Quality of life in a randomized trial of early closure of temporary ileostomy after rectal resection for cancer (EASY trial)

DEFF Research Database (Denmark)

Park, J; Danielsen, A K; Angenete, E

2018-01-01

BACKGROUND: A temporary ileostomy may reduce symptoms from anastomotic leakage after rectal cancer resection. Earlier results of the EASY trial showed that early closure of the temporary ileostomy was associated with significantly fewer postoperative complications. The aim of the present study...... was to compare health-related quality of life (HRQOL) following early versus late closure of a temporary ileostomy. METHODS: Early closure of a temporary ileostomy (at 8-13 days) was compared with late closure (at more than 12 weeks) in a multicentre RCT (EASY) that included patients who underwent rectal...... after resection using the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires QLQ-C30 and QLQ-CR29 and Short Form 36 (SF-36®). RESULTS: There were 112 patients available for analysis. Response rates of the questionnaires were 82-95 per cent, except for EORTC QLQ-C30 at 12...

Patent ductus arteriosus in preterm infants: benefits of early surgical closure.

Science.gov (United States)

Fonseca, Elizabeth; Georgiev, Stanimir G; Gorenflo, Matthias; Loukanov, Tsvetomir S

2014-05-01

Patent ductus arteriosus in preterm neonates leads to significant morbidity. Surgery is indicated when pharmacological treatment fails or is contraindicated, but the optimal timing remains unclear. We retrospectively studied all 41 preterm neonates with symptomatic ductus arteriosus who underwent ligation between 1988 and 2009. We compared early complications rates and late neurological outcomes of patients operated on before 21 days of age with these operated on later. The median gestational age at birth was 26 weeks (range 23-31 weeks) and median weight at birth was 930 g (range 510-1500 g); 34 (82.9%) received pharmacological treatment before surgery. Fourteen (34.1%) patients underwent surgical closure before 21 days of age and 27 (65.9%) after 21 days. The 2 groups did not differ significantly in gestational age and weight at birth, but those operated on after 21 days received significantly more pharmacological treatment cycles. Patients in the early closure group had shorter intubation times: median 23 days (range 13-35 days) vs. 43 days (range 27-84 days; p ductus arteriosus after unsuccessful pharmacological therapy in preterm neonates might lower complication rates and improve neurological outcome. Prospective randomized studies are needed to determine the optimal treatment.

Consideration of early closure or continued operation of a nuclear power plant

International Nuclear Information System (INIS)

2006-07-01

This publication provides information to management and executives of electrical utilities responsible for the operation of nuclear power plants who are tasked with decision making related to early closures or continued operation. This information is based on the experiences of a number of countries in addressing a spectrum of issues broader than only the economics of the operation of the plant itself. Any major decision involving changes in direction for a major investment such as a nuclear power plant has the potential to incur considerable additional costs for stakeholders. Major economic risks can be unexpectedly encountered when decisions based on a simplified economic understanding of energy options are successfully challenged on the grounds that choices and decisions have been made without accounting for some environmental, social or economic issues which are considered of prime significance to important stakeholders. Such risks include not only changes in project scope and delays in project implementation due to re-evaluations necessitated by such challenges, but risks related to the effectiveness, efficiency and safety of ongoing operations or shutdown maintenance of the nuclear power plant. Additional risks encountered at this stage are the adequacy of the decommissioning fund and the need to establish a process whereby the availability of adequate funds will be assured at the time of the final plant shutdown. This publication provides information on several of these additional issues important to key stakeholders, and on methods that allow for their assessment and consideration when developing recommendations related to early closures or continued operations of a NPP. This publication consists of two parts: Part I: Includes a discussion of the main issues for consideration, with emphasis on issues important to stakeholders in addition to plant owners. Part II: Provides an example of a basic analytical approach to the assessment of plant life cycle

Influence of timing of two-stage palate closure on early phonological and lexical development in children with cleft palate

DEFF Research Database (Denmark)

Willadsen, Elisabeth

  BACKGROUND AND PURPOSE Numerous studies have indicated that early closure of the palatal cleft has a positive influence on the phonological development in children with cleft palate. So far, however, substantial evidence for this assumption has been lacking due to a variety of weaknesses...... of the studies conducted, including the lack of randomized clinical trials (RCT) (Peterson-Falzone 1996). A  prospective RCT was conducted to add to the knowledge of the influence of timing of hard palate closure on early phonological and lexical development from 1 to 3 years. METHODS Fourty-one children...... were video-recorded during a play interaction with a parent, and the video-recordings were transcribed in IPA. At 36 months, a naming test was administered. RESULTS At 18 months, the phonological development in the early group was more similar to that of the control group, than that of the late group...

Novel percutaneous suture-mediated patent foramen ovale closure technique. Early results of the NobleStitch EL Italian Registry.

Science.gov (United States)

Gaspardone, Achille; De Marco, Federico; Sgueglia, Gregory A; De Santis, Antonella; Iamele, Maria; D'Ascoli, Emanuela; Tusa, Maurizio; Corciu, Anca; Mullen, Michael; Nobles, Anthony; Carminati, Mario; Bedogni, Francesco

2018-04-03

To assess the efficacy of a novel percutaneous "device-less" suture mediated patent foramen ovale (PFO) closure system. Between June 2016 and October 2017, a prospective registry aimed at assessing the safety and efficacy of the NobleStitch EL (HeartStitch, Fountain Valley, CA) suture-based PFO closure system was carried out at 12 sites in Italy. Among 200 consecutive evaluated patients, 192 were considered suitable for suture-mediated PFO closure (44±13 years, 114 women). Suture of the septum with the NobleStitch EL system was carried out successfully in 186 (96%) patients. Median fluoroscopy time was 16.1 (13.0-22.5) minutes and contrast volume 200 (150-270) ml. At 206±130 days follow-up, microbubbles transthoracic echocardiography with Valsalva maneuver revealed no RLS (grade 0) in 139 (75%) patients and RLS grade ≤1 in 166 (89%) patients. Significant RLS was present in 20 (11%) patients (grade 2 and 3 in 11 and 9 patients, respectively). There were no device-related complications. The early results of this first Italian Registry indicates that the suture mediated "deviceless" closure of PFO is feasible in the majority of septal anatomies, provides an effective closure of PFO comparable to traditional devices with an excellent safety profile at medium term follow-up.

Evaluation of left ventricular function by tissue Doppler and speckle-derived strain rate echocardiography after percutaneous ductus closure.

Science.gov (United States)

Amoogzar, Hamid; Shakiba, Ali Mohammad; Derakhshan, Dorna; Ajami, Gholamhossein; Cheriki, Sirous; Borzouee, Mohammad; Edraki, Mohammad Reza; Mehdizadegan, Nima

2015-01-01

The aim of this study was to evaluate the left ventricular systolic and diastolic function before and after transcatheter percutaneous patent ductus arteriosus (PDA) closure. 21 children (age >6 months old) diagnosed with hemodynamically significant PDA underwent percutaneous PDA closure. Conventional, Doppler and tissue Doppler imaging and speckled-derived strain rate echocardiography were done at pre-closure, 1 day (early) and 1 month (late) post-closure. Mean age of the patients (female/male: 1.3) was 17.54 ± 24.7 months with the mean PDA diameter of 3.6 ± 0.8 mm. Systolic measures (ejection fraction, shortening fraction) reduced significantly early after PDA closure (P closure status. Early and late diastolic flow velocities of mitral (E M and A M) reduced considerably in early and late post-closure time (P closure. After 1 month, E'M increased considerably. (P = 0.01) but E'M/A'M had an insignificant rise (P > 0.05). E M/E'M ratio did not change in early post-closure but it had a considerable reduction in the subsequent month compared with the pre- and early post-closure (P closure (P closure causes a significant decrease in left ventricular performance early after PDA closure which recovers completely within 1 month. Also PDA size can affect post-closure left ventricular function.

Early Conversion of External Fixation to Interlocked Nailing in Open Fractures of Both Bone Leg Assisted with Vacuum Closure (VAC) - Final Outcome.

Science.gov (United States)

Gill, Simrat Pal Singh; Raj, Manish; Kumar, Sunil; Singh, Pulkesh; Kumar, Dinesh; Singh, Jasveer; Deep, Akash

2016-02-01

Management of compound grade III fractures of both bone leg includes external stabilization for long period, followed by various soft tissue coverage procedures. Primary interlocking of tibia had been also done with variable results. External fixation for long time without any bone loss often leads to infected nonunion, loss of reduction, pin tract infection and failure of fixation, primary interlocking in compound grade III fractures had shown high medullary infection rate. We managed all cases of compound grade III A/B fractures with primary external fixation, simultaneous wound management using vacuum assisted closure (VAC) followed by early conversion to interlocking within 2 weeks of fixator application. To determine the effectiveness of vacuum assisted closure (VAC) for the early conversion of external fixator to definitive interlocking in open fractures of the both bone leg. In current study we selected 84 cases of compound grade IIIA/B diaphyseal fractures of both bone leg during period of May 2010 to September 2013. We managed these cases by immediate debridement and application of external fixation followed by repeated debridement, application of vacuum assisted closure (VAC) and conversion to interlocking within two weeks. Out of 84 cases union was achieved in 80(95%) of cases with definitive tibial interlocking. Excellent to good result were obtained in 77(91.8%) of cases and fair to poor result seen in rest of 7(8.2%) of cases according to modified Ketenjian's criteria. 5 out of these 7 poor result group cases were from Compound Grade III B group to start with. Deep infection rate in our series were 7% i.e. total 6 cases and 4 out of these were from compound Grade III B group to start with. Vacuum assisted closure (VAC) give a good help for rapid closure of the wound and help in early conversion to definitive intramedullary nailing. Reamed nail could well be used in compound grade IIIA/B fractures without increasing the risk of infection. It gives

Angle closure glaucoma in congenital ectropion uvea

Directory of Open Access Journals (Sweden)

Grace M. Wang

2018-06-01

Full Text Available Purpose: Congenital ectropion uvea is a rare anomaly, which is associated with open, but dysplastic iridocorneal angles that cause childhood glaucoma. Herein, we present 3 cases of angle-closure glaucoma in children with congenital ectropion uvea. Observations: Three children were initially diagnosed with unilateral glaucoma secondary to congenital ectropion uvea at 7, 8 and 13 years of age. The three cases showed 360° of ectropion uvea and iris stromal atrophy in the affected eye. In one case, we have photographic documentation of progression to complete angle closure, which necessitated placement of a glaucoma drainage device 3 years after combined trabeculotomy and trabeculectomy. The 2 other cases, which presented as complete angle closure, also underwent glaucoma drainage device implantation. All three cases had early glaucoma drainage device encapsulation (within 4 months and required additional surgery (cycloablation or trabeculectomy. Conclusions and importance: Congenital ectropion uvea can be associated with angle-closure glaucoma, and placement of glaucoma drainage devices in all 3 of our cases showed early failure due to plate encapsulation. Glaucoma in congenital ectropion uvea requires attention to angle configuration and often requires multiple surgeries to obtain intraocular pressure control. Keywords: Congenital ectropion uvea, Juvenile glaucoma, Angle-closure glaucoma, Glaucoma drainage device

Angle closure glaucoma in congenital ectropion uvea.

Science.gov (United States)

Wang, Grace M; Thuente, Daniel; Bohnsack, Brenda L

2018-06-01

Congenital ectropion uvea is a rare anomaly, which is associated with open, but dysplastic iridocorneal angles that cause childhood glaucoma. Herein, we present 3 cases of angle-closure glaucoma in children with congenital ectropion uvea. Three children were initially diagnosed with unilateral glaucoma secondary to congenital ectropion uvea at 7, 8 and 13 years of age. The three cases showed 360° of ectropion uvea and iris stromal atrophy in the affected eye. In one case, we have photographic documentation of progression to complete angle closure, which necessitated placement of a glaucoma drainage device 3 years after combined trabeculotomy and trabeculectomy. The 2 other cases, which presented as complete angle closure, also underwent glaucoma drainage device implantation. All three cases had early glaucoma drainage device encapsulation (within 4 months) and required additional surgery (cycloablation or trabeculectomy). Congenital ectropion uvea can be associated with angle-closure glaucoma, and placement of glaucoma drainage devices in all 3 of our cases showed early failure due to plate encapsulation. Glaucoma in congenital ectropion uvea requires attention to angle configuration and often requires multiple surgeries to obtain intraocular pressure control.

Multipass mining sequence room closures: In situ data report

International Nuclear Information System (INIS)

Munson, D.E.; Jones, R.L.; Northrop-Salazar, C.L.; Woerner, S.J.

1992-12-01

During the construction of the Thermal/Structural In Situ Test Rooms at the Waste Isolation Pilot Plant (WIPP) facility, measurements of the salt displacements were obtained at very early times, essentially concurrent with the mining activity. This was accomplished by emplacing manually read closure gage stations directly at the mining face, actually between the face and the mining machine, immediately upon mining of the intended gage location. Typically, these mining sequence closure measurements were taken within one hour of mining of the location and within one meter of the mining face. Readings were taken at these gage stations as the multipass mining continued, with the gage station reestablished as each successive mining pass destroyed the earlier gage points. Data reduction yields the displacement history during the mining operation. These early mining sequence closure data, when combined with the later data of the permanently emplaced closure gages, gives the total time-dependent closure displacements of the test rooms. This complete closure history is an essential part of assuring that the in situ test databases will provide an adequate basis for validation of the predictive technology of salt creep behavior, as required by the WIPP technology development program for disposal of radioactive waste in bedded salt

The timing of ostomy closure in infants with necrotizing enterocolitis: a systematic review.

Science.gov (United States)

Struijs, Marie-Chantal; Sloots, Cornelius E J; Hop, Wim C J; Tibboel, Dick; Wijnen, Rene M H

2012-07-01

The optimal timing of ostomy closure is a matter of debate. We performed a systematic review of outcomes of early ostomy closure (EC, within 8 weeks) and late ostomy closure (LC, after 8 weeks) in infants with necrotizing enterocolitis. PubMed, EMbase, Web-of-Science, and Cinahl were searched for studies that detailed time to ostomy closure, and time to full enteral nutrition (FEN) or complications after ostomy closure. Patients with Hirschsprung's disease or anorectal malformations were excluded. Analysis was performed using SPSS 17 and RevMan 5. Of 778 retrieved articles, 5 met the inclusion criteria. The median score for study quality was 9 [range 8-14 on a scale of 0 to 32 points (Downs and Black, J Epidemiol Community Health 52:377-384, 1998)]. One study described mean time to FEN: 19.1 days after EC (n = 13) versus 7.2 days after LC (n = 24; P = 0.027). Four studies reported complication rates after ostomy closure, complications occurred in 27% of the EC group versus 23% of the LC group. The combined odds ratio (LC vs. EC) was 1.1 [95% CI 0.5, 2.5]. Evidence that supports early or late closure is scarce and the published articles are of poor quality. There is no significant difference between EC versus LC in the complication rate. This systematic review supports neither early nor late ostomy closure.

The timing of ostomy closure in infants with necrotizing enterocolitis: A systematic review

NARCIS (Netherlands)

A.E.C.J.M. Struijs (Marie-Chantal); C.E.J. Sloots (Pim); W.C.J. Hop (Wim); D. Tibboel (Dick); R.M.H. Wijnen (René)

2012-01-01

textabstractPurpose The optimal timing of ostomy closure is a matter of debate. We performed a systematic review of outcomes of early ostomy closure (EC, within 8 weeks) and late ostomy closure (LC, after 8 weeks) in infants with necro-tizing enterocolitis. Methods PubMed, EMbase, Web-of-Science,

The timing of ostomy closure in infants with necrotizing enterocolitis: a systematic review

NARCIS (Netherlands)

Struijs, M.C.; Sloots, C.E.J.; Hop, W.C.J.; Tibboel, D.; Wijnen, R.M.H.

2012-01-01

PURPOSE: The optimal timing of ostomy closure is a matter of debate. We performed a systematic review of outcomes of early ostomy closure (EC, within 8 weeks) and late ostomy closure (LC, after 8 weeks) in infants with necrotizing enterocolitis. METHODS: PubMed, EMbase, Web-of-Science, and Cinahl

Early results of transcatheter closure of patent ductus arteriosus: retrospective study of 61 patients

International Nuclear Information System (INIS)

Beg, A.M.; Younas, M.; Chaudary, A.T.

2013-01-01

Patent ductus arteriosus (PDA) accounts for 6 - 11% of all congenital heart defects. Complications of PDA include congestive heart failure, repeated chest infections, pulmonary hypertension, and an increased risk of infective endocarditis. Transcatheter closure of PDA has largely replaced surgical ligation in different age groups. Currently, surgical intervention is restricted to premature babies or small infants with large symptomatic PDA, cases with unfavorable duct anatomy, and whenever the cost of the closure devices is unaffordable. PDA was the first example of congenital heart dis-ease to be treated by transcatheter closure, which becomes an established form of treatment for the majority of patients with PDA and as a safe alternative to surgery. The per-cutaneous technique was first described by Porstmanur et al., since then various devices such as Rashkind PDA umbrella, button device, PDA coils and most recently the Amplatzer duct occluder (ADO) have been introduced. The ADO device was designed to provide the most desirable characteristics for a percutaneous closure device that can be used in most if not all patients with PDA. These include user - friendly delivery system, high complete closure rate, small delivery system (allowing its use in small infants), trans-venous delivery route, ability to adapt to various PDA sizes and types, and the ability to retrieve or reposition the device prior to release from a secure delivery system. Common complications of trans-catheter closure of PDA include residual shunt, left pulmonary artery (LPA) obstruction, protrusion of the device into the aorta, and embolization of the device. Incidence of complications increases with certain types and large size ducts, and with the use of multiple coils for occlusion. There are only a few reports correlating out-come and complications with the learning curve and experience. In this study, we are reporting our initial experience with PDA closure using Amplatzer duct occluder (ADO

Considerations for closure of low-level radioactive waste engineered disposal facilities

International Nuclear Information System (INIS)

1992-01-01

Proper stabilization and closure of low-level radioactive waste disposal facilities require detailed planning during the early stages of facility development. This report provides considerations for host States, compact regions, and unaffiliated States on stabilization and closure of engineered low-level radioactive waste and mixed waste disposal facilities. A time line for planning closure activities, which identifies closure considerations to be addressed during various stages of a facility's development, is presented. Current Federal regulatory requirements and guidance for closure and post-closure are outlined. Significant differences between host State and Federal closure requirements are identified. Design features used as stabilization measures that support closure, such as waste forms and containers, backfill materials, engineered barrier systems, and site drainage systems, are described. These design features are identified and evaluated in terms of how they promote long-term site stability by minimizing water infiltration, controlling subsidence and surface erosion, and deterring intrusion. Design and construction features critical to successful closure are presented for covers and site drainage. General considerations for stabilization and closure operations are introduced. The role of performance and environmental monitoring during closure is described

Comparison of fasciotomy wound closures using traditional dressing changes and the vacuum-assisted closure device.

Science.gov (United States)

Zannis, John; Angobaldo, Jeff; Marks, Malcolm; DeFranzo, Anthony; David, Lisa; Molnar, Joseph; Argenta, Louis

2009-04-01

Fasciotomy wounds can be a major contributor to length of stay for patients as well as a difficult reconstructive challenge. Once the compartment pressure has been relieved and stabilized, the wound should be closed as quickly and early as possible to avoid later complications. Skin grafting can lead to morbidity and scarring at both the donor and fasciotomy site. Primary closure results in a more functional and esthetic outcome with less morbidity for the patient, but can often be difficult to achieve secondary to edema, skin retraction, and skin edge necrosis. Our objective was to examine fasciotomy wound outcomes, including time to definitive closure, comparing traditional wet-to-dry dressings, and the vacuum-assisted closure (VAC) device. This retrospective chart review included a consecutive series of patients over a 10-year period. This series included 458 patients who underwent 804 fasciotomies. Of these fasciotomy wounds, 438 received exclusively VAC. dressings, 270 received only normal saline wet-to-dry dressings, and 96 were treated with a combination of both. Of the sample, 408 patients were treated with exclusively VAC therapy or wet-to-dry dressings and 50 patients were treated with a combination of both. In comparing all wounds, there was a statistically significant higher rate of primary closure using the VAC versus traditional wet-to-dry dressings (P lower extremities and P extremities). The time to primary closure of wounds was shorter in the VAC. group in comparison with the non-VAC group. This study has shown that the use of the VAC for fasciotomy wound closure results in a higher rate of primary closure versus traditional wet-to-dry dressings. In addition, the time to primary closure of wounds or time to skin grafting is shorter when the VAC was employed. The VAC used in the described settings decreases hospitalization time, allows for earlier rehabilitation, and ultimately leads to increased patient satisfaction.

Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial

OpenAIRE

Azuara-Blanco, Augusto; Burr, Jennifer; Ramsay, Craig; Cooper, David; Foster, Paul J.; Friedman, David S.; Scotland, Graham; Javanbakht, Mehdi; Cochrane, Claire; Norrie, John; For the EAGLE study group

2016-01-01

PJF is supported by salary funding from the National Institute for Health Research (NIHR) through a grant to the Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology. This work is supported by the Medical Research Council (MRC G0701604) and funding is managed by the NIHR (NIHR-EME 09-800-26) on behalf of the MRC–NIHR partnership. Background . Primary angle-closure glaucoma is a leading cause of irreversible blindness worldwide. In early-stage disease, in...

Stationary neutrino radiation transport by maximum entropy closure

International Nuclear Information System (INIS)

Bludman, S.A.

1994-11-01

The authors obtain the angular distributions that maximize the entropy functional for Maxwell-Boltzmann (classical), Bose-Einstein, and Fermi-Dirac radiation. In the low and high occupancy limits, the maximum entropy closure is bounded by previously known variable Eddington factors that depend only on the flux. For intermediate occupancy, the maximum entropy closure depends on both the occupation density and the flux. The Fermi-Dirac maximum entropy variable Eddington factor shows a scale invariance, which leads to a simple, exact analytic closure for fermions. This two-dimensional variable Eddington factor gives results that agree well with exact (Monte Carlo) neutrino transport calculations out of a collapse residue during early phases of hydrostatic neutron star formation

Factors affecting successful closure of hemodynamically significant patent ductus arteriosus with indomethacin in extremely low birth weight infants.

Science.gov (United States)

Yang, Chuan-Zhong; Lee, Jiun

2008-05-01

The incidence of patent ductus arteriosus (PDA) is high in extremely low birth weight (ELBW) infants. Indomethacin has been widely used in the prophylaxis and treatment of hemodynamically significant PDA. This retrospective study was undertaken to identify factors such as birth weight, gestational age, gender, fetal growth retardation, ductal size, timing of the first dose of indomethacin and side effects of indomethacin, which may affect the successful closure of the PDA with indomethacin in ELBW infants. A cohort of 139 ELBW infants who had received indomethacin treatment for PDA during a consecutive period of more than three years (September 2000 to December 2003) was retrospectively analyzed. Administration of indomethacin was associated with closure of PDA in 108 (77.7%) of 139 ELBW infants, and only 19.4% of infants required surgical ligation of the ductus eventually. There was no significant relationship between closure of PDA with gestational age, gender, fetal growth retardation, and ductal size. A higher birth weight and early use of indomethacin after birth could significantly increase the closure rate of PDA (P<0.05). Side effects of indomethacin such as transient oliguria and hyponatremia during indomethacin therapy did not affect PDA closure. Indomethacin is effective for the treatment of PDA in ELBW infants. A higher rate of ductal closure is related to the increase of birth weight. PDA closure with indomethacin is age-related, and early administration of indomethacin could increase PDA closure and reduce the incidence of hyponatremia. There is no significant difference in major morbidities such as bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and retinopathy of prematurity (ROP) after early treatment. Early screening for hemodynamically significant PDA in ELBW infants and early treatment with indomethacin are recommended.

Evaluation of Container Closure System Integrity for Frozen Storage Drug Products.

Science.gov (United States)

Nieto, Alejandra; Roehl, Holger; Brown, Helen; Nikoloff, Jonas; Adler, Michael; Mahler, Hanns-Christian

2016-01-01

Sometimes, drug product for parenteral administration is stored in a frozen state (e.g., -20 °C or -80 °C), particularly during early stages of development of some biotech molecules in order to provide sufficient stability. Shipment of frozen product could potentially be performed in the frozen state, yet possibly at different temperatures, for example, using dry ice (-80 °C). Container closure systems of drug products usually consist of a glass vial, rubber stopper, and an aluminum crimped cap. In the frozen state, the glass transition temperature (Tg) of commonly used rubber stoppers is between -55 and -65 °C. Below their Tg, rubber stoppers are known to lose their elastic properties and become brittle, and thus potentially fail to maintain container closure integrity in the frozen state. Leaks during frozen temperature storage and transportation are likely to be transient, yet, can possibly risk container closure integrity and lead to microbial contamination. After thawing, the rubber stopper is supposed to re-seal the container closure system. Given the transient nature of the possible impact on container closure integrity in the frozen state, typical container closure integrity testing methods (used at room temperature conditions) are unable to evaluate and thus confirm container closure integrity in the frozen state. Here we present the development of a novel method (thermal physical container closure integrity) for direct assessment of container closure integrity by a physical method (physical container closure integrity) at frozen conditions, using a modified He leakage test. In this study, different container closure systems were evaluated with regard to physical container closure integrity in the frozen state to assess the suitability of vial/stopper combinations and were compared to a gas headspace method. In summary, the thermal physical container closure integrity He leakage method was more sensitive in detecting physical container closure

Simulating school closure policies for cost effective pandemic decision making

Directory of Open Access Journals (Sweden)

Araz Ozgur M

2012-06-01

Full Text Available Abstract Background Around the globe, school closures were used sporadically to mitigate the 2009 H1N1 influenza pandemic. However, such closures can detrimentally impact economic and social life. Methods Here, we couple a decision analytic approach with a mathematical model of influenza transmission to estimate the impact of school closures in terms of epidemiological and cost effectiveness. Our method assumes that the transmissibility and the severity of the disease are uncertain, and evaluates several closure and reopening strategies that cover a range of thresholds in school-aged prevalence (SAP and closure durations. Results Assuming a willingness to pay per quality adjusted life-year (QALY threshold equal to the US per capita GDP ($46,000, we found that the cost effectiveness of these strategies is highly dependent on the severity and on a willingness to pay per QALY. For severe pandemics, the preferred strategy couples the earliest closure trigger (0.5% SAP with the longest duration closure (24 weeks considered. For milder pandemics, the preferred strategies also involve the earliest closure trigger, but are shorter duration (12 weeks for low transmission rates and variable length for high transmission rates. Conclusions These findings highlight the importance of obtaining early estimates of pandemic severity and provide guidance to public health decision-makers for effectively tailoring school closures strategies in response to a newly emergent influenza pandemic.

Clinical evaluation of RNFL and GCC for diagnosis in early stage of chronic primary angle-closure glaucoma

Directory of Open Access Journals (Sweden)

Shi Liu

2015-08-01

Full Text Available AIM:To explore the diagnosis value of retina nerve fiber layer(RNFLand ganglion cell complex(GCCin the early stage of chronic primary angle-closure glaucoma(CPACG, and investigate their relationship with mean defect(MDof visual field.METHODS: Twenty-one patients with CPACG(38 eyes, 25 patients with suspected glaucoma(SG(46 eyesand 25 normal controls(49 eyeswere selected to perform SD-OCT. Statistical difference was analyzed the thickness of RNFL and GCC of average and all quadrants, and correlation between RNFL, GCC and MD of visual field. RESULTS:There were significant differences in average and all quadrant thickness of RNFL and GCC between CPACG group and control group(PPPPPr=0.65, GCC(r=0.72in CPACG group. CONCLUSION:RNFL and GCC are useful to diagnose and monitor the early stage of CPACG, and GCC may be more significant for the disease.

Predictors of transient left ventricular dysfunction following transcatheter patent ductus arteriosus closure in pediatric age

Directory of Open Access Journals (Sweden)

Hala Mounir Agha

2017-10-01

Conclusion: Transcatheter PDA closure causes a significant decrease in left ventricular performance early after PDA closure, which recovers completely within 1 month. Preclosure global longitudinal strain can be a predictor of postclosure myocardial dysfunction.

Predictors of transient left ventricular dysfunction following transcatheter patent ductus arteriosus closure in pediatric age.

Science.gov (United States)

Agha, Hala Mounir; Hamza, Hala S; Kotby, Alyaa; Ganzoury, Mona E L; Soliman, Nanies

2017-10-01

To evaluate the left ventricular function before and after transcatheter percutaneous patent ductus arteriosus (PDA) closure, and to identify the predictors of myocardial dysfunction post-PDA closure if present. Transcatheter PDA closure; conventional, Doppler, and tissue Doppler imaging; and speckle tracking echocardiography. To determine the feasibility and reliability of tissue Doppler and myocardial deformation imaging for evaluating myocardial function in children undergoing transcatheter PDA closure. Forty-two children diagnosed with hemodynamically significant PDA underwent percutaneous PDA closure. Conventional, Doppler, and tissue Doppler imaging, and speckle-derived strain rate echocardiography were performed at preclosure and at 48 hours, 1 month, and 6 months postclosure. Tissue Doppler velocities of the lateral and septal mitral valve annuli were obtained. Global and regional longitudinal peak systolic strain values were determined using two-dimensional speckle tracking echocardiography. The median age of the patients was 2 years and body weight was 15 kg, with the mean PDA diameter of 3.11 ± 0.99 mm. M-mode measurements (left ventricular end diastolic diameter, left atrium diameter to aortic annulus ratio, ejection fraction, and shortening fraction) reduced significantly early after PDA closure ( p  closure causes a significant decrease in left ventricular performance early after PDA closure, which recovers completely within 1 month. Preclosure global longitudinal strain can be a predictor of postclosure myocardial dysfunction.

Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial.

