Infant growth is a key indicator of health and a relevant component of paediatric surveillance. Certain growth characteristics are also associated with greater risk for diseases such as obesity and cardiovascular disease. South Asian populations are known to demonstrate poor infant growth and suffer from a high prevalence of non-communicable disease. Relatively little is known about the growth of Pakistani infants, especially following migration. In the United kingdom (UK), infant growth is routinely monitored to detect poor health, and this process produces a repository of largely unutilised data. In 2009, new growth charts, which include a component of the World Health Organisation (WHO) growth standards, were introduced to routine practice. The adoption of prescriptive standards, which are based on breastfed infants living in an unconstrained environment, will have implications for the assessment of growth. To develop and assess the quality of routine growth monitoring data collected in Bradford, UK, so that it can be used to describe the differences in growth between White British and Pakistani infants in the same city. To investigate the factors that influence this growth. To assess the implications of adopting growth standards for practice. The frequency of routine growth monitoring data that are collected at prescribed age periods was assessed. Test-retest growth data were collected from 192 practitioners, and technical error of measurements were calculated. Data on 2464 (boys 51%, White British 45%) infants were submitted to multilevel modelling analysis to produce sex and ethnic specific weight-for-age, abdominal circumference-for-age, head circumference-for-age, and length-for-age growth curves between birth and nine months. Multivariable linear regression models were used to investigate factors that influence size at birth and at nine months. Growth curves were plotted against the WHO standards and the UK 1990 references, Z-scores were calculated, and the relative risks (RR) of underweight, obesity, and poor infant weight gain using the standards compared to the references were assessed. During each prescribed age period for routine growth monitoring generally only 30% to 35% of measurements were recorded. None of the technical error of measurements were excessively large, and coefficients of reliability ranged from 0.96 to 1.00. Multilevel models explained that Pakistani infants were smaller than White British infants, in the first nine months of life, for weight (-210.3g to -321.7g), abdominal circumference (-1.15cm to -0.39cm), head circumference (-0.59cm), and length (-0.32cm). Compared to the WHO standards, infants demonstrated dissimilar weight growth, but similar head circumference and length growth. The common weight growth pattern was slow growth between birth and two months, followed by rapid growth. Using the standards, infants were significantly less likely to be classified as underweight (RR at birth 0.496; 95% Confidence Interval 0.363 to 0.678) and demonstrating poor weight gain from birth to nine months (0.783; 0.644 to 0.952). Growth monitoring data are not collected at prescribed age periods, but following initial training of practitioners are reliable. Integrating research with practice has developed routine data to research calibre and has established protocols to make data more accessible. Pakistani infants were consistently smaller than White British infants, and, despite efforts, the determinants of this phenomenon have not yet been fully elucidated. Growth in weight of infants in Bradford differs significantly from that represented by the WHO standards, and without adequate training of practitioners infant growth may be incorrectly interpreted.

The need to save energy, cut costs, and increase profit margin in process manufactureincreases continually. There is also a global drive to reduce energy use and cut down co2 emission and combat climate change. These in turn have led to more stringent requirements on process control performance. Hence, the requirements for modern systems are often not achievable using classical control techniques. Therefore, advanced control strategies are often required to ensure optimal process performance. Despite these challenges, PID has continued to be the dominant industrial control scheme. However, for systems with complex dynamics and/or high performance requirements, PID control may not be sufficient. Therefore, a significant number of industrial control loops are not performing optimally and more advanced control than PID may be required in order to achieve optimal performance. MPC is one of the advanced control schemes that has had a significant impact in the industry. Despite the benefits associated with the implementation of MPC, the technology has remained a niche application in process manufacture. This thesis seeks to address these issues by developing ways that could lead to widespread application of MPC. In the first part of this thesis, a study was carried out to understand the characteristics of processes that would benefit from the application of MPC at the regulatory control level even in the single-input single-output (SISO) case. This is a departure from the common practice in which MPC is applied at the supervisory control layer delivering set points to PID controllers at the regulatory control layer. Both numerical simulation and industrial studies were used to show and quantify benefits of MPC for SISO applications at the regulatory control layer. Some issues that have led to the limited application of MPC include the cost and human efforts associated with modelling and controller design. And to achieve high process performance, accurate models are required. To address this issue, in the second part of this thesis, a novel technique for designing MPC from routine plant data – routine data MPC (RMPC) is proposed. The proposed technique was successfully implemented on process models. This technique would reduce the high human cost associated with MPC deployment, which could make it a widespread rather than niche application in the process manufacturing industry.

