138 resultados para Drought relief
Resumo:
Railway crew scheduling problem is the process of allocating train services to the crew duties based on the published train timetable while satisfying operational and contractual requirements. The problem is restricted by many constraints and it belongs to the class of NP-hard. In this paper, we develop a mathematical model for railway crew scheduling with the aim of minimising the number of crew duties by reducing idle transition times. Duties are generated by arranging scheduled trips over a set of duties and sequentially ordering the set of trips within each of duties. The optimisation model includes the time period of relief opportunities within which a train crew can be relieved at any relief point. Existing models and algorithms usually only consider relieving a crew at the beginning of the interval of relief opportunities which may be impractical. This model involves a large number of decision variables and constraints, and therefore a hybrid constructive heuristic with the simulated annealing search algorithm is applied to yield an optimal or near-optimal schedule. The performance of the proposed algorithms is evaluated by applying computational experiments on randomly generated test instances. The results show that the proposed approaches obtain near-optimal solutions in a reasonable computational time for large-sized problems.
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Impaction bone grafting for reconstitution of bone stock in revision hip surgery has been used for nearly 30 years. We used this technique, in combination with a cemented acetabular component, in the acetabula of 304 hips in 292 patients revised for aseptic loosening between 1995 and 2001. The only additional supports used were stainless steel meshes placed against the medial wall or laterally around the acetabular rim to contain the graft. All Paprosky grades of defect were included. Clinical and radiographic outcomes were collected in surviving patients at a minimum of 10 years following the index operation. Mean follow-up was 12.4 years (SD 1.5; range 10.0-16.0). Kaplan-Meier survivorship with revision for aseptic loosening as the endpoint was 85.9% (95% CI 81.0 to 90.8%) at 13.5 years. Clinical scores for pain relief remained satisfactory, and there was no difference in clinical scores between cups that appeared stable and those that appeared loose radiographically.
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"It’s late in the night. And after a long day at work, you have a splitting headache. You rattle around in the bottom drawer of the bathroom vanity to find a packet of paracetamol tablets you know are hiding there. Phew, relief is at hand! Then you turn the packet over and discover that the crumpled box of pills actually expired two years ago..."--http://theconversation.com/explainer-do-we-need-to-follow-medication-use-by-dates-4329
Resumo:
Benzodiazepines are widely prescribed to manage sleep disorders, anxiety and muscular tension. While providing short-term relief, continued use induces tolerance and withdrawal, and in older users, increases the risk of falls. However, long-term prescription remains common, and effective interventions are not widely available. This study developed a self-managed cognitive behaviour therapy package for cessation of benzodiazepine use delivered to participants via mail (M-CBT) and trialled its effectiveness as an adjunct to a general practitioner (GP)-managed dose reduction schedule. In the pilot trial, participants were randomly assigned to GP management with immediate or delayed M-CBT. Significant recruitment and engagement problems were experienced, and only three participants were allocated to each condition. After immediate M-CBT, two participants ceased use, while none receiving delayed treatment reduced daily intake by more than 50%. Across the sample, doses at 12 months remained significantly lower than baseline, and qualitative feedback from participants was positive. While M-CBT may have promise, improved engagement of GPs and participants is needed for this approach to substantially impact on community-wide benzodiazepine use.
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Aim To test the efficacy of Medilixir [cream] against the standard treatment of aqueous cream in the provision of relief from the symptoms of postburn itch. Design RCT with two parallel arms. Setting Professor Stuart Pegg Adult Burns Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia. Participants Fifty-two patients aged between 18 and 80 years, admitted directly to the burns centre between 10 March and 22 July 2008, were able to provide informed consent, and had shown no allergic reaction to a patch test with the study medication, were randomised. Patients admitted from intensive care or high dependency were excluded. Main results Effect estimates and confidence intervals were not reported for any of the outcomes; only group means/proportions and P-values from hypothesis testing were provided. More patients in the intervention group reported itch reduction compared to comparison treatment (91 vs. 82%, P=0.001). Itch recurrence after cream application occurred later in the intervention group compared to the control group (P<0.001). Use of antipruritic medication was significantly greater in the control group (P=0.023). There was no difference in sleep disturbance between groups (not quantified). On average, Medilixir took longer to apply than aqueous cream (157s for Medilixir vs. 139s for aqueous cream; mean difference 17s), but authors noted that the groups did not differ significantly (CI for mean difference and P-values were not reported).