Science.gov (United States)

Azuara-Blanco, Augusto; Burr, Jennifer; Ramsay, Craig; Cooper, David; Foster, Paul J; Friedman, David S; Scotland, Graham; Javanbakht, Mehdi; Cochrane, Claire; Norrie, John

2016-10-01

Primary angle-closure glaucoma is a leading cause of irreversible blindness worldwide. In early-stage disease, intraocular pressure is raised without visual loss. Because the crystalline lens has a major mechanistic role, lens extraction might be a useful initial treatment. From Jan 8, 2009, to Dec 28, 2011, we enrolled patients from 30 hospital eye services in five countries. Randomisation was done by a web-based application. Patients were assigned to undergo clear-lens extraction or receive standard care with laser peripheral iridotomy and topical medical treatment. Eligible patients were aged 50 years or older, did not have cataracts, and had newly diagnosed primary angle closure with intraocular pressure 30 mm Hg or greater or primary angle-closure glaucoma. The co-primary endpoints were patient-reported health status, intraocular pressure, and incremental cost-effectiveness ratio per quality-adjusted life-year gained 36 months after treatment. Analysis was by intention to treat. This study is registered, number ISRCTN44464607. Of 419 participants enrolled, 155 had primary angle closure and 263 primary angle-closure glaucoma. 208 were assigned to clear-lens extraction and 211 to standard care, of whom 351 (84%) had complete data on health status and 366 (87%) on intraocular pressure. The mean health status score (0·87 [SD 0·12]), assessed with the European Quality of Life-5 Dimensions questionnaire, was 0·052 higher (95% CI 0·015-0·088, p=0·005) and mean intraocular pressure (16·6 [SD 3·5] mm Hg) 1·18 mm Hg lower (95% CI -1·99 to -0·38, p=0·004) after clear-lens extraction than after standard care. The incremental cost-effectiveness ratio was £14 284 for initial lens extraction versus standard care. Irreversible loss of vision occurred in one participant who underwent clear-lens extraction and three who received standard care. No patients had serious adverse events. Clear-lens extraction showed greater efficacy and was more cost-effective than

Information report issued in application of the article 146 of the Regulation by the Commission for finances, general economy and budget control about the cost of the early closure of nuclear reactors: the example of Fessenheim - Nr 2233

International Nuclear Information System (INIS)

Goua, Marc; Mariton, Herve

2014-01-01

The first part of this report discusses the early closures of nuclear power stations for matters of energy policy. It comments how the reduction of the nuclear share in the electric mix would lead to the early closure of about twenty reactors, i.e. two reactors a year. It also notices that the future of the nuclear stock could better be an extension of its exploitation beyond 40 and even 50 years. The authors discuss the fact that the bill project on energy transition for a green growth modifies the legal framework for the closure of a nuclear plant. They state that no technical reason leads to the choice of the Fessenheim site for a closure: it significantly contributes to the de-carbonated electricity production, its age has only a symbolic meaning as it never has been so safe, the ASN authorized the operation of two reactors for ten additional years, and the investments prescribed by the ASN and achieved by the operator guarantee the highest level of safety. The second part of this report addresses and discusses the various issues associated with the costs of an early closure of a nuclear plant: cost for the community, impact on jobs, and loss of earnings for the operator which will result in compensation paid by the State

Closure of tubular patent ductus arteriosus with the Amplatzer Vascular Plug IV: feasibility and safety.

Science.gov (United States)

Baruteau, Alban-Elouen; Lambert, Virginie; Riou, Jean-Yves; Angel, Claude-Yves; Belli, Emre; Petit, Jérôme

2015-01-01

Closure of tubular patent ductus arteriosus remains a challenging procedure. Anecdotal use of Amplatzer Vascular Plug IV for tubular ductus closure has been reported but feasibility and safety in a consecutive patients' series remain unknown. We performed a monocenter prospective study at the Marie Lannelongue Hospital in Paris, France. From 2009 to 2014, a total of 47 patients (39 infants, 3 children, and 5 adults) underwent ductus closure with the Plug IV. Ductus morphology was a type E in 34 (72.3%) patients and a type C in 13 (27.7%) patients. Ductus closure occurred in 39 (83.0%) infants at a median age of seven months (range: 3-23 months) and a median weight of 6.9 kg (range: 4.1-17.0 kg). A past history of prematurity and very low birth weight was found in 33 (70.2%) of them. Twelve (25.5%) patients had pulmonary hypertension. Mean Plug IV diameter was 1.9 ± 0.1 mm larger than the mean maximal ductus diameter. Early complete closure of the ductus was obtained in all patients. Early migration of an undersized Plug IV occurred in one (2.1%) patient and was suitable for percutaneous device retrieval. After a mean follow-up of 3.4 ± 1.4 years, all patients are alive and asymptomatic, no late complication occurred. Transcatheter closure of tubular ductus with the Amplatzer Vascular Plug IV can be safe and effective, with a 100% early occlusion rate. This device, suitable for a 4F sheath, is a new alternative for tubular ductus closure in low-body-weight infants. © The Author(s) 2014.

Closure requirements

International Nuclear Information System (INIS)

Hutchinson, I.P.G.; Ellison, R.D.

1992-01-01

Closure of a waste management unit can be either permanent or temporary. Permanent closure may be due to: economic factors which make it uneconomical to mine the remaining minerals; depletion of mineral resources; physical site constraints that preclude further mining and beneficiation; environmental, regulatory or other requirements that make it uneconomical to continue to develop the resources. Temporary closure can occur for a period of several months to several years, and may be caused by factors such as: periods of high rainfall or snowfall which prevent mining and waste disposal; economic circumstances which temporarily make it uneconomical to mine the target mineral; labor problems requiring a cessation of operations for a period of time; construction activities that are required to upgrade project components such as the process facilities and waste management units; and mine or process plant failures that require extensive repairs. Permanent closure of a mine waste management unit involves the provision of durable surface containment features to protect the waters of the State in the long-term. Temporary closure may involve activities that range from ongoing maintenance of the existing facilities to the installation of several permanent closure features in order to reduce ongoing maintenance. This paper deals with the permanent closure features

ASSESSMENT OF LENS THICKNESS IN ANGLE CLOSURE DISEASE

Directory of Open Access Journals (Sweden)

Nishat Sultana Khayoom

2016-08-01

Full Text Available BACKGROUND Anterior chamber depth and lens thickness have been considered as important biometric determinants in primary angle-closure glaucoma. Patients with primary narrow angle may be classified as a primary angle closure suspect (PACS, or as having primary angle closure (PAC or primary angle closure glaucoma (PACG. 23.9% of patients with primary angle closure disease are in India, which highlights the importance of understanding the disease, its natural history, and its underlying pathophysiology, so that we may try to establish effective methods of treatment and preventative measures to delay, or even arrest, disease progression, thereby reducing visual morbidity. AIM To determine the lens thickness using A-scan biometry and its significance in various stages of angle closure disease. MATERIALS AND METHODS Patients attending outpatient department at Minto Ophthalmic Hospital between October 2013 to May 2015 were screened for angle closure disease and subsequently evaluated at glaucoma department. In our study, lens thickness showed a direct correlation with shallowing of the anterior chamber by determining the LT/ ACD ratio. A decrease in anterior chamber depth is proportional to the narrowing of the angle which contributes to the progression of the angle closure disease from just apposition to occlusion enhancing the risk for optic nerve damage and visual field loss. Hence, if the lens thickness values are assessed earlier in the disease process, appropriate intervention can be planned. CONCLUSION Determination of lens changes along with anterior chamber depth and axial length morphometrically can aid in early detection of angle closure. The role of lens extraction for PACG is a subject of increased interest. Lens extraction promotes the benefits of anatomical opening of the angle, IOP reduction and improved vision. This potential intervention may be one among the armamentarium of approaches for PACG. Among the current treatment modalities

Full-Thickness Thermal Injury Delays Wound Closure in a Murine Model

Science.gov (United States)

2015-01-01

skin replacement is achieved using autologous skin graft or skin substitute graft. While this strategy of early excision and grafting, first proposed in...several investigators have utilized the more appropriate model of burn eschar excision followed by sponta- neous wound closure or by skin graft or...without the application of a skin graft or a skin substitute graft. Furthermore, the effect of interval burn eschar excision on wound closure is also re

Long-term follow up after transcatheter closure of atrial septal defect and patent foramen ovale in adults

Directory of Open Access Journals (Sweden)

Jure Dolenc

2014-01-01

Full Text Available Background: The aim of our study was to define long-term electrocardiographic and echocardiographic changes and complications after transcatheter closure of atrial septal defect and patent foramen ovale in adults.Methods: The clinical, electrocardiographic and echocardiographic follow-up of 137 consecutive patients that underwent transcatheter closure of atrial septal defect (51 patients or patent foramen ovale (86 patients in a 10-year period was analyzed retrospectively.Results: In the patent foramen ovale group, we observed no significant postprocedural changes. There were no changes in heart rate, heart rhythm and PR or QRS duration in both groups. In the atrial septal defect group, we observed a leftward shift in the heart axis (p = 0.017, a decrease in the estimated systolic pulmonary artery pressure (p = 0.024, decreased tricuspid early diastolic flow velocity (p = 0.002, a decrease in the right chamber dimensions (p = 0.0004 and interventricular septal movement normalization (p < 0.0001. Most of the complications were mild and occurred early after the procedure. Three early serious complications were documented.Conclusions: No electrocardiographic or echocardiographic changes occurred after patent foramen ovale closure. Atrial septal defect closure is related to significant early morphological and hemodynamic improvement. Postprocedural complications are usually early and mild but serious late complications can occur. For that reason, long-term follow up is recommended in these patients.

Hybrid closure of atrial septal defect: A modified approach

Directory of Open Access Journals (Sweden)

Kshitij Sheth

2015-01-01

Full Text Available A 3.5-year-old girl underwent transcatheter closure of patent ductus arteriosus in early infancy during which time her secundum atrial septal defect (ASD was left alone. When she came for elective closure of ASD, she was found to have bilaterally blocked femoral veins. The defect was successfully closed with an Amplatzer septal occluder (ASO; St. Jude Medical, Plymouth, MN, USA using a hybrid approach via a sub-mammary mini-thoracotomy incision without using cardiopulmonary bypass. At the end of 1-year follow-up, the child is asymptomatic with device in a stable position without any residual shunt.

Measured and calculated closures of open and brine filled shafts and deep vertical boreholes in salt

International Nuclear Information System (INIS)

Munson, D.E.; DeVries, K.L.; Schiermeister, D.M.; DeYonge, W.F.; Jones, R.L.

1991-01-01

Shaft closure measurements are presented which are based on a rather unusual emplacement of very early time closure points. These data are in good agreement with calculations based on the prediction technique developed for underground rooms in salt using a complete stratigraphy. However, a simplified calculational mesh also gives good agreement, which permits this mesh to be used for parametric studies of long term closures of open and brine filled shafts and boreholes

Measured and calculated closures of open and brine filled shafts and deep vertical boreholes in salt

International Nuclear Information System (INIS)

Munson, D.E.; DeVries, K.L.; Schiermeister, D.M.; DeYonge, W.F.; Jones, R.L.

1992-01-01

Shaft closure measurements are presented which are based on a rather unusual emplacement of very early time closure points. These data are in good agreement with calculations based on the prediction techniques developed for underground rooms in salt using a complete stratigraphy. However, a simplified calculational mesh also gives good agreement, which permits this mesh to be used for parametric studies of long term closures of open and brine filled shafts and boreholes

Influence of Closure & Non-Closure of the Visceral and Parietal Peritoneum on Post Cesarean Morbidity

Directory of Open Access Journals (Sweden)

Tabasi Z.

2010-01-01

Full Text Available AbstractBackground and Objectives: One of the most important issues in promoting mother and child health is reducing the morbidity rate after cesarean section. The aim of this study was to investigate the influence of closure and non-closure of the visceral and parietal peritoneum on post cesarean morbidity in women attending Shabihkhani Maternity Hospital in Kashan, Iran.Methods: This study was conducted with a single blind randomized clinical trial method on 100 parturient women that underwent emergency or elective cesarean section. Patients with previous cesarean section and or abdominal surgery, diseases such as hypertension, diabetes mellitus and premature rupture of membrane and pre operative bleeding, were excluded from this study. Then, the participants were randomly divided into two groups: in one group both peritoneal layers were closed while in the other group, they were not closed. Post operative morbidity including fever, bleeding, post operative pain, analgesic consumption and time of operation were assessed. Data were analyzed with t-tests, and χ2 and a P<0.05 were considered significant.Results: In this study, there were no significant differences between the two groups with respect to age, gestational age, the reason for caesarean section and gravidity, nor were there any differences with respect to the incidence of fever or bleeding and was similar between the two groups, but there was a significant difference between the two groups regarding to feeling of severe pain (P=0.0003, analgesic consumption (P=0.0003 and time of operation (P=0.004. In the non-closure group, dose of analgesic drugs, pain severity and time of operation were less than those of the other group.Conclusion: The Findings showed that non-closure of peritoneal layers as a shorter and simpler procedure has no influence on increasing post cesarean morbidity. Therefore, due to maternal health promotion and early neonatal breastfeeding, non closure of peritoneal

Road Closures

Data.gov (United States)

Montgomery County of Maryland — This is an up to date map of current road closures in Montgomery County.This dataset is updated every few minutes from the Department of Transportation road closure...

Influence of lip closure on alveolar cleft width in patients with cleft lip and palate

Directory of Open Access Journals (Sweden)

Schmelzle Rainer

2011-01-01

Full Text Available Abstract Background The influence of surgery on growth and stability after treatment in patients with cleft lip and palate are topics still under discussion. The aim of the present study was to investigate the influence of early lip closure on the width of the alveolar cleft using dental casts. Methods A total of 44 clefts were investigated using plaster casts, 30 unilateral and 7 bilateral clefts. All infants received a passive molding plate a few days after birth. The age at the time of closure of the lip was 2.1 month in average (range 1-6 months. Plaster casts were obtained at the following stages: shortly after birth, prior to lip closure, prior to soft palate closure. We determined the width of the alveolar cleft before lip closure and prior to soft palate closure measuring the alveolar cleft width from the most lateral point of the premaxilla/anterior segment to the most medial point of the smaller segment. Results After lip closure 15 clefts presented with a width of 0 mm, meaning that the mucosa of the segments was almost touching one another. 19 clefts showed a width of up to 2 mm and 10 clefts were still over 2 mm wide. This means a reduction of 0% in 5 clefts, of 1-50% in 6 clefts, of 51-99% in 19 clefts, and of 100% in 14 clefts. Conclusions Early lip closure reduces alveolar cleft width. In most cases our aim of a remaining cleft width of 2 mm or less can be achieved. These are promising conditions for primary alveolar bone grafting to restore the dental bony arch.

Interferometric Imaging Directly with Closure Phases and Closure Amplitudes

Science.gov (United States)

Chael, Andrew A.; Johnson, Michael D.; Bouman, Katherine L.; Blackburn, Lindy L.; Akiyama, Kazunori; Narayan, Ramesh

2018-04-01

Interferometric imaging now achieves angular resolutions as fine as ∼10 μas, probing scales that are inaccessible to single telescopes. Traditional synthesis imaging methods require calibrated visibilities; however, interferometric calibration is challenging, especially at high frequencies. Nevertheless, most studies present only a single image of their data after a process of “self-calibration,” an iterative procedure where the initial image and calibration assumptions can significantly influence the final image. We present a method for efficient interferometric imaging directly using only closure amplitudes and closure phases, which are immune to station-based calibration errors. Closure-only imaging provides results that are as noncommittal as possible and allows for reconstructing an image independently from separate amplitude and phase self-calibration. While closure-only imaging eliminates some image information (e.g., the total image flux density and the image centroid), this information can be recovered through a small number of additional constraints. We demonstrate that closure-only imaging can produce high-fidelity results, even for sparse arrays such as the Event Horizon Telescope, and that the resulting images are independent of the level of systematic amplitude error. We apply closure imaging to VLBA and ALMA data and show that it is capable of matching or exceeding the performance of traditional self-calibration and CLEAN for these data sets.

Development of Infrared Phase Closure Capability in the Infrared-Optical Telescope Array (IOTA)

Science.gov (United States)

Traub, Wesley A.

2002-01-01

We completed all major fabrication and testing for the third telescope and phase-closure operation at the Infrared-Optical Telescope Array (IOTA) during this period. In particular we successfully tested the phase-closure operation, using a laboratory light source illuminating the full delay-line optical paths, and using an integrated-optic beam combiner coupled to our Picnic-detector camera. This demonstration is an important and near-final milestone achievement. As of this writing, however, several tasks yet remain, owing to development snags and weather, so the final proof of success, phase-closure observation of a star, is now expected to occur in early 2002, soon after this report has been submitted.

Incidence and severity of gingival invaginations associated with early versus late initiation of orthodontic space closure after tooth extraction : A multicenter pilot and randomized controlled trial.

Science.gov (United States)

Reichert, Christoph; Kutschera, Eric; Plötz, Christina; Scharf, Sven; Gölz, Lina; Fimmers, Rolf; Fuhrmann, Christine; Wahl, Gerhard; Braumann, Bert; Jäger, Andreas

2017-09-01

Gingival invaginations are a common side effect of orthodontic extraction-space closure. The timing of initiating the closure of an extraction space varies greatly in clinical practice. In this multicenter pilot and randomized controlled trial, we prospectively investigated whether initiating space closure in the early stage of wound healing would benefit the incidence and severity of invaginations developing in the extraction sites. A total of 368 patients were screened for indications to extract at least one mandibular premolar. Those recruited were randomly assigned to one of two treatment arms: initiation of space closure either 2-4 weeks (arm A) or ≥12 weeks (arm B) after tooth extraction. Clinical data regarding treatment process and periodontal tissue response were recorded during and after space closure and analyzed by a specialized biometrics unit. The study was performed under continuous surveillance by an independent study control center. A total of 74 extraction sites were analyzed. Regarding the incidence of gingival invaginations, there were no significant intergroup differences [p = 0.13; group A comprising 37/44 (84.1%) and group B 29/30 (96.7%) invaginated sites]. The same was true based on either maxillary (p = 0.52) or mandibular (p = 0.21) sites only, and the severity of the invaginations did not differ between the treatment arms. As to the incidence and severity of gingival invaginations, we did not notice any statistically significant differences between the two timeframes. Our data do, however, provide a basis to identify additional confounders and to improve the accuracy of case-load estimations for future trials.

Transcatheter Closure of Patent Ductus Arteriosus in Extremely Premature Newborns: Early Results and Midterm Follow-Up.

Science.gov (United States)

Zahn, Evan M; Peck, Daniel; Phillips, Alistair; Nevin, Phillip; Basaker, Kaylan; Simmons, Charles; McRae, Marion E; Early, Tracy; Garg, Ruchira

2016-12-12

The goal of this study was to describe early and midterm outcomes of extremely premature newborns (EPNs) who underwent transcatheter echocardiographically guided patent ductus arteriosus (PDA) closure. Surgical ligation of PDA in EPNs confers significant risk for procedural morbidity and adverse long-term outcomes. The Amplatzer Vascular Plug II was used in all cases. Post-ligation syndrome was defined using previously published parameters. Patients were followed at pre-specified intervals, and prospectively collected data were reviewed. Transcatheter closure was attempted in 24 EPNs (mean procedural age 30 days [range 5 to 80 days], mean procedural weight 1,249 g [range 755 to 2,380 g]) and was successful in 88%. The 3 procedural failures were related to the development of left pulmonary artery (LPA) stenosis caused by the device, and all devices were removed uneventfully. Complications included 2 instances of device malposition, resolved with device repositioning, and 1 instance of LPA stenosis, requiring an LPA stent. There were no procedural deaths, cases of post-ligation syndrome, residual PDA, or device embolization. Survival to discharge was 96% (23 of 24), with a single late death unrelated to the procedure. After a median follow-up period of 11.1 months, all patients were alive and well, with no residual PDA or evidence of LPA or aortic coarctation. This newly described technique can be performed safely with a high success rate and minimal procedural morbidity in EPNs. Early and midterm follow-up is encouraging. Future efforts should be directed toward developing specific devices for this unique application. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Closure The Definitive Guide

CERN Document Server

Bolin, Michael

2010-01-01

If you're ready to use Closure to build rich web applications with JavaScript, this hands-on guide has precisely what you need to learn this suite of tools in depth. Closure makes it easy for experienced JavaScript developers to write and maintain large and complex codebases -- as Google has demonstrated by using Closure with Gmail, Google Docs, and Google Maps. Author and Closure contributor Michael Bolin has included numerous code examples and best practices, as well as valuable information not available publicly until now. You'll learn all about Closure's Library, Compiler, Templates, tes

Is it too early to recommend patent foramen ovale closure for all patients who suffer from migraine? A single-centre study.

Science.gov (United States)

Chessa, Massimo; Colombo, Chiara; Butera, Gianfranco; Negura, Diana; Piazza, Luciane; Varotto, Leonardo; Bussadori, Claudio; Fesslova, Vlasta; Meola, Giovanni; Carminati, Mario

2009-05-01

To evaluate the course of migraine in migraine headache patients undergoing patent foramen ovale (PFO) transcatheter closure. Migraine has an important impact on the quality of life, and it seems to be one of the most disabling medical illnesses. In several studies, a high prevalence of right-to-left shunt has been described in patients with migraine, especially migraine with aura. The presence of right-to-left shunt, whatever the mechanism, may be the most potent trigger of migraine attacks in both migraine with aura and migraine without aura and the main determinant of aura in migraine with aura. A cohort of 42 patients (nine men/33 women; mean age 39 +/- 11.2 years), current migraineurs, underwent PFO percutaneous closure in our centre between January 2004 and December 2007. All patients rated the severity of their migraine preoperatively and 6 months postoperatively, indicating the frequency, duration, and intensity of the attacks and the occurrence of the aura in the prodromal phase, during the past 6 months, according to the migraine severity score. Baseline severity of migraine was higher in migraine with aura patients than in migraine without aura ones (8.8 vs. 7.5; P = 0.037). The resolution of migraine was verified in 11 patients (26%) after the closure of the PFO. A reduction in the frequency of the attacks (>=50%) was observed in 22 patients (52%). Multiple logistic regression analysis showed that the improvement in migraine with aura and migraine without aura was independent of migraine type, sex, age, cerebrovascular risk factors and cerebrovascular events, type of cardiac defect, and thrombophilic conditions. The consistent observations of this and other studies are provocative and worthy of evaluation with a prospective randomized trial using objective measures of migraine frequency and severity. However, it seems too early to recommend PFO closure for all patients who suffer from migraine until the results of ongoing large randomized trials are

The clinical effects of closure of the hernia gap after laparoscopic ventral hernia repair:

DEFF Research Database (Denmark)

Christoffersen, Mette W; Westen, Mikkel; Assadzadeh, Sami

2014-01-01

randomised controlled trials. The primary purpose of this paper is to compare early post-operative activity-related pain in patients undergoing laparoscopic ventral hernia repair with closure of the gap with patients undergoing standard laparoscopic ventral hernia repair (non-closure of the gap). Secondary...... outcomes are patient-rated cosmesis and hernia-specific quality of life. METHODS: A randomised, controlled, double-blinded study is planned. Based on power calculation, we will include 40 patients in each arm. Patients undergoing elective laparoscopic umbilical, epigastric or umbilical trocar-site hernia...... repair at Hvidovre Hospital and Herlev Hospital, Denmark, are invited to participate. CONCLUSION: The gap closure technique may induce more post-operative pain than the non-closure repair, but it may also be superior with regard to other important surgical outcomes. No studies have previously...

Influence of Closure & Non-Closure of the Visceral and Parietal Peritoneum on Post Cesarean Morbidity

Directory of Open Access Journals (Sweden)

Z Tabasi

2012-05-01

>Findings showed that non-closure of peritoneal layers as a shorter and simpler procedure has no influence on increasing post cesarean morbidity. Therefore, due to maternal health promotion and early neonatal breastfeeding, non closure of peritoneal layers is recommended

Impact of Different Standard Type A7A Drum Closure-Ring Practices on Gasket Contraction and Bolt Closure Distance– 15621

Energy Technology Data Exchange (ETDEWEB)

Ketusky, Edward [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Blanton, Paul [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Bobbitt, John H. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2015-03-11

The Department of Energy, the Savannah River National Laboratory, several manufacturers of specification drums, and the United States Department of Transportation (DOT) are collaborating in the development of a guidance document for DOE contractors and vendors who wish to qualify containers to DOT 7A Type A requirements. Currently, the effort is focused on DOT 7A Type A 208-liter (55-gallons) drums with a standard 12-gauge bolted closure ring. The U.S. requirements, contained in Title 49, Part 178.350 “Specification 7A; general packaging, Type A specifies a competent authority review of the packaging is not required for the transport of (Class 7) radioactive material containing less than Type A quantities of radioactive material. For Type AF drums, a 4 ft. regulatory free drop must be performed, such that the drum “suffers maximum damage.” Although the actual orientation is not defined by the specification, recent studies suggest that maximum damage would result from a shallow angle top impact, where kinetic energy is transferred to the lid, ultimately causing heavy damage to the lid, or even worse, causing the lid to come off. Since each vendor develops closure recommendations/procedures for the drums they manufacture, key parameters applied to drums during closing vary based on vendor. As part of the initial phase of the collaboration, the impact of the closure variants on the ability of the drum to suffer maximum damage is investigated. Specifically, closure testing is performed varying: 1) the amount of torque applied to the closure ring bolt; and, 2) stress relief protocol, including: a) weight of hammer; and, b) orientation that the hammer hits the closure ring. After closure, the amount of drum lid gasket contraction and the distance that the closure bolt moves through the closure ring is measured.

Neural correlates of early-closure garden-path processing: Effects of prosody and plausibility.

Science.gov (United States)

den Ouden, Dirk-Bart; Dickey, Michael Walsh; Anderson, Catherine; Christianson, Kiel

2016-01-01

Functional magnetic resonance imaging (fMRI) was used to investigate neural correlates of early-closure garden-path sentence processing and use of extrasyntactic information to resolve temporary syntactic ambiguities. Sixteen participants performed an auditory picture verification task on sentences presented with natural versus flat intonation. Stimuli included sentences in which the garden-path interpretation was plausible, implausible because of a late pragmatic cue, or implausible because of a semantic mismatch between an optionally transitive verb and the following noun. Natural sentence intonation was correlated with left-hemisphere temporal activation, but also with activation that suggests the allocation of more resources to interpretation when natural prosody is provided. Garden-path processing was associated with upregulation in bilateral inferior parietal and right-hemisphere dorsolateral prefrontal and inferior frontal cortex, while differences between the strength and type of plausibility cues were also reflected in activation patterns. Region of interest (ROI) analyses in regions associated with complex syntactic processing are consistent with a role for posterior temporal cortex supporting access to verb argument structure. Furthermore, ROI analyses within left-hemisphere inferior frontal gyrus suggest a division of labour, with the anterior-ventral part primarily involved in syntactic-semantic mismatch detection, the central part supporting structural reanalysis, and the posterior-dorsal part showing a general structural complexity effect.

Reconstructing in space and time the closure of the middle and western segments of the Bangong-Nujiang Tethyan Ocean in the Tibetan Plateau

Science.gov (United States)

Fan, Jian-Jun; Li, Cai; Wang, Ming; Xie, Chao-Ming

2018-01-01

When and how the Bangong-Nujiang Tethyan Ocean closed is a highly controversial subject. In this paper, we present a detailed study and review of the Cretaceous ophiolites, ocean islands, and flysch deposits in the middle and western segments of the Bangong-Nujiang suture zone (BNSZ), and the Cretaceous volcanic rocks, late Mesozoic sediments, and unconformities within the BNSZ and surrounding areas. Our aim was to reconstruct the spatial-temporal patterns of the closing of the middle and western segments of the Bangong-Nujiang Tethyan Ocean. Our conclusion is that the closure of the ocean started during the Late Jurassic and was mainly complete by the end of the Early Cretaceous. The closure of the ocean involved both "longitudinal diachronous closure" from north to south and "transverse diachronous closure" from east to west. The spatial-temporal patterns of the closure process can be summarized as follows: the development of the Bangong-Nujiang Tethyan oceanic lithosphere and its subduction started before the Late Jurassic; after the Late Jurassic, the ocean began to close because of the compressional regime surrounding the BNSZ; along the northern margin of the Bangong-Nujiang Tethyan Ocean, collisions involving the arcs, back-arc basins, and marginal basins of a multi-arc basin system first took place during the Late Jurassic-early Early Cretaceous, resulting in regional uplift and the regional unconformity along the northern margin of the ocean and in the Southern Qiangtang Terrane on the northern side of the ocean. However, the closure of the Bangong-Nujiang Tethyan Ocean cannot be attributed to these arc-arc and arc-continent collisions, because subduction and the development of the Bangong-Nujiang Tethyan oceanic lithosphere continued until the late Early Cretaceous. The gradual closure of the middle and western segments of Bangong-Nujiang Tethyan Ocean was diachronous from east to west, starting in the east in the middle Early Cretaceous, and being mainly

Use of early hard palate closure using a vomer flap in cleft lip and palate patients.

Science.gov (United States)

Smarius, Bram J A; Breugem, Corstiaan C

2016-08-01

The aim of the present study was to determine the influence of the vomer flap during cleft palate closure. A retrospective review was performed of all consecutive unilateral/bilateral complete cleft lip and palate (Veau III en IV) children who were treated by a simultaneous lip and hard palate closure using a vomer flap. Data were collected for sex, date of birth, syndrome, adoption, cleft palate type, type of repair, date of cleft repair, cleft width, lateral incisions, fistula and location of fistula. Ninety-one children (M = 62, F 29) were operated. Mean age at time of lip closure and vomer flap was 5.8 months (range 2.9 months to 49.2 months, SD 7.1) and the mean age at palate closure was 13.6 months (range 6.3 months to 79.9 months, SD 10.8). The mean cleft width at first assessment was 13.0 mm (range 7-22 mm) compared to 8.8 mm (range 4-15 mm) at second assessment (mean difference 4.6 mm, 95% CI 3.93-5.35, p cleft width, subsequently leading to a low fistula incidence (1.1%). Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Professional Closure Beyond State Authorization

Directory of Open Access Journals (Sweden)

Gitte Sommer Harrits

2014-03-01

Full Text Available For decades, the Weberian approach to the study of professions has been strong, emphasizing state authorization and market monopolies as constituting what is considered a profession. Originally, however, the Weberian conception of closure, or the ways in which a profession is constituted and made separate, was broader. This article suggests a revision of the closure concept, integrating insights from Pierre Bourdieu, and conceptualizing professional closure as the intersection of social, symbolic and legal closure. Based on this revision, this article demonstrates how to apply such a concept in empirical studies. This is done by exploring social, symbolic and legal closure across sixteen professional degree programs. The analyses show a tendency for some overlap between different forms of closure, with a somewhat divergent pattern for legal closure. Results support the argument that we need to study these processes as an intersection of different sources of closure, including capital, lifestyles and discourse

Tight closure and vanishing theorems

International Nuclear Information System (INIS)

Smith, K.E.

2001-01-01

Tight closure has become a thriving branch of commutative algebra since it was first introduced by Mel Hochster and Craig Huneke in 1986. Over the past few years, it has become increasingly clear that tight closure has deep connections with complex algebraic geometry as well, especially with those areas of algebraic geometry where vanishing theorems play a starring role. The purpose of these lectures is to introduce tight closure and to explain some of these connections with algebraic geometry. Tight closure is basically a technique for harnessing the power of the Frobenius map. The use of the Frobenius map to prove theorems about complex algebraic varieties is a familiar technique in algebraic geometry, so it should perhaps come as no surprise that tight closure is applicable to algebraic geometry. On the other hand, it seems that so far we are only seeing the tip of a large and very beautiful iceberg in terms of tight closure's interpretation and applications to algebraic geometry. Interestingly, although tight closure is a 'characteristic p' tool, many of the problems where tight closure has proved useful have also yielded to analytic (L2) techniques. Despite some striking parallels, there had been no specific result directly linking tight closure and L∼ techniques. Recently, however, the equivalence of an ideal central to the theory of tight closure was shown to be equivalent to a certain 'multiplier ideal' first defined using L2 methods. Presumably, deeper connections will continue to emerge. There are two main types of problems for which tight closure has been helpful: in identifying nice structure and in establishing uniform behavior. The original algebraic applications of tight closure include, for example, a quick proof of the Hochster-Roberts theorem on the Cohen-Macaulayness of rings of invariants, and also a refined version of the Brianqon-Skoda theorem on the uniform behaviour of integral closures of powers of ideals. More recent, geometric

40 CFR 264.228 - Closure and post-closure care.

Science.gov (United States)

2010-07-01

... remaining wastes to a bearing capacity sufficient to support final cover; and (iii) Cover the surface....112 must include both a plan for complying with paragraph (a)(1) of this section and a contingent plan... practicably removed at closure; and (ii) The owner or operator must prepare a contingent post-closure plan...

