences of different wave climates. The experiments were conducted in a wave flume at medium scale using both monochromatic and random waves, representing 2D conditions. Beach profiles were obtained with high spatial resolution at frequent intervals with a laser profiler, from which shoreline location, bar position and sediment transport rates were derived. Experiments were conducted for sequences of wave climates, where a sequence comprised of 6–13 sequential tests, each commencing with the beach profile from the preceding test. Each test was run until equilibrium conditions were obtained and had a constant wave height, increased or decreased relative to the preceding test. Cyclical conditions were also included, with erosive and accretive wave conditions of short durations alternating through multiple cycles, so that equilibrium conditions were not reached during a test. With a sequence of increasing wave heights, the relationship between the shoreline position and the bulk cross-shore sediment transport, at equilibrium, was non-monotonic, indicating a maximum in the landward sediment transport rate. For test series comprised of a sequence of increasing wave heights followed by a sequence of decreasing wave heights, morphological hysteresis was observed in the equilibrium shoreline position and bulk cross-shore sediment transport, such that shoreline recession, or offshore transport, continued in some instances after reductions in wave height. This is inconsistent with classical equilibrium type shoreline evolution models. However, when equilibrium conditions were not reached, in the cyclic sequences, no such morphological hysteresis was observed and a dynamic equilibrium is reached. The morphological hysteresis occurs because of the decay, stranding, or increased relative depth, of the breaker bar following a reduction in wave height, often in conjunction with a new breaker bar generated by further offshore transport in the inner surf zone. Similar sequences of morphological response are evident in field data and larger scale tests in the literature. Finally, it is shown that the morphological hysteresis can be explained using the classical equilibrium beach state model of Wright et al. (1985) by introducing the concept of a subsequent alternate active beach state, which may occur following a change in wave conditions.

The effect of milling on the leaching of Pb (and other metals like Fe, Cu, Ni and Zn) from a secondary lead smelter matte was studied. The effects of milling time, milling environment (dry or wet milling) and leaching reagent (Fe(III)-HNO3 or citrate solution) on the leaching efficiency of metals were investigated. A 1–2 mm ferromagnetic fraction of the matte, containing 54% Fe, 5.8% Pb, 24% S and minor levels of Cu (1.2%), Ni (0.2%) and Zn (0.3%), was used. Pb leaching in a Fe(III)-HNO3 solution was enhanced from 53% (no milling) to 85% after 5 min of dry milling. Prolonged milling resulted in an agglomeration of particles causing a galvanic effect (between FeS and Pb), which led to electrochemical precipitation of Pb2 + cations from the solution as PbS. Because of this electrochemical precipitation, almost no Pb2 + was detected in the Fe(III)-HNO3 solution after 10 min of dry milling. In order to avoid/reduce agglomeration and to obtain a finer particle size and higher leaching efficiencies, wet milling was carried out. The highest Pb leaching was obtained after 20 min of wet milling (88% in the Fe(III)-HNO3 and 94% in the citrate solution). Citrate solution was more selective towards Pb leaching, with

Prima facie, the supine verb forms in Swedish and Danish appear almost identical in terms of morphological form and syntactic function, but a closer look reveals fundamental differences regarding t...

The optimal parameters and time points for the measurement of iron overload (IO) in allogeneic stem cell transplantation (ASCT) patients are still under discussion. Hyperferritinemia and IO are poor prognostic factors in ASCT. We hypothesize that non-transferrin-bound iron (NBTI) is possibly a better marker to predict the effect of IO on the outcome than serum ferritin (SF), which however is not specific for IO. The aim of this prospective observational trial was to evaluate the influence of NBTI in comparison to SF on the outcome of ASCT patients [overall survival, bloodstream infections (BSIs), and invasive fungal infections (IFIs)]. We analyzed daily transferrin saturation (TSAT), SF, and NTBI (if TSAT exceeded 70%) in 100 patients who received ASCT during conditioning, and on day 0, +7, and +14 post-ASCT. After a median NTBI level of 0 μmol/l at baseline, the median of the area under the curve (AUC) of NTBI between conditioning and ASCT (d0) increased to 17 μmol*d/l, and between ASCT and day +14 to 56.3 μmol*d/l. Higher NTBI-AUC d0 resulted in a higher risk of BSI (HR 1.042, p = 0.009) and IFI (HR 1.070, p = 0.001) and showed a trend of inferior 1-year survival (65 vs. 76%, p = 0.09). Baseline SF did not influence BSI, but higher levels resulted in more IFI (HR 1.26, p

