Evaluation of the restrained shrinkage cracking potential of self compacting concrete for modulus for radioactive waste disposal

For the disposal of radioactive low- and intermediate-level short-lived waste, surface disposal modules will be built in Belgium. In order to withstand accidental loading conditions, the walls of these constructions are densely reinforced, making an implementation in traditional vibrated concrete not self-evident. A Self Compacting Concrete can facilitate this execution. Questions however exist with regard to the cracking tendency of these concretes against restrained shrinkage, since this might impair the safety of the radioactive waste disposal. Therefore analyses of restraint shrinkage cracking potential of two SCC mixtures, especially developed for this application, was conducted within a research project presented in this paper

Preporuke Stalne međuvladine grupe ‘Europe de l’Enfance’ za politiku ranog djetinjstva u Europi 2010. - 2020.

Florence Pirard i Benoit Parmentier izvještavaju o preporukama koje su usuglašene od strane Stalne međuvladine grupe ‘Europe de l\u27Enfance’ na sastanku u Bruxellesu u studenome 2010. godine

Impact of early enteral versus parenteral nutrition on mortality in patients requiring mechanical ventilation and catecholamines: study protocol for a randomized controlled trial (NUTRIREA-2)

BACKGROUND: Nutritional support is crucial to the management of patients receiving invasive mechanical ventilation (IMV) and the most commonly prescribed treatment in intensive care units (ICUs). International guidelines consistently indicate that enteral nutrition (EN) should be preferred over parenteral nutrition (PN) whenever possible and started as early as possible. However, no adequately designed study has evaluated whether a specific nutritional modality is associated with decreased mortality. The primary goal of this trial is to assess the hypothesis that early first-line EN, as compared to early first-line PN, decreases day 28 all-cause mortality in patients receiving IMV and vasoactive drugs for shock. METHODS/DESIGN: The NUTRIREA-2 study is a multicenter, open-label, parallel-group, randomized controlled trial comparing early PN versus early EN in critically ill patients requiring IMV for an expected duration of at least 48 hours, combined with vasoactive drugs, for shock. Patients will be allocated at random to first-line PN for at least 72 hours or to first-line EN. In both groups, nutritional support will be started within 24 hours after IMV initiation. Calorie targets will be 20 to 25 kcal/kg/day during the first week, then 25 to 30 kcal/kg/day thereafter. Patients receiving PN may be switched to EN after at least 72 hours in the event of shock resolution (no vasoactive drugs for 24 consecutive hours and arterial lactic acid level below 2 mmol/L). On day 7, all patients receiving PN and having no contraindications to EN will be switched to EN. In both groups, supplemental PN may be added to EN after day 7 in patients with persistent intolerance to EN and inadequate calorie intake. We plan to recruit 2,854 patients at 44 participating ICUs. DISCUSSION: The NUTRIREA-2 study is the first large randomized controlled trial designed to assess the hypothesis that early EN improves survival compared to early PN in ICU patients. Enrollment started on 22 March 2013 and is expected to end in November 2015. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01802099 (registered 27 February 2013)

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

COVID-19 in Europe : Dataset at a sub-national level

The COVID-19 pandemic has hit humanity, straining health care systems, economies, and governments worldwide. In one of the responses to the pandemic, a big global effort has been mounted to collect, analyze, and make data publicly available. However, many of the existing COVID-19 public datasets are (i) aggregated at country level, and (ii) tend not to bring the COVID-19-specific data coupled with socio-demographic, economic, public policy, health, pollution and environmental factors, all of which may be key elements to study the transmission of the SARS-CoV-2 and its severity. To aid the evaluation of the determinants and impact of the COVID-19 pandemic at a large scale, we present here a new dataset with socio-demographic, economic, public policy, health, pollution and environmental factors for the European Union at the small regions level (NUTS3). The database is freely accessible at http://dx.doi.org/10.17632/2ghxnrkr9p.4. This dataset can help to monitor the COVID-19 mortality and infections at the sub-national level and enable analysis that may inform future policymaking

Modelling and mapping the intra-urban spatial distribution of Plasmodium falciparum parasite rate using very-high-resolution satellite derived indicators