RCRA corrective action and closure

International Nuclear Information System (INIS)

1995-02-01

This information brief explains how RCRA corrective action and closure processes affect one another. It examines the similarities and differences between corrective action and closure, regulators' interests in RCRA facilities undergoing closure, and how the need to perform corrective action affects the closure of DOE's permitted facilities and interim status facilities

Post-operative analgesic requirement in non-closure and closure of peritoneum during open appendectomy

International Nuclear Information System (INIS)

Khan, A.W.; Maqsood, R.; Saleem, M.M.

2017-01-01

To compare the mean post-operative analgesic requirement in non-closure and closure of peritoneum during open appendectomy. Study Design: Randomized controlled trial. Place and Duration of Study: Department of General Surgery Combined Military Hospital Quetta, from 1st August 2014 to 30th April 2015. Material and Methods: A total of 60 patients were included in this study and were divided into two groups of 30 each. Patients in group A underwent open appendectomy with closure of peritoneum while patients in group B had non-closure of peritoneum during the same procedure. Post-operatively, pain severity was assessed on visual analogue scale (VAS) numeric pain distress scale. On presence of VAS numeric pain distress scale between 5 to 7, intramuscular (IM) diclofenac sodium was given and on score >7, intravascular (IV) tramadol was given. The final outcome was measured at day 0 and day 1. Results: Pain score and analgesic requirements were significantly less in non-closure group than closure group on day 0 and day 1, showing statistically significant difference between the two groups. Conclusion: Mean post-operative analgesic requirement is significantly less in non-closure group as compared to closure group during open appendectomy. (author)

Primary closure after carotid endarterectomy is not inferior to other closure techniques.

Science.gov (United States)

Avgerinos, Efthymios D; Chaer, Rabih A; Naddaf, Abdallah; El-Shazly, Omar M; Marone, Luke; Makaroun, Michel S

2016-09-01

Primary closure after carotid endarterectomy (CEA) has been much maligned as an inferior technique with worse outcomes than in patch closure. Our purpose was to compare perioperative and long-term results of different CEA closure techniques in a large institutional experience. A consecutive cohort of CEAs between January 1, 2000, and December 31, 2010, was retrospectively analyzed. Closure technique was used to divide patients into three groups: primary longitudinal arteriotomy closure (PRC), patch closure (PAC), and eversion closure (EVC). End points were perioperative events, long-term strokes, and restenosis ≥70%. Multivariate regression models were used to assess the effect of baseline predictors. There were 1737 CEA cases (bilateral, 143; mean age, 71.4 ± 9.3 years; 56.2% men; 35.3% symptomatic) performed during the study period with a mean clinical follow-up of 49.8 ± 36.4 months (range, 0-155 months). More men had primary closure, but other demographic and baseline symptoms were similar between groups. Half the patients had PAC, with the rest evenly distributed between PRC and EVC. The rate of nerve injury was 2.7%, the rate of reintervention for hematoma was 1.5%, and the length of hospital stay was 2.4 ± 3.0 days, with no significant differences among groups. The combined stroke and death rate was 2.5% overall and 3.9% and 1.7% in the symptomatic and asymptomatic cohort, respectively. Stroke and death rates were similar between groups: PRC, 11 (2.7%); PAC, 19 (2.2%); EVC, 13 (2.9%). Multivariate analysis showed baseline symptomatic disease (odds ratio, 2.4; P = .007) and heart failure (odds ratio, 3.1; P = .003) as predictors of perioperative stroke and death, but not the type of closure. Cox regression analysis demonstrated, among other risk factors, no statin use (hazard ratio, 2.1; P = .008) as a predictor of ipsilateral stroke and severe (glomerular filtration rate <30 mL/min/1.73 m(2)) renal insufficiency (hazard ratio, 2.6; P�

Closure of the vertebral canal in human embryos and fetuses

NARCIS (Netherlands)

Mekonen, Hayelom K.; Hikspoors, Jill P. J. M.; Mommen, Greet; Kruepunga, Nutmethee; Köhler, S. Eleonore; Lamers, Wouter H.

2017-01-01

The vertebral column is the paradigm of the metameric architecture of the vertebrate body. Because the number of somites is a convenient parameter to stage early human embryos, we explored whether the closure of the vertebral canal could be used similarly for staging embryos between 7 and 10weeks of

Ring closure in actin polymers

Energy Technology Data Exchange (ETDEWEB)

Sinha, Supurna, E-mail: supurna@rri.res.in [Raman Research Institute, Bangalore 560080 (India); Chattopadhyay, Sebanti [Doon University, Dehradun 248001 (India)

2017-03-18

We present an analysis for the ring closure probability of semiflexible polymers within the pure bend Worm Like Chain (WLC) model. The ring closure probability predicted from our analysis can be tested against fluorescent actin cyclization experiments. We also discuss the effect of ring closure on bend angle fluctuations in actin polymers. - Highlights: • Ring closure of biopolymers. • Worm like chain model. • Predictions for experiments.

Tubular closure device

International Nuclear Information System (INIS)

Klahn, F.C.; Nolan, J.H.; Wills, C.

1982-01-01

This invention relates to a closure mechanism for closing openings such as the bore of a conduit and for releasably securing members within the bore. More particularly, this invention relates to a closure mechanism for tubular irradiation surveillance specimen assembly holders used in nuclear reactors

CIRSE Vascular Closure Device Registry

NARCIS (Netherlands)

Reekers, Jim A.; Müller-Hülsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zeleňák, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

2011-01-01

Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. The CIRSE registry of closure devices

Optimal Technique for Abdominal Fascial Closure in Liver Transplant Patients

Directory of Open Access Journals (Sweden)

Unal Aydin

2010-01-01

Conclusion: Our results indicate that the novel technique used in this study contributed to overcoming early and late postoperative complications associated with closure of the abdominal fascia in liver transplant patients. In addition, this new technique has proven to be easily applicable, faster, safer and efficient in these patients; it is also potentially useful for conventional surgery.

Sternocleidomastoid flap augmentation of the pharyngeal closure after total laryngectomy.

Science.gov (United States)

Ibrahim, Sherif Gabr; Wahba, Basim Metwally; Elbatawi, Ahmed Mahmoud; Eltelety, Ahmad Mohamed

2017-08-01

The objective of the study was to evaluate the effect of sternocleidomastoid (SCM) flap augmentation of the pharyngeal closure after total laryngectomy on the incidence of pharyngocutaneous fistula (PCF). Thirty patients with T4a laryngeal carcinoma and none of them receiving primary radiotherapy previously were divided into two equal groups. Group A patients had SCM flap augmentation of the pharyngeal closure after total laryngectomy. Group B patients had the standard pharyngeal closure without augmentation. Both groups were followed up for 30 days postoperatively for the development of PCF. The use of the SCM added about extra 15 min to the surgical procedure in all patients (p laryngectomy. Three patients in each group developed PCF either early (10 days or less postoperatively) or late (more than 10 days but less than 30 days postoperatively). There was no statistically significant difference in the length of hospital stay between the two groups. The use of SCM flap did not reduce the incidence of PCF after total laryngectomy.

Closure Report for Corrective Action Unit 254: Area 25, R-MAD Decontamination Facility, Nevada Test Site, Nevada

Energy Technology Data Exchange (ETDEWEB)

G. N. Doyle

2002-02-01

Corrective Action Unit (CAU) 254 is located in Area 25 of the Nevada Test Site (NTS), approximately 100 kilometers (km) (62 miles) northwest of Las Vegas, Nevada. The site is located within the Reactor Maintenance, Assembly and Disassembly (R-MAD) compound and consists of Building 3126, two outdoor decontamination pads, and surrounding areas within an existing fenced area measuring approximately 50 x 37 meters (160 x 120 feet). The site was used from the early 1960s to the early 1970s as part of the Nuclear Rocket Development Station program to decontaminate test-car hardware and tooling. The site was reactivated in the early 1980s to decontaminate a radiologically contaminated military tank. This Closure Report (CR) describes the closure activities performed to allow un-restricted release of the R-MAD Decontamination Facility.

Use of a Collagen-Based Device for Closure of Low Brachial Artery Punctures

International Nuclear Information System (INIS)

Belenky, A.; Aranovich, D.; Greif, F.; Bachar, G.; Bartal, G.; Atar, E.

2007-01-01

Purpose. To report our experience with the Angioseal vascular closure device for hemostasis of distal brachial artery puncture. Methods. Between September 2003 and August 2005, 64 Angioseal vascular closure devices were inserted in 64 patients (40 men, 24 women; mean age 65 years) immediately after diagnostic or therapeutic arterial angiographies performed through a 5 Fr to 7 Fr sheath via the distal brachial artery. Ultrasound examination of the brachial artery preceded the angiography in all cases and only arteries wider than 4 mm were closed by the Angioseal. In cases of a sonographically evident thin subcutaneous space of the cubital fossa, tissue tumescence, using 1% Lidocaine, was performed prior to the arterial closure. Results. The deployment success rate was 100%. No major complications were encountered; only 2 patients developed puncture site hematoma, and these were followed conservatively. Conclusions. Closure of low brachial artery punctures with the Angioseal is simple and safe. No additional manual compression is required. We recommend its use after brachial artery access interventions, through appropriately wide arteries, to improve early patient ambulation and potentially reduce possible puncture site complications

Meconium Ileus–Is a Single Surgical Procedure Adequate?

Directory of Open Access Journals (Sweden)

Hagith Nagar

2006-07-01

Full Text Available Meconium ileus is one of the gastrointestinal manifestations of cystic fibrosis (CF, and affects 15% of neonates. The condition results from the accumulation of sticky inspissated meconium. Both nonoperative and operative therapies may be effective in relieving obstruction. The treatment of choice for uncomplicated meconium ileus is the use of enteral N-acetylcysteine or Gastrografin enemata. Once such therapy fails, surgery is indicated. A number of operative procedures are in use, including Bishop-Koop enterostomy, T-tube irrigation, resection and primary anastomosis, and enterotomy with irrigation and primary closure. During the period 1991-2003, five newborns required surgical intervention for uncomplicated meconium ileus. None responded to conservative management. All were males, including one set of twins. All underwent laparotomy, enterotomy, appendectomy, irrigation and closure of enterotomy. None required a second surgical procedure. CF was confirmed in all, and in each case, both parents were found to be genetic carriers of a mutational form of CF. A single surgical intervention is preferable in these patients, in view of the high rate of pulmonary involvement in CF patients. Enterotomy, irrigation and primary closure are the treatment of choice for uncomplicated meconium ileus.

Anesthetic management of Amplatzer atrial septal defect closure device embolization to right ventricular outflow tract

Directory of Open Access Journals (Sweden)

S Das

2016-01-01

Full Text Available Percutaneous device closure of atrial septal defect (ASD is an alternative treatment to surgery with advantages of avoidance of surgery, short procedure time, early discharge from hospital, and lower rates of complications. However, percutaneous device closure is associated with infrequent life-threatening complications such as device embolization. We report a case device embolization of the ASD occlude device into right ventricular outflow tract resulting progressive hypoxia. The role of anesthesiologist as a team leader in managing such emergency is discussed.

Sternal exploration or closure

Science.gov (United States)

VAC - vacuum-assisted closure - sternal wound; Sternal dehiscence; Sternal infection ... in the wound to look for signs of infection Remove dead or infected ... use a VAC (vacuum-assisted closure) dressing. It is a negative ...

Full closure strategic analysis.

Science.gov (United States)

2014-07-01

The full closure strategic analysis was conducted to create a decision process whereby full roadway : closures for construction and maintenance activities can be evaluated and approved or denied by CDOT : Traffic personnel. The study reviewed current...

Closure of secundum atrial septal defect in adults

International Nuclear Information System (INIS)

Elahi, M.M.; Pollock, J.C.S.

2003-01-01

Objective: To examine the outcome of ASD closure in adults and the effect of patients age on drug therapy, symptoms and incidence of atrial fibrillation. Results: There were no deaths. Five patients from early in the series were lost to follow-up. Large defect size was associated with patch rather than direct closure but there was extensive crossover. Analysis by age showed that patients over 49 had more postoperative atrial fibrillation (P 0.001), more chest pain (P>0.0001), more postoperative dyspnea (p = 0.021), greater use of diuretics (p = 0.20) and longer hospital stay (10.1 plus minis 2.6 vs. 8.5 plus minis 1.6 days; p = 0.007) than patients under 49. Conclusion: Operation for atrial septal defects in adults can be performed with no mortality and low morbidity. The age at which complications appear more frequent suggests that closer analysis of these patients is required. (author)

Crack closure, a literature study

Science.gov (United States)

Holmgren, M.

1993-08-01

In this report crack closure is treated. The state of the art is reviewed. Different empirical formulas for determining the crack closure are compared with each other, and their benefits are discussed. Experimental techniques for determining the crack closure stress are discussed, and some results from fatigue tests are also reported. Experimental data from the literature are reported.

Scalp Wound Closure with K wires: An alternative easier method to scalp wound closure.

Science.gov (United States)

Ramesh, S; Ajik, S

2012-12-01

Scalp defects and lacerations present a reconstructive challenge to plastic surgeons. Many methods have been described from the use of skin grafting to rotation flaps. Here we present a method of closure of a contaminated scalp wound with the use of Kirschner wires. In our case, closure of scalp laceration was made possible with the use of 1.4 Kirschner wires and cable tie/ zip tie fasteners. The duration to closure of wound was 10 days. In reconstructing the scalp defect, this method was found to adhere to principles of scalp reconstruction. There were no post operative complications found from the procedure. On initial application on the edge of the wound, tension applied caused the K wires to cut through the wound edge. On replacement of K wires 1cm away from wound edge the procedure was not plagued by any further complication. In conclusion we find scalp closure with Kirschner wires are a simple and effective method for scalp wound closure.

Revisit to Grad's Closure and Development of Physically Motivated Closure for Phenomenological High-Order Moment Model

International Nuclear Information System (INIS)

Myong, R. S.; Nagdewe, S. P.

2011-01-01

The Grad's closure for the high-order moment equation is revisited and, by extending his theory, a physically motivated closure is developed for the one-dimensional velocity shear gas flow. The closure is based on the physical argument of the relative importance of various terms appearing in the moment equation. Also, the closure is derived such that the resulting theory may be inclusive of the well established linear theory (Navier-Stokes-Fourier) as limiting case near local thermal equilibrium.

Closure of giant omphaloceles by the abdominal wall component separation technique in infants.

NARCIS (Netherlands)

Eijck, F.C. van; Blaauw, I. de; Bleichrodt, R.P.; Rieu, P.N.M.A.; Staak, F.H.J.M. van der; Wijnen, M.H.W.A.; Wijnen, R.M.H.

2008-01-01

BACKGROUND/PURPOSE: Several techniques have been described to repair giant omphaloceles. There is no procedure considered to be the criterion standard worldwide. The aim of the present prospective study was to analyze the early and late results of secondary closure of giant omphaloceles using the

Prospective, randomized, controlled trial of polymer cable ties versus standard wire closure of midline sternotomy.

Science.gov (United States)

Marasco, Silvana F; Fuller, Louise; Zimmet, Adam; McGiffin, David; Seitz, Michael; Ch'ng, Stephanie; Gangahanumaiah, Shivanand; Bailey, Michael

2018-04-16

Midline sternotomy remains the most common access incision for cardiac operations. Traditionally, the sternum is closed with stainless steel wires. Wires are well known to stretch and break, however, leading to pain, nonunion, and potential deep sternal wound infection. We hypothesized that biocompatible plastic cable ties would achieve a more rigid sternal fixation, reducing postoperative pain and analgesia requirements. A prospective, randomized study compared the ZIPFIX (De Puy Synthes, West Chester, Pa) sternal closure system (n = 58) with standard stainless steel wires (n = 60). Primary outcomes were pain and analgesia requirements in the early postoperative period. Secondary outcome was sternal movement, as assessed by ultrasound at the postoperative follow-up visit. Groups were well matched in demographic and operative variables. There were no significant differences between groups in postoperative pain, analgesia, or early ventilatory requirements. Patients in the ZIPFIX group had significantly more movement in the sternum and manubrium on ultrasound at 4 weeks. ZIPFIX sternal cable ties provide reliable closure but no demonstrable benefit in this study in pain or analgesic requirements relative to standard wire closure after median sternotomy. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Nevada Test Site closure program

International Nuclear Information System (INIS)

Shenk, D.P.

1994-08-01

This report is a summary of the history, design and development, procurement, fabrication, installation and operation of the closures used as containment devices on underground nuclear tests at the Nevada Test Site. It also addresses the closure program mothball and start-up procedures. The Closure Program Document Index and equipment inventories, included as appendices, serve as location directories for future document reference and equipment use

Integrating scientific results for a post-closure safety demonstration

International Nuclear Information System (INIS)

Taylor, E.C.; Ramspott, L.D.; Sinnock, S.; Sprecher, W.M.

1994-01-01

The U.S. Department of Energy (DOE) is developing a nuclear waste management system that will accept high-level radioactive waste, transport it, store it, and ultimately emplace it in a deep geologic repository. The key activity now is determining whether Yucca Mountain, Nevada is suitable as a site for the repository. If so, the crucial technological advance will be the demonstration that disposal of nuclear waste will be safe for thousands of years after closure. Recent regulatory, legal, and scientific developments imply that the safety demonstration must be simple. The scientific developments taken together support a simple set of hypotheses that constitute a post-closure safety argument for a repository at Yucca Mountain. If the understanding of Yucca Mountain hydrology presented in the Site Characterization Plan proves correct, then these hypotheses might be confirmed by combining results of Surface-Based Testing with early testing results in the Exploratory Studies Facility

Evaluation of a novel trocar-site closure and comparison with a standard Carter-Thomason closure device.

Science.gov (United States)

del Junco, Michael; Okhunov, Zhamshid; Juncal, Samuel; Yoon, Renai; Landman, Jaime

2014-07-01

The aim of this study was to evaluate and compare a novel trocars-site closure device, the WECK EFx™ Endo Fascial Closure System (EFx) with the Carter-Thomason CloseSure System® (CT) for the closure of laparoscopic trocar site defects created by a 12-mm dilating trocar. We created standardized laparoscopic trocars-site abdominal wall defects in cadaver models using a standard 12-mm laparoscopic dilating trocar. Trocar defects were closed in a randomized fashion using one of the two closure systems. We recorded time and number of attempts needed for complete defect closure. In addition, we recorded the ability to maintain pneumoperitoneum, endoscopic visualization, safety, security, and facility based on the surgeon's subjective evaluations. We compared outcomes for the EFx and CT closure systems. We created 72 standardized laparoscopic trocars-site abdominal wall defects. The mean time needed for complete defect closure was 98.53 seconds (±28.9) for the EFx compared with 133.61 seconds (±54.61) for the CT (Psafety were 2.92 for EFx vs 2.19 for CT (Pvs 1.83 for EFx and CT, respectively (Pvs 2.33 for CT (P=0.022). No significant difference was observed between the EFx and the CT systems for endoscopic visualization (2.28 vs 2.50, P=0.080). In this in vitro cadaver trial, the EFx was superior in terms of time needed to complete defect closure, safety, and facility. CT was superior in terms of maintenance of pneumoperitoneum. Both systems were equal in the number of attempts needed to complete the defect closure and endoscopic visualization.

Occupancy estimation and the closure assumption

Science.gov (United States)

Rota, Christopher T.; Fletcher, Robert J.; Dorazio, Robert M.; Betts, Matthew G.

2009-01-01

1. Recent advances in occupancy estimation that adjust for imperfect detection have provided substantial improvements over traditional approaches and are receiving considerable use in applied ecology. To estimate and adjust for detectability, occupancy modelling requires multiple surveys at a site and requires the assumption of 'closure' between surveys, i.e. no changes in occupancy between surveys. Violations of this assumption could bias parameter estimates; however, little work has assessed model sensitivity to violations of this assumption or how commonly such violations occur in nature. 2. We apply a modelling procedure that can test for closure to two avian point-count data sets in Montana and New Hampshire, USA, that exemplify time-scales at which closure is often assumed. These data sets illustrate different sampling designs that allow testing for closure but are currently rarely employed in field investigations. Using a simulation study, we then evaluate the sensitivity of parameter estimates to changes in site occupancy and evaluate a power analysis developed for sampling designs that is aimed at limiting the likelihood of closure. 3. Application of our approach to point-count data indicates that habitats may frequently be open to changes in site occupancy at time-scales typical of many occupancy investigations, with 71% and 100% of species investigated in Montana and New Hampshire respectively, showing violation of closure across time periods of 3 weeks and 8 days respectively. 4. Simulations suggest that models assuming closure are sensitive to changes in occupancy. Power analyses further suggest that the modelling procedure we apply can effectively test for closure. 5. Synthesis and applications. Our demonstration that sites may be open to changes in site occupancy over time-scales typical of many occupancy investigations, combined with the sensitivity of models to violations of the closure assumption, highlights the importance of properly addressing

Multidisciplinary Assessment in Optimising Results of Percutaneous Patent Foramen Ovale Closure.

Science.gov (United States)

Davies, Allan; Ekmejian, Avedis; Collins, Nicholas; Bhagwandeen, Rohan

2017-03-01

Amplatzer device used in 83 cases (74.1%). Early residual shunting was visible in seven patients (6.3%), however on follow-up agitated saline study only two patients had residual shunt (1.8%). The annual risk of recurrent stroke or TIA was 0.21%. Percutaneous patent foramen ovale closure can be performed safely and effectively in patients with paradoxical embolism. In selected patients, following appropriate multidisciplinary specialist pre-procedural assessment, excellent long-term results with low incidence of recurrent events may be achieved. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Eyelid closure at death

Directory of Open Access Journals (Sweden)

A D Macleod

2009-01-01

Full Text Available Aim: To observe the incidence of full or partial eyelid closure at death. Materials and Methods: The presence of ptosis was recorded in 100 consecutive hospice patient deaths. Results: Majority (63% of the patients died with their eyes fully closed, however, 37% had bilateral ptosis at death, with incomplete eye closure. In this study, central nervous system tumor involvement and/or acute hepatic encephalopathy appeared to be pre-mortem risk factors of bilateral ptosis at death. Conclusion: Organicity and not psychogenicity is, therefore, the likely etiology of failure of full eyelid closure at death.

Unilateral Optic Neuropathy and Acute Angle-Closure Glaucoma following Snake Envenomation

Directory of Open Access Journals (Sweden)

Osman Okan Olcaysu

2015-01-01

Full Text Available Purpose. We aimed to describe a unique case in which a patient developed unilateral optic neuritis and angle-closure glaucoma as a result of snake envenomation. Case Report. Approximately 18 hours after envenomation, a 67-year-old female patient described visual impairment and severe pain in her left eye (LE. The patient’s best corrected visual acuity was 10/10 in the RE and hand motion in the LE. Cranial magnetic resonance imaging showed signs of neuropathy in the left optic nerve. In the LE, corneal haziness, closure of the iridocorneal angle, and mild mydriasis were observed and pupillary light reflex was absent. Intraocular pressure was 25 mmHg and 57 mmHg in the RE and LE, respectively. The patient was diagnosed with acute angle-closure glaucoma in the LE. Optic neuropathy was treated with intravenous pulse methylprednisolone. Left intraocular pressure was within normal range starting on the fourth day. One month after the incident, there was no sign of optic neuropathy; relative afferent pupillary defect and optic nerve swelling disappeared. Conclusions. Patients with severe headache and visual loss after snake envenomation must be carefully examined for possible optic neuropathy and angle-closure glaucoma. Early diagnosis and treatment of these cases are necessary to prevent permanent damage to optic nerves.

Closure and Sealing Design Calculation

International Nuclear Information System (INIS)

T. Lahnalampi; J. Case

2005-01-01

The purpose of the ''Closure and Sealing Design Calculation'' is to illustrate closure and sealing methods for sealing shafts, ramps, and identify boreholes that require sealing in order to limit the potential of water infiltration. In addition, this calculation will provide a description of the magma that can reduce the consequences of an igneous event intersecting the repository. This calculation will also include a listing of the project requirements related to closure and sealing. The scope of this calculation is to: summarize applicable project requirements and codes relating to backfilling nonemplacement openings, removal of uncommitted materials from the subsurface, installation of drip shields, and erecting monuments; compile an inventory of boreholes that are found in the area of the subsurface repository; describe the magma bulkhead feature and location; and include figures for the proposed shaft and ramp seals. The objective of this calculation is to: categorize the boreholes for sealing by depth and proximity to the subsurface repository; develop drawing figures which show the location and geometry for the magma bulkhead; include the shaft seal figures and a proposed construction sequence; and include the ramp seal figure and a proposed construction sequence. The intent of this closure and sealing calculation is to support the License Application by providing a description of the closure and sealing methods for the Safety Analysis Report. The closure and sealing calculation will also provide input for Post Closure Activities by describing the location of the magma bulkhead. This calculation is limited to describing the final configuration of the sealing and backfill systems for the underground area. The methods and procedures used to place the backfill and remove uncommitted materials (such as concrete) from the repository and detailed design of the magma bulkhead will be the subject of separate analyses or calculations. Post-closure monitoring will not

Scope and closures

CERN Document Server

Simpson, Kyle

2014-01-01

No matter how much experience you have with JavaScript, odds are you don’t fully understand the language. This concise yet in-depth guide takes you inside scope and closures, two core concepts you need to know to become a more efficient and effective JavaScript programmer. You’ll learn how and why they work, and how an understanding of closures can be a powerful part of your development skillset.

The River Corridor Closure Contract How Washington Closure Hanford is Closing A Unique Department of Energy Project - 12425

Energy Technology Data Exchange (ETDEWEB)

Feist, E.T. [Washington Closure Hanford, 2620 Fermi Avenue, Richland, WA 99354 (United States)

2012-07-01

Cleanup of the Hanford River Corridor has been one of Hanford Site's top priorities since the early 1990's. This urgency is due to the proximity of hundreds of waste sites to the Columbia River and the groundwater that continues to threaten the Columbia River. In April 2005, the U.S. Department of Energy, Richland Operations Office (DOE-RL) awarded the Hanford River Corridor Closure Contract (RCCC), a cost-plus incentive-fee closure contract with a 2015 end date and first of its kind at Hanford Site, to Washington Closure Hanford (WCH), a limited-liability company owned by URS, Bechtel National, and CH2M HILL. WCH is a single-purpose company whose goal is to safely, compliantly, and efficiently accelerate cleanup in the Hanford River Corridor and reduce or eliminate future obligations to DOE-RL for maintaining long-term stewardship over the site. Accelerated performance of the work-scope while keeping a perspective on contract completion presents challenges that require proactive strategies to support the remaining work-scope through the end of the RCCC. This paper outlines the processes to address the challenges of completing work-scope while planning for contract termination. WCH is responsible for cleanup of the River Corridor 569.8 km{sup 2} (220 mi{sup 2}) of the 1,517.7 km{sup 2} (586 mi{sup 2}) Hanford Site's footprint reduction. At the end of calendar year 2011, WCH's closure implementation is well underway. Fieldwork is complete in three of the largest areas within the RCCC scope (Segments 1, 2, and 3), approximately 44.5% of the River Corridor (Figure 3). Working together, DOE-RL and WCH are in the process of completing the 'paper work' that will document the completion of the work-scope and allow DOE-RL to relieve WCH of contractual responsibilities and transition the completed areas to the Long-Term Stewardship Program, pending final action RODs. Within the next 4 years, WCH will continue to complete cleanup of the River

Echocardiographic Follow-Up of Patent Foramen Ovale and the Factors Affecting Spontaneous Closure.

Science.gov (United States)

Yildirim, Ali; Aydin, Alperen; Demir, Tevfik; Aydin, Fatma; Ucar, Birsen; Kilic, Zubeyir

2016-11-01

The aim of the present study was to evaluate the echocardiographic follow-up of patent foramen ovale, which is considered a potential etiological factor in various diseases, and to determine the factors affecting spontaneous closure. Between January 2000 and June 2012, records of 918 patients with patent foramen ovale were retrospectively reviewed. Patency of less than 3 mm around the fossa ovalis is called patent foramen ovale. Patients with cyanotic congenital heart diseases, severe heart valve disorders and severe hemodynamic left to right shunts were excluded from the study. The patients were divided into three groups based on age; 1 day-1 month in group 1, 1 month-12 months in group 2, and more than 12 months in group 3. Of the 918 patients, 564 (61.4%) had spontaneous closure, 328 (35.8%) had patent foramen ovale continued, 15 (1.6%) patients had patent foramen ovale enlarged to 3-5 mm, 6 patients were enlarged to 5-8 mm, and in one patient patent foramen ovale reached to more than 8 mm size. Defect was spontaneously closed in 65.9% of the patients in group 1, 66.7% of the patients in group 2, and 52.3% of the patients in group 3. There was a negative correlation between the age of diagnosis and spontaneous closure (p patent ductus arteriosus and atrial septal aneurysm did not have any effect on spontaneous closure of patent foramen ovale (p > 0.05). However, ventricular septal defect and spontaneous closure of patent foramen ovale had a positive correlation (p closure rate of patent foramen ovale is high. Furthermore, a positive correlation was found between spontaneous closure of patent foramen ovale with early diagnosis and small defect size.

100-D Ponds closure plan. Revision 1

International Nuclear Information System (INIS)

Petersen, S.W.

1997-09-01

The 100-D Ponds is a Treatment, Storage, and Disposal (TSD) unit on the Hanford Facility that received both dangerous and nonregulated waste. This Closure Plan (Rev. 1) for the 100-D Ponds TSD unit consists of a RCRA Part A Dangerous Waste Permit Application (Rev. 3), a RCRA Closure Plan, and supporting information contained in the appendices to the plan. The closure plan consists of eight chapters containing facility description, process information, waste characteristics, and groundwater monitoring data. There are also chapters containing the closure strategy and performance standards. The strategy for the closure of the 100-D Ponds TSD unit is clean closure. Appendices A and B of the closure plan demonstrate that soil and groundwater beneath 100-D Ponds are below cleanup limits. All dangerous wastes or dangerous waste constituents or residues associated with the operation of the ponds have been removed, therefore, human health and the environment are protected. Discharges to the 100-D Ponds, which are located in the 100-DR-1 operable unit, were discontinued in June 1994. Contaminated sediment was removed from the ponds in August 1996. Subsequent sampling and analysis demonstrated that there is no contamination remaining in the ponds, therefore, this closure plan is a demonstration of clean closure

Closure for spent-fuel transport and storage containers

International Nuclear Information System (INIS)

Ahner, S.; Knackstedt, H.G.; Srostlik, P.

1980-01-01

The container has a transport closure and a shielding closure. This shielding closure consists of two pieces (double closure system), which can be fartened to one another like a bayonet fixing. A central motion of rotation is enough to open the closure. It can be done remote-controlled as well as manually. (DG) [de

Echocardiographic predictors of coil vs device closure in patients undergoing percutaneous patent ductus arteriosus closure.