Lead times and their nature have received limited interest in literature despite their large impact on the performance and the management of supply chains. This paper presents a method and a case implementation of the same, to establish the behavior of real lead times in supply chains. The paper explores the behavior of lead times and illustrates how in one particular case they can and should be considered to be independent and identically distributed (i.i.d.). The conclusion is also that the stochastic nature of the lead times contributes more to lead time demand variance than demand variance.

Background Hip fractures constitute a major health problem in elderly people and are often fall-related. Several factors can contribute to a fall episode leading to hip fracture, including fall-risk-increasing drugs (FRIDs), which are often used by elderly people. We aimed to investigate the prevalence of medication-related falls and to assess the role of FRIDs and potentially inappropriate medications (PIMs) in a population of elderly patients hospitalized for a hip fracture. Methods We reviewed the patient records of 200 consecutive patients, aged ≥65 years, who were admitted for a hip fracture and evaluated whether medications were likely to have contributed to the fall episode. PIMs were identified using the Screening Tool of Older Persons’ Prescriptions version 2 (STOPP) and by evaluating indications, contra-indications and interactions of the prescribed medications for each patient. Results FRIDs were used by 175 patients (87.5%). Medications were considered a likely contributor to the fall in 82 patients (41%). These were most often psychotropic medications alone or in combination with antihypertensives and/or diuretics. The 82 patients with suspected medication-related falls used more medications, FRIDs and PIMs than the rest of the patients, and in 74 (90%) of the 82 patients, at least one medication considered to be a contributor to the fall was also a PIM. Conclusions The prevalence of suspected medication-related falls was 41%. It seems likely that a medication review could have reduced, though not eliminated, the risk of falling in this group of patients.

The Comprehensive Nuclear-Test-Ban Treaty (CTBT) International Monitoring System (IMS) is a world-wide network of stations and laboratories designed to detect nuclear explosions underground, in the oceans and in the atmosphere. The IMS incorporates four technologies: seismic, hydroacoustic and infrasound (collectively referred to as waveform technologies), and radionuclide (particulate and noble gas). The focus of this presentation is the hydroacoustic component of the IMS, which consists of 6 hydroacoustic stations employing hydrophones deployed in the oceans and 5 near-shore seismic stations, called T-phase stations, located on islands or continental coastal regions. The purpose of T-phase stations is to detect water-borne hydroacoustic pressure waves converted into seismic waves that propagate on the earth’s crust and are detected by land seismometers. However, the conversion process from in-water pressure to near-interface seismic waves is complex and strongly dependent on the properties of the local underwater and geological environment. To further understand this conversion process, state-of-the-art hybrid seismo-acoustic wave propagation models have been applied to simplified environments and to scenarios representative of the conditions encountered at IMS T-phase stations to compute broadband pressure time-series in the water and particle velocity components on-land. Transfer functions from in-water pressure to on-land seismic particle velocity and vice versa were estimated both from modelling results and from real data acquired in locations where the hydrophones and (non-IMS) seismic stations were within 50-km distance. The presented results have been used to give a first assessment of the feasibility of characterizing the hydroacoustic phase of an in-water event by on-land seismic recordings at IMS T-phase stations, subject to limited a-priori environmental information and limiting factors, such as band-width and instrumental and/or environmental noise.