BACKGROUND: The rapid and often uncontrolled rural-urban migration in Sub-Saharan Africa is transforming urban landscapes expected to provide shelter for more than 50% of Africa's population by 2030. Consequently, the burden of malaria is increasingly affecting the urban population, while socio-economic inequalities within the urban settings are intensified. Few studies, relying mostly on moderate to high resolution datasets and standard predictive variables such as building and vegetation density, have tackled the topic of modeling intra-urban malaria at the city extent. In this research, we investigate the contribution of very-high-resolution satellite-derived land-use, land-cover and population information for modeling the spatial distribution of urban malaria prevalence across large spatial extents. As case studies, we apply our methods to two Sub-Saharan African cities, Kampala and Dar es Salaam. METHODS: Openly accessible land-cover, land-use, population and OpenStreetMap data were employed to spatially model Plasmodium falciparum parasite rate standardized to the age group 2-10 years (PfPR2-10) in the two cities through the use of a Random Forest (RF) regressor. The RF models integrated physical and socio-economic information to predict PfPR2-10 across the urban landscape. Intra-urban population distribution maps were used to adjust the estimates according to the underlying population. RESULTS: The results suggest that the spatial distribution of PfPR2-10 in both cities is diverse and highly variable across the urban fabric. Dense informal settlements exhibit a positive relationship with PfPR2-10 and hotspots of malaria prevalence were found near suitable vector breeding sites such as wetlands, marshes and riparian vegetation. In both cities, there is a clear separation of higher risk in informal settlements and lower risk in the more affluent neighborhoods. Additionally, areas associated with urban agriculture exhibit higher malaria prevalence values. CONCLUSIONS: The outcome of this research highlights that populations living in informal settlements show higher malaria prevalence compared to those in planned residential neighborhoods. This is due to (i) increased human exposure to vectors, (ii) increased vector density and (iii) a reduced capacity to cope with malaria burden. Since informal settlements are rapidly expanding every year and often house large parts of the urban population, this emphasizes the need for systematic and consistent malaria surveys in such areas. Finally, this study demonstrates the importance of remote sensing as an epidemiological tool for mapping urban malaria variations at large spatial extents, and for promoting evidence-based policy making and control efforts.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Principles for the application of life cycle sustainability assessment

Purpose and context This paper aims to establish principles for the increased application and use of life cycle sustainability assessment (LCSA). Sustainable development (SD) encompassing resilient economies and social stability of the global system is growingly important for decision-makers from business and governments. The "17 SDGs" emerge as a high-level shared blueprint for peace, abundance, and prosperity for people and the planet, and "sustainability" for supporting improvements of products and organizations. A "sustainability" interpretation-successful in aligning stakeholders' understanding-subdivides the impacts according to a triple bottom line or three pillars: economic, social, and environmental impacts. These context and urgent needs inspired the LCSA framework. This entails a sustainability assessment of products and organizations in accordance with the three pillars, while adopting a life cycle perspective. Methods The Life Cycle Initiative promotes since 2011 a pragmatic LCSA framework based on the three techniques: LCSA = environmental life cycle assessment (LCA) + life cycle costing (LCC) + social life cycle assessment (S-LCA). This is the focus of the paper, while acknowledging previous developments. Identified and reviewed literature shows challenges of addressing the three pillars in the LCSA framework implementation like considering only two pillars; not being fully aligned with ISO 14040; lacking interconnectedness among the three pillars; not having clear criteria for results' weighting nor clear results' interpretation; and not following cause-effect chains and mechanisms leading to an endpoint. Agreement building among LCSA experts and reviewing processes strengthened the consensus on this paper. Broad support and outreach are ensured by publishing this as position paper. Results For harmonizing practical LCSA applications, easing interpretation, and increasing usefulness, consensed ten LCSA principles (10P) are established: understanding the areas of protection, alignment with ISO 14040, completeness, stakeholders' and product utility considerations, materiality of system boundaries, transparency, consistency, explicit trade-offs' communication, and caution when compensating impacts. Examples were provided based on a fictional plastic water bottle Conclusions In spite of increasing needs for and interest in SD and sustainability supporting tools, LCSA is at an early application stage of application. The 10P aim to promote more and better LCSA applications by ensuring alignment with ISO 14040, completeness and clear interpretation of integrated results, among others. For consolidating its use, however, more consensus-building is needed (e.g., on value-laden ethical aspects of LCSA, interdependencies and interconnectedness among the three dimensions, and harmonization and integration of the three techniques) and technical and policy recommendations for application.Industrial Ecolog

The FLUXNET2015 dataset and the ONEFlux processing pipeline for eddy covariance data

The FLUXNET2015 dataset provides ecosystem-scale data on CO2, water, and energy exchange between the biosphere and the atmosphere, and other meteorological and biological measurements, from 212 sites around the globe (over 1500 site-years, up to and including year 2014). These sites, independently managed and operated, voluntarily contributed their data to create global datasets. Data were quality controlled and processed using uniform methods, to improve consistency and intercomparability across sites. The dataset is already being used in a number of applications, including ecophysiology studies, remote sensing studies, and development of ecosystem and Earth system models. FLUXNET2015 includes derived-data products, such as gap-filled time series, ecosystem respiration and photosynthetic uptake estimates, estimation of uncertainties, and metadata about the measurements, presented for the first time in this paper. In addition, 206 of these sites are for the first time distributed under a Creative Commons (CC-BY 4.0) license. This paper details this enhanced dataset and the processing methods, now made available as open-source codes, making the dataset more accessible, transparent, and reproducible.Peer reviewe