Science.gov (United States)

Roushdy, Alaa; Abd El Razek, Yasmeen; Mamdouh Tawfik, Ahmed

2018-01-01

To determine anatomic and hemodynamic echocardiographic predictors for patent ductus arteriosus (PDA) device vs coil closure. Seventy-six patients who were referred for elective transcatheter PDA closure were enrolled in the study. All patients underwent full echocardiogram including measurement of the PDA pulmonary end diameter, color flow width and extent, peak and end-diastolic Doppler gradients across the duct, diastolic flow reversal, left atrial dimensions and volume, left ventricular sphericity index, and volumes. The study group was subdivided into 2 subgroups based on the mode of PDA closure whether by coil (n = 42) or device (n = 34). Using univariate analysis there was a highly significant difference between the 2 groups as regard the pulmonary end diameter measured in both the suprasternal and parasternal short-axis views as well as the color flow width and color flow extent (P closure group had statistically significant higher end-systolic and end-diastolic volumes indexed, left atrial volume, and diastolic flow reversal. Receiver operating characteristic curve analysis showed a pulmonary end diameter cutoff point from the suprasternal view > 2.5 mm and from parasternal short-axis view > 2.61 mm to have the highest balanced sensitivity and specificity to predict the likelihood for device closure (AUC 0.971 and 0.979 respectively). The pulmonary end diameter measured from the suprasternal view was the most independent predictor of device closure. The selection between PDA coil or device closure can be done on the basis of multiple anatomic and hemodynamic echocardiographic variables. © 2017 Wiley Periodicals, Inc.

Excision and primary closure of pilonidal sinus disease: worthwhile option with an acceptable recurrence rate.

LENUS (Irish Health Repository)

Gilani, S N S

2012-01-31

BACKGROUND: Treatment of pilonidal sinus disease is controversial. Many claim policy of marsupialisation and healing by secondary intention. This is demanding in terms of nursing care and time lost from work. AIMS: To examine outcome of excision and primary closure of chronic pilonidal disease on recurrence rate and patient\\'s daily activities. PATIENTS AND METHODS: One hundred and fourteen consecutive elective patients who had excision and primary closure of pilonidal sinus disease were reviewed. The demographic data and the post-operative outcome were studied. RESULTS: The recurrence of pilonidal sinus was noted in 9% of patients, wound breakdown occasioning delayed healing in 9%, patients able to drive by day 16 on average. The mean time to return to work was 20.5 days; duration of analgesia, 2.4 days; and duration of antibiotic treatment, 4.7 days. CONCLUSION: Excision and primary closure of chronic pilonidal sinus has low recurrence rate with early return to activities. Primary closure appears to be a cost-effective option for uncomplicated pilonidal sinus disease.

Tools for Closure Project and Contract Management: Development of the Rocky Flats Integrated Closure Project Baseline

International Nuclear Information System (INIS)

Gelles, C. M.; Sheppard, F. R.

2002-01-01

This paper details the development of the Rocky Flats Integrated Closure Project Baseline - an innovative project management effort undertaken to ensure proactive management of the Rocky Flats Closure Contract in support of the Department's goal for achieving the safe closure of the Rocky Flats Environmental Technology Site (RFETS) in December 2006. The accelerated closure of RFETS is one of the most prominent projects within the Department of Energy (DOE) Environmental Management program. As the first major former weapons plant to be remediated and closed, it is a first-of-kind effort requiring the resolution of multiple complex technical and institutional challenges. Most significantly, the closure of RFETS is dependent upon the shipment of all special nuclear material and wastes to other DOE sites. The Department is actively working to strengthen project management across programs, and there is increasing external interest in this progress. The development of the Rocky Flats Integrated Closure Project Baseline represents a groundbreaking and cooperative effort to formalize the management of such a complex project across multiple sites and organizations. It is original in both scope and process, however it provides a useful precedent for the other ongoing project management efforts within the Environmental Management program

50 CFR 648.161 - Closures.

Science.gov (United States)

2010-10-01

... Bluefish Fishery § 648.161 Closures. (a) EEZ closure. NMFS shall close the EEZ to fishing for bluefish by... dealer permit holders that no commercial quota is available for landing bluefish in that state. ...

Early experience with the Occlutech PLD occluder for mitral paravalvar leak closure through a hybrid transapical approach.

Science.gov (United States)

Bedair, Radwa; Morgan, Gareth J; Bapat, Vinayak; Kapetanakis, Stamatis; Goreczny, Sebastian; Simpson, John; Qureshi, Shakeel A

2016-12-10

We sought to evaluate the feasibility and efficacy of hybrid transapical closure of paravalvar mitral leaks using a new Occlutech PLD occluder in patients with heart failure and/or haemolytic anaemia. Retrospective analysis of clinical and procedural data was undertaken for patients who had attempted closure of paravalvar mitral leaks via a hybrid transapical approach with the Occlutech PLD occluder. Eight patients (four males, median age 69 years) underwent closure of 10 mitral paravalvar leaks using eight Occlutech PLD occluders and two AMPLATZER Vascular Plugs (AVP II). Successful deployment, with significant reduction of the paravalvar leak was achieved in seven patients with short procedure (median 131 min) and fluoroscopy times (median 22 min). One patient had mechanical interference with prosthetic valve function, requiring surgery. Another patient with a high EuroSCORE (48.8%) died of multi-organ failure two days after the procedure. Clinical improvement in either heart failure or haemolysis was seen in all discharged patients. In our series of patients with challenging anatomy, the Occlutech PLD occluders performed well when implanted via a hybrid transapical approach. Further work is needed to assess this methodology fully for a wider population and to assess other deployment approaches for this promising new occluder.

Hanford Patrol Academy Demolition Sites Closure Plan

International Nuclear Information System (INIS)

1992-11-01

From 1975 to 1991 the Hanford Patrol Academy Demolition Sites (HPADS) were used for demolition events. These demolition events were a form of thermal treatment for spent or abandoned chemical waste. Because the HPADS will no longer be used for this thermal activity, the sites will be closed. Closure will be conducted pursuant to the requirements of the Washington State Department of Ecology (Ecology) Dangerous Waste Regulations, Washington Administrative Code (WAC) 173-303-610 and 40 CFR 270.1. Closure also will satisfy closure requirements of WAC 173-303-680 and for the thermal treatment closure requirements of 40 CFR 265.381. This closure plan presents a description of the HPADS, the history of the waste treated, and the approach that will be followed to close the HPADS. Because dangerous waste does not include the source, special nuclear, and by-product material components of mixed waste, radionuclides are not within the scope of WAC 173-303 or of this closure plan. The information on radionuclides is provided only for general knowledge where appropriate. Only dangerous constituents derived from HPADS operations will be addressed in this closure plan in accordance with WAC 173-303-610(2)(b)(i). The HPADS are actually two distinct soil closure areas within the Hanford Patrol Academy training area

ASD Closure in Structural Heart Disease.

Science.gov (United States)

Wiktor, Dominik M; Carroll, John D

2018-04-17

While the safety and efficacy of percutaneous ASD closure has been established, new data have recently emerged regarding the negative impact of residual iatrogenic ASD (iASD) following left heart structural interventions. Additionally, new devices with potential advantages have recently been studied. We will review here the potential indications for closure of iASD along with new generation closure devices and potential late complications requiring long-term follow-up. With the expansion of left-heart structural interventions and large-bore transseptal access, there has been growing experience gained with management of residual iASD. Some recently published reports have implicated residual iASD after these procedures as a potential source of diminished clinical outcomes and mortality. Additionally, recent trials investigating new generation closure devices as well as expanding knowledge regarding late complications of percutaneous ASD closure have been published. While percutaneous ASD closure is no longer a novel approach to managing septal defects, there are several contemporary issues related to residual iASD following large-bore transseptal access and new generation devices which serve as an impetus for this review. Ongoing attention to potential late complications and decreasing their incidence with ongoing study is clearly needed.

32 CFR 989.25 - Base closure and realignment.

Science.gov (United States)

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Base closure and realignment. 989.25 Section 989... PROTECTION ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.25 Base closure and realignment. Base closure or realignment may entail special requirements for environmental analysis. The permanent base closure...

Emergency evacuation/transportation plan update: Traffic model development and evaluation of early closure procedures. Final report

Energy Technology Data Exchange (ETDEWEB)

NONE

1993-10-28

Prolonged delays in traffic experienced by Laboratory personnel during a recent early dismissal in inclement weather, coupled with reconstruction efforts along NM 502 east of the White Rock Wye for the next 1 to 2 years, has prompted Los Alamos National Laboratory (LANL) to re-evaluate and improve the present transportation plan and its integration with contingency plans maintained in other organizations. Facilities planners and emergency operations staff need to evaluate the transportation system`s capability to inefficiently and safely evacuate LANL under different low-level emergency conditions. A variety of potential procedures governing the release of employees from the different technical areas (TAs) requires evaluation, perhaps with regard to multiple emergency-condition scenarios, with one or more optimal procedures ultimately presented for adoption by Lab Management. The work undertaken in this project will hopefully lay a foundation for an on-going, progressive transportation system analysis capability. It utilizes microscale simulation techniques to affirm, reassess and validate the Laboratory`s Early Dismissal/Closure/Delayed Opening Plan. The Laboratory is required by Federal guidelines, and compelled by prudent practice and conscientious regard for the welfare of employees and nearby residents, to maintain plans and operating procedures for evacuation if the need arises. The tools developed during this process can be used outside of contingency planning. It is anticipated that the traffic models developed will allow site planners to evaluate changes to the traffic network which could better serve the normal traffic levels. Changes in roadway configuration, control strategies (signalization and signing), response strategies to traffic accidents, and patterns of demand can be modelled using the analysis tools developed during this project. Such scenarios typically are important considerations in master planning and facilities programming.

Patent ductus arteriosus closure using an Amplatzer™ ventricular septal defect closure device

Science.gov (United States)

Fernando, Rajeev; Koranne, Ketan; Loyalka, Pranav; Kar, Biswajit; Gregoric, Igor

2013-01-01

The ductus arteriosus originates from the persistence of the distal portion of the left sixth aortic arch. It connects the descending aorta (immediately distal to the left subclavian artery) to the roof of the main pulmonary artery, near the origin of the left pulmonary artery. Persistence of the duct beyond 48 h after birth is abnormal and results in patent ductus arteriosus (PDA). PDA is rare in adults because it is usually discovered and treated in childhood. Mechanical closure remains the definitive therapy because the patency of ductus arteriosus may lead to multiple complications, depending on the size and flow through the ductus. PDA closure is indicated in patients with symptoms and evidence of left heart enlargement, and in patients with elevated pulmonary pressures when reversal is possible. Transcatheter closure is the preferred technique in adults because it avoids sternotomy, reduces the length of hospital stay and is associated with fewer complications compared with surgery. First demonstrated in 1967, both the technique and the occluder devices used have since evolved. However, designing an ideal PDA occluder has been a challenge due to the variability in size, shape and orientation of PDAs. The present article describes a case involving a 35-year-old woman who presented to the Center for Advanced Heart Failure (Houston, USA) with congestive heart failure due to a large PDA, which was successfully occluded using an Amplatzer (St Jude Medical, USA) muscular ventricular septal defect closure device. The wider waist and dual-retention discs of these ventricular septal defect closure devices may be important factors to consider in the future development of devices for the occlusion of large PDAs. PMID:24294051

Evaluation of the Momentum Closure Schemes in MPAS-Ocean

Science.gov (United States)

Zhao, Shimei; Liu, Yudi; Liu, Wei

2018-04-01

In order to compare and evaluate the performances of the Laplacian viscosity closure, the biharmonic viscosity closure, and the Leith closure momentum schemes in the MPAS-Ocean model, a variety of physical quantities, such as the relative reference potential energy (RPE) change, the RPE time change rate (RPETCR), the grid Reynolds number, the root mean square (RMS) of kinetic energy, and the spectra of kinetic energy and enstrophy, are calculated on the basis of results of a 3D baroclinic periodic channel. Results indicate that: 1) The RPETCR demonstrates a saturation phenomenon in baroclinic eddy tests. The critical grid Reynolds number corresponding to RPETCR saturation differs between the three closures: the largest value is in the biharmonic viscosity closure, followed by that in the Laplacian viscosity closure, and that in the Leith closure is the smallest. 2) All three closures can effectively suppress spurious dianeutral mixing by reducing the grid Reynolds number under sub-saturation conditions of the RPETCR, but they can also damage certain physical processes. Generally, the damage to the rotation process is greater than that to the advection process. 3) The dissipation in the biharmonic viscosity closure is strongly dependent on scales. Most dissipation concentrates on small scales, and the energy of small-scale eddies is often transferred to large-scale kinetic energy. The viscous dissipation in the Laplacian viscosity closure is the strongest on various scales, followed by that in the Leith closure. Note that part of the small-scale kinetic energy is also transferred to large-scale kinetic energy in the Leith closure. 4) The characteristic length scale L and the dimensionless parameter D in the Leith closure are inherently coupled. The RPETCR is inversely proportional to the product of D and L. When the product of D and L is constant, both the simulated RPETCR and the inhibition of spurious dianeutral mixing are the same in all tests using the Leith

Phacoemulsification with intraocular lens implantation in primary angle-closure suspect, primary angle-closure and primary angle-closure glaucoma with cataract

Directory of Open Access Journals (Sweden)

Kun Zeng

2013-08-01

Full Text Available AIM: To evaluate the features and clinical outcomes of cataract extraction by phacoemulsification with intraocular lens implantation in primary angle-closure suspect(PACS, primary angle-closure(PACand primary angle-closure glaucoma(PACGwith cataract.METHODS:Phacoemulsification with intraocular lens implantation was performed on 86 cases(86 eyesdiagnosed as PACS, PAC and PACG co-existing cataract from January to December 2012. All cases were followed up for 3 months to 1 year. Pre-operative and post-operative visual acuity, intraocular pressure(IOP, gonioscopy, ultrasound biomicroscopy(UBM, visual field and usage of anti-glaucomaous eye drops were recorded.RESULTS:Zonular dialysis existed in 19 eyes(22%. The post-operative visual acuity improved in 84 eyes(98%. The post-operative visual acuity was CONCLUSION: PACS, PAC and PACG co-existing zonular dialysis is common. Phacoemulsification with IOL implantation can reduce IOP, deepen anterior chamber and open angle.

Neural tube closure depends on expression of Grainyhead-like 3 in multiple tissues.

Science.gov (United States)

De Castro, Sandra C P; Hirst, Caroline S; Savery, Dawn; Rolo, Ana; Lickert, Heiko; Andersen, Bogi; Copp, Andrew J; Greene, Nicholas D E

2018-03-15

Failure of neural tube closure leads to neural tube defects (NTDs), common congenital abnormalities in humans. Among the genes whose loss of function causes NTDs in mice, Grainyhead-like3 (Grhl3) is essential for spinal neural tube closure, with null mutants exhibiting fully penetrant spina bifida. During spinal neurulation Grhl3 is initially expressed in the surface (non-neural) ectoderm, subsequently in the neuroepithelial component of the neural folds and at the node-streak border, and finally in the hindgut endoderm. Here, we show that endoderm-specific knockout of Grhl3 causes late-arising spinal NTDs, preceded by increased ventral curvature of the caudal region which was shown previously to suppress closure of the spinal neural folds. This finding supports the hypothesis that diminished Grhl3 expression in the hindgut is the cause of spinal NTDs in the curly tail, carrying a hypomorphic Grhl3 allele. Complete loss of Grhl3 function produces a more severe phenotype in which closure fails earlier in neurulation, before the stage of onset of expression in the hindgut of wild-type embryos. This implicates additional tissues and NTD mechanisms in Grhl3 null embryos. Conditional knockout of Grhl3 in the neural plate and node-streak border has minimal effect on closure, suggesting that abnormal function of surface ectoderm, where Grhl3 transcripts are first detected, is primarily responsible for early failure of spinal neurulation in Grhl3 null embryos. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

40 CFR 264.178 - Closure.

Science.gov (United States)

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Use and Management of Containers § 264.178 Closure. At closure, all hazardous waste and hazardous waste residues must be removed...

Closure report for N Reactor

International Nuclear Information System (INIS)

1994-01-01

This report has been prepared to satisfy Section 3156(b) of Public Law 101-189 (Reports in Connection with Permanent Closures of Department of Energy Defense Nuclear Facilities), which requires submittal of a Closure Report to Congress by the Secretary of Energy upon the permanent cessation of production operations at a US Department of Energy (DOE) defense nuclear facility (Watkins 1991). This closure report provides: (1) A complete survey of the environmental problems at the facility; (2) Budget quality data indicating the cost of environmental restoration and other remediation and cleanup efforts at the facility; (3) A proposed cleanup schedule

Closure report for N Reactor

Energy Technology Data Exchange (ETDEWEB)

1994-01-01

This report has been prepared to satisfy Section 3156(b) of Public Law 101-189 (Reports in Connection with Permanent Closures of Department of Energy Defense Nuclear Facilities), which requires submittal of a Closure Report to Congress by the Secretary of Energy upon the permanent cessation of production operations at a US Department of Energy (DOE) defense nuclear facility (Watkins 1991). This closure report provides: (1) A complete survey of the environmental problems at the facility; (2) Budget quality data indicating the cost of environmental restoration and other remediation and cleanup efforts at the facility; (3) A proposed cleanup schedule.

Transcatheter Closure of Patent Ductus Arteriosus in Children with the Occlutech Duct Occluder.

Science.gov (United States)

Bilici, Meki; Demir, Fikri; Akın, Alper; Türe, Mehmet; Balık, Hasan; Kuyumcu, Mahir

2017-12-01

The aim of this study was to evaluate the feasibility, efficacy and safety of transcatheter closure of patent ductus arteriosus (PDA) with the Occlutech duct occluder (ODO) in children. We reviewed the clinical records of 71 patients who underwent percutaneous closure of PDA with an ODO between September 2014 and August 2016. The Occlutech duct occluder was applied to 71 patients during the study period (September 2014-August 2016), and the results were analyzed in this study. Forty-two of the patients were female and 29 male. The median age was 20.5 months (range, 6-194 months) and median weight was 16 kg (range, 6-68 kg). The PDA was classified as type A in 54 patients (76.1%), type E in 14 (19.7%), type C in 2 (2.8%) and type B in 1 (1.4%) based on the Krichenko classification. A standard ODO device was used for the transcatheter closure procedure in 66 patients and the long-shank ODO device in 5. In the echocardiographic measurement of PDA, the median smallest diameter was 2.7 mm (range, 1.5-7.0 mm), and in the angiographic measurement, the median smallest diameter was 2.5 mm (range, 1.5-6.5 mm). All 71 patients underwent successful PDA closure with the ODO. Angiography following the procedure showed complete closure in 47 patients (66.2%), mild residual shunt in 13 patients (18.3%) and a trivial shunt in 11 patients (15.5%). Color flow Doppler echocardiogpaphy at 24 h post-implantation showed that complete closure was achieved in 65 patients (91.5%), and 6 patients (8.5%) had mild residual shunt. All patients (100%) had complete closure at 30 days of follow-up. The results of this study showed that the Occlutech PDA occluder device is safe and effective in the closure of PDA. As the pulmonary artery side of the device is wider than the aortic side, protrusion toward the aortic side and embolization are prevented, but there is residual shunt in the early period, although this residual shunt disappeared after a few months.

Femoral Artery Stenosis Following Percutaneous Closure Using a Starclose Closure Device

International Nuclear Information System (INIS)

Bent, Clare Louise; Kyriakides, Constantinos; Matson, Matthew

2008-01-01

Starclose (Abbott Vascular Devices, Redwood City, CA) is a new arterial closure device that seals a femoral puncture site with an extravascular star-shaped nitinol clip. The clip projects small tines into the arterial wall which fold inward, causing the arterial wall to pucker, producing a purse-string-like seal closing the puncture site. The case history is that of a 76-year-old female patient who underwent day-case percutaneous diagnostic coronary angiography. A Starclose femoral artery closure device was used to achieve hemostasis with subsequent femoral artery stenosis.

9 CFR 318.301 - Containers and closures.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Containers and closures. 318.301... Canning and Canned Products § 318.301 Containers and closures. (a) Examination and cleaning of empty containers. (1) Empty containers, closures, and flexible pouch roll stock shall be evaluated by the...

75 FR 29322 - Base Closure and Realignment

Science.gov (United States)

2010-05-25

... DEPARTMENT OF DEFENSE Office of the Secretary Base Closure and Realignment AGENCY: Office of...)(ii) of the Defense Base Closure and Realignment Act of 1990. It provides a partial list of military installations closing or realigning pursuant to the 2005 Base Closure and Realignment (BRAC) Report. It also...

Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Stroke.

Science.gov (United States)

Saver, Jeffrey L; Carroll, John D; Thaler, David E; Smalling, Richard W; MacDonald, Lee A; Marks, David S; Tirschwell, David L

2017-09-14

Whether closure of a patent foramen ovale reduces the risk of recurrence of ischemic stroke in patients who have had a cryptogenic ischemic stroke is unknown. In a multicenter, randomized, open-label trial, with blinded adjudication of end-point events, we randomly assigned patients 18 to 60 years of age who had a patent foramen ovale (PFO) and had had a cryptogenic ischemic stroke to undergo closure of the PFO (PFO closure group) or to receive medical therapy alone (aspirin, warfarin, clopidogrel, or aspirin combined with extended-release dipyridamole; medical-therapy group). The primary efficacy end point was a composite of recurrent nonfatal ischemic stroke, fatal ischemic stroke, or early death after randomization. The results of the analysis of the primary outcome from the original trial period have been reported previously; the current analysis of data from the extended follow-up period was considered to be exploratory. We enrolled 980 patients (mean age, 45.9 years) at 69 sites. Patients were followed for a median of 5.9 years. Treatment exposure in the two groups was unequal (3141 patient-years in the PFO closure group vs. 2669 patient-years in the medical-therapy group), owing to a higher dropout rate in the medical-therapy group. In the intention-to-treat population, recurrent ischemic stroke occurred in 18 patients in the PFO closure group and in 28 patients in the medical-therapy group, resulting in rates of 0.58 events per 100 patient-years and 1.07 events per 100 patient-years, respectively (hazard ratio with PFO closure vs. medical therapy, 0.55; 95% confidence interval [CI], 0.31 to 0.999; P=0.046 by the log-rank test). Recurrent ischemic stroke of undetermined cause occurred in 10 patients in the PFO closure group and in 23 patients in the medical-therapy group (hazard ratio, 0.38; 95% CI, 0.18 to 0.79; P=0.007). Venous thromboembolism (which comprised events of pulmonary embolism and deep-vein thrombosis) was more common in the PFO closure group

Closure of Myelomeningocele Defects Using a Limberg Flap or Direct Repair

Directory of Open Access Journals (Sweden)

Jung-Hwan Shim

2016-01-01

Full Text Available BackgroundThe global prevalence of myelomeningocele has been reported to be 0.8–1 per 1,000 live births. Early closure of the defect is considered to be the standard of care. Various surgical methods have been reported, such as primary skin closure, local skin flaps, musculocutaneous flaps, and skin grafts. The aim of this study was to describe the clinical characteristics of myelomeningocele defects and present the surgical outcomes of recent cases of myelomeningocele at our institution.MethodsPatients who underwent surgical closure of myelomeningocele at our institution from January 2004 to December 2013 were included in this study. A retrospective chart review of their medical records was performed, and comorbidities, defect size, location, surgical procedures, complications, and the final results were analyzed.ResultsA total of 14 patients underwent surgical closure for myelomeningocele defects. Twelve cases were closed with direct skin repair, while two cases required local skin flaps to cover the skin defects. Three cases of infection occurred, requiring incision and either drainage or removal of allogenic materials. One case of partial flap necrosis occurred, requiring secondary revision using a rotational flap and a full-thickness skin graft. Despite these complications, all wounds eventually healed completely.ConclusionsMost myelomeningocele defects can be managed by direct skin repair alone. In cases of large defects, in which direct repair is not possible, local flaps may be used to cover the defect. Complications such as wound dehiscence and partial flap necrosis occurred in this study; however, all such complications were successfully managed with simple ancillary procedures.

Closure Welding of Plutonium Bearing Storage Containers

International Nuclear Information System (INIS)

Cannell, G.R.

2002-01-01

A key element in the Department of Energy (DOE) strategy for the stabilization, packaging and storage of plutonium-bearing materials involves closure welding of DOE-STD-3013 Outer Containers (3013 container). The 3013 container provides the primary barrier and pressure boundary preventing release of plutonium-bearing materials to the environment. The final closure (closure weld) of the 3013 container must be leaktight, structurally sound and meet DOE STD 3013 specified criteria. This paper focuses on the development, qualification and demonstration of the welding process for the closure welding of Hanford PFP 3013 outer containers

Fuel channel closure and adapter

International Nuclear Information System (INIS)

Cashen, W.S.

1985-01-01

This invention provides a mechanical closure/actuating ram combination particularly suited for use in sealing the ends of the pressure tubes when a CANDU-type reactor is refueled. It provides a cluster that may be inserted into a fuel channel end fitting to provide at least partial closing off of a pressure tube while permitting the disengagement of the fueling machine and its withdrawal from the closure for other purposes. The invention also provides a ram/closure combination wherein the application of loading force to a deformable sealing disk is regulated by a massive load bar component forming part of the fueling machine and being therefore accessible for maintenance or replacement

Restaurant closures

CERN Document Server

Novae Restauration

2012-01-01

Christmas Restaurant closures Please note that the Restaurant 1 and Restaurant 3 will be closed from Friday, 21 December at 5 p.m. to Sunday, 6 January, inclusive. They will reopen on Monday, 7 January 2013.   Restaurant 2 closure for renovation To meet greater demand and to modernize its infrastructure, Restaurant 2 will be closed from Monday, 17 December. On Monday, 14 January 2013, Sophie Vuetaz’s team will welcome you to a renovated self-service area on the 1st floor. The selections on the ground floor will also be expanded to include pasta and pizza, as well as snacks to eat in or take away. To ensure a continuity of service, we suggest you take your break at Restaurant 1 or Restaurant 3 (Prévessin).

Anterior Segment Imaging Predicts Incident Gonioscopic Angle Closure.

Science.gov (United States)

Baskaran, Mani; Iyer, Jayant V; Narayanaswamy, Arun K; He, Yingke; Sakata, Lisandro M; Wu, Renyi; Liu, Dianna; Nongpiur, Monisha E; Friedman, David S; Aung, Tin

2015-12-01

To investigate the incidence of gonioscopic angle closure after 4 years in subjects with gonioscopically open angles but varying degrees of angle closure detected on anterior segment optical coherence tomography (AS OCT; Visante; Carl Zeiss Meditec, Dublin, CA) at baseline. Prospective, observational study. Three hundred forty-two subjects, mostly Chinese, 50 years of age or older, were recruited, of whom 65 were controls with open angles on gonioscopy and AS OCT at baseline, and 277 were cases with baseline open angles on gonioscopy but closed angles (1-4 quadrants) on AS OCT scans. All subjects underwent gonioscopy and AS OCT at baseline (horizontal and vertical single scans) and after 4 years. The examiner performing gonioscopy was masked to the baseline and AS OCT data. Angle closure in a quadrant was defined as nonvisibility of the posterior trabecular meshwork by gonioscopy and visible iridotrabecular contact beyond the scleral spur in AS OCT scans. Gonioscopic angle closure in 2 or 3 quadrants after 4 years. There were no statistically significant differences in age, ethnicity, or gender between cases and controls. None of the control subjects demonstrated gonioscopic angle closure after 4 years. Forty-eight of the 277 subjects (17.3%; 95% confidence interval [CI], 12.8-23; P < 0.0001) with at least 1 quadrant of angle closure on AS OCT at baseline demonstrated gonioscopic angle closure in 2 or more quadrants, whereas 28 subjects (10.1%; 95% CI, 6.7-14.6; P < 0.004) demonstrated gonioscopic angle closure in 3 or more quadrants after 4 years. Individuals with more quadrants of angle closure on baseline AS OCT scans had a greater likelihood of gonioscopic angle closure developing after 4 years (P < 0.0001, chi-square test for trend for both definitions of angle closure). Anterior segment OCT imaging at baseline predicts incident gonioscopic angle closure after 4 years among subjects who have gonioscopically open angles and iridotrabecular contact on AS OCT at

Randomized clinical trial of intestinal ostomy takedown comparing pursestring wound closure vs conventional closure to eliminate the risk of wound infection.

Science.gov (United States)

Camacho-Mauries, Daniel; Rodriguez-Díaz, José Luis; Salgado-Nesme, Noel; González, Quintín H; Vergara-Fernández, Omar

2013-02-01

The use of temporary stomas has been demonstrated to reduce septic complications, especially in high-risk anastomosis; therefore, it is necessary to reduce the number of complications secondary to ostomy takedowns, namely wound infection, anastomotic leaks, and intestinal obstruction. To compare the rates of superficial wound infection and patient satisfaction after pursestring closure of ostomy wound vs conventional linear closure. Patients undergoing colostomy or ileostomy closure between January 2010 and February 2011 were randomly assigned to linear closure (n = 30) or pursestring closure (n = 31) of their ostomy wound. Wound infection within 30 days of surgery was defined as the presence of purulent discharge, pain, erythema, warmth, or positive culture for bacteria. Patient satisfaction, healing time, difficulty managing the wound, and limitation of activities were analyzed with the Likert questionnaire. The infection rate for the control group was 36.6% (n = 11) vs 0% in the pursestring closure group (p ostomy wound closure (shorter healing time and improved patient satisfaction).

Patent ductus arteriosus closure using an Amplatzer(™) ventricular septal defect closure device.

Science.gov (United States)

Fernando, Rajeev; Koranne, Ketan; Loyalka, Pranav; Kar, Biswajit; Gregoric, Igor

2013-01-01

The ductus arteriosus originates from the persistence of the distal portion of the left sixth aortic arch. It connects the descending aorta (immediately distal to the left subclavian artery) to the roof of the main pulmonary artery, near the origin of the left pulmonary artery. Persistence of the duct beyond 48 h after birth is abnormal and results in patent ductus arteriosus (PDA). PDA is rare in adults because it is usually discovered and treated in childhood. Mechanical closure remains the definitive therapy because the patency of ductus arteriosus may lead to multiple complications, depending on the size and flow through the ductus. PDA closure is indicated in patients with symptoms and evidence of left heart enlargement, and in patients with elevated pulmonary pressures when reversal is possible. Transcatheter closure is the preferred technique in adults because it avoids sternotomy, reduces the length of hospital stay and is associated with fewer complications compared with surgery. First demonstrated in 1967, both the technique and the occluder devices used have since evolved. However, designing an ideal PDA occluder has been a challenge due to the variability in size, shape and orientation of PDAs. The present article describes a case involving a 35-year-old woman who presented to the Center for Advanced Heart Failure (Houston, USA) with congestive heart failure due to a large PDA, which was successfully occluded using an Amplatzer (St Jude Medical, USA) muscular ventricular septal defect closure device. The wider waist and dual-retention discs of these ventricular septal defect closure devices may be important factors to consider in the future development of devices for the occlusion of large PDAs.