Starting with a finite point set $X \subset \mathbf{R}^d$, the peeling process repeatedly removes the set of the vertices of the convex hull of the current set. The number of peeling steps required to completely remove $X$ is called the layer number of $X$, denoted by $L(X)$. In the article, we study the layer number of evenly distributed families of point sets contained in $B^d$, the $d$-dimensional unit ball. These sets consist of points in $B^d$ whose minimal distance is asymptotically as large as possible. We show that for a set $X$ belonging to an evenly distributed family, $L(X) \geq \Omega(|X|^{1/d})$ holds, with the bound being asymptotically sharp. On the other hand, building on earlier results, we prove that $L(X)\leq O(|X|^{2/d})$ holds for $d\geq 2$, which improves greatly on the current upper bound of $O(|X|^{(d+1)/2d})$ for $d \geq 3$. Finally, we provide a recursive construction of evenly distributed families whose sets satisfy $L(X) = \Theta(|X|^{2/d - 1/(d 2^{d-1})})$, showing that our upper bound is nearly tight., Comment: Accepted for publication in Discrete Mathematics

This paper is based on the interest to see how problems are addressed in information systems design research. Problems addressed by design research are often implicit, sometimes open, and sometimes even underdeveloped. Problem-solving processes, action research and in a broader sense, engaged scholarship all encompass the explicit addressing of problems and investigation problem situations. Such a problem-orientation is to a lesser degree part of design research. In this paper, we will investigate how we can provide a better understanding of problematizing in design research; and in particular what we may learn from other approaches with a stronger problem-orientation.

Purpose A rapidly increasing use of biological drugs has led to substantial costs. Shift to biosimilars enables considerable reduction of these costs without jeopardizing the treatment of patients, but most countries have extensive possibilities of untappedcost-savings. The aim of this study was to describe the Danish quick and near-complete implementation of the two first TNF inhibitor biosimilars (infliximab and etanercept).Methods We shed light on the considerations and experiences made during the implementation, and present key figures from theimplementation.ResultsThe infliximab biosimilar constituted 90.6% of the total amount of infliximab four months following patent expiration of the biooriginator. Similar results were seen for etanercept biosimilar. Substantial cost reductions were experienced in the way that e.g. the infliximab-shift reduced cost by two thirds.Conclusion We believe that a thorough preparation and an organizational setting supporting the implementation is crucial for the successful implementation. This same implementation model will be used for future biosimilars. Purpose A rapidly increasing use of biological drugs has led to substantial costs. Shift to biosimilars enables considerable reduction of these costs without jeopardizing the treatment of patients, butmost countries have extensive possibilities of untapped cost-savings. The aim of this study was to describe the Danish quick and near-complete implementation of the two first TNFinhibitor biosimilars (infliximab and etanercept).Methods We shed light on the considerations and experiences made during the implementation, and present key figures from the implementation.Results The infliximab biosimilar constituted 90.6%of the total amount of infliximab fourmonths following patent expiration of the biooriginator. Similar results were seen for etanercept biosimilar. Substantial cost reductions were experienced in the way that e.g. the infliximab-shift reduced cost by two thirds.Conclusion We believe that a thorough preparation and an organizational setting supporting the implementation is crucial for the successful implementation. This same implementation model will be used for future biosimilars.

Human exhalation can emit pathogens in droplets that can represent the origin of airborne cross infections. Simplified respiratory airway models have been used in experimental and numerical studies in order to simulate exhalation flows. This study presents a comparison between two different airway models, a simplification (SA) and a realistic 3D scanned model (RA) in performing two different exhalation patterns corresponding to two different female metabolic rates, corresponding to a standing relaxed (SR) activity (1.2 met) and walking active (WA) metabolic level (2 met). A time resolved particle image velocimetry (TR-PIV) study of the flow emitted to the surroundings in each case is obtained for each airway and exhalation combination. Results show that the scanned 3D model (RA) presents a different and more realistic flow development. Transient puff structures have been identified for both airway models. Results can be useful for further research on pollution control in indoor and outdoor spaces.

Recent supply chain research has concluded that stochastic lead times are a significant source of bullwhip effect in reorder-based supply chains. Despite this, the study of lead times and their nature has received remarkably little attention in literature. In this research we prove there exists an interdependency between lead time and service level measure, and thus the magnitude of the bullwhip effect. In a multi-echelon supply chain setting, the decision maker can experience disproportionate bullwhip effect. One cause of this is the fact that lead time distribution may likely stem from skewed and peaked distributions. As a member of a multi-echelon supply chain, a firm can experience an order variance that depend on the total number of echelon and information about their lead-time dependencies. These results correspond well with the few contributions found in literature showing actual lead times.

