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Level of Service Criteria for Urban Arterials with Heterogeneous and Undisciplined Traffic Streams
No full textAccurate evaluation of the prevailing traffic operations plays an important part in developing sustainable transport systems. This research examines the suitability of the level of service (LOS) criteria developed by the Indian and United States (US) Highway Capacity Manuals (HCM) for heterogeneous and undisciplined traffic streams and proposes new criteria using a data-driven approach. Traffic data were collected from a selected major arterial in Karachi, and fundamental diagrams were developed using these data. These fundamental diagrams and field-collected data were analyzed using the K-mean clustering approach to examine the actual traffic states at various LOS bands used in practice. Associating the field-measured volume-to-capacity ratio with the speed bands used for LOS analysis gives insights into actual traffic conditions at various LOS categories. The research shows that the volume-to-capacity ratio corresponding to the speed range for LOS A is about 0.45, which implies that the heterogeneous traffic moves with comparatively higher speeds despite an increase in traffic volume. The criteria for LOS were developed using the K-mean cluster analysis technique. The proposed values of LOS criteria for speed percentages are significantly higher than those reported in both the HCMs. This research highlights the need to develop separate LOS criteria for heterogeneous and undisciplined traffic for all transportation facilities. The development of such new criteria can provide researchers and engineers with a schematic for the effective and realistic evaluation of local traffic regimes.This paper is based on a project that received funding from the European Union’s Horizon 2020 research and innovation program under Grant Agreement No 101037193. Partial funding for this research is also arranged from Zayed University, UAE, under research grant No. R23081
Extracellular vesicles: innovative cell-free solutions for wound repair
No full textChronic non-healing wounds are often associated with conditions such as diabetes and peripheral vascular disease, pose significant medical and socioeconomic challenges. Cell-based therapies have shown promise in promoting wound healing but have major drawbacks such as immunogenicity and tumor formation. As a result, recent research has shifted to the potential of extracellular vesicles (EVs) derived from these cells. EVs are nanosized lipid bilayer vesicles, naturally produced by all cell types, which facilitate intercellular communication and carry bioactive molecules, offering advantages such as low immunogenicity, negligible toxicity and the potential to be re-engineered. Recent evidence recognizes that during wound healing EVs are released from a wide range of cells including immune cells, skin cells, epithelial cells and platelets and they actively participate in wound repair. This review comprehensively summarizes the latest research on the function of EVs from endogenous cell types during the different phases of wound healing, thereby presenting interesting therapeutic targets. Additionally, it gives a critical overview of the current status of mesenchymal stem cell-derived EVs in wound treatment highlighting their tremendous therapeutic potential as a non-cellular of-the-shelf alternative in wound care.The author(s) declare that financial support was received for the research and/or publication of this article. This research was supported by the research fund “BOF Grand Challenges” provided by Hasselt University (grant number: 21GP08BROA) to AB and EP and following research grants of the “FWO- Research Fund Flanders” 1S28025N to SW and grant 1269322N to PL
Integrating International Consensus Guidelines for Anticancer Drug Dosing in Kidney Dysfunction (ADDIKD) into everyday practice
No full textPart 2 of the International Consensus Guideline on Anticancer Drug Dosing in Kidney Dysfunction (ADDIKD) offers drug-specific consensus recommendations based on both evidence and practical experience. These recommendations build upon the kidney function assessment and classification guidelines established in Part 1 of ADDIKD. Here we illustrate how dosing recommendations differ between ADDIKD and existing guidance for four commonly used drugs: methotrexate, cisplatin, carboplatin and nivolumab. We then describe how the recommendations can be distilled into practice points for methotrexate and cisplatin. While ADDIKD is a significant improvement from previous guidelines, adoption of this new guideline requires further endorsement from key external stakeholders, 'change championing' by clinicians locally and encouraging its integration into existing reference sources, clinical trial protocols and electronic prescribing systems.Development of the ADDIKD guideline is funded by the NSW Government as part of the Cancer Institute NSW and received no funding from external commercial sources
Evaluation of Rolling Surveillance Methods in Context of Prior Aberrations: A Simulation Study With Routine Data From Low- and Middle-Income Countries
