An economic evaluation of proposed amendments to the Illinois sulfur dioxide regulations, R74-2, R75-5, and R76-9 /

"Project no. 10.062."

Effect Of Different Hydrological Model Structures On The Assimilation Of Distributed Uncertain Observations

The reliable evaluation of the flood forecasting is a crucial problem for assessing flood risk and consequent damages. Different hydrological models (distributed, semi-distributed or lumped) have been proposed in order to deal with this issue. The choice of the proper model structure has been investigated by many authors and it is one of the main sources of uncertainty for a correct evaluation of the outflow hydrograph. In addition, the recent increasing of data availability makes possible to update hydrological models as response of real-time observations. For these reasons, the aim of this work it is to evaluate the effect of different structure of a semi-distributed hydrological model in the assimilation of distributed uncertain discharge observations. The study was applied to the Bacchiglione catchment, located in Italy. The first methodological step was to divide the basin in different sub-basins according to topographic characteristics. Secondly, two different structures of the semi-distributed hydrological model were implemented in order to estimate the outflow hydrograph. Then, synthetic observations of uncertain value of discharge were generated, as a function of the observed and simulated value of flow at the basin outlet, and assimilated in the semi-distributed models using a Kalman Filter. Finally, different spatial patterns of sensors location were assumed to update the model state as response of the uncertain discharge observations. The results of this work pointed out that, overall, the assimilation of uncertain observations can improve the hydrologic model performance. In particular, it was found that the model structure is an important factor, of difficult characterization, since can induce different forecasts in terms of outflow discharge. This study is partly supported by the FP7 EU Project WeSenseIt.

Arteriolar vasoconstrictive response: comparing the effects of arginine vasopressin and norepinephrine

INTRODUCTION: This study was designed to examine differences in the arteriolar vasoconstrictive response between arginine vasopressin (AVP) and norepinephrine (NE) on the microcirculatory level in the hamster window chamber model in unanesthetized, normotonic hamsters using intravital microscopy. It is known from patients with advanced vasodilatory shock that AVP exerts strong additional vasoconstriction when incremental dosage increases of NE have no further effect on mean arterial blood pressure (MAP). METHODS: In a prospective controlled experimental study, eleven awake, male golden Syrian hamsters were instrumented with a viewing window inserted into the dorsal skinfold. NE (2 microg/kg/minute) and AVP (0.0001 IU/kg/minute, equivalent to 4 IU/h in a 70 kg patient) were continuously infused to achieve a similar increase in MAP. According to their position within the arteriolar network, arterioles were grouped into five types: A0 (branch off small artery) to A4 (branch off A3 arteriole). RESULTS: Reduction of arteriolar diameter (NE, -31 +/- 12% versus AVP, -49 +/- 7%; p = 0.002), cross sectional area (NE, -49 +/- 17% versus AVP, -73 +/- 7%; p = 0.002), and arteriolar blood flow (NE, -62 +/- 13% versus AVP, -80 +/- 6%; p = 0.004) in A0 arterioles was significantly more pronounced in AVP animals. There was no difference in red blood cell velocities in A0 arterioles between groups. The reduction of diameter, cross sectional area, red blood cell velocity, and arteriolar blood flow in A1 to A4 arterioles was comparable in AVP and NE animals. CONCLUSION: Within the microvascular network, AVP exerted significantly stronger vasoconstriction on large A0 arterioles than NE under physiological conditions. This observation may partly explain why AVP is such a potent vasopressor hormone and can increase systemic vascular resistance even in advanced vasodilatory shock unresponsive to increases in standard catecholamine therapy.