Background: Asthma is a common chronic airway disease associated with hyperresponsiveness and airway inflammation. Anti-inflammatory medication especially inhaled corticosteroids are important for control of airway inflammation, decrease of airway hyperresponsiveness and lung function variability, reduce asthma symptoms, and improve lung function as well as quality of life. Most studies investigating the influence of complementary and alternative medicine (CAM) in asthma measure clinical effectiveness, but only few evaluate the impact on markers of airway inflammation. Objective: The aim of this study was to investigate the effect of reflexology and homeopathy added to conventional treatment on different markers of airway inflammation in asthma. Methods: Eighty-four patients with asthma were randomized to receive conventional treatment alone or conventional treatment with addition of homeopathy or reflexology in a single center, investigator blinded, controlled, one-year trial. During the study period, patients regularly consulted their general practitioner for evaluation and asthma treatment. At randomization, and after 6 and 12 months, methacholine challenge test and measurement of exhaled nitric oxide were performed. Blood samples were collected for eosinophil count and measurement of serum eosinophil cationic protein. Results: No significant differences between groups for any of the inflammatory markers were demonstrated. Methacholine responsiveness improved in all three groups but improvements were not statistically significant within and between groups. Conclusions: This randomized controlled study of reflexology and homeopathy failed to show significant improvement on selected markers of inflammation and airway hyperresponsiveness in asthma.

Projekterne i både Aalborg og Hvidovre havde fokus på parkeringsanalyser ved nybyggeri og tilbygning, samt benyttelse af dobbeltudnyttelse ved hjælp af to metoder. I det ene projekt er dobbeltudnyttelsesgraden fastsat ved tælling på en næsliggende parkeringsplads med tilsvarende funktioner og i det andet projekt er dobbeltudnyttelsesgraden fastsat ved tælling på parkeringsplads ved den eksisterende bygning som udvides. Resultatet for projektet i Aalborg viste, at antallet af parkeringsbåse kunne nedsættes yderligere på baggrund af tællingen. Resultatet for projekt i Hvidovre foreligger endnu ikke, men præsenteres på Trafikdage., Proceedings from the Annual Transport Conference at Aalborg University, Vol. 26 No. 1 (2019): Proceedings from the Annual Transport Conference at Aalborg University

Ventilation and air distribution methods are important for indoor thermal environments and air quality. Effective distribution of airflow for indoor built environments with the aim of simultaneously offsetting thermal and ventilation loads in an energy efficient manner has been the research focus in the past several decades. Based on airflow characteristics, ventilation methods can be categorized as fully mixed or non-uniform. Non-uniform methods can be further divided into piston, stratified and task zone ventilation. In this paper, the theory, performance, practical applications, limitations and solutions pertaining to ventilation and air distribution methods are critically reviewed. Since many ventilation methods are buoyancy driving that confines their use for heating mode, some methods suitable for heating are discussed. Furthermore, measuring and evaluating methods for ventilation and air distribution are also discussed to give a comprehensive framework of the review.

The CHROMIC project (effiCient mineral processing and Hydrometallurgical RecOvery of by-product Metals from low-grade metal contaIning seCondary raw materials) aims to recover chromium from steelmaking and ferrochrome slags to regain valuable resources and simultaneously reduce potential environmental impacts. To develop the recovery flowsheets and reliably calculate metal recovery, an accurate assessment of chromium concentration and distribution is essential. Therefore, model streams were thoroughly characterized using a combination of analytical techniques. In all materials, chromium is present in distinct but often small spinel phases, intergrown with other minerals and showing a considerable zonation in Cr content with higher amounts in the cores. The small size of the Cr-rich particles makes recovery by mineral processing challenging. Measured chromium content was found to differ largely based on the chemical dissolution method applied. The analysis of insoluble residues and comparison with a standard reference material evidenced that standard acid dissolution procedures based on HCl/HNO3/HBF4 and HNO3/HF/H2O2 are insufficient to fully dissolve spinel structures, leading to severe underestimations of chromium content. A sodium peroxide treatment is required for a full dissolution of spinels. This is noteworthy, since most of the legislation for the reuse of slags is currently based on acid dissolution methods.

