Uneven Utilization Research Articles

Mapping Li Concentration Gradients across Battery Cathodes

Lithium-ion batteries (LIBs) are playing an increasingly important role in enabling the transition to a low-carbon global economy, in electric vehicle and grid storage applications. Despite increasing LIB ubiquity, there remains gaps in our understanding of how to optimize further LIB electrode design and structure, and how to achieve such designs in practice and at scale without excessive trial-and-error experimentation. For example, thicker electrodes are desirable for improved volumetric capacity but particularly during rapid charging and discharging cycles, a significant through-electrode thickness Li ion concentration gradient in the electrolyte builds up. This leads to a spatially varying concentration overpotential that in turns leads to uneven utilization of the active material, resulting in diminished capacity and accelerated degradation. Although models of electrode dynamics can help qualitatively to understand concentration polarization effects as a function of electrode design, there are few practical experimental tools to visualize or resolve Li-ion concentration gradients in practice. For example, the widely-used energy dispersive X-ray spectroscopy (EDS) in a scanning electron microscopy cannot resolve elements with very low atomic number such as Li.In this presentation we describe the development of a methodology to visualize Li-ion concentration gradients across a range of electrodes based on secondary ion mass spectroscopy (SIMS). We combine SIMS with EDS to collect elemental maps of all principle LIB electrode elements in a single workflow, which is also extended to 3D by further combining with a plasma field ion microscope (P-FIB) capability. We apply the new methodology for LIB cathodes based on LiFePO4 (LFP) and LiMn2O4 (LMO) that are at different state of overall charge, achieved at a range charging rates. The electrodes also span a range of thicknesses from 100 to 700 µm. We show how the approach can operate over cross-sections large enough to encompass all the electrode thickness while maintaining sufficient spatial resolution to capture key features of the local Li concentration. While EDS elemental maps, with appropriate calibration, can be correlated to local element concentration with good accuracy, SIMS spectra and specifically the intensity of the 7Li+ peaks cannot be readily related to local Li concentration since the yield of 7Li+ ion relates to additional factors, such as the local atomic environment, surface topology and more. We describe how we inter-relate the EDS and SIMS maps for non-Li elements to account for some of these features, and show how these reveals the underlying Li distributions. We consider how these measurements of the Li concentration in the solid particles of the electrode relate to the local state of charge, and the conditions in the electrolyte when charge/discharge was halted and the sample was retrieved from the cell for examination. Fine-scale variations in local 7Li+ ion intensity are also revealed and explained in terms of local microstructural features such as particle size, any particle cracking, the growth of secondary electrolyte interphase, etc.

Exploring the need and potential of ambulatory pharmacy practice for empowering patient and care delivery in India.

In recent years, rapidly changing disease profile patterns, shortage & uneven utilization of healthcare professionals contributed massive burden on the Indian healthcare system, which resulted in varying, fragmented, inconsistent healthcare delivery to the patients and poor patient management. Patients often face and experience many challenges like lack of accessibility, poor patient-healthcare provider relationships, and inadequate quality of care, resulting in unnecessary economic burden in managing their health conditions. Thus Indian healthcare reform is essential in enhancing its capacity to fulfill patients' health needs that can be addressed by focusing on key sustainable strategies and initiatives meant for enhancing coordination of care, expanding services accessibility, redeveloping healthcare infrastructure, implementing workforce innovation and strong governance with the incorporation of core principles such as patient-centeredness, integrated care and collaborative care approaches. The clinical and ambulatory pharmacy practice are fragment of the healthcare delivery which delivers pharmaceutical care and fulfils the needs of patients across healthcare settings. This paper focuses on the present & future perspectives of ambulatory pharmacy practice in India and the factors to be considered for implementing it in patient care.

Monitoring the world-oldest zoo-housed male giant panda (Ailuropoda melanoleuca): A case-study on pathway utilization.

