Development of a biogas distribution model for a wastewater treatment plant: a mixed integer linear programming approach.

In this paper, we propose a realistic model for gas distribution of an advanced municipal wastewater treatment works and through minimisation of the total cost of gas distribution we perform retrospective optimisation (RO) using historical plant data. This site is the first in the UK with a mixed operational strategy for biomethane produced on site: to burn in combined heat and power (CHP) engines to create electricity, burn in steam boilers for onsite steam use or inject the biomethane into the National Grid. In addition, natural gas can be imported to make up shortfalls in biomethane if required. Implemented using a novel mixed integer linear programming (MILP) approach, to ensure a fast and robust solution, our results indicate the plant operated optimally within accepted tolerance 98% of the time. However, improving plant robustness (such as reducing unexpected breakdown incidents) could yield a significant increase in gas revenue of 7.8%.

Acupuncture and herbal medicine in in vitro fertilisation: a review of the evidence for clinical practice.

The objectives of this systematic review were to determine the effectiveness of (a) acupuncture and (b) Chinese herbal medicine on the treatment of male and female subfertility by assisted reproductive technologies (ART). All reports from RCTs of acupuncture and/or Chinese herbal medicine in ART were obtained via searches through The Cochrane Menstrual Disorders and Sub-fertility Group's Specialised Register of controlled trials, and other major databases. The outcome measures were determined prior to starting the search, and comprised: live birth rate, ongoing pregnancy rate, clinical pregnancy rate, the incidence of ovarian hyperstimulation syndrome and multiple pregnancy, miscarriage rate and adverse effects arising from treatment. Overall, 14 trials (a total of 2670 subjects) were included in the meta-analysis. The results provided no evidence of benefit in the use of acupuncture during assisted conception. Further studies should attempt to explore the potential placebo, as well as treatment, effects of this complimentary therapy. Essential elements for a quality RCT will be the size of the trial, the use of a standardised acupuncture method and of placebo needles.

Psychiatric morbidity following endometrial ablation and its association with genuine menorrhagia.

OBJECTIVE: To explore the relation between pre-operative psychiatric morbidity, menstrual blood loss and psychiatric outcome in women receiving endometrial ablation for heavy periods. DESIGN: A prospective cohort study. SETTING: The menorrhagia clinic at Leeds General Infirmary. POPULATION: One hundred and twenty consecutive women referred to the Clinic for endometrial ablation. METHODS: Psychiatric interview and actual menstrual blood loss measurements at presentation pre-operatively and one year post endometrial ablation. MAIN OUTCOME MEASURE: Psychiatric status using the semi-structured interview, Present State Examination, with measurement of menstrual blood loss. RESULTS: Endometrial ablation was performed on 92 women. Of the 87 women evaluated 51 (59%) had clinically significant psychiatric symptoms, mainly depression and anxiety. Psychiatric morbidity fell to 21.8% at one year after endometrial ablation. Women with the best psychiatric outcome (6% post-operative psychiatric morbidity) were those with genuine menorrhagia (> or =80 mL) and low psychiatric morbidity pre-operatively. Those who fared worst (39% post-operative psychiatric morbidity) were women with high pre-operative psychiatric morbidity and low menstrual blood loss. Of seven women with very low losses [mean 19 mL (SD 17)] who did not proceed to surgery after counselling, six (86%) had significant psychiatric morbidity. CONCLUSIONS: Pre-operative psychiatric status and menstrual blood loss are predictors of outcome of surgery for women with reported heavy periods.