Background Viruses and other infectious agents cause more than 15% of human cancer cases. High-throughput sequencing-based studies of virus-cancer associations have mainly focused on cancer transcriptome data. Methods In this study, we applied a diverse selection of presequencing enrichment methods targeting all major viral groups, to characterize the viruses present in 197 samples from 18 sample types of cancerous origin. Using high-throughput sequencing, we generated 710 datasets constituting 57 billion sequencing reads. Results Detailed in silico investigation of the viral content, including exclusion of viral artefacts, from de novo assembled contigs and individual sequencing reads yielded a map of the viruses detected. Our data reveal a virome dominated by papillomaviruses, anelloviruses, herpesviruses, and parvoviruses. More than half of the included samples contained 1 or more viruses; however, no link between specific viruses and cancer types were found. Conclusions Our study sheds light on viral presence in cancers and provides highly relevant virome data for future reference., High-throughput sequencing of approximately 200 cancer samples detected viruses from 7 viral families. More than half of the investigated samples contained 1 or more viruses; however, no associations linking specific viruses with specific cancer types were found.

Background:\ud Infectious mononucleosis (IM) is a common adverse presentation of primary infection with Epstein-Barr virus (EBV) in adolescence and later, but is rarely recognized in early childhood where primary EBV infection commonly occurs. It is not known what triggers IM, and also not why IM risk upon primary EBV infection (IM attack rate) seemingly varies between children and adolescents. IM symptoms may be severe and persist for a long time. IM also markedly elevates the risk of Hodgkin lymphoma and multiple sclerosis for unknown reasons. The way IM occurrence depends on age and sex is incompletely described and hard to interpret etiologically, because it depends on three quantities that are not readily observable: the prevalence of EBV-naϊve persons, the hazard rate of seroconverting and the attack rate, i.e. the fraction of primary EBV infections that is accompanied by IM. We therefore aimed to provide these quantities indirectly, to obtain epidemiologically interpretable measures of the dynamics of IM occurrence to provide etiological clues.\ud \ud Methods and findings:\ud We used joint modeling of EBV prevalence and IM occurrence data to provide detailed sex- and age-specific EBV infection rates and IM attack rates and derivatives thereof for a target population of all Danes age 0–29 years in 2006–2011. We demonstrate for the first time that IM attack rates increase dramatically rather precisely in conjunction to typical ages of puberty onset. The shape of the seroconversion hazard rate for children and teenagers confirmed a priori expectations and underlined the importance of what happens at age 0–2 years. The cumulative risk of IM before age 30 years was 13.3% for males and 22.4% for females. IM is likely to become more common through delaying EBV infection in years to come.\ud \ud Conclusions:\ud The change in attack rate at typical ages of puberty onset suggests that the immunologic response to EBV drastically changes over a relatively short age-span. We speculate that these changes are an integrated part of normal sexual maturation. Our findings may inform further etiologic research into EBV-related diseases and vaccine design. Our methodology is applicable to the epidemiological study of any infectious agent that establishes a persistent infection in the host and the sequelae thereof.

PurposeThe purpose of this paper is to address four interrelated questions: what is the prevalence of ageism amongst employers? What are the factors conditioning employers’ age stereotypes? To what extent are ageist attitudes among employers translated into discriminatory recruitment, retention and firing practices? And what factors can moderate the stereotype–discrimination interaction?Design/methodology/approachThe paper draws on a survey conducted among Danish employers; 2,525 completed the survey questionnaires; response rate 25 per cent.FindingsThe major finding is that ageist stereotypes among employers do not translate into discriminatory personnel management practices.Research limitations/implicationsThe findings may be specific to Denmark. Denmark is renowned to be a non-hierarchical, egalitarian society, which may have implications for personnel management practices.Originality/valueContrary to this study, most studies analysing ageist stereotypes do not assess the extent to which stereotypes are translated into discriminatory personnel management practices in the workplace.