Habitat use monitoring is necessary for a comprehensive understanding of the biological and psychological requirements of animals under human care, facilitating improved exhibit designs and promoting animal welfare. Current studies focused on the space use of the exhibit while limited studies examined the pathway use of the zoo-housed animals. This study aimed to investigate the habitat use of An An, the world-oldest male giant panda (Ailuropoda melanoleuca) at Ocean Park Hong Kong using a pathway utilization monitoring method. The result showed uneven utilization of pathways favoring the upper area near his den over the lower area which required longer walking in the hilly exhibit. Moreover, the comparisons of walking directions showed a preference for gentle slopes during uphill movement and a favor for steep slopes during downhill movement. Our study also compared the walking distance between uphill and downhill movements and the results showed that An An walked longer distances heading upward than moving downward due to his choice of pathways. Our results are in line with the findings in the wild population, showing a preference for gentle slopes, especially in uphill movement. Our study demonstrated the value of the pathway monitoring technique. Due to its easy and time-effective use, this technique can be incorporated into the care teams' operation, providing valuable information on daily activity (e.g. accessing the walking ability of the aged animals by investigating the pathway use and walking distance) and habitat use. Consequently, the pathway monitoring technique can help improve exhibit designs promoting welfare.

Nano-structure of hydrolyzed polyacrylamide strengthened ultra stable nitrogen foam: Lab experiments and molecular dynamics simulation

Foam flooding is an extremely effective method of enhanced oil recovery used to address uneven utilization in strongly heterogeneous reservoirs. However, conventional foam is not stable and is unevenly distributed in oil reservoirs during conventional foam flooding. Hydrolyzed polyacrylamide-strengthened nitrogen foam (HSNF) was therefore proposed to overcome the defects of conventional foam flooding. In this investigation, a comprehensive method was utilized to understand the mechanisms of HSNF with regard to its stability and distribution in reservoirs. In situ experimental characterization and molecular dynamics simulations were designed to examine the characteristics of HSNF. Foam stability was analyzed as a function of the viscosity of the liquid phase, adsorption, and pressure for HSNF and conventional foam. Parallel core flooding experiments were conducted to compare the oil recovery efficiencies of HSNF and conventional foam. Molecular dynamics simulations were utilized to examine the nanostructure of HSNF in brine. Foam stability tests demonstrated that foam stability was enhanced by increasing the viscosity and pressure of the liquid phase and reducing the adsorption capacity of the surfactant. HSNF increased the foam half-life by a factor of 1.67–27.1. The parallel core flooding experiments showed that HSNF effectively initiated flow in low-permeability cores to increase the mobilization of oil even when the permeability ratio was 14.86. However, conventional foam only achieved similar performance at a permeability ratio of less than 10.64. The molecular dynamics simulations revealed that the addition of hydrolyzed polyacrylamide improved the uniform distribution of the oil displacement agent in porous media, inhibited the diffusion of nitrogen in the foam system, and enhanced the interactions between the water phase and crude oil. This suggests that HSNF is a promising oil recovery agent for use in low-porosity, low-permeability, and strongly heterogeneous sandstone reservoirs.

Mapping changes in the utilization of childhood immunization over 5 years in a south Indian tertiary care hospital

Background: Altered vaccine demands and uneven utilization patterns in childhood immunization are evident nationwide. These variabilities may stem from a range of internal and external factors influencing parental preferences. Regular checks and balances are necessary to ensure equal accessibility for all sections of society. Aim: To assess the usage trends of childhood vaccines for 5 years (2018–2022) and to monitor instances of delayed/incomplete immunization status within the community. Methodology: This study recorded the utilization trends of all recommended childhood vaccines over a 5-year period using an ambispective design. The immunization details from 3 years (2018, 2019 and 2020) were retrieved retrospectively, while those from 2 years (2021–2022) were collected prospectively through the immunization registry. Trends in childhood vaccine utilization were recorded across different years, and delays and incomplete vaccine utilization among children, along with factors resulting in deviated immunization timelines, were analysed and compared. The association of factors with deviated immunization utilization was determined using the chi-square test, and a two-way ANOVA analysed utilization variabilities over 5 years. Result: Overall, the study profiled 32,085 children’s (who utilized 87,782 vaccine doses) vaccine utilization pattern for 5 years. Optional vaccines were less utilized (18.12% doses by 25.14% children) compared to mandatory vaccines (81.88% doses utilized by 74.86%). The most utilized mandatory vaccine was oral polio (17.48%) and for optional vaccines, it was measles mumps rubella (MMR; 28.31%). Boys had the highest utilization (55.97%) with a significant male preponderance in optional vaccine utilization ( p value <0.05). Overall, there was a 26.12% decline (percent change) in vaccine utilization in 2022 compared to 2018. Among children with delayed immunization timelines (6.02%), 3.38% were on catch-up, and 2.45% were not. The most commonly delayed vaccines were diphtheria + tetanus + pertussis boosters (30.90%), Tdap (26.19%) and MMR vaccines (20.65%). Influenza vaccines (28.08%) were the most partially utilized optional vaccine, followed by varicella vaccines (20.92%). Factors such as gender (female), age over 1 year, rural residence and low- to middle-income families were significant predictors of deviated immunization status in children. Conclusion: The study mapped the utilization trends of immunizations at a tertiary care hospital in south India over the past 5 years, including the COVID-19 years. Gender inequality in the utilization of optional vaccines is a concern that warrants further research and redressal. Timely administration of childhood vaccinations is crucial for reducing susceptibility to vaccine-preventable diseases and promoting overall well-being.

