Jacobs (United Kingdom)

The Thames Tideway Tunnel project is a deep tunnel system for combined sewer overflow (CSO) control in London, UK. The project controls flows from 34 CSOs by transferring flows to Beckton Sewage Treatment Works for treatment. This paper focusses on the CSO interception works undertaken at Hammersmith Pumping Station, from outline design development through to the detailed design, construction and commissioning. The development of the hydraulic and structural design for the interception of the combined sewage flows at the existing Thames Water pumping station is described. The methods of construction and logistics for these works and for the drop shaft, connection tunnel to the main tunnel and other civil engineering works are also described. There is a focus on the temporary works undertaken to enable works in the pumping station’s inlet channel and for the adjacent interception chamber, the instrumentation undertaken in the upstream catchment sewers and the close working relationship with Thames Water. Design and construction methods and working arrangements accommodated significant constraints, including limited available land for the construction site, working adjacent to a new property development, maintaining a good relationship with the local community and ensuring the pumping station remained operational at all times.

ABSTRACT Environmental concerns in recent years have encouraged governments worldwide to integrate large proportions of renewable energy sources (RESs) into electricity networks. However, the intermittent nature of the RESs has introduced new challenges, such as the imbalance between electrical supply and demand. The power‐to‐gas (P2G) and gas‐fired units (GFUs) are practical solutions to overcome these challenges. Therefore, this paper presents a bi‐level bidding strategy for GFUs, P2G facilities and RESs in a coordinated energy market considering the demand response program (DRP). To enhance the flexibility of the system, DRP is modelled as a price‐responsive bidding mechanism for shifting loads. Furthermore, the stochastic nature of RESs and load is modelled using a scenario tree concept. In the bi‐level model, the upper‐level problem maximises the profits of the GFUs and P2G facility, while the lower‐level problem maximises social welfare in the energy market. The nonlinear bi‐level formulation is changed into a single‐level mixed‐integer linear programming problem by substituting the lower‐level optimisation by its Karush‐Kuhn‐Tucker (KKT) optimality conditions and converting nonlinearities to linear equivalents. The CPLEX solver in the GAMS optimisation program is utilised to solve the model. The beneficial effect of the suggested model was evaluated using an adjusted twenty‐node Belgium gas network and an adjusted sixteen‐bus UK distribution system. Numerical results show that when natural gas demand is limited, the production of gas from the P2G facility can improve the secure and cost‐effective functioning of the coordinated electricity and gas networks. It further shows that by converting renewable electricity into natural gas, P2G facilities can enable a broader penetration of volatile renewable energy.

ABSTRACTImportanceThe multicenter, prospective, single-arm, non-randomized SCENT trial on flow diverter (FD) treatment for intracranial aneurysms (IA) was analyzed for patients’ age and IA characteristics impacting stroke and occlusion rates over 5 years.DesignThe impact on major ipsilateral stroke and IA occlusion was studied by stratifying age as ≤ 65 years versus >65 years. Product-limit (Kaplan-Meier) estimates of time to both endpoints, stratified by age group, were created. Univariate predictors of time to stroke were identified by including candidate variables in univariable proportional hazards regression models. Those variables found to be significant (p<0.10) at the univariate level were entered into a multivariable survival model to identify independent predictors. The stepwise selection produced a final reduced model with a significance level to both enter and stay set at 0.05.FindingsOf 180 patients with 180 large or giant IA enrolled in the modified intention-to-treat cohort, 119 subjects were ≤ 65, while 61 patients were > 65 years old. When parent artery stenosis and IA size were entered into a multiple-stepwise survival model, only stenosis remained as an independently significant predictor of time to stroke. At 3-year follow-up, there were a total of 23 strokes (12.8%), with 11 occurring in subjects ≤ 65 years; there was a greater risk for seniors (HR1.96, 95% CI 0.83-4.78). Four patients (4/180; 2.2%) experienced aneurysm rupture within the first week post-treatment, with 3 being ≤ 65 and the fourth aged 66 years. No new strokes were reported between 3 and 5 years. Complete IA occlusion rates for seniors were 60.0% (33/55), 67.6% (25/37), and 85.7% (18/21) at 12, 36, and 60 months, respectively, as compared to 79.1% (87/110), 82.5% (66/80), and 91.8% (56/61) for younger subjects. The time to complete IA occlusion was shorter in younger patients (HR1.53, 95% CI 1.07-2.19). Five subjects (2.8%) underwent retreatment, 2 in 60-year-old patients, and one each aged 64, 70, and 75.Conclusions and RelevanceAge > 65 and parent artery stenosis are related to an increased risk of major ipsilateral stroke in patients with intracranial aneurysms treated with a flow diverter. Age > 65 is also predictive of increased time to and incomplete healing. With demographic shifts, future treatments need to focus on expedited and improved healing.Trial Registrationhttps://www.clinicaltrials.govNCT01716117KEY POINTSQuestionWhat key variables, including patients’ age and intracranial aneurysm (IA) characteristics, determine procedural stroke risks in subjects treated for large or giant IA with flow-diverting stents?FindingsAneurysm size and parent artery stenosis impacted occlusion rates and stroke risk, respectively. Over a 5-year observation period, the senior population had a significantly lower occlusion rate and higher risk for stroke, while the younger population was at higher risk for early aneurysm bleed following treatment.MeaningWith demographic shifts and a higher senior population being treated for IA, the stroke risk and incomplete occlusion rates need to be discussed with the patient before treatment.