No full textSyndromic surveillance integrated into routine health management information systems could improve timely detection of disease outbreaks, particularly in low- and middle-income countries that have limited diagnostic data. This study evaluates the impact of prior anomalies referred to as "aberrations," such as historical outbreaks, that can distort "baseline data" on the accuracy of rolling surveillance methods that track ongoing disease trends. We assessed five widely used outbreak detection algorithms-EARS, Farrington, Holt-Winters, and two versions of the Weinberger-Fulcher model (negative binomial (WF NB) and quasipoisson (WF QP))-under simulation scenarios motivated by 5 years of acute respiratory infection data from Liberia. We evaluated seven data-generating mechanisms that cover a wide range of temporal and seasonal patterns. We assessed the accuracy of the outbreak detection algorithms under varied size and timing of outbreaks and aberrations. Accuracy was measured through sensitivity and specificity, with a joint assessment of both metrics using pseudo-ROC curves. Results showed that the introduction of aberrations reduced sensitivity in general, but the algorithms' relative performances were highly context-dependent. EARS and WF models demonstrated high sensitivity for detecting outbreaks when no recent aberrations were present. However, when aberrations occurred within the last year of baseline data, Holt-Winters-unless there was evidence of strong time trends-and WF QP maintained better overall balance between sensitivity and specificity. The Farrington algorithm exhibited strong sensitivity with recent aberrations but at the cost of lower specificity. These findings provide actionable insights and practical recommendations for implementing rolling surveillance in resource-constrained environments, emphasizing the need to consider historical data disturbances and rigorously evaluate sensitivity and specificity jointly.This research was supported by the National Institutes of Health (NIH) under grant F31AI172187. The funding was provided through the NIH F31Individual Predoctoral Fellowship to promote the development of the author’s doctoral dissertation research.
Acknowledgments
I am grateful to Dr. Rafael Irizarry and Dr. Marc Lipsitch, members ofmy thesis committee, for their invaluable guidance and insightful sugges-tions for the evaluation of the rolling surveillance methods. Additionally,I extend my gratitude to Partners In Health (PIH) Liberia for their ongo-ing partnership and for facilitating access to the data that motivated thesimulation study and its applications. This research was supported by theNational Institutes of Health (NIH) under grant F31AI172187. The fund-ing was provided through the NIH F31 Individual Predoctoral Fellowshipto promote the development of the author’s doctoral dissertation research
Long-Term Clinical Benefits of Pulsed Field Ablation in Paroxysmal Atrial Fibrillation: Subanalyses From the Multicenter inspIRE Trial
No full textThe authors thank all inspIRE study (Study for Treatment of Paroxysmal Atrial Fibrillation [PAF] by Pulsed Field Ablation [PFA] System With Irreversible Electroporation [IRE]) personnel and patients for their valuable participation in this trial. The authors thank the following individuals for their efforts in trial execution, statistical analysis, and input during the development of this article: Christina Kaneko, Jaclyn Alcazar, Guixia Huang, Stephen Hynes, Ramona Wu, Carmen Rousseeuw, Sarah Rabau, and Nathalie Marcours. Michelle Hughes, PhD, of Lumanity Communications Inc, provided medical writing and editorial support, funded by Biosense Webster, Inc, under the direction of the authors. The inspIRE Trial Investigators: Luigi Di Biase, Jim Hansen, Sebastien Knecht, Georgios Kollias, Peter Lukac, Andrea Natale, Jan Petru, and Thomas Phlips
Local governments’ tools as enforcement actors of EU law: stored in a black box
No full textAs a result of the expansion of EU law, today’s local governments are strongly Europeanised. Therefore, over
the past decennia, they became increasingly important enforcement actors within the European Union. Even
more, a positive execution obligation on the part of local governments can be inferred from EU legal principles
such as the primacy principle and the principle of sincere cooperation. In short, this means that local
governments are expected to actively apply EU law, even when they are confronted with a contradiction
between European law on the one hand and national law on the other. However, political science research
illustrates that local governments are not fully aware of their execution obligation to enforce EU law, nor of
the scope of it. In other words, local governments are not fully aware of their enforcement responsibilities
within the EU legal order. This paper explains that the ambiguity at the local level derives from the diffuse
legal framing of the local execution obligation and seeks for the possibility of a more unequivocal approach
of local governments as enforcement actors
Correction: Efects and mechanisms of supramaximal high-intensity interval training on extrapulmonary manifestations in people with and without chronic obstructive pulmonary disease (COPD-HIIT): study protocol for a multi-centre, randomized controlled trial
No full textChallenges and opportunities for falls prevention: an online survey across European healthcare professionals