Modified social force model considering emotional contagion for crowd evacuation simulation

Pedestrian behavior in emergency situations is an important part of emergency management, and crowd evacuation simulation provides a low-cost and low-risk method for investigating pedestrian evacuation dynamics by describing pedestrian evacuation behavior and predicting evacuation outcomes under hypothetical situations. This study proposed a modified social force model that combines dynamic hazard and emotional contagion frameworks to investigate the effect of panic on pedestrian evacuation dynamics under heterogeneous personality trait distributions. First, the emotional contagion framework was improved, and an updated emotional model was developed considering personality characteristics. Second, the individual self-driving force in the social force model was transformed from a physical drive mode to a psychological drive mode by introducing panic factors. Lastly, new rules for the spread of panic within small groups were formulated based on the important influence of small group behavior on evacuation. The simulation results confirmed the feasibility of analyzing crowd evacuation from the perspective of social psychology, and revealed that the spread of panic was closely related to the distribution of personality characteristics, individual walking speed, exit usage, evacuation efficiency, and small groups. In addition, the model could reproduce self-organizing behavior in crowd evacuation, such as fast is slow and herd behavior. Further, the results revealed that moderate panic can help improve evacuation efficiency, whereas excessive panic can result in uneven utilization of exits. In addition, the presence of small groups in panic crowds increased the crowd evacuation time.

Effective phase utilization and efficiency improvement of high power interleaved DC–DC converter using modified rotating phase shedding control

The interleaved bidirectional DC–DC converters (IBC’s) have a poor efficiency profile at light load conditions because the switching and core losses are more dominant than conduction losses. A phase shedding control (PSC) approach is one of the methods for multi-phase IBC to maintain a good efficiency profile across all load circumstances. However, in a PSC of IBC, one phase remains active throughout the load change while the remaining phases only operate at the significant load change. This uneven utilization of phases causes the aging problem of over-exploited phase, which also may cause thermal instability and long-term reliability issues of the converter. This paper proposes an efficiency-based modified rotating phase-shedding control (MRPSC) algorithm for 3−ϕ IBC with an automatic phase selection to improve efficiency across all loading conditions and minimize the uneven aging effect in all phases by proper phase utilization. In addition, an auto-change inner loop-average current mode control (ACIL-ACMC) has been included in the proposed MRPSC algorithm to maintain equal current sharing and voltage regulations. The sampling and computational delay of ADC have also been considered for designing adequate inner and outer loop PI controllers of ACIL-ACMC. The proposed MRPSC algorithm has been implemented in the DSP (TMS320F28335) for 7.5kW IBC.

A Lyapunov-Optimized Dynamic Task Offloading Strategy for Satellite Edge Computing

Satellite edge computing (SEC) has garnered significant attention for its potential to deliver services directly to users. However, the uneven distribution of receiving tasks among satellites in the constellation can lead to uneven utilization of computing resources. This paper proposes a task offloading strategy for SEC that aims to minimize the average delay and energy consumption of tasks by assigning them to appropriate satellite nodes. The approach uses Lyapunov optimization to convert the long-term optimization problem with task queue length constraints into an assignment problem within a single time slot and solve it based on the Hungarian algorithm. Experimental simulations have shown that the proposed algorithm performs better than other baseline algorithms.