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This chapter begins with a discussion of the economic, political, and social context of the recent global financial crisis, which casts into relief current boundaries of criminology, permeated and made fluid in criminology's recent cultural turn. This cultural turn has reinvigorated criminology, providing new objects of analysis and rich and thick descriptions of the relationship between criminal justice and the conditions of life in ‘late modernity’. Yet in comparison with certain older traditions that sought to articulate criminal justice issues with a wider politics of contestation around political economies and social welfare policies of different polities, many of the current leading culturalist accounts tend in their globalized convergences to produce a strangely decontextualized picture in which we are all subject to the zeitgeist of a unitary ‘late modernity’ which does not differ between, for example, social democratic and neo-liberal polities, let alone allow for the widespread persistence of the pre-modern. It is argued that that contrary to this globalizing trend there are signs within criminology that life is being breathed back into social democratic and penal welfare concerns, habitus, and practices. The chapter discusses three of these signs: the emergence of neo-liberalism as a subject of criminology; a developing comparative penology which recognizes differences in the political economies of capitalist states and evinces a renewed interest in inequality; and a nascent revolt against the ‘generative grammar’, ‘pathological disciplinarities’, and ‘imaginary penalities’ of neoliberal managerialism.
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Numerous crops grow in sugar regions that have the potential to increase the amount of biomass available to a small bagasse-based pulp factory. Arundo donax and Sorghum offer unique advantages to farmers compared to other agricultural crops. Sorghum bicolour requires only 1/3 of the water of sugarcane. Arundo donax is a very high yield crop, it can also grow with little water but it has the further advantage in that it is also highly stress tolerant, making it suitable for land which is unsuited to other crops. Pulps produced from these crops were benchmarked against sugarcane bagasse pulp. Arundo, sorghum and bagasse were pulped using KOH and anthraquinone to 20 Kappa number so as to produce a bleachable pulp which is suitable for making photocopier paper and tissue products. The unbleached sorghum pulp has better tensile strength properties than the unbleached Arundo pulp (43.8 Nm/g compared to 21.4 Nm/g) and the bleached sorghum pulp tensile strength was similar to bagasse (28.4 Nm/g). At 20 Kappa number, sorghum pulp had acceptable yield for a non-wood fibre (45% c.f. 55% for bagasse), Arundo donax pulp had low tensile strength, and relatively low yield (38.7%), even for an agricultural fibre and required severe cooking conditions to achieve similar delignification to sugarcane bagasse or sorghum. Sorghum and Arundo donax produced thicker handsheets than bagasse (>160 µm c.f. 122 µm for bagasse). In preliminary experiments sorghum and bagasse responded slightly better to Totally Chlorine Free peroxide bleaching (QPP), although none achieved a satisfactory brightness level and further improvement would be required to produce a bleached pulp.
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Sorghum is a food and feed cereal crop adapted to heat and drought and a staple for 500 million of the world’s poorest people. Its small diploid genome and phenotypic diversity make it an ideal C4 grass model as a complement to C3 rice. Here we present high coverage (16–45 × ) resequenced genomes of 44 sorghum lines representing the primary gene pool and spanning dimensions of geographic origin, end-use and taxonomic group. We also report the first resequenced genome of S. propinquum, identifying 8 M high-quality SNPs, 1.9 M indels and specific gene loss and gain events in S. bicolor. We observe strong racial structure and a complex domestication history involving at least two distinct domestication events. These assembled genomes enable the leveraging of existing cereal functional genomics data against the novel diversity available in sorghum, providing an unmatched resource for the genetic improvement of sorghum and other grass species.
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Addressing the Crew Scheduling Problem (CSP) in transportation systems can be too complex to capture all details. The designed models usually ignore or simplify features which are difficult to formulate. This paper proposes an alternative formulation using a Mixed Integer Programming (MIP) approach to the problem. The optimisation model integrates the two phases of pairing generation and pairing optimisation by simultaneously sequencing trips into feasible duties and minimising total elapsed time of any duty. Crew scheduling constraints in which the crew have to return to their home depot at the end of the shift are included in the model. The flexibility of this model comes in the inclusion of the time interval of relief opportunities, allowing the crew to be relieved during a finite time interval. This will enhance the robustness of the schedule and provide a better representation of real-world conditions.