Magister Public Health - MPH / Ensuring that routine health information systems provide good quality information for informed decision making and planning in health systems remain a major priority in several countries and health systems. The lack of use of health information or use of poor quality data in health care and systems results in inadequate assessments and evaluation of health care and result in weak and poorly functioning health systems. The Nigerian health system like in many developing countries has challenges with the building blocks of the health system with a weak Health Information System. Although the quality of data in the Nigerian routine health information system has been deemed poor in some reports and studies, there is little research based evidence of the current state of data quality in the country as well as factors that may influence data quality in routine health information systems. This study explored the data quality of routine health information generated from health facilities in Oyo State, Nigeria, providing the state of data quality of the routine health information. This study was a cross sectional descriptive study taking a retrospective look at paper based and electronic data records in the National Health Management Information System in Nigeria. A mixed methodology approaches with quantitative to assess the quality of data within the health information system and qualitative methods to identify factors influencing the quality of health information at the health facilities in the district. Assessment of the quality of information was done using a structured evaluation tool looking at completeness, accuracy and consistency of routine health statistics generated at these health facilities. A multistage sampling method was used in the quantitative component of the research. For the qualitative component of the research, purposive sampling was done to select respondents from each health facility to describe the factors influencing data quality. The study found incomplete and inaccurate data in facility paper summaries as well as in the electronic databases storing aggregate information from the facility data.

Yes / Anticholinergic medicines are associated with adverse outcomes for older people. However, little is known about their use in frailty. The objectives were to (1) investigate the prevalence of anticholinergic prescribing for older patients, and (2) examine anticholinergic burden according to frailty status. Methods: Cross-sectional analysis of Welsh primary care data from the Secure Anonymised Information Linkage (SAIL) databank including patients aged ≥65 at their first GP consultation between 1st January and 31st December 2018. Frailty was identified using the electronic Frailty Index (eFI) and anticholinergic burden using the Anticholinergic Cognitive Burden (ACB) scale. Descriptive analysis and logistic regression were conducted to 1) describe the type and frequency of anticholinergics prescribed; 2) to estimate the association between frailty and cumulative ACB score (ACB-Sum). Results: In this study of 529,095 patients, 47.4% of patients receiving any prescription medications were prescribed at least one anticholinergic medicine. Adjusted regression analysis showed that patients with increasing frailty had higher odds of having an ACB-Sum of >3 compared to patients who were fit (mild frailty, adj OR 1.062 (95%CI 1.061–1.064), moderate frailty, adj OR 1.134 (95%CI 1.131–1.136), severe frailty, adj OR 1.208 (95%CI 1.203–1.213)). Conclusions: Anticholinergic prescribing was high in this older population. Older people with advancing frailty are exposed to the highest anticholinergic burden despite being the most vulnerable to the associated adverse effects. Older people with advancing frailty should be considered for medicines review to prevent overaccumulation of anticholinergic medications given the risks of functional and cognitive decline that frailty presents. / NIHR / Research Development Fund Publication Prize Award winner, May 2023.