Temporary Closure of the Open Abdomen: A Systematic Review on Delayed Primary Fascial Closure in Patients with an Open Abdomen

NARCIS (Netherlands)

Boele van Hensbroek, Pieter; Wind, Jan; Dijkgraaf, Marcel G. W.; Busch, Olivier R. C.; Goslings, J. Carel

2009-01-01

Background This study was designed to systematically review the literature to assess which temporary abdominal closure (TAC) technique is associated with the highest delayed primary fascial closure (FC) rate. In some cases of abdominal trauma or infection, edema or packing precludes fascial closure

Special closures for steel drum shipping containers

International Nuclear Information System (INIS)

Bonzon, L.L.; Otts, J.V.

1976-01-01

The objective of this program was to develop special lid closures for typical, steel drum, radioactive material shipping containers. Previous experience and testing had shown that the existing container was adequate to withstand the required environmental tests for certification, but that the lid and closure were just marginally effective. Specifically, the lid closure failed to consistently maintain a tight seal between the container and the lid after drop tests, thus causing the package contents to be vulnerable in the subsequent fire test. Recognizing the deficiency, the United States Energy Research and Development Administration requested the development of new closure(s) which would: (1) be as strong and resistant to a drop as the bottom of the container; (2) have minimal economic impact on the overall container cost; (3) maximize the use of existing container designs; (4) consider crush loads; and (5) result in less dependence on personnel and loading procedures. Several techniques were evaluated and found to be more effective than the standard closure mechanism. Of these, three new closure techniques were designed, fabricated, and proven to be structurally adequate to provide containment when a 454-kg drum was drop tested from 9.14-m onto an unyielding surface. The three designs were: (1) a 152-mm long lid extension or skirt welded to the standard drum lid, (2) a separate inner lid, with 152-mm long skirt and (3) C-clamps used at the container-lid interface. Based upon structural integrity, economic impact, and minimal design change, the lid extension is the recommended special closure

Some Recent Developments in Turbulence Closure Modeling

Science.gov (United States)

Durbin, Paul A.

2018-01-01

Turbulence closure models are central to a good deal of applied computational fluid dynamical analysis. Closure modeling endures as a productive area of research. This review covers recent developments in elliptic relaxation and elliptic blending models, unified rotation and curvature corrections, transition prediction, hybrid simulation, and data-driven methods. The focus is on closure models in which transport equations are solved for scalar variables, such as the turbulent kinetic energy, a timescale, or a measure of anisotropy. Algebraic constitutive representations are reviewed for their role in relating scalar closures to the Reynolds stress tensor. Seamless and nonzonal methods, which invoke a single closure model, are reviewed, especially detached eddy simulation (DES) and adaptive DES. Other topics surveyed include data-driven modeling and intermittency and laminar fluctuation models for transition prediction. The review concludes with an outlook.

The safety and efficacy of hemostasis with Clo-Sur P.A.D. after transcatheter arterial chemoembolization

International Nuclear Information System (INIS)

Jung, Seung Chai; Jae, Hwan Jun; Kim, Sang Youn; Lee, Whal; Chung, Jin Wook; Park, Jae Hyung

2007-01-01

We wanted to evaluate the safety and efficacy of a new hemostatic device, Clo-Sur P.A.D., at an arterial access site after performing femoral arterial catheterization to achieve transcatheter arterial chemoembolization (TACE). From August 2002 to March 2005, 113 patients who underwent TACE and agreed on using the Clo-Sur P.A.D. were enrolled in this study. We evaluated the mean time interval from compression to the first movement and also to the first walk. We also evaluated such complications as rebleeding, pseudoaneurysm, vascular occlusion, hematoma, infection and pain. For 92 patients who had previous experiences with manual compression, we evaluated their preference of hemostatic method by asking them. Successful hemostasis was achieved with the Clo-Sur P.A.D. in 105 subjects (92%). The mean time interval from compression to the first movement was 201 minutes, and that to the first walk was 267 minutes. There was no statistical difference between the complicated and the uncomplicated groups for the mean time, prothrombin time, Child-Pugh class and platelet count (ρ > 0.05). Rebleeding occurred in 3 patients (2.7%) and mild hematoma around puncture site was noted in 5 patients (5.4%). Eighty-seven patients (95%) preferred Clo-Sur P.A.D. to the manual compression method. The Clo-Sur P.A.D. is a safe and effective hemostatic device and it provides early ambulation after TACE

Planning for closures of hazardous waste land disposal units at the Oak Ridge Y-12 plant

International Nuclear Information System (INIS)

Welch, S.H.; Kelly, B.A.; DeLozier, M.F.P.; Manrod, W.E.

1988-01-01

Eight hazardous waste land disposal units at the Oak Ridge Y-12 Plant are being closed in accordance with the Resource Conservation and Recovery Act (RCRA) under an integrated multi-year program. The units, some of which date back to the early 1950s and include five surface impoundments, two landfills and a land treatment unit, have been used for the management of a variety of types of hazardous wastes. Closure plans for the units have been submitted and are in various stages of revision and regulatory review. The units will be closed by various combinations of methods, including liquid removal and treatment, sludge stabilization, contaminated sludge and/or soil removal, and capping. Closure of all eight units must be initiated by November 8, 1988. Funding for the eight closures is being provided by a new Department of Energy budget category, the environmental Restoration Budget Category (ERBC), which is intended to allow for a more rapid response to environmental problems and regulatory requirements. A major project, Closure and Post-Closure Activities (CAPCA) has been identified for ERBC funding to close the land disposal units in accordance with RCRA requirements. Establishing the project scope has required the development of a detailed set of assumptions and a confirmation program for each assumption. Other significant activities in the CAPCA project include risk assessments and the preparation of an integrated project schedule

Analysis of Mining-induced Valley Closure Movements

Science.gov (United States)

Zhang, C.; Mitra, R.; Oh, J.; Hebblewhite, B.

2016-05-01

Valley closure movements have been observed for decades in Australia and overseas when underground mining occurred beneath or in close proximity to valleys and other forms of irregular topographies. Valley closure is defined as the inward movements of the valley sides towards the valley centreline. Due to the complexity of the local geology and the interplay between several geological, topographical and mining factors, the underlying mechanisms that actually cause this behaviour are not completely understood. A comprehensive programme of numerical modelling investigations has been carried out to further evaluate and quantify the influence of a number of these mining and geological factors and their inter-relationships. The factors investigated in this paper include longwall positional factors, horizontal stress, panel width, depth of cover and geological structures around the valley. It is found that mining in a series passing beneath the valley dramatically increases valley closure, and mining parallel to valley induces much more closure than other mining orientations. The redistribution of horizontal stress and influence of mining activity have also been recognised as important factors promoting valley closure, and the effect of geological structure around the valley is found to be relatively small. This paper provides further insight into both the valley closure mechanisms and how these mechanisms should be considered in valley closure prediction models.

Biomechanics Strategies for Space Closure in Deep Overbite

Directory of Open Access Journals (Sweden)

Harryanto Wijaya

2013-07-01

Full Text Available Space closure is an interesting aspect of orthodontic treatment related to principles of biomechanics. It should be tailored individually based on patient’s diagnosis and treatment plan. Understanding the space closure biomechanics basis leads to achieve the desired treatment objective. Overbite deepening and losing posterior anchorage are the two most common unwanted side effects in space closure. Conventionally, correction of overbite must be done before space closure resulted in longer treatment. Application of proper space closure biomechanics strategies is necessary to achieve the desired treatment outcome. This cases report aimed to show the space closure biomechanics strategies that effectively control the overbite as well as posterior anchorage in deep overbite patients without increasing treatment time. Two patients who presented with class II division 1 malocclusion were treated with fixed orthodontic appliance. The primary strategies included extraction space closure on segmented arch that employed two-step space closure, namely single canine retraction simultaneously with incisors intrusion followed by enmasse retraction of four incisors by using differential moment concept. These strategies successfully closed the space, corrected deep overbite and controlled posterior anchorage simultaneously so that the treatment time was shortened. Biomechanics strategies that utilized were effective to achieve the desired treatment outcome.

Magnetisable container closure and means for its removal

International Nuclear Information System (INIS)

Barrett, W.I.

1984-01-01

A container has a closed lower end and an open upper end, is made of a non-magnetic material such as aluminium, and has a peripheral groove spaced from the open end. A disc-like closure is of magnetic material such as ferritic steel, has a pair of spring jaws joined to the disc by a joining member such that when the disc of the closure is in position closing the open end of the container, the jaws engage in groove and hold the closure in position. To remove the closure, it is engaged by magnetic means mounted for example on a wall and having a step such that when the container is moved laterally away the closure is retained by the magnetic means aided by the step and thereby the closure becomes removed from the container. (author)

Urethrovaginal fistula closure.

Science.gov (United States)

Clifton, Marisa M; Goldman, Howard B

2017-01-01

In the developed world, urethrovaginal fistulas are most the likely the result of iatrogenic injury. These fistulas are quite rare. Proper surgical repair requires careful dissection and tension-free closure. The objective of this video is to demonstrate the identification and surgical correction of an urethrovaginal fistula. The case presented is of a 59-year-old woman with a history of pelvic organ prolapse and symptomatic stress urinary incontinence who underwent vaginal hysterectomy, anterior colporrhaphy, posterior colporrhaphy, and synthetic sling placement. Postoperatively, she developed a mesh extrusion and underwent sling excision. After removal of her synthetic sling, she began to experience continuous urinary incontinence. Physical examination and cystourethroscopy demonstrated an urethrovaginal fistula at the midurethra. Options were discussed and the patient wished to undergo transvaginal fistula repair. The urethrovaginal fistula was intubated with a Foley catheter. The fistula tract was isolated and removed. The urethra was then closed with multiple tension-free layers. This video demonstrates several techniques for identifying and subsequently repairing an urethrovaginal fistula. Additionally, it demonstrates the importance of tension-free closure. Urethrovaginal fistulas are rare. They should be repaired with careful dissection and tension-free closure.

Multifilament Cable Wire versus Conventional Wire for Sternal Closure in Patients Undergoing Major Cardiac Surgery

Directory of Open Access Journals (Sweden)

You Na Oh

2015-08-01

Full Text Available Background: Stainless steel wiring remains the most popular technique for primary sternal closure. Recently, a multifilament cable wiring system (Pioneer Surgical Technology Inc., Marquette, MI, USA was introduced for sternal closure and has gained wide acceptance due to its superior resistance to tension. We aimed to compare conventional steel wiring to multifilament cable fixation for sternal closure in patients undergoing major cardiac surgery. Methods: Data were collected retrospectively on 1,354 patients who underwent sternal closure after major cardiac surgery, using either the multifilament cable wiring system or conventional steel wires between January 2009 and October 2010. The surgical outcomes of these two groups of patients were compared using propensity score matching based on 18 baseline patient characteristics. Results: Propensity score matching yielded 392 pairs of patients in the two groups whose baseline profiles showed no significant differences. No significant differences between the two groups were observed in the rates of early mortality (2.0% vs. 1.3%, p=0.578, major wound complications requiring reconstruction (1.3% vs. 1.3%, p＞0.99, minor wound complications (3.6% vs. 2.0%, p=0.279, or mediastinitis (0.8% vs. 1.0%, p=1.00. Patients in the multifilament cable group had fewer sternal bleeding events than those in the conventional wire group, but this tendency was not statistically significant (4.3% vs. 7.4%, p=0.068. Conclusion: The surgical outcomes of sternal closure using multifilament cable wires were comparable to those observed when conventional steel wires were used. Therefore, the multifilament cable wiring system may be considered a viable option for sternal closure in patients undergoing major cardiac surgery.

Multifilament Cable Wire versus Conventional Wire for Sternal Closure in Patients Undergoing Major Cardiac Surgery.

Science.gov (United States)

Oh, You Na; Ha, Keong Jun; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won

2015-08-01

Stainless steel wiring remains the most popular technique for primary sternal closure. Recently, a multifilament cable wiring system (Pioneer Surgical Technology Inc., Marquette, MI, USA) was introduced for sternal closure and has gained wide acceptance due to its superior resistance to tension. We aimed to compare conventional steel wiring to multifilament cable fixation for sternal closure in patients undergoing major cardiac surgery. Data were collected retrospectively on 1,354 patients who underwent sternal closure after major cardiac surgery, using either the multifilament cable wiring system or conventional steel wires between January 2009 and October 2010. The surgical outcomes of these two groups of patients were compared using propensity score matching based on 18 baseline patient characteristics. Propensity score matching yielded 392 pairs of patients in the two groups whose baseline profiles showed no significant differences. No significant differences between the two groups were observed in the rates of early mortality (2.0% vs. 1.3%, p=0.578), major wound complications requiring reconstruction (1.3% vs. 1.3%, p>0.99), minor wound complications (3.6% vs. 2.0%, p=0.279), or mediastinitis (0.8% vs. 1.0%, p=1.00). Patients in the multifilament cable group had fewer sternal bleeding events than those in the conventional wire group, but this tendency was not statistically significant (4.3% vs. 7.4%, p=0.068). The surgical outcomes of sternal closure using multifilament cable wires were comparable to those observed when conventional steel wires were used. Therefore, the multifilament cable wiring system may be considered a viable option for sternal closure in patients undergoing major cardiac surgery.

Closure of shallow underground injection wells

International Nuclear Information System (INIS)

Veil, J.A.; Grunewald, B.

1993-01-01

Shallow injection wells have long been used for disposing liquid wastes. Some of these wells have received hazardous or radioactive wastes. According to US Environmental Protection Agency (EPA) regulations, Class IV wells are those injection wells through which hazardous or radioactive wastes are injected into or above an underground source of drinking water (USDW). These wells must be closed. Generally Class V wells are injection wells through which fluids that do not contain hazardous or radioactive wastes are injected into or above a USDW. Class V wells that are responsible for violations of drinking water regulations or that pose a threat to human health must also be closed. Although EPA regulations require closure of certain types of shallow injection wells, they do not provide specific details on the closure process. This paper describes the regulatory background, DOE requirements, and the steps in a shallow injection well closure process: Identification of wells needing closure; monitoring and disposal of accumulated substances; filling and sealing of wells; and remediation. In addition, the paper describes a major national EPA shallow injection well enforcement initiative, including closure plan guidance for wells used to dispose of wastes from service station operations

Reliability assessment of underground shaft closure

International Nuclear Information System (INIS)

Fossum, A.F.; Munson, D.E.

1994-01-01

The intent of the WIPP, being constructed in the bedded geologic salt deposits of Southeastern New Mexico, is to provide the technological basis for the safe disposal of radioactive Transuranic (TRU) wastes generated by the defense programs of the United States. In determining this technological basis, advanced reliability and structural analysis techniques are used to determine the probability of time-to-closure of a hypothetical underground shaft located in an argillaceous salt formation and filled with compacted crushed salt. Before being filled with crushed salt for sealing, the shaft provides access to an underground facility. Reliable closure of the shaft depends upon the sealing of the shaft through creep closure and recompaction of crushed backfill. Appropriate methods are demonstrated to calculate cumulative distribution functions of the closure based on laboratory determined random variable uncertainty in salt creep properties

Response of Mediterranean circulation to Miocene shoaling and closure of the Indian Gateway : A model study

NARCIS (Netherlands)

De La Vara, Alba; Meijer, Paul

2016-01-01

In this regional ocean model study, we explore the effect of the Early to Middle Miocene shoaling and closure of the Indian Gateway on Mediterranean circulation and its exchange with the adjacent oceans. For this we use the regional ocean circulation model "sbPOM" and a collection of bathymetries

Comparison of cost-effectiveness and postoperative outcome of device closure and open surgery closure techniques for treatment of patent ductus arteriosus

Directory of Open Access Journals (Sweden)

Alireza Ahmadi

2014-01-01

Full Text Available BACKGROUND: Various devices have been recently employed for percutaneous closure of the patent ductus arteriosus (PDA. Although the high effectiveness of device closure techniques has been clearly determined, a few studies have focused on the cost-effectiveness and also postoperative complications of these procedures in comparison with open surgery. The present study aimed to evaluate the clinical outcome and cost-effectiveness of PDA occlusion by Amplatzer and coil device in comparisong with open surgery. METHODS: In this cross-sectional study, a randomized sample of 201 patients aged 1 month to 16 years (105 patients with device closure and 96 patients with surgical closure was selected. The ratio of total pulmonary blood flow to total systemic blood flow, the Qp/Qs ratio, was measured using a pulmonary artery catheter. The cost analysis included direct medical care costs associated with device implantation and open surgery, as well as professional fees. All costs were calculated in Iranian Rials and then converted to US dollars. RESULTS: There was no statistical difference in mean Qp/Qs ratio before the procedure between the device closure group and the open surgery group (2.1 ± 0.7 versus 1.7 ± 0.6, P = 0.090. The mean measured costs were overall higher in the device closure group than in open closure group (948.87 ± 548.76 US$ versus 743.70 ± 696.91 US$, P < 0.001. This difference remained significant after adjustment for age and gender (Standardized Beta = 0.160, P = 0.031. PDA closure with the Amplatzer ductal occluder (1053.05 ± 525.73 US$ or with Nit-Occlud coils (PFM (912.73 ± 565.94 US$, P < 0.001 was more expensive than that via open surgery. However, the Cook detachable spring coils device closure (605.65 ± 194.62 US$, P = 0.650 had a non-significant cost difference with open surgery. No event was observed in the device closure group regarding in-hospital mortality or morbidity; however, in another group, 2 in-hospital deaths

Numerical approximation of the Boltzmann equation : moment closure

NARCIS (Netherlands)

Abdel Malik, M.R.A.; Brummelen, van E.H.

2012-01-01

This work applies the moment method onto a generic form of kinetic equations to simplify kinetic models of particle systems. This leads to the moment closure problem which is addressed using entropy-based moment closure techniques utilizing entropy minimization. The resulting moment closure system

WASTE PACKAGE OPERATIONS FY99 CLOSURE METHODS REPORT

Energy Technology Data Exchange (ETDEWEB)

M. C. Knapp

1999-09-23

The waste package (WP) closure weld development task is part of a larger engineering development program to develop waste package designs. The purpose of the larger waste package engineering development program is to develop nuclear waste package fabrication and closure methods that the Nuclear Regulatory Commission will find acceptable and will license for disposal of spent nuclear fuel (SNF), non-fuel components, and vitrified high-level waste within a Monitored Geologic Repository (MGR). Within the WP closure development program are several major development tasks, which, in turn, are divided into subtasks. The major tasks include: WP fabrication development, WP closure weld development, nondestructive examination (NDE) development, and remote in-service inspection development. The purpose of this report is to present the objectives, technical information, and work scope relating to the WP closure weld development.and NDE tasks and subtasks and to report results of the closure weld and NDE development programs for fiscal year 1999 (FY-99). The objective of the FY-99 WP closure weld development task was to develop requirements for closure weld surface and volumetric NDE performance demonstrations, investigate alternative NDE inspection techniques, and develop specifications for welding, NDE, and handling system integration. In addition, objectives included fabricating several flat plate mock-ups that could be used for NDE development, stress relief peening, corrosion testing, and residual stress testing.

WASTE PACKAGE OPERATIONS FY-99 CLOSURE METHODS REPORT

International Nuclear Information System (INIS)

M. C. Knapp

1999-01-01

The waste package (WP) closure weld development task is part of a larger engineering development program to develop waste package designs. The purpose of the larger waste package engineering development program is to develop nuclear waste package fabrication and closure methods that the Nuclear Regulatory Commission will find acceptable and will license for disposal of spent nuclear fuel (SNF), non-fuel components, and vitrified high-level waste within a Monitored Geologic Repository (MGR). Within the WP closure development program are several major development tasks, which, in turn, are divided into subtasks. The major tasks include: WP fabrication development, WP closure weld development, nondestructive examination (NDE) development, and remote in-service inspection development. The purpose of this report is to present the objectives, technical information, and work scope relating to the WP closure weld development.and NDE tasks and subtasks and to report results of the closure weld and NDE development programs for fiscal year 1999 (FY-99). The objective of the FY-99 WP closure weld development task was to develop requirements for closure weld surface and volumetric NDE performance demonstrations, investigate alternative NDE inspection techniques, and develop specifications for welding, NDE, and handling system integration. In addition, objectives included fabricating several flat plate mock-ups that could be used for NDE development, stress relief peening, corrosion testing, and residual stress testing

T-tube vs Primary Common Bile Duct Closure

Directory of Open Access Journals (Sweden)

M R Joshi

2010-09-01

Full Text Available INTRODUCTION: Closure of the common bile duct over T-tube after exploration is a widely practiced traditional method. However, its use may give rise to many complications. We do primary closure of common bile duct after exploration. Aim of the study is to see the efficacy and safety of the primary closure. METHODS: Study was carried out to compare the results of both the techniques from 2006 to 2009 in the cases proven to have common bile duct stone with or without the features of obstructive jaundice. Post operative hospital stay and morbidities related to both the groups were recorded and analyzed. RESULTS: There were total 71 cases included in the study. Thirty one in T-tube group and 40 in primary closure group. T-tube was removed in most of the cases after three weeks where as average time of drain removal in primary closure group is 5.79 +/-1.79 days. Incidence of retained stone was equal in each group. Major complication in T-tube group is biliary peritonitis in four patients at the time of T-tube removal whereas none of the patient from primary closure group suffered from such major complication. CONCLUSIONS: Primary closure after the common bile duct exploration is safe and it helps to avoid the morbidities related to T-tube. Keywords: Choledocholithiasis, Primary closure, retained stone, T-tube, Ureterorenoscope.

Initial experience with the Cardiva Boomerang vascular closure device in diagnostic catheterization.

Science.gov (United States)

Doyle, Brendan J; Godfrey, Michael J; Lennon, Ryan J; Ryan, James L; Bresnahan, John F; Rihal, Charanjit S; Ting, Henry H

2007-02-01

The authors studied the safety and efficacy of the Cardiva Boomerang vascular closure device in patients undergoing diagnostic cardiac catheterization. Conventional vascular closure devices (sutures, collagen plugs, or metal clips) have been associated with catastrophic complications including arterial occlusion and foreign body infections; furthermore, they cannot be utilized in patients with peripheral vascular disease or vascular access site in a vessel other than the common femoral artery. The Cardiva Boomerang device facilitates vascular hemostasis without leaving any foreign body behind at the access site, can be used in peripheral vascular disease, and can be used in vessels other than the common femoral artery A total of 96 patients undergoing transfemoral diagnostic cardiac catheterization were included in this study, including 25 (26%) patients with contraindications to conventional closure devices. Femoral angiography was performed prior to deployment of the Cardiva Boomerang closure device. Patients were ambulated at 1 hr after hemostasis was achieved. The device was successfully deployed and hemostasis achieved with the device alone in 95 (99%) patients. The device failed to deploy in 1 (1%) patient and required conversion to standard manual compression. Minor complications were observed in 5 (5%) patients. No patients experienced major complications including femoral hematoma > 4 cm, red blood cell transfusion, retroperitoneal bleed, arteriovenous fistula, pseudoaneurysm, infection, arterial occlusion, or vascular surgery. The Cardiva Boomerang device is safe and effective in patients undergoing diagnostic cardiac catheterization using the transfemoral approach, facilitating early ambulation with low rates of vascular complications. (c) 2006 Wiley-Liss, Inc.

Relationships between basin architecture, basin closure, and occurrence of sulphide-bearing schists: an example from Tampere Schist Belt, Finland

DEFF Research Database (Denmark)

Kalliomäki, Henrik; Torvela, Taija; Moreau, Julien

, therefore, offers an excellent opportunity to examine the volcano-sedimentary evolution of an ancient marginal basin, and the mechanics of and strain distribution during its subsequent closure. The aim of this study is to investigate the structural development and the architecture of a part of the TSB...... in more detail, including the relationships between the volcano-sedimentary sequences, the tectonic structures, and the sulphide-bearing schist horizons. Important insights are gained into understanding the mechanisms of the basin closure and the localisation of the sulphide mineralisation within......, in order to accommodate the crustal shortening during basin closure. Furthermore, it is suggested that there is a genetic relationship between the interpreted palaeothrusts and the sulphide-bearing schist horizons in the study area: early, gently dipping thrusts acted as both channels and traps...

Uncertainty Quantification of Multi-Phase Closures

Energy Technology Data Exchange (ETDEWEB)

Nadiga, Balasubramanya T. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Baglietto, Emilio [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States)

2017-10-27

In the ensemble-averaged dispersed phase formulation used for CFD of multiphase ows in nuclear reactor thermohydraulics, closures of interphase transfer of mass, momentum, and energy constitute, by far, the biggest source of error and uncertainty. Reliable estimators of this source of error and uncertainty are currently non-existent. Here, we report on how modern Validation and Uncertainty Quanti cation (VUQ) techniques can be leveraged to not only quantify such errors and uncertainties, but also to uncover (unintended) interactions between closures of di erent phenomena. As such this approach serves as a valuable aide in the research and development of multiphase closures. The joint modeling of lift, drag, wall lubrication, and turbulent dispersion|forces that lead to tranfer of momentum between the liquid and gas phases|is examined in the frame- work of validation of the adiabatic but turbulent experiments of Liu and Banko , 1993. An extensive calibration study is undertaken with a popular combination of closure relations and the popular k-ϵ turbulence model in a Bayesian framework. When a wide range of super cial liquid and gas velocities and void fractions is considered, it is found that this set of closures can be validated against the experimental data only by allowing large variations in the coe cients associated with the closures. We argue that such an extent of variation is a measure of uncertainty induced by the chosen set of closures. We also nd that while mean uid velocity and void fraction pro les are properly t, uctuating uid velocity may or may not be properly t. This aspect needs to be investigated further. The popular set of closures considered contains ad-hoc components and are undesirable from a predictive modeling point of view. Consequently, we next consider improvements that are being developed by the MIT group under CASL and which remove the ad-hoc elements. We use non-intrusive methodologies for sensitivity analysis and calibration (using

Factors affecting closure of a temporary stoma.

Science.gov (United States)

Taylor, Claire; Varma, Sarah

2012-01-01

The purpose of the study was to examine time to reversal of a temporary ostomy, reasons for delayed closure, and patient satisfaction with the scheduling of their closure and related hospital care. Cross-sectional, descriptive study. The target population comprised patients who underwent creation of a temporary ostomy and reversal surgery within one National Health System Hospital Trust in the United Kingdom. The population served by this Trust are ethnically and socioeconomically diverse, predominantly living in urban areas around Greater London. Sixty-one persons who met inclusion criteria were identified. A two-step analytical process was undertaken. First, a literature review examining incidence and causes of delayed stoma closure was undertaken. Second, a postal survey of all patients who had had their stoma closed in 2009 was conducted. Respondents were allowed 2 weeks to complete and return the questionnaire. The survey instrument was developed locally and subjected to content validation using ostomy patients, surgical and nursing colleagues. It consisted of 9 questions querying time from original surgery to closure, reasons for delaying closure surgery beyond 12 weeks, and satisfaction with care. Twenty-seven patients returned their questionnaires, indicating they consented to participate; a response rate of 44%. Half of the respondents (n = 14 [52%]) underwent closure surgery within 6 months of stoma formation; the remaining 48% waited more than 6 months (median: 6.5 months, range: 1.5-26 months). Thirteen patients (48%) reported a delay in receiving their stoma closure; the main reason cited was the need for a course of adjuvant postoperative chemotherapy. Three quarters of respondents (22 [74%]) were satisfied with the overall care they received. Findings from this study suggest that stoma closure may be associated with fewest complications if performed before 12 weeks.

以家庭为中心的护理指导在肠造口患儿家庭中的应用效果%Effect of the family-centered care guidance on the families with enterostomy children

Institute of Scientific and Technical Information of China (English)

肖方; 曾战东; 李婉丽

2017-01-01

Objective:To explore the effects of the family-centered care guidance on the enterostomy children and their patient.Methods:The data of 52 children treated with enterostomy and their parent were collected using the method of convenient sampling from January 2014 to May 2015,and the parent were intervened with the family-centered care mode.The psychological condition and disease awareness of parents were evaluated before and after intervention.Results:During the intervention,5 cases with skin dermatitis around stoma were found,and which was improved after care guidance.The scores of anxiety and depression of parent after intervention were significantly lower than those before intervention(P<0.01).The awareness of pediatric colostomy nursing knowledge in parent after intervention was significantly higher than those before intervention(P<0.01).Conclusions:The family-centered care mode can effectively alleviate the psychological burden of parent,significantly improve the ability of taking care of infants with stoma of parent,and reduce the postoperative complications.%目的:探讨以家庭为中心的护理指导在小儿肠造口护理和患儿家庭中的应用效果.方法:采用方便抽样方法,选取2014年1月至2015年5月行肠造口手术的52例患儿及其家长,采用以家庭为中心的护理模式对家长进行干预,评估干预前后患儿家长的心理状况和患儿家长对疾病的知晓率.结果:干预期间,仅有5例患儿造口周围皮肤发生皮炎,给予护理指导后好转.患儿家长干预后的焦虑和抑郁得分均显著低于干预前(P<0.01),干预后患儿家长关于小儿肠造口护理知识的知晓率均显著高于干预前(P<0.01).结论:以家庭为中心的护理干预方案能有效减轻患儿家长的不良心理症状,明显提高患儿家长照护患儿的能力,大大减少患儿术后并发症的发生.

CIRSE Vascular Closure Device Registry

International Nuclear Information System (INIS)

Reekers, Jim A.; Müller-Hülsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zeleňák, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

2011-01-01

Purpose: Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. Methods: The CIRSE registry of closure devices with an anchor and a plug started in January 2009 and ended in August 2009. A total of 1,107 patients were included in the registry. Results: Deployment success was 97.2%. Deployment failure specified to access type was 8.8% [95% confidence interval (95% CI) 5.0–14.5] for antegrade access and 1.8% (95% CI 1.1–2.9) for retrograde access (P = 0.001). There was no difference in deployment failure related to local PVD at the access site. Calcification was a reason for deployment failure in only 5.9 cm, and two vessel occlusions. Conclusion: The conclusion of this registry of closure devices with an anchor and a plug is that the use of this device in interventional radiology procedures is safe, with a low incidence of serious access site complications. There seems to be no difference in complications between antegrade and retrograde access and other parameters.

40 CFR 267.143 - Financial assurance for closure.

Science.gov (United States)

2010-07-01

...), utilizing the certificate of insurance for closure specified at 40 CFR 264.151(e). (f) Corporate financial... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Financial assurance for closure. 267... PERMIT Financial Requirements § 267.143 Financial assurance for closure. The owner or operator must...

Closure plan for the proposed Millennium Project

International Nuclear Information System (INIS)

Tuttle, S.; Sisson, R.

1999-01-01

A $2.2 billion expansion of the current oil sands operation has been proposed by Suncor Energy Inc. The expansion would more than double the productive capacity of the present facility. As part of the application for this expansion, called Project Millennium, a comprehensive closure plan has been developed and filed by the Corporation. The Plan includes a systematic evaluation of the area to be developed, a description of the development activities planned, and the goals and objectives of the Corporation in re-establishing the landforms and ecosystems concurrently with running the operation. The Plan envisages surface contouring as early as practicable during the mine development, soil reconstruction, and re-establishment of vegetation, surface drainage and wetlands. The Corporation undertakes to monitor the performance of the reclaimed areas based on landform performance, the impact of chemical constituents on the landscape and ecosystem sustainability. An annual monitoring report assessing herbaceous vegetation growth, major species composition, tree and shrub survival and growth rate, groundwater conditions, amount of precipitation, the utility of constructed wetlands for treatment of reclamation area seepage and runoff waters, and wildlife population changes, will be prepared annually. A future research program associated with the Reclamation and Closure Plan will also examine the effectiveness of the reclamation drainage system as fish habitat, and the potential of the proposed end-pit lake to provide a viable aquatic ecosystem. 8 refs., 2 figs

Tubular closure mechanism

International Nuclear Information System (INIS)

Kalen, D.D.; Mitchem, J.W.