No full textPurposeTo explore the challenges and opportunities for the implementation of falls preventive services across Europe.MethodsAn online cross-sectional survey among healthcare professionals was initiated by the European Geriatric Medicine Society (EuGMS) Special Interest Group on Falls and Fractures containing a Likert scale and multiple-choice questions on education and knowledge, current practices, barriers, and facilitators for falls prevention. Survey participation for healthcare professionals was encouraged by the EuGMS through an email invitation, website banner, and social media. National representatives from 24 countries further promoted it via societies, local networks, and hospital channels.ResultsA total of 1669 multidisciplinary healthcare professionals participated from 34 European countries (median 47 years; 75% female; 40.6% physicians (73.3% geriatricians/trainees), 36% physiotherapists, 23.4% other healthcare professionals). Only 26.9% believed their undergraduate education adequately prepared them for clinical practice in this area. A total of 75.8% of respondents reported opportunistically screening older adults for fall risk often or always during consultations. Gait and balance assessment was considered the most important and was the most frequently performed component of the multifactorial fall risk assessment. The top-five barriers were staffing issues, lack of time, older adults' non-adherence to recommended strategies, workload related to falls prevention, and prioritizing other tasks. The top-five facilitators were more time, easy-to-use guidelines, sufficient resources, increased education and training on falls prevention, and increased collaboration. We observed regional and country-level variation in these top barriers and facilitators.ConclusionThis survey highlights the need for improved undergraduate education in falls prevention across Europe. It is essential to educate and engage governmental bodies and insurers to secure their support and prioritization of falls prevention initiatives. Furthermore, enhancing education, addressing older adults' nonadherence, interdisciplinary collaboration and providing easy-to-use guidelines seem crucial for effective implementation. The falls prevention strategy should be tailored to the local context.European Union Geriatric Medicine Society (EuGMS
Ethics, architecture and prison design - a primer
No full textAfter some decades of neglect, the importance of prison design on well-being, rehabilitation and reintegration has been gaining acknowledgement over the past years. In parallel, there is growing interest in prison studies and rising awareness in new penology to seek alternative understandings to counter the dominant rationale that focuses on efficiency and surveillance. However, the ethical underpinnings of prison design remain underrepresented in architectural theory. This paper argues that, given that one’s ethical view on punishment is relevant to guide deliberative design choices, architects have the responsibility to critically engage and contemplate the ethical foundations of prison designs. The paper explains the ethical nature of architecture and design briefly and then turns to how we can make sense of the practice of punishment as a moral and symbolic practice while recognising concerns about its moral justification. The paper suggests that, in order to morally justify the practice and to make it symbolically intelligible, we need a concept of detention that is radically oriented at rehabilitation. By way of illustrating possible design responses, the paper refers to the Belgian case of the twenty-first-century detention houses. Intended as a primer, this paper considers the relation between ethics and architecture and aims to show the inevitability and relevance of ethical reflection to architectural design by focussing in particular on penal design. The paper aims to enrich the debate on penal design and to invite further reflection but does not intend here to expand the notion of penal design, nor to exhaustively engage or list different forms of penal designs and their ethical status or meanings
Detection of invasive and alien land planarians as threats to agriculture and ecosystem stability
No full textAlien land planarians are considered potential threats to European agriculture and ecosystem stability. Severe impact of alien land planarian species in Europe but also worldwide was reported including depletion of local and native soil invertebrates and possible detrimental changes at the ecosystem level. Given the increasing number of studies reporting non-native and potentially invasive species of geoplanid planarians, further action in first response related to worldwide plant trade is called for. To date, the only flatworm on the list of “Invasive Alien Species of European Union Concern” is the New Zealand flatworm Arthurdendyus triangulatus.
To help authorities detect and prevent introduction of the New Zealand flatworm, we designed an experiment in order to develop a species-specific barcoding protocol to check possible contamination by A. triangulatus of containerised flowerpots, identified as the most probable source of its co-introduction to non-native region.
Based on our results, specific behavior of A. triangulatus staying restricted to the surface and upper layer of the flowerpot determines accessibility of DNA in the soil. Therefore, water-based eDNA methodology combined with a newly established qPCR protocol is preferred as it provides a sensitive approach for detection of A. triangulatus in the flowerpots. Further testing is needed to determine sensitivity of the persistence of eDNA following the flatworm’s removal, to estimate the risk of false positives.
The newly designed barcoding protocols provide species-specific diagnosis of one invasive and three non-native land planarians currently being assessed for their invasion risks. However, the species-specificity of the developed barcoding protocols might need to be re-evaluated in case of introduction of new planarian species, and in view of apparent misidentifications regarding published genetic resources. Instead, general protocols requiring genetic sequence analyses would offer a more robust approach to assess species diversity of introduced and potentially invasive land planarians