Background: Coronary artery disease is a common cause of morbidity and mortality in the UK. Interventional revascularisation procedures for addressing the disease include percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), which respectively seek to open up or bypass blocked arteries to restore blood flow to heart muscle. Rates at which these procedures are carried out have changed in recent years, as have clinical indications for referral. PCI is delivered by interventional cardiologists, while CABG is carried out by cardiothoracic surgeons, necessitating multi-disciplinary decision making. There is both within- and cross-speciality debate as to the optimal treatment strategy in some case types. Evaluation of the care provided is of clinical and political importance, and requires information about how post-procedure event rates per operator and hospital compare with those expected given the composition of patient populations. Methods: Two UK-wide audit databases of PCI and CABG procedures were used to explore a range of clinical outcome questions. The patient populations contained within each database were compared to see how they differed, and also how each had changed in recent years. In CABG patients, comparative effectiveness of two different surgical techniques (single vs bilateral mammary artery grafting) was assessed with respect to both short-term and long-term mortality outcomes. In PCI patients, a risk model to predict 30-day mortality was developed for use in clinical appraisal. Results: In both patient populations there had been changes to the relative frequencies of many characteristics over time. In the CABG population, multivariable analysis showed that patients undergoing single mammary artery grafting had lower odds of all-cause mortality within 30 days of procedure than those receiving bilateral mammary artery grafting, but had worse overall survival in the long term. In the PCI population, the developed risk model demonstrated good calibration and discrimination at predicting 30-day all-cause mortality. Discussion: The studies described above demonstrate that large-scale routinely collected data can be used to gain insights into clinical care quality and delivery. These resources are under-utilised at present; correcting this requires an understanding of the limitations of the data and how the information contained therein relates to actual clinical care.

Doctor Educationis / The weak routine immunization activities in Nigeria have led to an upsurge of vaccine preventable diseases such as poliomyelitis in the northern parts of the country. This made the federal government to intensify efforts to improve routine immunization activities with various intervention programmes over the years. This commitment of the federal government towards improving routine immunization as a way to promote infant and child survival led to the partnership between the UK Department for International Development (DFID) to support the launching of Partnership for Reviving Routine Immunization in Northern Nigeria (PRRINN) programme in 2006. The programme, implemented in the northern states of Jigawa, Katsina, Yobe, and Zamfara was intended to augment other federal government immunization intervention efforts in improving routine immunizations services. After five years of programme implementation, assessment of the effectiveness of PRRINN had not be undertaken using a survey based immunization coverage to establish how well the primary objectives of the programme are being met in terms of improving routine immunization. This study was designed to evaluate the performance of the PRRINN programme in improving routine immunization coverage in Jigawa State using coverage data from the National Immunization Coverage Survey (NICS) of 2010.