1982-01-01

This invention relates to a closure mechanism for tubular irradiation surveillance specimen assembly holder used in nuclear reactors. The closure mechanism is composed of a latching member which includes a generally circular chamber with a plurality of elongated latches depending therefrom. The latching member circumscribes part of an actuator member which is disposed within the latching member so as to be axially movable. The axial movement of the actuator actuates positioning of the latches between positions in which the latches are locked and secured within the actuator member. Means, capable of being remotely manipulated, are provided to move the actuator in order to position the latches and load the articles within the tube

Design and analysis of PCRV core cavity closure

International Nuclear Information System (INIS)

Lee, T.T.; Schwartz, A.A.; Koopman, D.C.A.

1980-05-01

Design requirements and considerations for a core cavity closure which led to the choice of a concrete closure with a toggle hold-down as the design for the Gas-Cooled Fast Breeder Reactor (GCFR) plant are discussed. A procedure for preliminary stress analysis of the closure by means of a three-dimensional finite element method is described. A limited parametric study using this procedure indicates the adequacy of the present closure design and the significance of radial compression developed as a result of inclined support reaction

40 CFR 265.280 - Closure and post-closure.

Science.gov (United States)

2010-07-01

... contaminants caused by wind erosion; and (4) Compliance with § 265.276 concerning the growth of food-chain... and post-closure care objectives of paragraph (a) of this section: (1) Type and amount of hazardous..., including amount, frequency, and pH of precipitation; (5) Geological and soil profiles and surface and...

Site closure and perpetual care of a low-level radioactive waste disposal facility in semi-arid climate

International Nuclear Information System (INIS)

Singh, P.N.; Breeden, K.H.; Hana, S.L.A.

1988-01-01

A study has been performed on site closure and perpetual care and maintenance requirements for the commercially operated low-level radioactive waste (LLRW) disposal facility, referred to as the Richland Facility, on the Hanford Reservation near Richland, Washington. The study included a site assessment and identification and formulation of site specific design elements for closure and perpetual care and maintenance. This paper summarizes the observations, findings and conclusions resulting from Phase I of this study. Three release mechanisms and four destructive processes are considered in the conceptual closure design process. The release mechanisms considered include subsurface liquid movement, biological transport of wastes to the surface and subsurface gas movement. The destructive processes considered are wind erosion, biological penetration or damage of cover, vegetation destroying processes and subsidence and seismic activity. The closure design elements were developed with several key principles in mind. The primary goals were to prevent intrusion into, or exposure of, the waste; to prevent or minimize release from the trenches; to provide early warning of any release that should occur; and to provide definitive information as to whether or not any observed environmental contamination actually originated from the facility

Airport Movement Area Closure Planner, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — This SBIR research develops an automation tool improving temporary and permanent runway closure management. The Movement Area Closure Planner (MACP) provides airport...

Left ventricular remodeling and change of systolic function after closure of patent ductus arteriosus in adults: device and surgical closure.

Science.gov (United States)

Jeong, Young-Hoon; Yun, Tae-Jin; Song, Jong-Min; Park, Jung-Jun; Seo, Dong-Man; Koh, Jae-Kon; Lee, Se-Whan; Kim, Mi-Jeong; Kang, Duk-Hyun; Song, Jae-Kwan

2007-09-01

Left ventricular (LV) remodeling and predictors of LV systolic function late after closure of patent ductus arteriosus (PDA) in adults remain to be clearly demonstrated. In 45 patients with PDA, including 28 patients who received successful occlusion using the Amplatzer device (AD group) (AGA, Golden Valley, MN) and 17 patients who received surgical closure (OP group), echocardiography studies were performed before closure and 1 day (AD group) or within 7 days (OP group) after closure, and then were repeated at > or = 6 months (17 +/- 13 months). In both groups, LV ejection fraction (EF) and end-diastolic volume index were significantly decreased immediately after closure, whereas end-systolic volume index did not change. During the long-term follow-up period, end-systolic as well as end-diastolic volume indices decreased significantly in both groups and LV EF recovered compared to the immediate postclosure state. However, LV EF remained low compared to the preclosure state. Five patients (11.1%) including 3 patients in the AD group and 2 patients in the OP group showed persistent late LV systolic dysfunction (EF or = 62% had a sensitivity of 72% and a specificity of 83% for predicting late normal LV EF after closure. Left ventricular EF remains low late after PDA closure compared with preclosure state in adults. Preclosure LV EF is the best index to predict late postclosure LV EF.

Nickel titanium springs versus stainless steel springs: A randomized clinical trial of two methods of space closure.

Science.gov (United States)

Norman, Noraina Hafizan; Worthington, Helen; Chadwick, Stephen Mark

2016-09-01

To compare the clinical performance of nickel titanium (NiTi) versus stainless steel (SS) springs during orthodontic space closure. Two-centre parallel group randomized clinical trial. Orthodontic Department University of Manchester Dental Hospital and Orthodontic Department Countess of Chester Hospital, United Kingdom. Forty orthodontic patients requiring fixed appliance treatment were enrolled, each being randomly allocated into either NiTi (n = 19) or SS groups (n = 21). Study models were constructed at the start of the space closure phase (T0) and following the completion of space closure (T1). The rate of space closure achieved for each patient was calculated by taking an average measurement from the tip of the canine to the mesiobuccal groove on the first permanent molar of each quadrant. The study was terminated early due to time constraints. Only 30 patients completed, 15 in each study group. There was no statistically significant difference between the amounts of space closed (mean difference 0.17 mm (95%CI -0.99 to 1.34; P = 0.76)). The mean rate of space closure for NiTi coil springs was 0.58 mm/4 weeks (SD 0.24) and 0.85 mm/4 weeks (SD 0.36) for the stainless steel springs. There was a statistically significant difference between the two groups (P = 0.024), in favour of the stainless steel springs, when the mean values per patient were compared. Our study shows that stainless steel springs are clinically effective; these springs produce as much space closure as their more expensive rivals, the NiTi springs.

Single-site neural tube closure in human embryos revisited.

Science.gov (United States)

de Bakker, Bernadette S; Driessen, Stan; Boukens, Bastiaan J D; van den Hoff, Maurice J B; Oostra, Roelof-Jan

2017-10-01

Since the multi-site closure theory was first proposed in 1991 as explanation for the preferential localizations of neural tube defects, the closure of the neural tube has been debated. Although the multi-site closure theory is much cited in clinical literature, single-site closure is most apparent in literature concerning embryology. Inspired by Victor Hamburgers (1900-2001) statement that "our real teacher has been and still is the embryo, who is, incidentally, the only teacher who is always right", we decided to critically review both theories of neural tube closure. To verify the theories of closure, we studied serial histological sections of 10 mouse embryos between 8.5 and 9.5 days of gestation and 18 human embryos of the Carnegie collection between Carnegie stage 9 (19-21 days) and 13 (28-32 days). Neural tube closure was histologically defined by the neuroepithelial remodeling of the two adjoining neural fold tips in the midline. We did not observe multiple fusion sites in neither mouse nor human embryos. A meta-analysis of case reports on neural tube defects showed that defects can occur at any level of the neural axis. Our data indicate that the human neural tube fuses at a single site and, therefore, we propose to reinstate the single-site closure theory for neural tube closure. We showed that neural tube defects are not restricted to a specific location, thereby refuting the reasoning underlying the multi-site closure theory. Clin. Anat. 30:988-999, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Moment Closure for the Stochastic Logistic Model

National Research Council Canada - National Science Library

Singh, Abhyudai; Hespanha, Joao P

2006-01-01

..., which we refer to as the moment closure function. In this paper, a systematic procedure for constructing moment closure functions of arbitrary order is presented for the stochastic logistic model...

Comparison of cost-effectiveness and postoperative outcome of device closure and open surgery closure techniques for treatment of patent ductus arteriosus.

Science.gov (United States)

Ahmadi, Alireza; Sabri, Mohammadreza; Bigdelian, Hamid; Dehghan, Bahar; Gharipour, Mojgan

2014-01-01

Various devices have been recently employed for percutaneous closure of the patent ductus arteriosus (PDA). Although the high effectiveness of device closure techniques has been clearly determined, a few studies have focused on the cost-effectiveness and also postoperative complications of these procedures in comparison with open surgery. The present study aimed to evaluate the clinical outcome and cost-effectiveness of PDA occlusion by Amplatzer and coil device in comparisong with open surgery. In this cross-sectional study, a randomized sample of 201 patients aged 1 month to 16 years (105 patients with device closure and 96 patients with surgical closure) was selected. The ratio of total pulmonary blood flow to total systemic blood flow, the Qp/Qs ratio, was measured using a pulmonary artery catheter. The cost analysis included direct medical care costs associated with device implantation and open surgery, as well as professional fees. All costs were calculated in Iranian Rials and then converted to US dollars. There was no statistical difference in mean Qp/Qs ratio before the procedure between the device closure group and the open surgery group (2.1 ± 0.7 versus 1.7 ± 0.6, P = 0.090). The mean measured costs were overall higher in the device closure group than in open closure group (948.87 ± 548.76 US$ versus 743.70 ± 696.91 US$, P gender (Standardized Beta = 0.160, P = 0.031). PDA closure with the Amplatzer ductal occluder (1053.05 ± 525.73 US$) or with Nit-Occlud coils (PFM) (912.73 ± 565.94 US$, P < 0.001) was more expensive than that via open surgery. However, the Cook detachable spring coils device closure (605.65 ± 194.62 US$, P = 0.650) had a non-significant cost difference with open surgery. No event was observed in the device closure group regarding in-hospital mortality or morbidity; however, in another group, 2 in-hospital deaths occurred, two patients experienced pneumonia and seizure, and one suffered electrolyte abnormalities including

Mass extraction container closure integrity physical testing method development for parenteral container closure systems.

Science.gov (United States)

Yoon, Seung-Yil; Sagi, Hemi; Goldhammer, Craig; Li, Lei

2012-01-01

Container closure integrity (CCI) is a critical factor to ensure that product sterility is maintained over its entire shelf life. Assuring the CCI during container closure (C/C) system qualification, routine manufacturing and stability is important. FDA guidance also encourages industry to develop a CCI physical testing method in lieu of sterility testing in a stability program. A mass extraction system has been developed to check CCI for a variety of container closure systems such as vials, syringes, and cartridges. Various types of defects (e.g., glass micropipette, laser drill, wire) were created and used to demonstrate a detection limit. Leakage, detected as mass flow in this study, changes as a function of defect length and diameter. Therefore, the morphology of defects has been examined in detail with fluid theories. This study demonstrated that a mass extraction system was able to distinguish between intact samples and samples with 2 μm defects reliably when the defect was exposed to air, water, placebo, or drug product (3 mg/mL concentration) solution. Also, it has been verified that the method was robust, and capable of determining the acceptance limit using 3σ for syringes and 6σ for vials. Sterile products must maintain their sterility over their entire shelf life. Container closure systems such as those found in syringes and vials provide a seal between rubber and glass containers. This seal must be ensured to maintain product sterility. A mass extraction system has been developed to check container closure integrity for a variety of container closure systems such as vials, syringes, and cartridges. In order to demonstrate the method's capability, various types of defects (e.g., glass micropipette, laser drill, wire) were created in syringes and vials and were tested. This study demonstrated that a mass extraction system was able to distinguish between intact samples and samples with 2 μm defects reliably when the defect was exposed to air, water

105-DR Large Sodium Fire Facility closure activities evaluation report

International Nuclear Information System (INIS)

Adler, J.G.

1996-01-01

This report evaluates the closure activities at the 105-DR Large Sodium Fire Facility. The closure activities discussed include: the closure activities for the structures, equipment, soil, and gravel scrubber; decontamination methods; materials made available for recycling or reuse; and waste management. The evaluation compares these activities to the regulatory requirements and closure plan requirements. The report concludes that the areas identified in the closure plan can be clean closed

Storage shaft definitive closure plug and method

International Nuclear Information System (INIS)

Dardaine, M.

1992-01-01

A definitive closure plug system for radioactive waste storage at any deepness, is presented. The inherent weight of the closure materials is used to set in the plug: these materials display an inclined sliding surface in such a way that when the closure material rests on a stable surface of the shaft storage materials, the relative sliding of the different materials tends to spread them towards the shaft internal wall so as to completely occlude the shaft

Laser peripheral iridoplasty for angle-closure.

Science.gov (United States)

Ng, Wai Siene; Ang, Ghee Soon; Azuara-Blanco, Augusto

2012-02-15

Angle-closure glaucoma is a leading cause of irreversible blindness in the world. Treatment is aimed at opening the anterior chamber angle and lowering the IOP with medical and/or surgical treatment (e.g. trabeculectomy, lens extraction). Laser iridotomy works by eliminating pupillary block and widens the anterior chamber angle in the majority of patients. When laser iridotomy fails to open the anterior chamber angle, laser iridoplasty may be recommended as one of the options in current standard treatment for angle-closure. Laser peripheral iridoplasty works by shrinking and pulling the peripheral iris tissue away from the trabecular meshwork. Laser peripheral iridoplasty can be used for crisis of acute angle-closure and also in non-acute situations.   To assess the effectiveness of laser peripheral iridoplasty in the treatment of narrow angles (i.e. primary angle-closure suspect), primary angle-closure (PAC) or primary angle-closure glaucoma (PACG) in non-acute situations when compared with any other intervention. In this review, angle-closure will refer to patients with narrow angles (PACs), PAC and PACG. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2011, Issue 12), MEDLINE (January 1950 to January 2012), EMBASE (January 1980 to January 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to January 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 5 January 2012. We included only randomised controlled trials (RCTs) in this review. Patients with narrow angles, PAC or PACG were eligible. We excluded studies that included only patients with acute presentations

The potential migration effect of rural hospital closures

DEFF Research Database (Denmark)

Sørensen, Jens Fyhn Lykke

2008-01-01

to out-migration, although the hypothetical way of questioning leaves uncertainty about the actual scale of out-migration. Child families appear to be the most likely out-migrants. Elderly people may be hardest hit by a hospital closure, being most reliant on health care and least inclined to move away.......Rural hospital closures are high on the current health care agenda in Denmark. One raised concern is that rural hospital closures may further decrease population numbers in rural areas, as closures may induce some residents to move away from affected areas, i.e. closer to health care services...

Early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma: an economic evaluation based on data from the EAGLE trial

Science.gov (United States)

Javanbakht, Mehdi; Azuara-Blanco, Augusto; Burr, Jennifer M; Ramsay, Craig; Cooper, David; Cochran, Claire; Norrie, John; Scotland, Graham

2017-01-01

Objective To investigate the cost-effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma (PACG) compared to standard care. Design Cost-effectiveness analysis alongside a multicentre pragmatic two-arm randomised controlled trial. Patients were followed-up for 36 months, and data on health service usage and health state utility were collected and analysed within the trial time horizon. A Markov model was developed to extrapolate the results over a 5-year and 10-year time horizon. Setting 22 hospital eye services in the UK. Population Males and females aged 50 years or over with newly diagnosed PACG or primary angle closure (PAC). Interventions Lens extraction compared to standard care (ie, laser iridotomy followed by medical therapy and glaucoma surgery). Outcome measures Costs of primary and secondary healthcare usage (UK NHS perspective), quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) for lens extraction versus standard care. Results The mean age of participants was 67.5 (8.42), 57.5% were women, 44.6% had both eyes eligible, 1.4% were of Asian ethnicity and 35.4% had PAC. The mean health service costs were higher in patients randomised to lens extraction: £2467 vs £1486. The mean adjusted QALYs were also higher with early lens extraction: 2.602 vs 2.533. The ICER for lens extraction versus standard care was £14 284 per QALY gained at three years. Modelling suggests that the ICER may drop to £7090 per QALY gained by 5 years and that lens extraction may be cost saving by 10 years. Our results are generally robust to changes in the key input parameters and assumptions. Conclusions We find that lens extraction has a 67–89% chance of being cost-effective at 3 years and that it may be cost saving by 10 years. Trial registration number ISRCTN44464607; Results. PMID:28087548

304 Concretion facility closure plan

International Nuclear Information System (INIS)

1990-04-01

The Hanford Site, located northwest of Richland, Washington, houses reactors, chemical-separation systems, and related facilities used for the production of special nuclear materials. The 300 Area of the Hanford Site contains reactor fuel manufacturing facilities and several research and development laboratories. Recyclable scrap uranium Zircaloy-2 and copper silicon alloy, uranium-titanium alloy, beryllium/Zircaloy-2 alloy, and Zircaloy-2 chips and fines were secured in concrete billets in the 304 Concretion Facility, located in the 300 Area. The beryllium/Zircaloy-2 alloy and Zircaloy-2 chips and fines are designated as low-level radioactive mixed waste (LLRMW) with the characteristic of ignitability. The concretion process reduced the ignitability of the fines and chips for safe storage and shipment. This process has been discontinued and the 304 Concretion Facility is now undergoing closure as defined in the Resource Conservation and Recovery Act of 1976 (RCRA). This closure plan presents a description of the facility, the history of materials and wastes managed, and the procedures that will be followed to close the 304 Concretion Facility (304 Facility). Clean closure of the 304 Facility is the proposed method for closure of the facility. Justification for this proposal is presented. 15 refs., 22 figs., 4 tabs

CIRSE Vascular Closure Device Registry

Science.gov (United States)

Müller-Hülsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zeleňák, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

2010-01-01

Purpose Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. Methods The CIRSE registry of closure devices with an anchor and a plug started in January 2009 and ended in August 2009. A total of 1,107 patients were included in the registry. Results Deployment success was 97.2%. Deployment failure specified to access type was 8.8% [95% confidence interval (95% CI) 5.0–14.5] for antegrade access and 1.8% (95% CI 1.1–2.9) for retrograde access (P = 0.001). There was no difference in deployment failure related to local PVD at the access site. Calcification was a reason for deployment failure in only 5.9 cm, and two vessel occlusions. Conclusion The conclusion of this registry of closure devices with an anchor and a plug is that the use of this device in interventional radiology procedures is safe, with a low incidence of serious access site complications. There seems to be no difference in complications between antegrade and retrograde access and other parameters. PMID:20981425

Occupational closure in nursing work reconsidered

DEFF Research Database (Denmark)

Traynor, Michael; Nissen, Nina; Lincoln, Carol

2015-01-01

In healthcare, occupational groups have adopted tactics to maintain autonomy and control over their areas of work. Witz described a credentialist approach to occupational closure adopted by nursing in the United Kingdom during the 19th and early 20th centuries. However, the recent advancement...... boundaries and a usurpatory stance towards these boundaries. Participants had usually been handpicked by managers and some were ambitious and confident in their abilities. Many aspired to train to be nurses claiming that they will gain recognition that they do not currently get but which they deserve....... Their scope of practice is based upon their managers' or supervisors' perception of their individual aptitude rather than on a credentialist claim. They 'usurp' nurses claim to be the healthcare worker with privileged access to patients, saying they have taken over what nursing has considered its core work...

200 West Ash Pit Demolition Site closure plan

International Nuclear Information System (INIS)

1992-11-01

The Hanford Facility is owned by the US Government and operated by the US Department of Energy, Richland Field Office. Dangerous waste and mixed waste (containing both radioactive and dangerous components) are managed and produced on the Hanford Facility. Westinghouse Hanford Company is a major contractor to the US Department of Energy, Richland Field Office and serves as cooperator of the 200 West Ash Pit Demolition Site, the unit addressed in this closure plan. The 200 West Ash Pit Demolition Site Closure Plan consists of a Part A Permit Application (Revision 3) and a closure plan. An explanation of the Part A Permit Application revision is provided at the beginning of the Part A section. The closure plan consists of nine chapters and three appendices. This 200 West Ash Pit Demolition Site Closure Plan submittal contains information current as of October 15, 1992

Assessment of consistent two-equation closure for forest flows

DEFF Research Database (Denmark)

Sogachev, Andrey; Cavar, Dalibor; Bechmann, Andreas

of grid turbulence and wall-bounded flow, the closure suggested is also valid for homogeneous shear flows commonly observed inside tall vegetative canopies. The present work assess the plant drag closure by comparing results of two different CFD models against observations derived over the forested area...... and can be applied for any twoequation closure. Results derived by different CFD models with k-epsilon and k-omega closure are similar and in good comparison with observations. Overall, numerical results show that the closure performs well, opening new possibilities for application to tasks related...... to the atmospheric boundary layer—where it is important to adequately account for the influences of vegetation....

A successful environmental remediation program closure and post-closure activities (CAPCA) Y-12 Plant, Oak Ridge, Tennessee

International Nuclear Information System (INIS)

Bowers, M.H.

1991-01-01

The Resource Conservation and Recovery Act (RCRA) closure of eleven waste management units at the Department of Energy's (DOE's) Oak Ridge Y-12 Plant is nearing completion. The Oak Ridge Y-12 Plant is managed by Martin Marietta Energy Systems, Inc. for the US Department of Energy under Contract DE-AC05-84OR21400. The Closure and Post Closure Program (CAPCA) has been accomplished on an accelerated schedule through the efforts of a dedicated team from several organizations. This paper relates experience gained from the program that can be of benefit on other DOE environmental remediation projects. Technical design and construction aspects, as well as project management considerations, are discussed

Corrective Action Management Unit Report of Post-Closure Care Activities Calendar Year 2017.

Energy Technology Data Exchange (ETDEWEB)

Ziock, Robert [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Little, Bonnie Colleen [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2018-02-01

The Corrective Action Management Unit (CAMU) at Sandia National Laboratories, New Mexico (SNL/NM) consists of a containment cell and ancillary systems that underwent regulatory closure in 2003 in accordance with the Closure Plan in Appendix D of the Class 3 Permit Modification (SNL/NM September 1997). The containment cell was closed with wastes in place. On January 27, 2015, the New Mexico Environment Department (NMED) issued the Hazardous Waste Facility Operating Permit (Permit) for Sandia National Laboratories (NMED January 2015). The Permit became effective February 26, 2015. The CAMU is undergoing post-closure care in accordance with the Permit, as revised and updated. This CAMU Report of Post-Closure Care Activities documents all activities and results for Calendar Year (CY) 2017 as required by the Permit. The CAMU containment cell consists of engineered barriers including a cover system, a bottom liner with a leachate collection and removal system (LCRS), and a vadose zone monitoring system (VZMS). The VZMS provides information on soil conditions under the cell for early leak detection. The VZMS consists of three monitoring subsystems, which include the primary subliner (PSL), a vertical sensor array (VSA), and the Chemical Waste Landfill (CWL) sanitary sewer (CSS) line. The PSL, VSA, and CSS monitoring subsystems are monitored quarterly for soil moisture concentration, the VSA is monitored quarterly for soil temperature, and the VSA and CSS monitoring subsystems are monitored annually for volatile organic compound (VOC) concentrations in the soil vapor at various depths. Baseline data for the soil moisture, soil temperature, and soil vapor were established between October 2003 and September 2004.

Tank closure reducing grout

International Nuclear Information System (INIS)

Caldwell, T.B.

1997-01-01

A reducing grout has been developed for closing high level waste tanks at the Savannah River Site in Aiken, South Carolina. The grout has a low redox potential, which minimizes the mobility of Sr 90 , the radionuclide with the highest dose potential after closure. The grout also has a high pH which reduces the solubility of the plutonium isotopes. The grout has a high compressive strength and low permeability, which enhances its ability to limit the migration of contaminants after closure. The grout was designed and tested by Construction Technology Laboratories, Inc. Placement methods were developed by the Savannah River Site personnel

Device closure of secundum atrial septal defect's and the risk of cardiac erosion.

Science.gov (United States)

Thomson, J D R; Qureshi, S A

2015-12-01

Cardiac erosion related to transcatheter atrial septal defect closure devices is of increasing concern. Erosion is reported to have occurred with most of currently available occluder devices. Perhaps due to the very large number of implants worldwide, the Amplatzer (St Jude) occluder is associated with the majority of cardiac erosion events reported in the literature. Best current estimates of the incidence of erosion with the St Jude device are between one and three cases per 1000 implants. Most events occur early after implantation and it is rare, although not unheard of, for events to occur after a year following device insertion. It is important that those involved with closure programmes are vigilant for the problem, because device-related erosion is associated with a significant mortality risk. Despite considerable debate, the risk factors (either patient or device) for erosion remain unclear and require further investigation. Currently available data sets have focussed largely on erosion cohorts and are unable to place these cases in appropriate context with non-erosion closure cases. What is certain is that programmes implanting these devices must take care to implant appropriately sized devices and have in place plans to ensure that patients are both well informed and can access help and advice in the event of developing symptoms.

A kinematic view of loop closure.

Science.gov (United States)

Coutsias, Evangelos A; Seok, Chaok; Jacobson, Matthew P; Dill, Ken A

2004-03-01

We consider the problem of loop closure, i.e., of finding the ensemble of possible backbone structures of a chain segment of a protein molecule that is geometrically consistent with preceding and following parts of the chain whose structures are given. We reduce this problem of determining the loop conformations of six torsions to finding the real roots of a 16th degree polynomial in one variable, based on the robotics literature on the kinematics of the equivalent rotator linkage in the most general case of oblique rotators. We provide a simple intuitive view and derivation of the polynomial for the case in which each of the three pair of torsional axes has a common point. Our method generalizes previous work on analytical loop closure in that the torsion angles need not be consecutive, and any rigid intervening segments are allowed between the free torsions. Our approach also allows for a small degree of flexibility in the bond angles and the peptide torsion angles; this substantially enlarges the space of solvable configurations as is demonstrated by an application of the method to the modeling of cyclic pentapeptides. We give further applications to two important problems. First, we show that this analytical loop closure algorithm can be efficiently combined with an existing loop-construction algorithm to sample loops longer than three residues. Second, we show that Monte Carlo minimization is made severalfold more efficient by employing the local moves generated by the loop closure algorithm, when applied to the global minimization of an eight-residue loop. Our loop closure algorithm is freely available at http://dillgroup. ucsf.edu/loop_closure/. Copyright 2004 Wiley Periodicals, Inc. J Comput Chem 25: 510-528, 2004

Rocky Flats Solar Evaporation Ponds RCRA hybrid-closure case study

International Nuclear Information System (INIS)

Ogg, R.T.; Everett, L.G.; Cullen, S.J.

1994-01-01

The Solar Evaporation Ponds (SEP)/Operable Unit 4 (OU 4), located at the Rocky Flats Plant (RFP) sixteen miles northwest of Denver, Colorado, is currently undergoing remediation/Resource Conservation and Recovery Act (RCRA) closure in accordance with the Rocky Flats Interagency Agreement (IAG) signed by the US Department of Energy (DOE), US Environmental Protection Agency (EPA) and Colorado Department of Health (CDH) on January 22, 1991. Based on the ''Phase 1'' (source and soils) RCRA Facility Investigation/Remedial Investigation (RFM data and interpretations), the DOE and EG and G Rocky Flats, Inc. (EG and G) have selected a permanent surface engineered/isolation barrier as the technological option for remediation of the SEP. The DOE and EG and G will utilize all natural materials to create an ''impermeable'' barrier/structure to isolate the waste being left in place from impacting human health and the environment for a minimum of 1,000 years. Their rationale for utilizing natural materials is two fold; (1) optimize long term performance of the barrier and; (2) design a structure which will be near maintenance free (passive remediation) for 1,000 years. The DOE and EG and G have taken a proactive approach in providing post closure performance assessment for this RCRA closure action. An integrated monitoring system has been designed which will include monitoring the engineered barrier, vadose zone and ground water systems. Rocky Flats will integrate instrumentation into the permanent engineered barrier which will provide early warning of potential liquid migration through the barrier and into the waste zone

Socket sclerosis--an obstacle for orthodontic space closure?

Science.gov (United States)

Baumgaertel, Sebastian

2009-07-01

Socket sclerosis is a rare reaction to tooth extraction resulting in high-density bone in the center of the alveolar process, where, under normal circumstances, cancellous bone is to be expected. In an adult orthodontic patient, routine extractions of the mandibular first permanent bicuspids were performed, resulting in socket sclerosis and unsuccessful orthodontic space closure. Orthodontic mini-implants were inserted to augment anchorage and aid in space closure. In the presence of socket sclerosis, conventional orthodontic mechanics failed to close the extraction spaces. However, with absolute anchorage in place, space closure occurred at a nearly normal rate. After treatment, no signs of socket sclerosis were discernible on the periapical radiographs. Socket sclerosis can be an obstacle for orthodontic space closure if traditional mechanics are employed. However, mini-implant-reinforced anchorage can lead to successful space closure, resulting in complete resolution of the sclerotic sites.

Primary closure of equine laryngotomy incisions

DEFF Research Database (Denmark)

Lindegaard, C.; Karlsson, L.; Ekstrøm, Claus Thorn

2016-01-01

incision between January 1995 and June 2012 were reviewed. Horses with a laryngotomy incision closed in three layers for primary healing were included. Descriptive data on healing characteristics and complications of laryngotomy wounds were collected from the medical records and via follow......The objective was to report healing characteristics and complications after primary closure of equine laryngotomies and analyse factors potentially associated with complications. This retrospective case series of the medical records of horses (n = 180) undergoing laryngoplasty and laryngotomy...... after primary closure of equine laryngotomy incisions are infrequent and considered of minimal severity and can be performed safely when paying careful attention to the closure of the cricothyroid membrane....

Detailed design report for an operational phase panel-closure system

International Nuclear Information System (INIS)

1996-01-01

Under contract to Westinghouse Electric Corporation (Westinghouse), Waste Isolation Division (WID), IT Corporation has prepared a detailed design of a panel-closure system for the Waste Isolation Pilot Plant (WIPP). Preparation of this detailed design of an operational-phase closure system is required to support a Resource Conservation and Recovery Act (RCRA) Part B permit application and a non-migration variance petition. This report describes the detailed design for a panel-closure system specific to the WIPP site. The recommended panel-closure system will adequately isolate the waste-emplacement panels for at least 35 years. This report provides detailed design and material engineering specifications for the construction, emplacement, and interface-grouting associated with a panel-closure system at the WIPP repository, which would ensure that an effective panel-closure system is in place for at least 35 years. The panel-closure system provides assurance that the limit for the migration of volatile organic compounds (VOC) will be met at the point of compliance, the WIPP site boundary. This assurance is obtained through the inherent flexibility of the panel-closure system

Percutaneous Transcatheter PDA Device Closure in Infancy

International Nuclear Information System (INIS)

Ullah, M.; Sultan, M.; Akhtar, K.; Sadiq, N.; Akbar, H.