Optimization referral rate design for hierarchical diagnosis and treatment system based on accessibility-utilization efficiency bi-objective collaboration: A case study of China

The hierarchical diagnosis and treatment reform of China can guide residents to seek medical treatment in an orderly manner and improve access to medical treatment. Most existing studies on hierarchical diagnosis and treatment used accessibility as the evaluation index to determine the referral rate between hospitals. However, the blind pursuit of accessibility will cause the problem of uneven utilization efficiency of hospitals at different levels. In response to this, we constructed a bi-objective optimization model based on the perspective of residents and medical institutions. This model can give the optimal referral rate for each province considering the accessibility of residents and the utilization efficiency of hospitals, to improve the utilization efficiency and equality of access for hospitals. The results showed that the applicability of bi-objective optimization model is good, and the optimal referral rate based on the model can ensure the maximum benefit of the two optimization goals. In the optimal referral rate model, residents' medical accessibility is relatively balanced overall. In terms of obtaining high-grade medical resources, the accessibility is better in the eastern and central regions, but poorer in the western China. According to the current allocation of medical resources in China, the medical tasks undertaken by high-grade hospitals account for 60%–78%, which are still the main force of medical services. In this way, there is a big gap in realizing the “serious diseases do not leave the county” goal of hierarchical diagnosis and treatment reform.

Priority based dynamic spectrum management using Virtual Utility Functions in Cognitive Radio enabled Internet of Things

Fast growth of wireless devices in IoT (Internet of Things), industry 5.0 and 6G cellular networks, is dealing with the challenge of spectrum scarcity and uneven utilization of available resources. To achieve Ambient Intelligence (AmI) in IoT communication network, dynamic utilization of available network resources, is a challenge faced by resource constraint IoT devices. Cognitive radio technology enables these devices to intelligently sense the free spectrum holes and smartly manage available channels opportunistically. To jointly deal with the challenge of spectrum scarcity and application specific network service provision, we propose a novel multi-attribute based two-tier framework called Cognitive Radio Efficient Spectrum Utilization (CR-ESU) which integrates the concept of Network Function Virtualization (NFV) as Virtual Utility Functions (VUFs) with cognitive radio enabled IoT devices to achieve the dynamic and flexible network services as well as spectral efficiency. The proposed framework is one of the pioneer works that incorporate the two ground breaking technologies, NFV and CRN to create a smart and flexible CR-enabled IoT network. CR-ESU also ensures the best channel selection using Dynamic Channel Reservation (DCR) scheme to decrease the channel switching rate. Continuous Time Markov Chain (CTMC) model is used for network modeling and mathematical expression formation. Promising results show the potential of CR-ESU framework to form a reconfigurable and efficient network.

(Invited) Operando Measurement of Heterogeneities in All-Solid-State Li Battery Electrodes

All-solid-state Li batteries are under intense research and development due to their potential to (a) replace flammable organic liquid electrolytes with solid materials, and (b) increase energy density by allowing Li metal anodes and resulting in a more compact battery.[1]Several types of Li+-conducting solid electrolytes are being studied, e.g. sulfides, oxides, phosphates, polymers, and various composites of these.[2] While polymers are very processable, they have low conductivities, generally <10-4 S/cm. Sulfides have high conductivities, >10-2 S/cm, but are unstable materials and require cells to be under high compression to get good cycling results.[3] Oxides and phosphates have good conductivity, but are hard and brittle, forming poor interfaces with electrode active materials. The ideal combination of solid electrolyte and active material remains elusive, but work continues.An additional challenge looms for the design of all-solid-state electrodes, as reaction distributions in battery electrodes are often heterogeneous, resulting in uneven utilization of active materials.[4] Uneven reaction distributions are generally the result of an imbalance between electronic and ionic transport in the cell, but can also be caused by other resistances such as those introduced by insulating layers surrounding active materials. In this talk I will report our experimental results measuring heterogeneous phenomena in all-solid-state batteries. We have employed electrochemical impedance spectroscopy (EIS) as well as energy dispersive X-ray diffraction (EDXRD). EDXRD is a high-energy synchrotron technique that allows the interiors of batteries to be profiled in a tomographic way during battery operation. We use this to directly observe heterogeneous lithiation gradients across the thickness of cathodes in all-solid-state batteries. We will focus on cells with sulfide electrolytes, such as Li6PS5Cl and Li6.6Ge0.6Sb0.4S5I. Heterogeneous structural stability of the electrolyte itself will also be discussed.[5] Acknowledgments We acknowledge financial support from the National Science Foundation under Award Number CBET-ES-1924534.