Resource use and outcome in critically ill patients with hematological malignancy: a retrospective cohort study

INTRODUCTION: The paucity of data on resource use in critically ill patients with hematological malignancy and on these patients' perceived poor outcome can lead to uncertainty over the extent to which intensive care treatment is appropriate. The aim of the present study was to assess the amount of intensive care resources needed for, and the effect of treatment of, hemato-oncological patients in the intensive care unit (ICU) in comparison with a nononcological patient population with a similar degree of organ dysfunction. METHODS: A retrospective cohort study of 101 ICU admissions of 84 consecutive hemato-oncological patients and 3,808 ICU admissions of 3,478 nononcological patients over a period of 4 years was performed. RESULTS: As assessed by Therapeutic Intervention Scoring System points, resource use was higher in hemato-oncological patients than in nononcological patients (median (interquartile range), 214 (102 to 642) versus 95 (54 to 224), P < 0.0001). Severity of disease at ICU admission was a less important predictor of ICU resource use than necessity for specific treatment modalities. Hemato-oncological patients and nononcological patients with similar admission Simplified Acute Physiology Score scores had the same ICU mortality. In hemato-oncological patients, improvement of organ function within the first 48 hours of the ICU stay was the best predictor of 28-day survival. CONCLUSION: The presence of a hemato-oncological disease per se is associated with higher ICU resource use, but not with increased mortality. If withdrawal of treatment is considered, this decision should not be based on admission parameters but rather on the evolutional changes in organ dysfunctions.

Climatological observations from ship logbooks between 1750 and 1854 (release 2.1)

The Climatological Database for the World's Oceans: 1750-1854 (CLIWOC) project, which concluded in 2004, abstracted more than 280,000 daily weather observations from ships' logbooks from British, Dutch, French, and Spanish naval vessels engaged in imperial business in the eighteenth and nineteenth centuries. These data, now compiled into a database, provide valuable information for the reconstruction of oceanic wind field patterns for this key period that precedes the time in which anthropogenic influences on climate became evident. These reconstructions, in turn, provide evidence for such phenomena as the El Niño-Southern Oscillation and the North Atlantic Oscillation. Of equal importance is the finding that the CLIWOC database the first coordinated attempt to harness the scientific potential of this resource represents less than 10 percent of the volume of data currently known to reside in this important but hitherto neglected source.

国際公共財としての感染症対策

HIV/AIDS、SARS、鳥インフルエンザといった新興感染症、薬剤耐性を持った病原体の出現によって問題が深刻化している結核、マラリア等再興感染症への関心が世界で高まっている。感染症の予防や治療はそれを個人に施すことのプラスの効果が国境を超えてスピル・オーバーすることが多く、国際公共財としての性質を持っている。また、新薬・ワクチンの成分・製法に関する情報および、感染症の流行に関する情報は典型的な公共財であり、誰しもがフリー・ライドするインセンティブを持っている。したがって、これら公共財の過少供給の問題を解決するためには国際的な協調行動が必要である。 　世界の感染症対策は、感染がより大規模に広まっている発展途上国を中心としたものにならざるを得ない。現在これをリードしているのはアメリカであり、日本はWHOへの出資については存在感を示しているものの、それ以外の機関への出資や二国間協力の面において、少なくとも今現在においては貢献度が大きいと見られていない。また、新薬・ワクチン開発については日本の財政的な面での貢献は全く目立たない。 　国際的な感染症対策に関する日本の印象を高めるためには、沖縄感染症イニシアティブの際になされたような形で金銭的貢献度を再び高める、あるいは、国際的に必要と考えられているものの他国が協力を決めていない分野への貢献をいち早く宣言する、等の対応が考えられる。

Postgraduate training offered to primary care pharmacists by schools of pharmacy - changes over the last five years

Poster session - A review of the postgraduate training courses offered by the 15 schools of pharmacy within Britain was undertaken - The training currently on offer was compared with that offered by the same schools of pharmacy five years ago - It was found that although the numbers of training courses offered by the 15 schools had significantly increased, the orientation of the courses remained more or less as it was five years ago - The increases in the number of courses had not reflected the increased roles that pharmacists currently have and are hoping to undertake in the future - Any new training offered will need to reflect a wider “modernising and managing NHS organisations” agenda