Seit mehr als 3 Jahrzehnten stehen Belebtschlammmodelle als Werkzeuge für die ingenieurtechnische Planung und Optimierung von Kläranlagen zur Verfügung. Die Verbreitung und Anwendung speziell im deutschsprachigen Raum ist dabei geringer als in anderen Weltregionen. Dies ist im Zusammenhang mit dem detaillierten DWA-Regel-werk zu sehen, das auf Seite der Anwendenden kaum zusätzlichen Bedarf für weitere Werk¬zeuge für die Anlagenplanung und –optimierung erwachsen lässt. Dies gilt ebenso für die Über¬wachungs- und Genehmigungsseite. Die vorliegende Arbeit bietet für verschiedenste Aspekte im Bereich der Kläranlagen-modellierung Methoden und Werkzeuge, um durch effizientere Nutzung eine weitere Etablierung voranzutreiben und eine breite allgemein verbindliche Anwendung zu manifestieren. Dies betrifft konkret:  Protokolldefinition für eine allgemeine Vorgehensweise (Kapitel 1.4 und 7.1)  Skriptbasierte Unterstützung der Datenauswertung, Prüfung und Aufbereitung (Kapitel 6 und 7.4)  Zulaufdatengenerierung für lückenbehaftete Betriebsdaten (Kapitel 3)  Analyse des Verweilzeitverhaltens basierend auf Betriebsdaten (Kapitel 5)  Modellkopplung für plant-wide modelling (Kapitel 4 und 7.3)  Modellerweiterungen für Belebtschlammmodelle (Kapitel 7.2) Basis sind wie bei klassischen Bemessungs¬frage¬stellungen die vorhandenen Betriebs¬da-ten von Kläranlagen. Für die Nutzung sowohl zur statischen Bemessung als auch zur dyna¬mi¬schen Simulation sind diese nach geeigneter Zusammenstellung und Aufbereitung hin¬sicht¬lich ihrer Eignung und Qualität zu bewerten. Dieser eher handwerkliche Schritt wird durch skriptbasierte Module unterstützt, um der eigentlichen Planungsaufgabe mehr Zeit widmen zu können. Eine beispielhafte Vorgehensweise wird in dieser Arbeit in Kapitel 6 präsentiert. Dies stellt aus Effizienz- und Qualitätsgründen einen Fortschritt dar. Die Betriebsdaten von kommunalen Kläranlagen speziell unterhalb der Größenklasse 5 sind sehr lückenbehaftet. Daher sind geeignete Methoden erforderlich, um die Daten zu einem kontinuierlichen Zulaufdatensatz aufzubereiten. Eine mögliche Methode findet sich in Kapitel 3 dieser Arbeit. Auch dies unterstützt die Qualitätsverbesserung. Für die praxisnahe Modellanwendung stellen die bereits verfügbaren Belebt¬schlamm-modelle eine geeignete Basis dar. Allerdings wurden einige offene Fragestellungen identifiziert. Konzepte und Vorschläge für entsprechende Modellerweiterungen finden sich im Kapitel 7.1. Dies betrifft den Umgang mit inerten Stofffrachten, Dosierung externer Kohlenstoffquellen, Lösungen für hohe Anteile industrieller Abwässer sowie die P-Elimination. Auch eine methodische Vorgehensweise für den praktischen Einsatz wurde basierend auf allgemeingültigeren Simulations¬protokollen entwickelt, um die Bear¬bei¬tung strukturierter und damit sowohl nachvollzieh¬barer als auch effizienter zu gestalten (Kapitel 1.4 und 7.1). Das Verweilzeitverhalten hat erheblichen Einfluss auf erzielbare Umsatzraten sowie die erreich¬baren Ablaufkonzentrationen. Eine diesbezügliche Analyse ist allerdings noch kein Standard¬werkzeug bei der Betrachtung bestehender Kläranlagen. Im Einzelfall bestehen allerdings erhebliche Optimierungspotentiale bei strömungsungünstiger Gestaltung. Neben der Nutzung von computational fluid dynamics (CFD) als Analysewerkzeug kann auch die Auswertung von speziellen Tracerversuchen oder die Nutzung vorliegender Daten für die Analyse des Verweilzeitverhaltens genutzt werden. Im Kapitel 5 finden sich entsprechende Erläuterungen und methodische Beispiele. Die zunehmende Durchdringung ingenieurtechnischer Bereiche mit IT-basierten Werk-zeu¬gen führt auch zu Weiterentwicklungen bei der Arbeit mit Daten. Die Besonder-heiten im Bereich der Kläranlagenplanung und Optimierung werden in dieser Arbeit beleuchtet und mit dem vorgestellten methodischen Rahmen eine Möglichkeit der modularisierten Abarbeitung wiederkehrender Aufgaben in Kapitel 6 demonstriert. Die Einbettung möglicher weiterer Werkzeuge wie z.B. Simulationssoftware in open source basierte Skripte ermöglicht eine maximale Flexibilität bei gleichzeitig hoher Transparenz. Je nach Aufgabenstellung finden sich in dieser Arbeit Ergänzungen und Hilfestellungen in Form von Werkzeugen oder methodischen Empfehlungen, um den Bearbeitungsaufwand zu minimieren sowie die Bearbeitungsqualität zu erhöhen unter gleichzeitiger Verbesserung der Transparenz für alle am Planungs- bzw. Optimierungsprozess Beteiligten. Dadurch wird eine tatsächliche Anwendung in der täglichen Ingenieurpraxis erheblich vereinfacht. Durch Integration der präsentierten Entwicklungen in die siedlungs¬wasserwirtschaftliche Ausbildung ist außerdem eine zukünftige niedrig¬schwelligere und damit breitere Nutzung zu erwarten.:1 General introduction 1 1.1 Explanation of terms 1 1.2 Motivation 