QF-PCR: a valuable first-line prenatal and postnatal test for common aneuploidies in South Africa.

Quantitative fluorescence-polymerase chain reaction (QF-PCR) is useful for the detection of aneuploidies involving chromosomes 13, 18, 21, X and Y. Due to the rapid turn-around time and reduced cost compared to traditional karyotyping, QF-PCR has been used as an alternative test for both pre- and postnatal aneuploidy detection in Johannesburg, South Africa since 2001. An internal review of 13,396 aneuploidy tests processed using QF-PCR between January 2015 and December 2019 was performed, and the results showed that the majority (~ 88%) of cases were postnatal tests, with prenatal samples accounting for only ~ 12% of cases. The most common aneuploidies detected were Trisomy 21 (20.6%), Trisomy 18 (3.7%) and Trisomy 13 (2.4%), while sex chromosome aneuploidies were only detected in < 1% of cases. The average percentage of positive cases over the 5-year period was 32.1% for postnatal samples and 11.3% for prenatal samples. QF-PCR testing of the common aneuploidies is being used appropriately, and the high percentage of positive cases demonstrates the value of QF-PCR as prenatal and postnatal tests, particularly in limited resource settings. The higher proportion of positive postnatal cases suggests that referrals are clinically appropriate. However, there is under- and uneven utilization of genetic services in many provinces in South Africa, and the state of prenatal genetic services is poor, as reflected by the low number of prenatal referrals. These results demonstrate the need for programs which will improve the genetic knowledge of referring doctors and the general public, thereby improving the broader utilisation of QF-PCR aneuploidy diagnostic testing, so that patients receive appropriate diagnoses and subsequent management.

Practice Diversity and Burn Center Growth: A 10-Year Profile of a State's Only Burn Center.

Growth and sustainability of burn practices can be impaired by irregular patterns of patient presentations, resulting in uneven utilization of facilities and staff. Burn care itself may not engage the full capacities of members of burn care teams. To address these problems, we organized a burn and reconstruction center to provide statewide acute care as Mississippi's only burn unit, to fully integrate reconstructive surgery into management of burn patients, and to diversify practice based on plastic surgery scope of practice. The first 10 years of this unit were reviewed to evaluate the performance of this scheme. Burn admissions to and surgical procedures at this unit between July 2009 and June 2019 were analyzed to quantify acute burn care, secondary reconstructive burn care, and categories of practice growth. The unit admitted 5469 acute burn patients with a mortality rate of 1.49%. Comparing year 10 to year 1 of practice, acute burn admissions increased 58%. Total operations increased 276%. Acute burn procedures increased 176%. Secondary burn procedures increased 405%. Nonburn procedures increased 352%, with the subset of nonburn hand surgery increasing 1062%. Acute burn admissions and procedures increased over this period, but greater growth was seen in secondary burn procedures and nonburn procedures, especially hand cases. Expansion of practice into areas within the overall skill sets of burn team members was an effective growth strategy.