Abstract IntroductionGlioblastoma is a devastating brain tumor with poor prognosis despite current treatment modalities. Chimeric antigen receptor T-cell (CAR T-cell) therapy has shown promise in other cancers but has yielded mixed results in glioblastoma. This augmented meta-analysis aims to address the limitations of previous studies and evaluate the safety and efficacy of CAR T-cell therapy for recurrent glioblastoma.MethodsWe followed PRISMA guidelines, including specific inclusion and exclusion criteria, for our literature review. Eight studies with 108 patients were included. We used standard and augmented meta-analyses to assess outcomes, complications, and publication bias.ResultsIt was found that the mean overall survival for glioblastoma patients who underwent CAR T-cell therapy was 6.49 months, demonstrating no significant deviation from the median survival observed in those following the standard protocol. CAR T-cell therapy did not lead to a statistically significant improvement in achieving complete responses, with only 80% of patients exhibiting this outcome. Conversely, 44% of patients experienced stable disease, while 58% faced disease progression after CAR T-cell therapy. Adverse events were notable, with CAR T cell therapy-related encephalopathy affecting 37% of treated patients, while cytokine release syndrome was a rare event, observed in only 3% of cases.ConclusionsTo our knowledge, this is the first study that utilizes this novel statistical technique to predict the outcomes of CAR T-cell therapy for recurrent glioblastoma. The results of this study are predictive rather than confirmatory. CAR T-cell therapy for glioblastoma was not predicted to significantly improve survival or achieve substantial complete responses. Stable disease rates are modest, while disease progression is notable. Adverse events, especially CAR T-cell therapy-related encephalopathy, raise safety concerns. Further trials and refinements are needed to enhance CAR T-cell therapy’s effectiveness and safety in glioblastoma treatment, Manuscript Click here to view linked References potentially through optimizing administration routes and target antigens or combining it with other therapies. This challenging disease necessitates continued research to improve patient outcomes.

The recent introduction of the Woven EndoBridge (WEB) has presented an alternative treatment modality for intracranial bifurcation and wide-neck aneurysms with a growing body of literature evaluating its efficacy. However, no previous systematic review has focused on comparing WEB with previously using endovascular approaches, specifically primary coiling (PC) and stent-assisted coiling (SAC). Herein, the authors present the first systematic review summarizing available literature to reach a consensus regarding the safety and effectiveness of WEB. A systematic review of articles identified through a search of PubMed, Embase, Scopus, and Web of Science was conducted. Studies were included if they compared WEB with PC or SAC from any aspect for intracranial aneurysms. Risk of bias was assessed using the Risk of Bias in Non-Randomized Studies-of Interventions tool. Meta-analyses of the outcomes based on stent use and rupture status were performed. A total of 16 studies were included. The three endovascular approaches were comparable in terms of baseline characteristics except for older age and smaller aneurysm neck in the PC group (p < 0.05). Moreover, the follow-up duration was shorter in the WEB group (p < 0.05). Although the WEB group demonstrated lower complete and adequate immediate occlusion rates (p < 0.01), the rates at follow-up evaluations were comparable with SAC and PC (p = 0.61 and p = 0.27, respectively). The WEB group experienced significantly fewer unfavorable neurological outcomes than the SAC group (p = 0.04), while comparable to the PC group (p = 0.36). Retreatment rates were comparable between WEB and coiling (p = 0.92). The WEB group had fewer hemorrhagic and thromboembolic complications (p < 0.01 and p = 0.01, respectively), with similar neurological and procedure-related complications compared with combined PC and SAC groups. Lastly, mortality was comparable among the different endovascular approaches. This study provides evidence on the noninferiority of WEB compared with PC and SAC in terms of angiographic outcomes. Meanwhile, our findings on lower complication rates, cost, and improved operative aspects associated with WEB establish this novel endovascular treatment as a safe and effective alternative for the treatment of bifurcation and wide-neck aneurysms.