2014-01-01

Objective: To evaluate the results and complications associated with transcatheter closure of patent ductus arteriosus (PDA) in infants. Study Design: Quasi-experimental study. Place and Duration of Study: Paediatric Cardiology Department of Armed Forces Institute of Cardiology / National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, from December 2010 to June 2012. Methodology: Infants undergoing transcatheter device closure of PDA were included. All patients were evaluated by experienced Paediatric Cardiologists with 2-D echocardiography and Doppler before the procedure. Success of closure and complications were recorded. Results: The age of patients varied from 05 - 12 months and 31 (56.4%) were females. Out of the 55 infants, 3 (5.4%) were not offered device closure after aortogram (two large tubular type ducts and one tiny duct, considered unsuitable for device closure); while in 50 (96.1%) patients out of remaining 52, the duct was successfully closed with transcatheter PDA device or coil. In one infant, device deployment resulted in acquired coarctation, necessitating device retrieval by Snare followed by surgical duct interruption and another patient had non-fatal cardiac arrest during device deployment leading to abandonment of procedure and subsequent successful surgical interruption. Local vascular complications occurred in 12 (21.8%) of cases and all were satisfactorily treated. Conclusion: Transcatheter device closure of PDA in infants was an effective procedure in the majority of cases; however, here were considerable number of local access site vascular complications. (author)

3718-F Alkali Metal Treatment and Storage Facility Closure Plan

International Nuclear Information System (INIS)

1991-12-01

Since 1987, Westinghouse Hanford Company has been a major contractor to the U.S. Department of Energy-Richland Operations Office and has served as co-operator of the 3718-F Alkali Metal Treatment and Storage Facility, the waste management unit addressed in this closure plan. The closure plan consists of a Part A Dangerous waste Permit Application and a RCRA Closure Plan. An explanation of the Part A Revision (Revision 1) submitted with this document is provided at the beginning of the Part A section. The closure plan consists of 9 chapters and 5 appendices. The chapters cover: introduction; facility description; process information; waste characteristics; groundwater; closure strategy and performance standards; closure activities; postclosure; and references

3718-F Alkali Metal Treatment and Storage Facility Closure Plan

Energy Technology Data Exchange (ETDEWEB)

None

1991-12-01

Since 1987, Westinghouse Hanford Company has been a major contractor to the U.S. Department of Energy-Richland Operations Office and has served as co-operator of the 3718-F Alkali Metal Treatment and Storage Facility, the waste management unit addressed in this closure plan. The closure plan consists of a Part A Dangerous waste Permit Application and a RCRA Closure Plan. An explanation of the Part A Revision (Revision 1) submitted with this document is provided at the beginning of the Part A section. The closure plan consists of 9 chapters and 5 appendices. The chapters cover: introduction; facility description; process information; waste characteristics; groundwater; closure strategy and performance standards; closure activities; postclosure; and references.

Transcatheter closure of patent ductus arteriosus: past, present and future.

Science.gov (United States)

Baruteau, Alban-Elouen; Hascoët, Sébastien; Baruteau, Julien; Boudjemline, Younes; Lambert, Virginie; Angel, Claude-Yves; Belli, Emre; Petit, Jérôme; Pass, Robert

2014-02-01

This review aims to describe the past history, present techniques and future directions in transcatheter treatment of patent ductus arteriosus (PDA). Transcatheter PDA closure is the standard of care in most cases and PDA closure is indicated in any patient with signs of left ventricular volume overload due to a ductus. In cases of left-to-right PDA with severe pulmonary arterial hypertension, closure may be performed under specific conditions. The management of clinically silent or very tiny PDAs remains highly controversial. Techniques have evolved and the transcatheter approach to PDA closure is now feasible and safe with current devices. Coils and the Amplatzer Duct Occluder are used most frequently for PDA closure worldwide, with a high occlusion rate and few complications. Transcatheter PDA closure in preterm or low-bodyweight infants remains a highly challenging procedure and further device and catheter design development is indicated before transcatheter closure is the treatment of choice in this delicate patient population. The evolution of transcatheter PDA closure from just 40 years ago with 18F sheaths to device delivery via a 3F sheath is remarkable and it is anticipated that further improvements will result in better safety and efficacy of transcatheter PDA closure techniques. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Patent foramen ovale closure using a bioabsorbable closure device: safety and efficacy at 6-month follow-up.

Science.gov (United States)

Van den Branden, Ben J; Post, Martijn C; Plokker, Herbert W; ten Berg, Jurriën M; Suttorp, Maarten J

2010-09-01

The aim of this study was to assess the mid-term safety and efficacy of percutaneous patent foramen ovale (PFO) closure using a bioabsorbable device (BioSTAR, NMT Medical, Boston, Massachusetts). Closure of PFO in patients with cryptogenic stroke has proven to be safe and effective using different types of permanent devices. All consecutive patients who underwent percutaneous PFO closure with the bioabsorbable closure device between November 2007 and January 2009 were included. Residual shunt was assessed using contrast transthoracic echocardiography. Sixty-two patients (55% women, mean age 47.7 ± 11.8 years) underwent PFO closure. The in-hospital complications were a surgical device retrieval in 2 patients (3.2%), device reposition in 1 (1.6%), and a minimal groin hematoma in 6 patients (9.7%). The short-term complications at 1-month follow-up (n = 60) were a transient ischemic attack in the presence of a residual shunt in 1 patient and new supraventricular tachycardia in 7 patients (11.3%). At 6-month follow-up (n = 60), 1 patient without residual shunt developed a transient ischemic attack and 1 developed atrial fibrillation. A mild or moderate residual shunt was noted in 51.7%, 33.9%, and 23.7% after 1-day, 1-month, and 6-month follow-up, respectively. A large shunt was present in 8.3%, 3.4%, and 0% after 1-day, 1-month, and 6-month follow-up. Closure of PFO using the bioabsorbable device is associated with a low complication rate and a low recurrence rate of embolic events. However, a relatively high percentage of mild or moderate residual shunting is still present at 6-month follow-up. Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Emergent properties during dorsal closure in Drosophila morphogenesis

International Nuclear Information System (INIS)

Peralta, X G; Toyama, Y; Edwards, G S; Kiehart, D P

2008-01-01

Dorsal closure is an essential stage of Drosophila development that is a model system for research in morphogenesis and biological physics. Dorsal closure involves an orchestrated interplay between gene expression and cell activities that produce shape changes, exert forces and mediate tissue dynamics. We investigate the dynamics of dorsal closure based on confocal microscopic measurements of cell shortening in living embryos. During the mid-stages of dorsal closure we find that there are fluctuations in the width of the leading edge cells but the time-averaged analysis of measurements indicate that there is essentially no net shortening of cells in the bulk of the leading edge, that contraction predominantly occurs at the canthi as part of the process for zipping together the two leading edges of epidermis and that the rate constant for zipping correlates with the rate of movement of the leading edges. We characterize emergent properties that regulate dorsal closure, i.e., a velocity governor and the coordination and synchronization of tissue dynamics

Economic evaluation of closure cap barrier materials study

Energy Technology Data Exchange (ETDEWEB)

Serrato, M.G.; Bhutani, J.S.; Mead, S.M.

1993-09-01

Volume II of the Economic Evaluation of the Closure Cap Barrier Materials, Revision I contains detailed cost estimates for closure cap barrier materials. The cost estimates incorporate the life cycle costs for a generic hazardous waste seepage basin closure cap under the RCRA Post Closure Period of thirty years. The economic evaluation assessed six barrier material categories. Each of these categories consists of several composite cover system configurations, which were used to develop individual cost estimates. The information contained in this report is not intended to be used as a cost estimating manual. This information provides the decision makers with the ability to screen barrier materials, cover system configurations, and identify cost-effective materials for further consideration.

Economic evaluation of closure cap barrier materials study

International Nuclear Information System (INIS)

Serrato, M.G.; Bhutani, J.S.; Mead, S.M.

1993-09-01

Volume II of the Economic Evaluation of the Closure Cap Barrier Materials, Revision I contains detailed cost estimates for closure cap barrier materials. The cost estimates incorporate the life cycle costs for a generic hazardous waste seepage basin closure cap under the RCRA Post Closure Period of thirty years. The economic evaluation assessed six barrier material categories. Each of these categories consists of several composite cover system configurations, which were used to develop individual cost estimates. The information contained in this report is not intended to be used as a cost estimating manual. This information provides the decision makers with the ability to screen barrier materials, cover system configurations, and identify cost-effective materials for further consideration

Early reported rectal sensation predicts continence in anorectal anomalies.

Science.gov (United States)

Skerritt, Clare; Tyraskis, Athanasios; Rees, Clare; Cockar, Iram; Kiely, Edward

2016-03-01

Straining at stool is an automatic reflex in babies and implies the presence of rectal sensation. We hypothesised that early reported rectal sensation would predict future continence in children with anorectal anomalies. The aim of this study is to determine if early straining at stool was a useful predictor of future continence in infants born with high anorectal malformations. A retrospective case note review of prospectively collected clinical information was performed with institutional review board approval. All patients with intermediate/high anorectal malformation operated on by a single surgeon from 1984 to 2010 were included. After stoma closure, parents were asked: The responses were noted within the first year of stoma closure and then all patients were followed up until they were at least 3 ½years old and continence could be assessed using the Krickenbeck outcome classification. Data were compared using Fisher's exact test and sensitivity, specificity and positive predictive value (PPV) were calculated. Forty-eight patients were included in the study. Sixteen (33%) were female (12 cloacal malformation, 3 rectovaginal fistula, 1 rectal atresia) and 32 (66%) were male (6 rectovesical fistulae, 22 rectourethral fistulae, 4 no fistula). Median follow-up was 9.7years (range 3.5-17.9). Twenty-one children were noted by their parents to exhibit early straining at stool after stoma closure. Twenty of them achieved long term continence. The sensitivity of early straining as a predictor for long term continence was 77%, specificity 95% and positive predictive value 95%. The presence of early rectal sensation reported by parents is a good predictor of long term continence. This allows more informed discussion with families in the early years of life. Copyright © 2016 Elsevier Inc. All rights reserved.

Key financial ratios can foretell hospital closures.

Science.gov (United States)

Lynn, M L; Wertheim, P

1993-11-01

An analysis of various financial ratios sampled from open and closed hospitals shows that certain leverage, liquidity, capital efficiency, and resource availability ratios can predict hospital closure up to two years in advance of the closure with an accuracy of nearly 75 percent.

Influence of timing of hard palate repair in a two-stage procedure on early language development in Danish children with cleft palate

DEFF Research Database (Denmark)

Willadsen, Elisabeth

2012-01-01

Objective: to investigate the influence of timing of hard palate closure on early language development from 18 months to 3 years of age. Design: a prospective, randomized clinical trial. Participants: thirty-four children with UCLP with velum closure at 4 months of age, and hard palate closure...... language development in cleft palate children. Key words: cleft palate, phonological development, lexical development, surgical timing....... at 12 months (EarlyHPR (Early hard palate repair)) or 36 months (LateHPU (Late hard palate Unrepaired)) by random assignment. Thirty-five control children matched for gender and age. Methods: all children were video recorded during a play interaction with a parent at 18 months of age. These recordings...

Hospital closure: Phoenix, Hydra or Titanic?

Science.gov (United States)

Dunne, T; Davis, S

1996-01-01

Very little has been published about the effects of hospital closure in terms of the service, financial or management issues of the process. Attempts through a case-study format to redress the balance and as such represents the reflections of practitioners who have recently undergone the experience of hospital closure and the often neglected issues arising both during and after the process.

Potential socio-economic consequences of mine closure

Directory of Open Access Journals (Sweden)

Marietjie Ackermann

2018-01-01

Full Text Available Background: Mine closures generally reveal negligence on the part of mining houses, not only in terms of the environment, but also the surrounding mining communities. Aim: This article reflects on the findings of research into the socio-economic consequences of mine closure. The research specifically explored how mineworkers’ dependency on their employment at a mine affects their ability to sustain their livelihood. Setting: The research was conducted at the Orkney Mine and the Grootvlei Mine (Springs. Methods: The research was conducted within a naturalistic domain, guided by a relativist orientation, a constructivist ontology and an interpretivist epistemology. Data were collected by means of document analysis, semi-structured interviews, focus group discussion and unstructured observation. Results: From the research findings, it is evident that mine closures, in general, have a devastating effect on the surrounding mining communities as well as on the employees. Mine closures in the case studies gradually depleted the mining communities’ livelihood assets and resulted in the collapse of their coping strategies and livelihood outcomes. It generally affected the communities’ nutrition, health, education, food security, water, shelter, levels of community participation and personal safety. Conclusion: If not managed efficiently and effectively, mine closures may pose significant challenges to the mining industry, government, the environment, national and local economic prosperity and communities in the peripheral areas of mines. This truly amplifies that mine closure, whether temporary or permanent, is an issue that needs to be addressed with responsibility towards all stakeholders, including the mining community and the labour force.

Top closure for control rod drive for nuclear reactor

International Nuclear Information System (INIS)

Raas, J.H.; Schwartz, J.I.

1978-01-01

A removable top closure and venting assembly for the tubular housing of a control rod drive includes a mounting ring threadably inserted in the upper end of the housing, a fluid-sealing closure member beneath the mounting ring and which is mounted in and coupled to the mounting ring by means of a ball and socket joint, a gas vent defined by interconnecting passages extending through the closure and through the ball and socket joint, and a vent valve accessible from the top of the closure assembly. 3 claims, 2 figures

Transcatheter closure of ventricular septal defect with Occlutech Duct Occluder.

Science.gov (United States)

Atik-Ugan, Sezen; Saltik, Irfan Levent

2018-04-01

Patent ductus arteriosus occluders are used for transcatheter closure of ventricular septal defects, as well as for closure of patent ductus arteriosus. The Occlutech Duct Occluder is a newly introduced device for transcatheter closure of patent ductus arteriosus. Here, we present a case in which the Occlutech Duct Occluder was successfully used on a patient for the closure of a perimembraneous ventricular septal defect.

Seven-year follow-up of percutaneous closure of patent foramen ovale.

Science.gov (United States)

Mirzada, Naqibullah; Ladenvall, Per; Hansson, Per-Olof; Johansson, Magnus Carl; Furenäs, Eva; Eriksson, Peter; Dellborg, Mikael

2013-12-01

Observational studies favor percutaneous closure of patent foramen ovale (PFO) over medical treatment to reduce recurrent stroke while randomized trials fail to demonstrate significant superiority of percutaneous PFO closure. Few long-term studies are available post PFO closure. This study reports long-term clinical outcomes after percutaneous PFO closure. Between 1997 and 2006, 86 consecutive eligible patients with cerebrovascular events, presumably related to PFO, underwent percutaneous PFO closure. All 86 patients were invited to a long-term follow-up, which was carried out during 2011 and 2012. Percutaneous PFO closure was successfully performed in 85 of 86 patients. The follow-up rate was 100%. No cardiovascular or cerebrovascular deaths occurred. Two patients (both women) died from lung cancer during follow-up. Follow-up visits were conducted for 64 patients and the remaining 20 patients were followed up by phone. The mean follow-up time was 7.3 years (5 to 12.4 years). Mean age at PFO closure was 49 years. One patient had a minor stroke one month after PFO closure and a transient ischemic attack (TIA) two years afterwards. One other patient suffered from a TIA six years after closure. No long-term device-related complications were observed. Percutaneous PFO closure was associated with very low risk of recurrent stroke and is suitable in most patients. We observed no mortality and no long-term device-related complications related to PFO closure, indicating that percutaneous PFO closure is a safe and efficient treatment even in the long term.

Primary closure versus non-closure of dog bite wounds. a randomised controlled trial.

Science.gov (United States)

Paschos, Nikolaos K; Makris, Eleftherios A; Gantsos, Apostolos; Georgoulis, Anastasios D

2014-01-01

Dog bite wounds represent a major health problem. Despite their importance, their management and especially the role of primary closure remain controversial. In this randomised controlled trial, the outcome between primary suturing and non-closure was compared. 168 consecutive patients with dog bite injuries were included in this study. The wounds were allocated randomly in two treatment approaches: Group 1, consisting of eighty-two patients, had their wound sutured, whilst Group 2, consisting of eighty-six patients, did not have their wounds sutured. All wounds were cleansed using high-pressure irrigation and povidone iodine. All patients received the same type of antibiotic treatment. Our measured outcomes included presence of infection and cosmetic appearance. Cosmetic outcome was evaluated using the Vancouver Scar Scale (VSS). Wound and patient characteristics, such as time of management, wound location and size, and patient age, were recorded and analysed for their potential role in the resulting outcome. The overall infection rate was 8.3%. No difference in the infection rate between primary suturing and non-suturing group was detected in the present study. The cosmetic appearance of the sutured wounds was significantly better (mean score 1.74) compared to the wounds that were left open (mean score 3.05) (p=0.0001). The infection rate was comparable among all age groups. Wounds treated within 8h of injury demonstrated an infection rate of 4.5%, which is lower compared to the 22.2% rate observed in wounds treated later than 8h. The wounds located at the head and neck exhibited better results in both infection rate and cosmetic outcome. Additionally, wounds >3 cm negatively affected the cosmetic appearance of the outcome. Primary suturing of wounds caused by dog bites resulted in similar infection rate compared to non-suturing. However, primary suturing exhibited improved cosmetic appearance. Time of management appeared to be critical, as early treatment

Permanent Closure of the TAN-664 Underground Storage Tank

Energy Technology Data Exchange (ETDEWEB)

Bradley K. Griffith

2011-12-01

This closure package documents the site assessment and permanent closure of the TAN-664 gasoline underground storage tank in accordance with the regulatory requirements established in 40 CFR 280.71, 'Technical Standards and Corrective Action Requirements for Owners and Operators of Underground Storage Tanks: Out-of-Service UST Systems and Closure.'

Single-shell tank closure work plan. Revision A

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-06-01

In January 1994, the Hanford Federal Facility Agreement and Conset Order (Tri-Party Agreement) was amended to reflect a revised strategy for remediation of radioactive waste in underground storage tanks. These amendments include milestones for closure of the single-shell tank (SST) operable units, to be initiated by March 2012 and completed by September 2024. This SST-CWP has been prepared to address the principal topical areas identified in Tri-Party Agreement Milestone M-45-06 (i.e., regulatory pathway, operable unit characterization, waste retrieval, technology development, and a strategy for achieving closure). Chapter 2.0 of this SST-CWP provides a brief description of the environmental setting, SST System, the origin and characteristics of SST waste, and ancillary equipment that will be remediated as part of SST operable unit closure. Appendix 2A provides a description of the hydrogeology of the Hanford Site, including information on the unsaturated sediments (vadose zone) beneath the 200 Areas Plateau. Chapter 3.0 provides a discussion of the laws and regulations applicable to closure of the SST farm operable units. Chapter 4.0 provides a summary description of the ongoing characterization activities that best align with the proposed regulatory pathway for closure. Chapter 5.0 describes aspects of the SST waste retrieval program, including retrieval strategy, technology, and sequence, potential tank leakage during retrieval, and considerations of deployment of subsurface barriers. Chapter 6.0 outlines a proposed strategy for closure. Chapter 7.0 provides a summary of the programs underway or planned to develop technologies to support closure. Ca. 325 refs.

Single-shell tank closure work plan. Revision A

International Nuclear Information System (INIS)

1995-06-01

In January 1994, the Hanford Federal Facility Agreement and Conset Order (Tri-Party Agreement) was amended to reflect a revised strategy for remediation of radioactive waste in underground storage tanks. These amendments include milestones for closure of the single-shell tank (SST) operable units, to be initiated by March 2012 and completed by September 2024. This SST-CWP has been prepared to address the principal topical areas identified in Tri-Party Agreement Milestone M-45-06 (i.e., regulatory pathway, operable unit characterization, waste retrieval, technology development, and a strategy for achieving closure). Chapter 2.0 of this SST-CWP provides a brief description of the environmental setting, SST System, the origin and characteristics of SST waste, and ancillary equipment that will be remediated as part of SST operable unit closure. Appendix 2A provides a description of the hydrogeology of the Hanford Site, including information on the unsaturated sediments (vadose zone) beneath the 200 Areas Plateau. Chapter 3.0 provides a discussion of the laws and regulations applicable to closure of the SST farm operable units. Chapter 4.0 provides a summary description of the ongoing characterization activities that best align with the proposed regulatory pathway for closure. Chapter 5.0 describes aspects of the SST waste retrieval program, including retrieval strategy, technology, and sequence, potential tank leakage during retrieval, and considerations of deployment of subsurface barriers. Chapter 6.0 outlines a proposed strategy for closure. Chapter 7.0 provides a summary of the programs underway or planned to develop technologies to support closure. Ca. 325 refs

Social and macro economic impact of closure

International Nuclear Information System (INIS)

Medeliene, D.

1999-01-01

The social consequences of closure of Ignalina NPP will largely depend on the actions the Government takes. If it puts in place the conditions which enable the International Financial Institutions to assist Lithuania, both in providing loans and grants for decommissioning and (in the case of the EU) providing Structural Adjustment Funds for the regional economic development of the Visaginas area, then solutions to the problems of closure can be found. But if the Government delays putting into place the necessary conditions, then Lithuania will be left to solve the problems of - inter alia necessary - closure of Ignalina NPP on its own. (author)

Closure Plan for the Area 3 Radioactive Waste Management Site at the Nevada Test Site

Energy Technology Data Exchange (ETDEWEB)

NSTec Environmental Management

2007-09-01

The Area 3 Radioactive Waste Management Site (RMWS) at the Nevada Test Site (NTS) is managed and operated by National Security Technologies, LLC (NSTec) for the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO). This document is the first update of the interim closure plan for the Area 3 RWMS, which was presented in the Integrated Closure and Monitoring Plan (ICMP) (DOE, 2005). The format and content of this plan follows the Format and Content Guide for U.S. Department of Energy Low-Level Waste Disposal Facility Closure Plans (DOE, 1999a). The major updates to the plan include a new closure date, updated closure inventory, the new institutional control policy, and the Title II engineering cover design. The plan identifies the assumptions and regulatory requirements, describes the disposal sites and the physical environment in which they are located, presents the design of the closure cover, and defines the approach and schedule for both closing and monitoring the site. The Area 3 RWMS accepts low-level waste (LLW) from across the DOE Complex in compliance with the NTS Waste Acceptance Criteria (NNSA/NSO, 2006). The Area 3 RWMS accepts both packaged and unpackaged unclassified bulk LLW for disposal in subsidence craters that resulted from deep underground tests of nuclear devices in the early 1960s. The Area 3 RWMS covers 48 hectares (119 acres) and comprises seven subsidence craters--U-3ax, U-3bl, U-3ah, U-3at, U-3bh, U-3az, and U-3bg. The area between craters U-3ax and U-3bl was excavated to form one large disposal unit (U-3ax/bl); the area between craters U-3ah and U-3at was also excavated to form another large disposal unit (U-3ah/at). Waste unit U-3ax/bl is closed; waste units U-3ah/at and U-3bh are active; and the remaining craters, although currently undeveloped, are available for disposal of waste if required. This plan specifically addresses the closure of the U-3ah/at and the U-3bh LLW units. A final closure

Closure Plan for the Area 3 Radioactive Waste Management Site at the Nevada Test Site

International Nuclear Information System (INIS)

NSTec Environmental Management

2007-01-01

The Area 3 Radioactive Waste Management Site (RMWS) at the Nevada Test Site (NTS) is managed and operated by National Security Technologies, LLC (NSTec) for the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO). This document is the first update of the interim closure plan for the Area 3 RWMS, which was presented in the Integrated Closure and Monitoring Plan (ICMP) (DOE, 2005). The format and content of this plan follows the Format and Content Guide for U.S. Department of Energy Low-Level Waste Disposal Facility Closure Plans (DOE, 1999a). The major updates to the plan include a new closure date, updated closure inventory, the new institutional control policy, and the Title II engineering cover design. The plan identifies the assumptions and regulatory requirements, describes the disposal sites and the physical environment in which they are located, presents the design of the closure cover, and defines the approach and schedule for both closing and monitoring the site. The Area 3 RWMS accepts low-level waste (LLW) from across the DOE Complex in compliance with the NTS Waste Acceptance Criteria (NNSA/NSO, 2006). The Area 3 RWMS accepts both packaged and unpackaged unclassified bulk LLW for disposal in subsidence craters that resulted from deep underground tests of nuclear devices in the early 1960s. The Area 3 RWMS covers 48 hectares (119 acres) and comprises seven subsidence craters--U-3ax, U-3bl, U-3ah, U-3at, U-3bh, U-3az, and U-3bg. The area between craters U-3ax and U-3bl was excavated to form one large disposal unit (U-3ax/bl); the area between craters U-3ah and U-3at was also excavated to form another large disposal unit (U-3ah/at). Waste unit U-3ax/bl is closed; waste units U-3ah/at and U-3bh are active; and the remaining craters, although currently undeveloped, are available for disposal of waste if required. This plan specifically addresses the closure of the U-3ah/at and the U-3bh LLW units. A final closure

A randomised placebo-controlled trial of early treatment of the patent ductus arteriosus.

Science.gov (United States)

Kluckow, Martin; Jeffery, Michele; Gill, Andy; Evans, Nick

2014-03-01

Failure of closure of the patent ductus arteriosus (PDA) may be associated with harm. Early cardiac ultrasound-targeted treatment of a large PDA may result in a reduction in adverse outcomes and need for later PDA closure with no increase in adverse effects. Multicentre, double-blind, placebo-controlled randomised trial. Three neonatal intensive care units in Australia. Eligible infants born <29 weeks were screened for a large PDA and received indomethacin or placebo before age 12 h. Death or abnormal cranial ultrasound. The trial ceased enrolment early due to lack of availability of indomethacin. 164 eligible infants were screened before 12 h; of the 92 infants with a large PDA, 44 were randomised to indomethacin and 48 to placebo. There was no difference in the main outcome between groups. Infants receiving early indomethacin had significantly less early pulmonary haemorrhage (PH) (2% vs 21%), a trend towards less periventricular/intraventricular haemorrhage (PIVH) (4.5% vs 12.5%) and were less likely to receive later open-label treatment for a PDA (20% vs 40%). The 72 non-randomised infants with a small PDA were at low risk of pulmonary haemorrhage and had an 80% spontaneous PDA closure rate. Early cardiac ultrasound-targeted treatment of a large PDA is feasible and safe, resulted in a reduction in early pulmonary haemorrhage and later medical treatment but had no effect on the primary outcome of death or abnormal cranial ultrasound. Australian New Zealand Clinical Trials Registry (ACTRN12608000295347).

Strategic Planning for Hot Cell Closure

International Nuclear Information System (INIS)

LANGSTAFF, D.C.

2001-01-01

The United States Department of Energy (DOE) and its contractor were remediating a large hot cell complex to mitigate the radiological hazard. A Resource Conservation and Recovery Act (RCRA) closure unit was determined to be located within the complex. The regulator established a challenge to develop an acceptable closure plan on a short schedule (four months). The scope of the plan was to remove all excess equipment and mixed waste from the closure unit, establish the requirements of the legally binding Closure Plan and develop an acceptable schedule. The complex has several highly radioactive tanks, tank vaults, piping, and large hot cells containing complex chemical processing equipment. Driven by a strong need to develop an effective strategy to meet cleanup commitments, three principles were followed to develop an acceptable plan: (1) Use a team approach, (2) Establish a buffer zone to support closure, and (3) Use good practice when planning the work sequence. The team was composed of DOE, contractor, and Washington State Department of Ecology (Regulator) staff. The team approach utilized member expertise and fostered member involvement and communication. The buffer zone established an area between the unregulated parts of the building and the areas that were allegedly not in compliance with environmental standards. Introduction of the buffer zone provided simplicity, clarity, and flexibility into the process. Using good practice means using the DOE Integrated Safety Management Core Functions for planning and implementing work safely. Paying adequate attention to detail when the situation required contributed to the process credibility and a successful plan

Subcostal closure technique for prevention of postthoracotomy pain syndrome.

Science.gov (United States)

Hong, Kipyo; Bae, Mikyung; Han, Sora

2016-09-01

The purpose of this study was to evaluate the efficacy of our subcostal closure technique in prevention of postthoracotomy pain syndrome. From July 2012 to March 2015, 29 patients in whom a lobectomy was indicated underwent a thoracotomy. The thoracotomy wounds were closed using a subcostal closure technique (subcostal closure group) and outcomes were compared with 31 patients who underwent video-assisted thoracoscopic surgery (thoracoscopy group). The duration of oral opioid consumption was evaluated from medical records, and postoperative pain was evaluated by telephone interview conducted by a trained nurse practitioner who was unaware of the patient's group. Pain scores were higher in the thoracoscopy group compared to the subcostal closure group, reaching statistical significance (Numeric Rating Scale 0.55 ± 0.948 in the subcostal closure group vs. 1.84 ± 1.614 in the thoracoscopy group; p Pain Scale 0.24 ± 0.435 in the subcostal closure group vs. 0.81 ± 0.703 in the thoracoscopy group; p pain syndrome. © The Author(s) 2016.

Comparing over-the-scope clip versus endoloop and clips (KING closure) for access site closure: a randomized experimental study

Czech Academy of Sciences Publication Activity Database

Martínek, J.; Ryska, O.; Tučková, I.; Filípková, T.; Doležel, R.; Juhás, Štefan; Motlík, Jan; Zavoral, M.; Ryska, M.

2013-01-01

Roč. 27, č. 4 (2013), s. 1203-1210 ISSN 0930-2794 R&D Projects: GA MZd NS9994 Institutional research plan: CEZ:AV0Z50450515 Keywords : NOTES * gastrotomy closure * rectotomy closure Subject RIV: FJ - Surgery incl. Transplants Impact factor: 3.313, year: 2013

A Crack Closure Model and Its Application to Vibrothermography Nondestructive Evaluation

Science.gov (United States)

Schiefelbein, Bryan Edward

Vibrothermography nondestructive evaluation (NDE) is in the early stages of research and development, and there exists uncertainty in the fundamental mechanisms and processes by which heat generation occurs. Holland et al. have developed a set of tools which simulate and predict the outcome of a vibrothermography inspection by breaking the inspection into three distinct processes: vibrational excitation, heat generation, and thermal imaging. The stage of vibrothermography which is not well understood is the process by which vibrations are converted to heat at the crack surface. It has been shown that crack closure and closure state impact the resulting heat generation. Despite this, research into the link between partial crack closure and vibrothermography is limited. This work seeks to rectify this gap in knowledge by modeling the behavior of a partially closed crack in response to static external loading and a dynamic vibration. The residual strains left by the plastic wake during fatigue crack growth manifest themselves as contact stresses acting at the crack surface interface. In response to an applied load below the crack opening stress, the crack closure state will evolve, but the crack will remain partially closed. The crack closure model developed in this work is based in linear elastic fracture mechanics (LEFM) and describes the behavior of a partially closed crack in response to a tensile external load and non-uniform closure stress distribution. The model builds on work by Fleck to describe the effective length, crack opening displacement, and crack tip stress field for a partially closed crack. These quantities are solved for by first establishing an equilibrium condition which governs the effective or apparent length of the partially closed crack. The equilibrium condition states that, under any external or crack surface loading, the effective crack tip will be located where the effective stress intensity factor is zero. In LEFM, this is equivalent to

Hexone Storage and Treatment Facility closure plan

International Nuclear Information System (INIS)

1992-11-01

The HSTF is a storage and treatment unit subject to the requirements for the storage and treatment of dangerous waste. Closure is being conducted under interim status and will be completed pursuant to the requirements of Washington State Department of Ecology (Ecology) Dangerous Waste Regulations, Washington Administrative Code (WAC) 173-303-610 and WAC 173-303-640. Because dangerous waste does not include the source, special nuclear, and by-product material components of mixed waste, radionuclides are not within the scope of WAC 173-303 or of this closure plan. The information on radionuclides is provided only for general knowledge where appropriate. The known hazardous/dangerous waste remaining at the site before commencing other closure activities consists of the still vessels, a tarry sludge in the storage tanks, and residual contamination in equipment, piping, filters, etc. The treatment and removal of waste at the HSTF are closure activities as defined in the Resource Conservation and Recovery Act (RCRA) of 1976 and WAC 173-303

Cyanoacrylate for Intraoral Wound Closure: A Possibility?