Survey on Recent Advancements in Energy-Efficient Routing Protocols for Underwater Wireless Sensor Networks

Underwater wireless sensor networks (UWSNs) have become highly efficient in conducting various operations in maritime environments. Compared to terrestrial wireless sensor networks, routing protocols in UWSNs are prone to high propagation delay, high energy consumption, low bandwidth, and low throughput. UWSNs are remotely located and operate without the need for human intervention. Most sensor batteries are energy restricted and very difficult to replace. One of the major challenges of UWSNs is the uneven utilization of energy resources, which reduces the network lifetime. Therefore, an energy-efficient routing mechanism is necessary to overcome the aforementioned problems. Many significant studies have attempted to realize this goal by designing energy-efficient routing protocols to provide efficient packet routing from source to destination. In this paper, we focus on discussing various energy-efficient routing protocols that are currently available for UWSNs, categorize them with a new taxonomy, and provide a comparative discussion. Finally, we present various research problems that remain open and challenges for future research.

A Study on Sizing of Substation for PV With Optimized Operation of BESS

Recent development and cost down of PV(Photovoltaic) technology drive change of power system structure. The participation of PV generation is increasing, and the size of each PV farm is getting larger. In order to integrate large PV farms into the main grid, substation for interconnection needs to be sized properly. Unlike substations for load and conventional generators, PV farm substation has an uneven utilization ratio due to characteristics of solar radiation. With proper sizing method for the capacity of the substation can reduce the building cost of facilities. A combination of an energy storage system can further reduce the capacity of the substation. Battery energy storage system (BESS) can shift the peak production of PV during the daytime to midnight. According to market circumstances, BESS can reduce further construction costs by producing profit based on time difference of electric cost. For proper sizing of substation capacity, several factors must be considered including environmental factors, market structure and BESS in the system. In this article, a series of assessment methodology is introduced to calculate the optimized capacity of substation and BESS for PV farm interconnection. The long-term solar radiation data is analyzed for a given site of the PV farm. Based on market structure, the operation of BESS is optimized to make maximum profit during operation. The iterative calculation of each step results in the calculation of the optimized capacity of BESS and substation for given PV farm size.

Modelling the effects of risk factor and time savings on pedestrians’ choice of crossing facilities at signalised intersections

Pedestrian foot overbridges are sparsely used compared to the at-grade crosswalks in Indian cities. At the signalised intersections, in the presence of at-grade crosswalk, the usage rate of foot overbridge is even less despite the additional pedestrian waiting time. The uneven utilization of the crossing facilities affects the safety and mobility of pedestrians. The objective of this study is to analyse the behaviour of pedestrians and their choices between an at-grade signalised crosswalk and a coexisting foot overbridge (which is quite common in Indian cities) for crossing the street. The actual crossing choice behaviour of 1134 pedestrians was observed from a video survey in Mumbai city, India. The usage rate of foot overbridge in the sample was 26% only. Binary logit model was estimated to find the significant variables influencing the pedestrian choice of crossing facility. The results showed that pedestrian’s total crossing time ratio (ratio of crossing time by foot overbridge to total crossing time by at-grade crossing which includes additional waiting time at signal) affects the choice of crossing facilities significantly. The probability of selecting foot overbridge increases by about 60% as the pedestrian’s total crossing time ratio reduces from 1.5 to 0.5, For more than 50% of pedestrians to use foot overbridge, the total crossing time ratio should be within 0.75. It was also inferred that choices of women and older pedestrians are influenced primarily by convenience to cross, whereas the choices of pedestrians accompanied by children are driven by the safety benefits of the crossing facility. Another important finding from the study was that pedestrians’ crossing behaviour depends on the level of risk they take while crossing (in terms of signal violation). The conclusions from this study may be helpful in strengthening the policy measures in the direction of the design of safe and efficient pedestrian crossing facilities.

Coherent Estimations for Residential Photovoltaic Uptake in Germany Including Spatial Spillover Effects

The share of solar energy in German electricity generation has increased strongly over recent years. This is largely due to guaranteed feed-in tariffs together with decreasing prices for solar panels. Residential PV systems play a decisive part providing households with a possibility to contribute to the Energiewende and benefit from the use of renewable energy. Their regional distribution varies distinctly across Germany implying different requirements in distribution grids as well as uneven utilization of national policy measures. Our paper focusses on the spatial diffusion of roof mounted PV systems and the underlying drivers in Germany. We extend previous findings not only by including additional explanatory variables but also by considering cross-regional spillover using spatial econometric models. Estimation results show that spatial dependence is a relevant determinant for explaining regional clusters of PV adoption. Recurrent visual perception or peer-effects might explain spatial autocorrelation as potential adopters follow decisions by actors in the proximity. Another reason for spatial dependence might be a concentration of craft skills or solar initiatives, which leads to an accelerated diffusion in a region and its surroundings. Whereas the first explanation corresponds to the specification of a spatial lag model, the latter is in line with a spatial error specification. However, our results indicate that although spatial lag is present, spatial dependence in the residuals has higher explanatory power. Hence, we suppose that spatial spillover is not mainly driven by social imitation but by unobserved regional characteristics. Notably, high values for solar radiation, the share of detached houses, electricity demand and inverse population density of a region favour the PV uptake.