2 1.3 Background 4 1.3.1 Quality assurance in the performance of simulation studies 4 1.3.2 Special features of simulation studies for wastewater treatment plants in German-speaking countries 6 1.4 Aims, differentiation and objectives 7 1.5 Structure of the document 9 1.6 References 10 2 Growth of science in activated sludge modelling – a critical bibliometric review 13 2.1 Highlights 13 2.2 Abstract 13 2.3 Introduction 14 2.3.1 Motivation 14 2.3.2 Introduction into bibliometrics 15 2.3.3 Objective 15 2.4 Material and Methods 16 2.4.1 Database and tools 16 2.4.1.1 Selection of database 16 2.4.1.2 Development of the number of data sets in the Web of Science 19 2.4.2 Bibliometric analysis of the entire data set 20 2.4.3 Analysis of time-related developments 23 2.4.4 Keyword development within the examined topic area 24 2.5 Results and Discussion 25 2.5.1 Bibliometric analysis of the entire database 25 2.5.2 Journal-based measures 28 2.5.3 Source dynamics 30 2.5.4 Author impact measures 30 2.5.5 Document-based measures 35 2.5.6 Structural Analysis 36 2.5.7 Analysis of time-related developments 40 2.5.8 Keyword development within the scientific field under investigation 44 2.6 Critical comments on the methodology 47 2.7 Recommendations for conducting a bibliometric analysis 49 2.8 Conclusions 50 2.9 References 52 3 A black-box model for generation of site-specific WWTP influent quality data based on plant routine data 56 3.1 Introduction 56 3.2 Material and Methods 58 3.3 Results and discussion 62 3.3.1 Test of robustness 63 3.3.2 Universality of the approach 66 3.4 Conclusions and outlook 69 3.5 References 70 4 Organic matter parameters in WWTP – a critical review and recommendations for application in activated sludge modelling 74 4.1 Highlights 74 4.2 Abstract 74 4.3 Introduction 75 4.4 Theoretical Considerations 76 4.5 Review of literature data of WWTP sludge 80 4.5.1 Literature survey 80 4.5.2 Measures related to total and volatile organic matter 81 4.5.3 Sludge composition based on biochemical families 83 4.6 Results and Discussion 85 4.6.1 Solids 85 4.6.2 COD and COD/VSS ratio 87 4.6.3 Connection between LPC and COD/VSS ratio 90 4.7 Application to plant-wide-modelling 92 4.7.1 Solids in Activated Sludge Models 92 4.7.2 Organic and inorganic solids 94 4.7.3 COD influent characterisation 96 4.7.4 Adaptation of research results and discussion 97 4.8 Conclusions 101 4.9 Data availability statement 101 4.10 References 101 5 Temperature as an alternative tracer for the determination of the mixing characteristics in wastewater treatment plants 108 5.1 Abstract 108 5.2 Introduction 108 5.2.1 Historical background 109 5.2.2 Alternatives in evaluation of tracer tests 110 5.2.3 Objective of this paper 112 5.3 Material and Methods 112 5.3.1 Lab-scale system 112 5.3.2 Pilot-scale system 113 5.3.3 Procedure 114 5.3.3.1 Substitute hydraulic model 114 5.3.3.2 Energy balance 115 5.3.3.3 Parameter estimation 117 5.4 Results and Discussion 118 5.4.1 Lab-scale system 118 5.4.2 Pilot-scale system 121 5.4.3 Sensitivity tests for optimised substitute model parameters 124 5.4.3.1 Lab scale tests 124 5.4.3.2 Pilot scale tests 126 5.4.4 Influence of recirculation 126 5.4.5 Consideration of variable flow rates 127 5.4.6 Impact of the structured model approach on ASM parameters 127 5.5 Conclusions 131 5.6 References 133 6 One script to solve it all – an open-source-based framework for a digital workflow based on WWTP data 137 6.1 Abstract 137 6.2 Highlights 138 6.3 Introduction 138 6.4 Fundamentals and requirements 138 6.5 Material and Methods 142 6.5.1 Background to the case study 142 6.5.2 Development of the concept 144 6.5.3 Technical implementation 145 6.6 Results 148 6.6.1 Preparation and data import 148 6.6.2 Plausibility checks 149 6.6.3 Calculation of design parameters (A198) 150 6.6.4 Design of WWTP (A131) 151 6.6.5 Activated sludge modelling 152 6.7 Discussion 153 6.7.1 Practical advantages of the developed methodology 153 6.7.2 Lessons learned from development process and first use 153 6.8 Conclusions 157 6.9 References 158 7 Enhancements for a practical application 161 7.1 Evolution of unified protocol of GMP taskgroup 161 7.1.1 Overview 161 7.1.2 Understand the plant + plant layout selection 163 7.1.3 Collection of existing data 163 7.1.4 Iterative