A sealed container for the geological disposal of spent nuclear fuel and vitrified high-level waste is the only component of a deep geological repository that provides complete containment of radionuclides. As such, attention is focused on its lifetime. The lifetime of the container is influenced by material degradation processes during disposal and is typically of the order of several millennia and, for some container materials, up to one million years. Designing, manufacturing, and predicting the performance of containers over such long periods requires an in-depth understanding of their material properties, fabrication processes, and degradation mechanisms. Scientific and technological progress can improve both the performance of containers and the robustness of lifetime predictions. Optimization of these aspects is of primary importance for many national radioactive waste disposal programs. In this article, the state of the art of complex coupled degradation processes, as well as the optimization potential of novel container materials, is presented. Furthermore, the existing tools allowing the prediction of long-term barrier integrity are discussed.

The Northern North Sea (NNS) is an archetype Giant Injected Sand Province (GISP). Previous studies have documented individual stratigraphically-bound injectite complexes in the North Sea and beyond. Despite two decades of continuous studies, there are still speculations in terms of parent sand identification, visible pathways, fluid source, overpressure generation mechanisms and triggers. This study is based on a 29,000 km2, 3D seismic volume calibrated to boreholes, and documents for the first time, the stratigraphy of the NNS Basin GISP, spanning five (5) injection episodes over 80 m.y. Sizes range from 500 m to 8 km wide and from 50 to 250 m in height, for individual intrusions. Well data confirms sandstones lithology emplaced within polygonally-faulted mudstones. Fluid budget has been attributed to a combination of several sources, which includes hydrocarbons and diagenetically-released water from opal A to opal CT transformation, smectite to illite transformation and physical compaction of sediments. Basin modelling in the North Viking Graben shows that hydrocarbon generation started during Late Cretaceous for oil and Late Neogene for gas. Presence of sandstone injectites suggests breach in the sealing host rocks, therefore needs to be incorporated into existing stratigraphic framework for accurate reservoir models in basins where they have been encountered.

The Covid-19 pandemic led to fundamental changes in working and commuting patterns for a segment of the workforce, with significant impacts on the level of patronage of public transport systems that are focused on catering to commuters. This aim of this work was to quantify this impact in the long term, using a longitudinal sample of 3826 commuters with a focus on those using rail in Great Britain. Using a panel built in 2020, commuting habits pre-pandemic were compared with those in February 2023. Survey data can now shed light on long-term behavioural adjustments. Building on previous waves, the current wave addresses topics such as commuting frequency, frequency of working from home (WFH) and individual perceptions of WFH and/or in the workplace plus long-term individual decisions such as changes in home location. The results revealed that the pandemic led to a reduction of 1.18 in the number of days commuting to work per week and an increase of 0.85 in the number of days WFH. In addition, if employers had not put restrictions on workplace attendance, the return to commuting would have been 12 percentage points lower. Nonetheless, there is evidence employees are internalising their employer's restrictions to some extent.

Improving road safety is hugely important with the number of deaths on the world’s roads remaining unacceptably high; an estimated 1.35 million people die each year (WHO, 2020). Current practice for treating collision hotspots is almost always reactive: once a threshold level of collisions has been exceeded during some predetermined observation period, treatment is applied (e.g. road safety cameras). However, more recently, methodology has been developed to predict collision counts at potential hotspots in future time periods, with a view to a more proactive treatment of road safety hotspots. Dynamic linear models provide a flexible framework for predicting collisions and thus enabling such a proactive treatment. In this paper, we demonstrate how such models can be used to capture both seasonal variability and spatial dependence in time dependent collision rates at several locations. The model allows for within- and out-of-sample forecasting for locations which are fully observed and for locations where some data are missing. We illustrate our approach using collision rate data from 8 Traffic Administration Zones in the US, and find that the model provides a good description of the underlying process and reasonable forecast accuracy.