Benzene

This article proposes Benzene, an energy-efficient distributed SRAM/STT-RAM hybrid cache for manycore systems running multiple applications. It is based on the observation that a naïve application of hybrid cache techniques to distributed caches in a manycore architecture suffers from limited energy reduction due to uneven utilization of scarce SRAM. We propose two-level optimization techniques: intra-bank and inter-bank. Intra-bank optimization leverages highly associative cache design, achieving more uniform distribution of writes within a bank. Inter-bank optimization evenly balances the amount of write-intensive data across the banks. Our evaluation results show that Benzene significantly reduces energy consumption of distributed hybrid caches.

Exploring factors associated with the uneven utilization of telemedicine in Norway: a mixed methods study

BackgroundNorway has a long history of using telemedicine, especially for geographical reasons. Despite the availability of promising telemedicine applications and the implementation of national initiatives and policies, the sustainability and scaling-up of telemedicine in the health system is still far from accomplished. The main objective of this study was to explore and identify the multi-level (micro, meso and macro) factors affecting telemedicine utilization in Norway.MethodsWe used a mixed methods approach. Data from a national registry were collected to analyze the use of outpatient visits and telemedicine contacts in Norway from 2009 to 2015. Interviews with key stakeholders at national, regional and local level helped complete and contextualize the data analysis and explore the main issues affecting the use of telemedicine by health authorities and hospitals. Relevant national documents were also used to support, contradict, contextualize or clarify information and data.ResultsTelemedicine use in Norway from 2009 to 2015 remained very low, not exceeding 0.5% of total outpatient activity at regional level and 0.1% at national level. All four regions used telemedicine. Of the 29 hospitals, 24 used it at least once over the 7-year period. Telemedicine was not used regularly everywhere, with some hospitals using it sporadically. Telemedicine was mostly used in selected specialties, including rehabilitation, neurosurgery, skin and venereal diseases. Three major themes affecting implementation and utilization of telemedicine in Norway emerged: (i) governance and strategy; (ii) organizational and professional dimensions; (iii) economic and financial dimensions. For each theme, a number of factors and challenges faced at different health care levels were identified.ConclusionsThis study allowed shedding light on multi-level and interdependent factors affecting utilization of telemedicine in Norway. The identification of the main implementation and utilization challenges might support decision makers and practitioners in the successful scaling-up of telemedicine. This work provides a knowledge base useful to other countries which intend to implement telemedicine or other digital health services into their healthcare systems.

Pumped hydroelectric storage utilization assessment: Forerunner of renewable energy integration or Trojan horse?

Pumped hydroelectric storage (PHS) is the main utility-scale storage technology. Although PHS systems generally constitute a fraction of generation, they receive increasing attention due to their potential balancing role towards higher penetration of variable renewable energy sources (RES). In the European context it is widely believed that PHS are key elements of the ongoing energy transition. The present analysis examines if this assumption is valid and PHS utilization grows parallel to RES. We collected, harmonised and analysed datasets for 1991–2016 revealing an uneven utilization among European states. While certain countries increased the utilization rates of PHS by a factor of three to four, in several others PHS units are heavily under-utilized. In three extreme cases the utilization rate, compared to the past, is at 10–25% level. We analysed this controversy by identifying tendencies in the electricity markets, ownership and management status in the various countries, as well as competition with other technologies with balancing potential. Finally, we developed a new approach to display PHS tendencies in a compact picture. Building on the growth-share matrix Economics framework, we identified the strategic direction of PHS for each of the analysed countries.