process cycle for data analysis and plant model setup / adjustment 164 7.2 Extensions to the activated sludge model (ASM_EDU) 166 7.2.1 Background 166 7.2.2 Separation of inert particulate COD by origin 168 7.2.3 Integration of external carbon sources 169 7.2.4 Consideration of the influence of industrial discharges 171 7.2.5 Consideration of different precipitants in chemical P elimination 174 7.3 Plant-wide modelling 176 7.4 Digital transformation for efficiency enhancement 178 7.5 References 182 8 Conclusions and Outlook 187 8.1 Developments in the field of WWTP modelling 187 8.2 Future significance in science and application practice 188 8.3 Further scientific research needs 189 8.4 Changing the way engineering works 191 8.5 References 193 9 Appendices 195 9.1 Supplementary material for Chapter 4 195 9.1.1 References for sludge data 195 9.1.2 Data survey from references 217 9.2 Supplementary material for Chapter 6 217 / For more than three decades, activated sludge models have been used as tools for the engineering planning and optimisation of wastewater treatment plants. However, their use is less widespread, particularly in German-speaking countries, due to the detailed rules and regulations of the DWA, which do not create a demand for additional tools for plant planning and optimisation. This also applies to the surveillance and authorisation side. The current work offers methods and tools for various aspects of wastewater treatment plant modeling in order to promote further adoption through more efficient use and to facilitate a broad, generally binding application. This includes:  Definition of a protocol for the general approach (Chapter 1.4 and 7.1)  Script-based support for data evaluation, testing, and processing (Chapters 6 and 7.4)  Generation of inflow data for incomplete operational data (Chapter 3)  Analysis of residence time behavior based on operational data (Chapter 5)  Model interfacing for plant-wide modeling (Chapters 4 and 7.3)  Model extensions for activated sludge models (Chapter 7.2) The existing operational data of wastewater treatment plants is the foundation for classical design questions. In order to be used in both static design and dynamic simulation, the data must be evaluated for their suitability and quality after appropriate compilation and processing. This manual step is supported by script-based modules to allow more time for the actual planning task. An exemplary procedure is presented in Chapter 6 of this thesis, which represents progress in terms of efficiency and quality. The operational data of municipal wastewater treatment plants, especially those below size class 5, are often incomplete. Therefore, it is necessary to develop suitable methods for processing these data into a continuous influent data set. One such method is presented in chapter 3 of this thesis. This method also helps to improve the quality of the data. For practical model application, the existing activated sludge models provide a suitable foundation. However, some open questions have been identified, and concepts and suggestions for corresponding model extensions can be found in chapter 7.1. These include handling inert material loads, dosing of external carbon sources, solutions for high proportions of industrial wastewater, and P elimination. A methodological approach for practical application has also been developed based on more general simulation protocols in order to structure the process and make it more comprehensible and efficient (Chapters 1.4 and 7.1). The residence time behaviour has a significant impact on the achievable conversion rates and effluent concentrations. However, an analysis of this behaviour is not yet a standard tool when considering existing wastewater treatment plants. In certain cases, however, there is significant potential for optimisation in cases of flow-unfavourable design. In addition to using computational fluid dynamics (CFD) as an analysis tool, the evaluation of special tracer tests or the use of existing data can also be used to analyse retention time behaviour. Chapter 1.4 und 7.1 provides explanations and examples The increasing use of IT-based tools in engineering fields also leads to further developments in working with data. The special features in the area of wastewater