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The 21st century will see monumental change. Either the human race will use its knowledge and skills and change the way it interacts with the environment, or the environment will change the way it interacts with its inhabitants. In the first case, the focus of this book, we would see our sophisticated understanding in areas such as physics, chemistry, engineering, biology, planning, commerce, business and governance accumulated over the last 1,000 years brought to bear on the challenge of dramatically reducing our pressure on the environment. The second case however is the opposite scenario, involving the decline of the planet’s ecosystems until they reach thresholds where recovery is not possible, and following which we have no idea what happens. For instance, if we fail to respond to Sir Nicolas Stern’s call to meet appropriate stabilisation trajectories for greenhouse gas emissions, and we allow the average temperature of our planets surface to increase by 4-6 degrees Celsius, we will see staggering changes to our environment, including rapidly rising sea level, withering crops, diminishing water reserves, drought, cyclones, floods… allowing this to happen will be the failure of our species, and those that survive will have a deadly legacy. In this update to the 1997 International Best Seller, Factor Four, Ernst von Weizsäcker again leads a team to present a compelling case for sector wide advances that can deliver significant resource productivity improvements over the coming century. The purpose of this book is to inspire hope and to then inform meaningful action in the coming decades to respond to the greatest challenge our species has ever faced – that of living in harmony with our planet and its other inhabitants.
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Providing mobility corridors for communities, enabling freight networks to transport goods and services, and a pathway for emergency services and disaster relief operations, roads are a vital component of our societal system. In the coming decades, a number of modern issues will face road agencies as a result of climate change, resource scarcity and energy related challenges that will have implications for society. To date, these issues have been discussed on a case by case basis, leading to a fragmented approach by state and federal agencies in considering the future of roads – with potentially significant cost and risk implications. Within this context, this paper summarises part of a research project undertaken within the ‘Greening the Built Environment’ program of the Sustainable Built Environment National Research Centre (SBEnrc, Australia), which identified key factors or ‘trends’ affecting the future of roads and key strategies to ensure that road agencies can continue to deliver road infrastructure that meets societal needs in an environmentally appropriate manner. The research was conducted over two years, including a review of academic and state agency literature, four stakeholder workshops in Western Australia and Queensland, and industry consultation. The project was supported financially and through peer review and contribution, by Main Roads Western Australia, QLD Department of Transport and Main Roads, Parsons Brinckerhoff, John Holland Group, and the Australian Green Infrastructure Council (AGIC). The project highlighted several potential trends that are expected to affect road agencies in the future, including predicted resource and materials shortages, increases in energy and natural resources prices, increased costs related to greenhouse gas emissions, changing use and expectations of roads, and changes in the frequency and intensity of weather events. Exploring the implications of these potential futures, the study then developed a number of strategies in order to prepare transport agencies for the associated risks that such trends may present. An unintended outcome of the project was the development of a process for enquiring into future scenarios, which will be explored further in Stage 2 of the project (2013-2014). The study concluded that regardless of the type and scale of response by the agency, strategies must be holistic in approach, and remain dynamic and flexible.
Resumo:
Background Lumbar Epidural Steroids Injections (ESI’s) have previously been shown to provide some degree of pain relief in sciatica. Number Needed To Treat (NNT) to achieve 50% pain relief has been estimated at 7 from the results of randomised controlled trials. Pain relief is temporary. They remain one of the most commonly provided procedures in the UK. It is unknown whether this pain relief represents good value for money. Methods 228 patients were randomised into a multi-centre Double Blind Randomised Controlled Trial. Subjects received up to 3 ESI’s or intra-spinous saline depending on response and fall off with the first injection. All other treatments were permitted. All received a review of analgesia, education and physical therapy. Quality of life was assessed using the SF36 at 6 points and compared using independent sample t-tests. Follow up was up to 1 yr. Missing data was imputed using last observation carried forward (LOCF). QALY’s (Quality of Life Years) were derived from preference based heath values (summary health utility score). SF-6D health state classification was derived from SF-36 raw score data. Standard gambles (SG) were calculated using Model 10. SG scores were calculated on trial results. LOCF was not used for this. Instead average SG were derived for a subset of patients with observations for all visits up to week 12. Incremental QALY’s were derived as the difference in the area between the SG curve for the active group and placebo group. Results SF36 domains showed a significant improvement in pain at week 3 but this was not sustained (mean 54 Active vs 61 Placebo P<0.05). Other domains did not show any significant gains compared with placebo. For derivation of SG the number in the sample in each period differed. In week 12, average SG scores for active and placebo converged. In other words, the health gain for the active group as measured by SG was achieved by the placebo group by week 12. The incremental QALY gained for a patient under the trial protocol compared with the standard care package was 0.0059350. This is equivalent to an additional 2.2 days of full health. The cost per QALY gained to the provider from a patient management strategy administering one epidural as suggested by results was £25 745.68. This result was derived assuming that the gain in QALY data calculated for patients under the trial protocol would approximate that under a patient management strategy based on the trial results (one ESI). This is above the threshold suggested by some as a cost effective treatment. Conclusions The transient benefit in pain relief afforded by ESI’s does not appear to be cost-effective. Further work is needed to develop more cost-effective conservative treatments for sciatica.