RESUMEN
The commoditization of nuclear power through the factory production of sealed micro-power units within a digitally enabled holistic assurance framework is described. This would revolutionize nuclear power-plant design, construction, operation and decommissioning through a paradigm shift to manufacture-operate-remove-recycle (MORR). The potential impact of recent research on an integrated nuclear digital environment for large bespoke nuclear power plants and the design, build and operation of fusion power plants using such a digital environment is explored. These strands are interwoven to discuss the technical, economic and socio-political implications of MORR in the context of micro-reactors and to consider the potential evolution of safeguarding issues based on a digital assurance framework that leads to type approvals. Commoditization of nuclear power would lower costs in line with offshore wind and the output from a single production line in a factory could replace a third of current fossil fuel-based electricity generation in the UK over a 15-year period, making a significant contribution to achieving zero greenhouse gas emissions. The challenges associated with the changes in culture, both in the nuclear industry and in society, as well as the technology gaps, that need to be addressed in realizing this paradigm shift are identified and discussed.
RESUMEN
Eosinophilic gastrointestinal diseases (EGIDs) are a group of diseases characterized by selective eosinophil infiltration of the gastrointestinal (GI) tract in the absence of other causes of eosinophilia. These diseases are generally driven by type 2 inflammation, often in response to food allergen exposure. Among all EGIDs, the clinical presentation often includes a history of atopic disease with a variety of GI symptoms. EGIDs are traditionally separated into eosinophilic esophagitis (EoE) and non-EoE EGIDs. EoE is relatively better understood and now associated with clinical guidelines and 2 US Food and Drug Administration-approved treatments, whereas non-EoE EGIDs are rarer and less well-understood diseases without US Food and Drug Administration-approved treatments. Non-EoE EGIDs are further subclassified by the area of the GI tract that is involved; they comprise eosinophilic gastritis, eosinophilic enteritis (including eosinophilic duodenitis), and eosinophilic colitis. As with other GI disorders, the disease presentations and mechanisms differ depending on the involved segment of the GI tract; however, the differences between EoE and non-EoE EGIDs extend beyond which GI tract segment is involved. The aim of this article is to summarize the commonalities and differences between the clinical presentations and disease mechanisms for EoE and non-EoE EGIDs.
Asunto(s)
Enteritis , Eosinofilia , Esofagitis Eosinofílica , Gastritis , Humanos , Eosinofilia/inmunología , Eosinofilia/diagnóstico , Eosinofilia/patología , Enteritis/diagnóstico , Enteritis/inmunología , Enteritis/patología , Gastritis/diagnóstico , Gastritis/inmunología , Gastritis/patología , Esofagitis Eosinofílica/diagnóstico , Esofagitis Eosinofílica/inmunología , Esofagitis Eosinofílica/patología , Animales , Eosinófilos/inmunología , Eosinófilos/patología , Enfermedades Gastrointestinales/inmunología , Enfermedades Gastrointestinales/diagnósticoRESUMEN
Eosinophilic gastrointestinal diseases (EGIDs) are chronic, immune-mediated disorders, characterized clinically by gastrointestinal (GI) symptoms and histologically by eosinophil-predominant infiltration in ≥1 GI tract segment.1 A recent, international consensus by 91 experts proposed a new framework for EGID nomenclature to establish updated terms, designations, and conventions.2 Although this framework offers a standardized starting point for the field, debate is ongoing regarding the appropriate terminology for cases involving multiple areas, such as "non-eosinophilic esophagitis (EoE) EGID and EoE" or "non-EoE EGID with esophageal involvement (EI)." Notably, in a survey of these experts, 61% agreed with the later term "non-EoE EGID with EI," because EoE is isolated to the esophagus by current diagnostic criteria.3 However, limited molecular and pathogenic data exist to support the distinction. Furthermore, disease burden of symptoms and comorbidities generally is higher in non-EoE EGIDs than EoE.4 Presently, there is no screen to predict non-EoE EGID concomitance in EoE; therefore, decision-making to further explore other GI segment involvement is clinically challenging. We aimed to answer 2 fundamental questions in the field (Figure 1A): Is there a shared or distinct pathogenesis between patients with isolated EoE and non-EoE EGIDs with EI as assessed by patient characteristics and molecular profiles? Can we predict concomitant non-EoE EGIDs when EoE exists? Herein, we report a similar molecular signature between EoE and EI and a potential predictive model to identify concomitant non-EoE EGIDs in patients with EoE.
Asunto(s)
Esofagitis Eosinofílica , Eosinófilos , Humanos , Esofagitis Eosinofílica/patología , Esofagitis Eosinofílica/diagnóstico , Eosinófilos/patología , Masculino , Femenino , Adulto , Persona de Mediana Edad , Esófago/patologíaRESUMEN
The management and exploitation of knowledge can contribute to the competitive advantage of an organisation and hence can be a driver of its value. This paper examines knowledge management practices within two engineering organisations with an emphasis on barriers to its effectiveness and the influence of current and anticipated deployment of digital technologies. Two methods were used to gather research data across both organisations by combining a series of semi-structured interviews with a quantitative social network analysis. Examination of the acquired data provided insights into the relationship between the knowledge management culture in both organisations and their adoption of digital tools. Hudson's evolutionary model of safety culture has been modified to describe the culture of knowledge management in an organisation and the acquired data used to locate the two organisations on their knowledge management journey. It is proposed that social networks could be used as an indicator of the stage of evolution of knowledge management in engineering organisations more generally with low network densities and dispersed networks representing higher stages of evolution.