treatment plant planning and optimisation are highlighted in this thesis and a possibility of modularised processing of recurring tasks is demonstrated with the presented methodological framework in chapter 6. The embedding of possible further tools such as simulation software in open source-based scripts allows for maximum flexibility while maintaining a high degree of transparency. Depending on the task, this thesis provides supplements and assistance in the form of tools or methodological recommendations to minimise the processing effort and increase the processing quality while improving transparency for all those involved in the planning or optimisation process. This considerably simplifies actual application in daily engineering practice. By integrating the presented developments into urban water management training, a lower-threshold and thus broader use can also be expected in the future.:1 General introduction 1 1.1 Explanation of terms 1 1.2 Motivation 2 1.3 Background 4 1.3.1 Quality assurance in the performance of simulation studies 4 1.3.2 Special features of simulation studies for wastewater treatment plants in German-speaking countries 6 1.4 Aims, differentiation and objectives 7 1.5 Structure of the document 9 1.6 References 10 2 Growth of science in activated sludge modelling – a critical bibliometric review 13 2.1 Highlights 13 2.2 Abstract 13 2.3 Introduction 14 2.3.1 Motivation 14 2.3.2 Introduction into bibliometrics 15 2.3.3 Objective 15 2.4 Material and Methods 16 2.4.1 Database and tools 16 2.4.1.1 Selection of database 16 2.4.1.2 Development of the number of data sets in the Web of Science 19 2.4.2 Bibliometric analysis of the entire data set 20 2.4.3 Analysis of time-related developments 23 2.4.4 Keyword development within the examined topic area 24 2.5 Results and Discussion 25 2.5.1 Bibliometric analysis of the entire database 25 2.5.2 Journal-based measures 28 2.5.3 Source dynamics 30 2.5.4 Author impact measures 30 2.5.5 Document-based measures 35 2.5.6 Structural Analysis 36 2.5.7 Analysis of time-related developments 40 2.5.8 Keyword development within the scientific field under investigation 44 2.6 Critical comments on the methodology 47 2.7 Recommendations for conducting a bibliometric analysis 49 2.8 Conclusions 50 2.9 References 52 3 A black-box model for generation of site-specific WWTP influent quality data based on plant routine data 56 3.1 Introduction 56 3.2 Material and Methods 58 3.3 Results and discussion 62 3.3.1 Test of robustness 63 3.3.2 Universality of the approach 66 3.4 Conclusions and outlook 69 3.5 References 70 4 Organic matter parameters in WWTP – a critical review and recommendations for application in activated sludge modelling 74 4.1 Highlights 74 4.2 Abstract 74 4.3 Introduction 75 4.4 Theoretical Considerations 76 4.5 Review of literature data of WWTP sludge 80 4.5.1 Literature survey 80 4.5.2 Measures related to total and volatile organic matter 81 4.5.3 Sludge composition based on biochemical families 83 4.6 Results and Discussion 85 4.6.1 Solids 85 4.6.2 COD and COD/VSS ratio 87 4.6.3 Connection between LPC and COD/VSS ratio 90 4.7 Application to plant-wide-modelling 92 4.7.1 Solids in Activated Sludge Models 92 4.7.2 Organic and inorganic solids 94 4.7.3 COD influent characterisation 96 4.7.4 Adaptation of research results and discussion 97 4.8 Conclusions 101 4.9 Data availability statement 101 4.10 References 101 5 Temperature as an alternative tracer for the determination of the mixing characteristics in wastewater treatment plants 108 5.1 Abstract 108 5.2 Introduction 108 5.2.1 Historical background 109 5.2.2 Alternatives in evaluation of tracer tests 110 5.2.3 Objective of this paper 112 5.3 Material and Methods 112 5.3.1 Lab-scale system 112 5.3.2 Pilot-scale system 113 5.3.3 Procedure 114 5.3.3.1 Substitute hydraulic model 114 5.3.3.2 Energy balance 115 5.3.3.3 Parameter estimation 117 5.4 Results and Discussion 118 5.4.1 Lab-scale system 118 5.4.2 Pilot-scale system 121 5.4.3 Sensitivity tests for optimised substitute model parameters 124 5.4.3.1 Lab scale tests 124 5.4.3.2 Pilot scale tests 126 5.4.4 Influence of recirculation 126 5.4.5 Consideration of variable flow rates 127 5.4.6 Impact of the structured model approach on ASM parameters 127 5.5 Conclusions 131 5.6 References 133 6 One script to solve it all – an open-source-based framework for a digital workflow based on WWTP data 137 6.1 Abstract 137 6.2 Highlights 138 6.3 Introduction 138 6.4 Fundamentals and requirements 138 6.5 Material and Methods 142 6.5.1 Background to the case study 142 6.5.2 Development of the concept 144 6.5.3 Technical implementation 145 6.6 Results 148 6.6.1 Preparation and data import 148 6.6.2 Plausibility checks 149 6.6.3 Calculation of design parameters (A198) 150 6.6.4 Design of WWTP (A131) 151 6.6.5 Activated sludge modelling 152 6.7 Discussion 153 6.7.1 Practical advantages of the developed methodology 153 6.7.2 Lessons learned from development process and first use 153 6.8 Conclusions 157 6.9 References 158 7 Enhancements for a practical application 161 7.1 Evolution of unified protocol of GMP taskgroup 161 7.1.1 Overview 161 7.1.2 Understand the plant + plant layout selection 163 7.1.3 Collection of existing data 163 7.1.4 Iterative process cycle for data analysis and plant model setup / adjustment 164 7.2 Extensions to the activated sludge model (ASM_EDU) 166 7.2.1 Background 166 7.2.2 Separation of inert particulate COD by origin 168 7.2.3 Integration of external carbon sources 169 7.2.4 Consideration of the influence of industrial discharges 171 7.2.5 Consideration of different precipitants in chemical P elimination 174 7.3 Plant-wide modelling 176 7.4 Digital transformation for efficiency enhancement 178 7.5 References 182 8 Conclusions and Outlook 187 8.1 Developments in the field of WWTP modelling 187 8.2 Future significance in science and application practice 188 8.3 Further scientific research needs 189 8.4 Changing the way engineering works 191 8.5 References 193 9 Appendices 195 9.1 Supplementary material for Chapter 4 195 9.1.1 References for sludge data 195 9.1.2 Data survey from references 217 9.2 Supplementary material for Chapter 6 217

No description available.

Background Close, continuous and efficient collaboration between different professions and sectors of care is necessary to provide patient-centered care for individuals with mental disorders. The lack of structured collaboration between in- and outpatient care constitutes a limitation of the German health care system. Since 2012, a new law in Germany (§64b Social code book (SGB) V) has enabled the establishment of cross-sectoral and patient-centered treatment models in psychiatry. Such model projects follow a capitation budget, i.e. a total per patient budget of inpatient and outpatient care in psychiatric clinics. Providers are able to choose the treatment form and adapt the treatment to the needs of the patients. The present study (EVA64) will investigate the effectiveness, costs and efficiency of almost all model projects established in Germany between 2013 and 2016. Methods/design A health insurance data-based controlled cohort study is used. Data from up to 89 statutory health insurance (SHI) funds, i.e. 79% of all SHI funds in Germany (May 2017), on inpatient and outpatient care, pharmaceutical and non-pharmaceutical treatments and sick leave for a period of 7 years will be analyzed. All patients insured by any of the participating SHI funds and treated in one of the model hospitals for any of 16 pre-defined mental disorders will be compared with patients in routine care. Sick leave (primary outcome), utilization of inpatient care (primary outcome), utilization of outpatient care, continuity of contacts in (psychiatric) care, physician and hospital hopping, re-admission rate, comorbidity, mortality, disease progression, and guideline adherence will be analyzed. Cost and effectivity of model and routine care will be estimated using cost-effectiveness analyses. Up to 10 control hospitals for each of the 18 model hospitals will be selected according to a pre-defined algorithm. Discussion The evaluation of complex interventions is an important main task of health services research and constitutes the basis of evidence-guided advancement in health care. The study will yield important new evidence to guide the future provision of routine care for mentally ill patients in Germany and possibly beyond. Trial registration This study was registered in the database “Health Services Research Germany” (trial number: VVfD_EVA64_15_003713).