Directory of Open Access Journals (Sweden)

Parimala Sagar

2015-01-01

Full Text Available Wound closure is a part of any surgical procedure and the objective of laceration repair or incision closure is to approximate the edges of a wound so that natural healing process may occur. Over the years new biomaterials have been discovered as an alternate to conventional suture materials. Cyanoacrylate bioadhesives are one among them. They carry the advantages of rapid application, patient comfort, resistance to infection, hemostatic properties, and no suture removal anxiety. Hence this study was undertaken to study the effect of long chain cyanoacrylate as an adhesive for intraoral wound closure and also to explore its hemostatic and antibacterial effects. Isoamyl-2-cyanoacrylate (AMCRYLATE was used as the adhesive in the study. In conclusion isoamyl cyanoacrylate can be used for intraoral wound closure, as an alternative to sutures for gluing the mucoperiosteum to bone, for example, after impaction removal, periapical surgeries, and cleft repair. Its hemostatic and antibacterial activity has to be further evaluated.

Project Management Approach to Transition of the Miamisburg Closure Project From Environmental Cleanup to Post-Closure Operations

International Nuclear Information System (INIS)

Carpenter, C.P.; Marks, M.L.; Smiley, S.L.; Gallaher, D.M.; Williams, K.D.

2006-01-01

The U.S. Department of Energy (DOE) used a project management approach to transition the Miamisburg Closure Project from cleanup by the Office of Environmental Management (EM) to post-closure operations by the Office of Legacy Management (LM). Two primary DOE orders were used to guide the site transition: DOE Order 430.1B, Real Property Asset Management, for assessment and disposition of real property assets and DOE Order 413.3, Program and Project Management for Acquisition of Capital Assets, for project closeout of environmental cleanup activities and project transition of post-closure activities. To effectively manage these multiple policy requirements, DOE chose to manage the Miamisburg Closure Project as a project under a cross-member transitional team using representatives from four principal organizations: DOE-LM, the LM contractor S.M. Stoller Corporation, DOE-EM, and the EM contractor CH2M Hill Mound Inc. The mission of LM is to manage the Department's post-transition responsibilities and long-term care of legacy liabilities and to ensure the future protection of human health and the environment for cleanup sites after the EM has completed its cleanup activities. (authors)

Design, production and initial state of the closure

International Nuclear Information System (INIS)

2010-12-01

The report is included in a set of Production reports, presenting how the KBS-3 repository is designed, produced and inspected. The production reports are included in the safety report for the KBS-3 repository and repository facility. The report provides input on the initial state of the closure and plugs in underground openings other than deposition tunnels for the assessment of the long-term safety, SR-Site. The initial state refers to the properties of the engineered barriers once they have been finally placed in the KBS-3 repository and will not be further handled within the repository facility. In addition, the report provides some input to the operational safety report, SR-Operation, on how the closure and plugs shall be handled and installed. The report presents the design premises and reference designs of the closure and plugs and verifies their conformity to the design premises. It also briefly deals with the production of the closure and plugs. Finally, the initial state of the closure and plugs and their conformity to the reference designs and design premises are presented

Design, production and initial state of the closure

Energy Technology Data Exchange (ETDEWEB)

2010-12-15

The report is included in a set of Production reports, presenting how the KBS-3 repository is designed, produced and inspected. The production reports are included in the safety report for the KBS-3 repository and repository facility. The report provides input on the initial state of the closure and plugs in underground openings other than deposition tunnels for the assessment of the long-term safety, SR-Site. The initial state refers to the properties of the engineered barriers once they have been finally placed in the KBS-3 repository and will not be further handled within the repository facility. In addition, the report provides some input to the operational safety report, SR-Operation, on how the closure and plugs shall be handled and installed. The report presents the design premises and reference designs of the closure and plugs and verifies their conformity to the design premises. It also briefly deals with the production of the closure and plugs. Finally, the initial state of the closure and plugs and their conformity to the reference designs and design premises are presented

Transcatheter Closure of Patent Foramen Ovale: Devices and Technique.

Science.gov (United States)

Price, Matthew J

2017-10-01

Transcatheter closure of a patent foramen ovale (PFO) reduces the risk of recurrent cryptogenic stroke compared with medical therapy. PFO closure is a prophylactic procedure, and will not provide the patient with symptomatic improvement, except in cases of hypoxemia due to right-to-left shunt or possibly migraine headaches. Therefore, appropriate patient selection is critical, and procedural safety is paramount. Herein, we review key characteristics of the devices currently available for transcatheter PFO closure within the United States, and highlight key technical aspects of the PFO closure procedure that will maximize procedural success. Copyright © 2017 Elsevier Inc. All rights reserved.

Digital signal processing of data from borehole creep closure

International Nuclear Information System (INIS)

Chakrabarti, S.; Patrick, W.C.; Duplancic, N.

1987-01-01

Digital signal processing, a technique commonly used in the fields of electrical engineering and communication technology, has been successfully used to analyze creep closure data obtained from a 0.91 m diameter by 5.13 deep borehole in bedded salt. By filtering the ''noise'' component of the closure data from a test borehole, important data trends were made more evident and average creep closure rates were able to be calculated. This process provided accurate estimates of closure rates that are used in the design of lined boreholes in which heat-generating transuranic nuclear wastes are emplaced at the Waste Isolation Pilot Plant

40 CFR 264.119 - Post-closure notices.

Science.gov (United States)

2010-07-01

...) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Closure... closure of each hazardous waste disposal unit, the owner or operator must submit to the local zoning... disposal unit of the facility. For hazardous wastes disposed of before January 12, 1981, the owner or...

A closure test for time-specific capture-recapture data

Science.gov (United States)

Stanley, T.R.; Burnham, K.P.

1999-01-01

The assumption of demographic closure in the analysis of capture-recapture data under closed-population models is of fundamental importance. Yet, little progress has been made in the development of omnibus tests of the closure assumption. We present a closure test for time-specific data that, in principle, tests the null hypothesis of closed-population model M(t) against the open-population Jolly-Seber model as a specific alternative. This test is chi-square, and can be decomposed into informative components that can be interpreted to determine the nature of closure violations. The test is most sensitive to permanent emigration and least sensitive to temporary emigration, and is of intermediate sensitivity to permanent or temporary immigration. This test is a versatile tool for testing the assumption of demographic closure in the analysis of capture-recapture data.

Reliability in maintenance and design of elastomer sealed closures

International Nuclear Information System (INIS)

Lake, W.H.

1978-01-01

The methods of reliability are considered for maintenance and design of elastomer sealed containment closures. Component reliability is used to establish a replacement schedule for system maintenance. Reliability data on elastomer seals is used to evaluate the common practice of annual replacement, and to calculate component reliability values for several typical shipment time periods. System reliability methods are used to examine the relative merits of typical closure designs. These include single component and redundant seal closure, with and without closure verification testing. The paper presents a general method of quantifying the merits of closure designs through the use of reliability analysis, which is a probabilistic technique. The reference list offers a general source of information in the field of reliability, and should offer the opportunity to extend the procedures discussed in this paper to other design safety applications

Reinvestigation into Closure Predictions of Room D at the Waste Isolation Pilot Plant

Energy Technology Data Exchange (ETDEWEB)

Reedlunn, Benjamin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2016-10-01

Room D was an in-situ, isothermal, underground experiment conducted at theWaste Isolation Pilot Plant between 1984 and 1991. The room was carefully instrumented to measure the horizontal and vertical closure immediately upon excavation and for several years thereafter. Early finite element simulations of salt creep around Room D under predicted the vertical closure by 4.5×, causing investigators to explore a series of changes to the way Room D was modeled. Discrepancies between simulations and measurements were resolved through a series of adjustments to model parameters, which were openly acknowledged in published reports. Interest in Room D has been rekindled recently by the U.S./German Joint Project III and Project WEIMOS, which seek to improve the predictions of rock salt constitutive models. Joint Project participants calibrate their models solely against laboratory tests, and benchmark the models against underground experiments, such as room D. This report describes updating legacy Room D simulations to today’s computational standards by rectifying several numerical issues. Subsequently, the constitutive model used in previous modeling is recalibrated two different ways against a suite of new laboratory creep experiments on salt extracted from the repository horizon of the Waste Isolation Pilot Plant. Simulations with the new, laboratory-based, calibrations under predict Room D vertical closure by 3.1×. A list of potential improvements is discussed.

Reinvestigation into Closure Predictions of Room D at the Waste Isolation Pilot Plant

Energy Technology Data Exchange (ETDEWEB)

Reedlunn, Benjamin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2016-09-27

Room D was an in-situ, isothermal, underground experiment conducted at the Waste Isolation Pilot Plant between 1984 and 1991. The room was carefully instrumented to measure the horizontal and vertical closure immediately upon excavation and for several years thereafter. Early finite element simulations of salt creep around Room D under-predicted the vertical closure by 4.5×, causing investigators to explore a series of changes to the way Room D was modeled. Discrepancies between simulations and measurements were resolved through a series of adjustments to model parameters, which were openly acknowledged in published reports. Interest in Room D has been rekindled recently by the U.S./German Joint Project III and Project WEIMOS, which seek to improve the predictions of rock salt constitutive models. Joint Project participants calibrate their models solely against laboratory tests, and benchmark the models against underground experiments, such as room D. This report describes updating legacy Room D simulations to today’s computational standards by rectifying several numerical issues. Subsequently, the constitutive model used in previous modeling is recalibrated two different ways against a suite of new laboratory creep experiments on salt extracted from the repository horizon of the Waste Isolation Pilot Plant. Simulations with the new, laboratory-based, calibrations under-predict Room D vertical closure by 3.1×. A list of potential improvements is discussed.

RELAP-7 Closure Correlations

Energy Technology Data Exchange (ETDEWEB)

Zou, Ling [Idaho National Lab. (INL), Idaho Falls, ID (United States); Berry, R. A. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Martineau, R. C. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Andrs, D. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zhang, H. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hansel, J. E. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Sharpe, J. P. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Johns, Russell C. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-04-01

The RELAP-7 code is the next generation nuclear reactor system safety analysis code being developed at the Idaho National Laboratory (INL). The code is based on the INL’s modern scientific software development framework, MOOSE (Multi-Physics Object Oriented Simulation Environment). The overall design goal of RELAP-7 is to take advantage of the previous thirty years of advancements in computer architecture, software design, numerical integration methods, and physical models. The end result will be a reactor systems analysis capability that retains and improves upon RELAP5’s and TRACE’s capabilities and extends their analysis capabilities for all reactor system simulation scenarios. The RELAP-7 code utilizes the well-posed 7-equation two-phase flow model for compressible two-phase flow. Closure models used in the TRACE code has been reviewed and selected to reflect the progress made during the past decades and provide a basis for the colure correlations implemented in the RELAP-7 code. This document provides a summary on the closure correlations that are currently implemented in the RELAP-7 code. The closure correlations include sub-grid models that describe interactions between the fluids and the flow channel, and interactions between the two phases.

The effectiveness of eye-closure in repeated interviews

OpenAIRE

Vredeveldt, A.; Baddeley, A.D.; Hitch, G.J.

2014-01-01

Purpose Closing the eyes during recall can help witnesses remember more about a witnessed event. This study examined the effectiveness of eye-closure in a repeated recall paradigm with immediate free recall followed 1 week later by both free and cued recall. We examined whether eye-closure was more or less effective during the second free-recall attempt compared with the first, whether eye-closure during the first recall attempt had an impact on subsequent free- and cued-recall performance, a...

Closure of the squared Zakharov--Shabat eigenstates

International Nuclear Information System (INIS)

Kaup, D.J.

1976-01-01

By solution of the inverse scattering problem for a third-order (degenerate) eigenvalue problem, the closure of the squared eigenfunctions of the Zakharov--Shabat equations is found. The question of the completeness of squared eigenstates occurs in many aspects of ''inverse scattering transforms'' (solving nonlinear evolution equations exactly by inverse scattering techniques), as well as in various aspects of the inverse scattering problem. The method used here is quite suggestive as to how one might find the closure of the squared eigenfunctions of other eigenvalue equations, and the strong analogy between these results and the problem of finding the closure of the eigenvectors of a nonself-adjoint matrix is pointed out

The Office of Site Closure: Progress in the Face of Challenges

International Nuclear Information System (INIS)

Fiore, J. J.; Murphie, W. E.; Meador, S. W.

2002-01-01

The Office of Site Closure (OSC) was formed in November 1999 when the Department of Energy's (DOE's) Office of Environmental Management (EM) reorganized to focus specifically on site cleanup and closure. OSC's objective is to achieve safe and cost-effective cleanups and closures that are protective of our workers, the public, and the environment, now and in the future. Since its inception, OSC has focused on implementing a culture of safe closure, with emphasis in three primary areas: complete our responsibility for the Closure Sites Rocky Flats, Mound, Fernald, Ashtabula, and Weldon Spring; complete our responsibility for cleanup at sites where the DOE mission has been completed (examples include Battelle King Avenue and Battelle West Jefferson in Columbus, and General Atomics) or where other Departmental organizations have an ongoing mission (examples include the Brookhaven, Livermore, or Los Alamos National Laboratories, and the Nevada Test Site); and create a framework a nd develop specific business closure tools that will help sites close, such as guidance for and decisions on post-contract benefit liabilities, records retention, and Federal employee incentives for site closure. This paper discusses OSC's 2001 progress in achieving site cleanups, moving towards site closure, and developing specific business closure tools to support site closure. It describes the tools used to achieve progress towards cleanup and closure, such as the application of new technologies, changes in contracting approaches, and the development of agreements between sites and with host states. The paper also identifies upcoming challenges and explores options for how Headquarters and the sites can work together to address these challenges. Finally, it articulates OSC's new focus on oversight of Field Offices to ensure they have the systems in place to oversee contractor activities resulting in site cleanups and closures

Spontaneous closure of midline diastema following frenectomy

Directory of Open Access Journals (Sweden)

Koora Kiran

2007-03-01

Full Text Available Maxillary midline diastema is a common aesthetic problem in mixed and early permanent dentitions. The space can occur either as a transient malocclusion or created by developmental, pathological or iatrogenical factors. Many innovative therapies varying from restorative procedures such as composite build-up to surgery (frenectomies and orthodontics are available. Although literature says every frenectomy procedure should be preceded by orthodontic treatment, we opted for frenectomy technique without any orthodontic intervention. Presented herewith is a case report of a 9-year-old girl with a high frenal attachment that had caused spacing of the maxillary central incisors. A spontaneous closure of the midline diastema was noted within 2 months following frenectomy. The patient was followed up for 4 months after which the space remained closed and there was no necessity for an orthodontic treatment at a later stage.

Stomal Closure: Strategies to Prevent Incisional Hernia

Science.gov (United States)

Harries, Rhiannon L.; Torkington, Jared

2018-01-01

Incisional hernias following ostomy reversal occur frequently. Incisional hernias at the site of a previous stoma closure can cause significant morbidity, impaired quality of life, lead to life-threatening hernia incarceration or strangulation and result in a significant financial burden on health care systems Despite this, the evidence base on the subject is limited. Many recognised risk factors for the development of incisional hernia following ostomy reversal are related to patient factors such as age, malignancy, diabetes, COPD, hypertension and obesity, and are not easily correctable. There is a limited amount of evidence to suggest that prophylactic mesh reinforcement may be of benefit to reduce the post stoma closure incisional hernia rate but a further large scale randomised controlled trial is due to report in the near future. There appears to be weak evidence to suggest that surgeons should favour circular, or “purse-string” closure of the skin following stoma closure in order to reduce the risk of SSI, which in turn may reduce incisional hernia formation. There remains the need for further evidence in relation to suture technique, skin closure techniques, mechanical bowel preparation and oral antibiotic prescription focusing on incisional hernia development as an outcome measure. Within this review, we discuss in detail the evidence base for the risk factors for the development of, and the strategies to prevent ostomy reversal site incisional hernias. PMID:29670882

Stomal Closure: Strategies to Prevent Incisional Hernia

Directory of Open Access Journals (Sweden)

Rhiannon L. Harries

2018-04-01

Full Text Available Incisional hernias following ostomy reversal occur frequently. Incisional hernias at the site of a previous stoma closure can cause significant morbidity, impaired quality of life, lead to life-threatening hernia incarceration or strangulation and result in a significant financial burden on health care systems Despite this, the evidence base on the subject is limited. Many recognised risk factors for the development of incisional hernia following ostomy reversal are related to patient factors such as age, malignancy, diabetes, COPD, hypertension and obesity, and are not easily correctable. There is a limited amount of evidence to suggest that prophylactic mesh reinforcement may be of benefit to reduce the post stoma closure incisional hernia rate but a further large scale randomised controlled trial is due to report in the near future. There appears to be weak evidence to suggest that surgeons should favour circular, or “purse-string” closure of the skin following stoma closure in order to reduce the risk of SSI, which in turn may reduce incisional hernia formation. There remains the need for further evidence in relation to suture technique, skin closure techniques, mechanical bowel preparation and oral antibiotic prescription focusing on incisional hernia development as an outcome measure. Within this review, we discuss in detail the evidence base for the risk factors for the development of, and the strategies to prevent ostomy reversal site incisional hernias.

Case Report: Rapid staged abdominal closure using Gore-Tex® mesh as a bridge to primary omphalocele sac closure

Directory of Open Access Journals (Sweden)

William C. Kethman

2016-06-01

Full Text Available Omphaloceles present an ongoing challenge due to significant variations in presentation and associated co-morbidities. Diverse management strategies have been described to tackle many of the fundamental challenges of closure and reconstruction of the abdominal wall – this fact demonstrates a need for increasingly individualized management options for this complex disease. We describe a novel method of rapid staged abdominal wall closure using Gore-Tex® mesh as a bridge to primary omphalocele closure in an infant with partial Pentalogy of Cantrell and giant ruptured omphalocele. This strategy can be used in management of some of the most complex abdominal wall defects.

Bidirectional Barbed Sutures for Wound Closure: Evolution and Applications

Science.gov (United States)

Paul, Malcolm D.

2009-01-01

Traditionally, wound closure sutures have in common the need to tie knots with the inherent risk of extrusion, palpability, microinfarcts, breakage, and slippage. Bidirectional barbed sutures have barbs arrayed in a helical fashion in opposing directions on either side of an unbarbed midsegment. This suture is inserted at the midpoint of a wound and pulled through till resistance is encountered from the opposing barbs; each half of the suture is then advanced to the lateral ends of the wound. This design provides a method of evenly distributing tension along the incision line, a faster suture placement and closure time with no need to tie knots, and the possibility of improved cosmesis. Bidirectional barbed sutures, which are available in both absorbable and nonabsorbable forms, can be used for simple closures, multilayered closures, and closure of high-tension wounds in a variety of surgical settings. PMID:24527114

Primary angle closure glaucoma in a myopic kinship.

Science.gov (United States)

Hagan, J C; Lederer, C M

1985-03-01

Three related myopic individuals with primary angle closure glaucoma are reported. They had true myopia and not pseudomyopia secondary to increased lenticular index of refraction. We believe one of these individuals (-8.62 spherical equivalent) to have the most myopic case of primary angle closure glaucoma reported in the literature. Although myopia is associated with anatomical factors that offer considerable protection from primary angle closure glaucoma, its presence does not eliminate the possibility of this disease. Laser iridectomy was effective in the treatment of these patients.

Closure of a mixed waste landfill: Lessons learned

International Nuclear Information System (INIS)

Phifer, M.A.

1990-01-01

Much experience has been gained during the closure of the Mixed Waste Management Facility (MWMF) at the Savannah River Site (SRS) and many lessons were learned. This knowledge was applied to other closures at SRS yielding decreased costs, schedule enhancement, and increased overall project efficiency. The next major area of experience to be gained at SRS in the field of waste site closures will be in the upkeep, maintenance, and monitoring of clay caps. Further test programs will be required to address these requirements

Hamiltonian closures in fluid models for plasmas

Science.gov (United States)

Tassi, Emanuele

2017-11-01

This article reviews recent activity on the Hamiltonian formulation of fluid models for plasmas in the non-dissipative limit, with emphasis on the relations between the fluid closures adopted for the different models and the Hamiltonian structures. The review focuses on results obtained during the last decade, but a few classical results are also described, in order to illustrate connections with the most recent developments. With the hope of making the review accessible not only to specialists in the field, an introduction to the mathematical tools applied in the Hamiltonian formalism for continuum models is provided. Subsequently, we review the Hamiltonian formulation of models based on the magnetohydrodynamics description, including those based on the adiabatic and double adiabatic closure. It is shown how Dirac's theory of constrained Hamiltonian systems can be applied to impose the incompressibility closure on a magnetohydrodynamic model and how an extended version of barotropic magnetohydrodynamics, accounting for two-fluid effects, is amenable to a Hamiltonian formulation. Hamiltonian reduced fluid models, valid in the presence of a strong magnetic field, are also reviewed. In particular, reduced magnetohydrodynamics and models assuming cold ions and different closures for the electron fluid are discussed. Hamiltonian models relaxing the cold-ion assumption are then introduced. These include models where finite Larmor radius effects are added by means of the gyromap technique, and gyrofluid models. Numerical simulations of Hamiltonian reduced fluid models investigating the phenomenon of magnetic reconnection are illustrated. The last part of the review concerns recent results based on the derivation of closures preserving a Hamiltonian structure, based on the Hamiltonian structure of parent kinetic models. Identification of such closures for fluid models derived from kinetic systems based on the Vlasov and drift-kinetic equations are presented, and

Monitoring calculation of closure change of Extradosed Cable-stayed Bridge

Science.gov (United States)

Shi, Jing Xian; Ran, Zhi Hong

2018-06-01

During the construction of extradosed cable-stayed bridge in Yunnan province, China, the construction unit has made certain changes in the construction process of the closure section due to environmental restrictions: remove the hanging basket after the closure, the sling shall not be provided in closure section, the function of the sling is realized by the hanging basket on the 16th beam. In case of this change, the bridge has been constructed to section 15th. In order to ensure the smooth and orderly progress of each stage in the closure phase, this article is arranged according to the construction plan, appropriate adjustment of related procedures, checking the bridge safety at all stages of construction, the stress and force of the main girder are compared to ensure the safety of the construction after closure changes. Adjust the height of the beam of the 16th and 17th to adapt the new construction plan, and the bridge closure smoothly.

MNC Subsidiary Closures

DEFF Research Database (Denmark)

Sofka, Wolfgang; Torres Preto, Miguel; de Faria, Pedro

2014-01-01

We investigate the consequences of MNC subsidiary closures for employees who lose their jobs. In particular, we examine the extent to which the human capital that these employees acquired while employed by the MNC influences the wages they receive in their new jobs. We propose an employee...

Improvement of tricuspid regurgitation after transcatheter ASD closure in older patients.

Science.gov (United States)

Chen, L; Shen, J; Shan, X; Wang, F; Kan, T; Tang, X; Zhao, X; Qin, Y

2017-07-19

Adult patients with undiagnosed atrial septal defect (ASD) may have right heart cavity enlargement and functional tricuspid valve insufficiency. Moderate or more severe tricuspid regurgitation has been associated with a worse prognosis, and more serious complications are typically seen in older patients. This study aimed to evaluate the improvement in functional tricuspid regurgitation and heart geometry after transcatheter ASD closure in older patients. The data of 111 patients over 60 years of age with moderate or severe tricuspid regurgitation before ASD closure were analyzed. At the 1‑month and 6‑month follow-up after closure, both tricuspid regurgitation jet area and right atrial volume decreased significantly. Right ventricular volume decreased 1 month after closure, showing a further decrease at the end of the 6‑month follow-up. However, 24 patients (21.6%) still had persistent severe tricuspid regurgitation after the procedure. Multivariate analysis revealed that patient age at ASD closure and pulmonary artery systolic pressure determined by echocardiography before closure were predictors of persistent tricuspid regurgitation after closure. Transcatheter ASD closure in older patients could significantly decrease tricuspid regurgitation and improve right heart geometry.

2727-S Nonradioactive Dangerous Waste Storage Facility clean closure evaluation report

International Nuclear Information System (INIS)

Luke, S.N.

1994-01-01

This report presents the analytical results of 2727-S NRDWS facility closure verification soil sampling and compares these results to clean closure criteria. The results of this comparison will determine if clean closure of the unit is regulatorily achievable. This report also serves to notify regulators that concentrations of some analytes at the site exceed sitewide background threshold levels (DOE-RL 1993b) and/or the limits of quantitation (LOQ). This report also presents a Model Toxics Control Act Cleanup (MTCA) (WAC 173-340) regulation health-based closure standard under which the unit can clean close in lieu of closure to background levels or LOQ in accordance with WAC 173-303-610. The health-based clean closure standard will be closure to MTCA Method B residential cleanup levels. This report reconciles all analyte concentrations reported above background or LOQ to this health-based cleanup standard. Regulator acceptance of the findings presented in this report will qualify the TSD unit for clean closure in accordance with WAC 173-303-610 without further TSD unit soil sampling, or soil removal and/or decontamination. Nondetected analytes require no further evaluation

Transcatheter closure of patent ductus arteriosus using Flipper coil and Amplatzer Duct Occluder: Ten-year experience from a single center

Directory of Open Access Journals (Sweden)

Đukić Milan

2017-01-01

Full Text Available Introduction/Objective. Transcatheter closure is a well-established procedure for treatment of patent ductus arteriosus (PDA. We aimed to make a comparison between transcatheter PDA occlusion with Flipper coil and Amplatzer Duct Occluder (ADO and to determine the incidence and significance of procedural complications. Methods. Between November 2004 and October 2014, 148 patients were eligible for transcatheter PDA closure at the University Children’s Hospital in Belgrade, Serbia. The median age was 5.9 years (the range of 0.9 years to 17.3 years and the median weight was 21 kg (the range of 8.8 kg to 94 kg. Follow-up evaluations with Doppler echocardiogram were performed at one day, three months, and one and two years after the PDA occlusion. Results. Median narrowest PDA diameter was 1.5 mm (the range of 0.5 mm to 5.6 mm. Flipper coil was used for PDA closure in 84 (59.2% and ADO in 58 patients (40.8%. There was no significant difference in the rate of immediate complete closure between the coil and the ADO group (86.9% vs. 75.9%, p = 0.089, but a significantly higher rate of complete closure was achieved with ADO at one day (83.3% vs. 98.3%, p = 0.004, three months (85.7% vs. 100%, p = 0.002, and both one and two years after the implantation (91.7% vs. 100%, p = 0.041. In total, 12 complications occurred during the procedure, seven of which with coil and five with ADO occlusion of PDA. Conclusion. Transcatheter closure of PDA using both coils and ADOs is a very safe and effective procedure. ADO proved superior to coil in terms of complete closure rate as early as one day after the procedure.

Mitigation of social and environmental impacts resulting from final closure of uranium mines

International Nuclear Information System (INIS)

Cipriani, Moacir

2002-11-01

This thesis focus on the impact of uranium mines in Brazil. It is recent, in the order of the Brazilian mining, the concern with the impact of mining activities. The Federal Constitution of 1988 compels the miner to rehabilitate the degraded environment, in accordance with the technical solution demanded by the competent public agency, which makes use of a system of environmental norms conditioning the mining activity. However, the concern with the closure of mines is in an early stage, for whose achievement the public power still lacks of norms and regulations. The closure of the first uranium mining in Brazil assumes special meaning, because the possible environmental problems related to uranium mines are considered to be serious and the uranium industry is state owned. This thesis is divided in two sections. The first one describes the state of the art of the uranium industry and the rules and management practices regarding the final closure of uranium mining in Brazil and countries like Australia, Canada, USA and France, that have been selected on the basis of the following criteria: production, exportation, control of reserves and final consumption of uranium. In the second part, a case study of Pocos de Caldas mine is presented, with description of historical production, plant waste and the chemical treatment of the ore. This part also presents the research carried out since the beginning of the operations aiming to remedial actions, including the dismantling of surface structures, tailings reclamation, and ground-water restoration, following CNEN (Brazilian Nuclear Energy Commission) rules, as well as a survey of local press coverage of the impact of the industry. A final recommendation is made regarding a management model and strategies to mitigate social and environmental impacts resulting from final closure of the CIPC. (author)

Waste Dump Closure and Cost Estimates at AngloGold Ashanti ...

African Journals Online (AJOL)

Michael

2017-12-02

Dec 2, 2017 ... 2University of Mines and Technology, P.O. Box 237, Tarkwa, Ghana ... The mine has closure plans for the waste dumps and the closure activity ... incur additional cost, it was advised that the mine should execute the closure and reclamation plan without delay. .... Progressively rehabilitate the project area.

A short summary on finite element modelling of fatigue crack closure

Energy Technology Data Exchange (ETDEWEB)

Singh, Konjengbam Darunkumar [Indian Institute of Technology, Guwahati (India); Parry, Matthew Roger [Airbus Operations Ltd, Bristol(United Kingdom); Sinclair, Ian [University of Southampton, Southampton (United Kingdom)

2011-12-15

This paper presents a short summary pertaining to the finite element modelling of fatigue crack closure. Several key issues related to finite element modelling of fatigue crack closure are highlighted: element type, mesh refinement, stabilization of crack closure, crack-tip node release scheme, constitutive model, specimen geometry, stress-states (i.e., plane stress, plane strain), crack closure monitoring. Reviews are presented for both straight and deflected cracks.

Staged closure of a giant omphalocele with amnion preservation, modified technique

Directory of Open Access Journals (Sweden)

Akram H. Aljahdali

2017-04-01

Full Text Available Closure of a giant omphalocele can be challenging. Preservation of the amnion in staged closure is not commonly practiced. Here, we describe 2 cases of giant omphalocele treated with a modified amnion preservation, staged closure technique. This paper demonstrates the feasibility and safety of this technique, and the versatility of amnion to adapt to an escharization strategy if closure is not achievable.

DESIGN OF A WELDING AND INSPECTION SYSTEM FOR WASTE STORAGE CLOSURE

International Nuclear Information System (INIS)

H.B. Smartt; A.D. Watkins; D.P. Pace; R.J. Bitsoi; E.D. Larsen T.R. McJunkin; C.R. Tolle

2005-01-01

This work reported here was done to provide a conceptual design for a robotic welding and inspection system for the Yucca Mountain Repository waste package closure system. The welding and inspection system is intended to make the various closure welds that seal and/or structurally join the lids to the waste package vessels. The welding and inspection system will also perform surface and volumetric inspections of the various closure welds and has the means to repair closure welds, if required. The system is designed to perform these various activities remotely, without the necessity of having personnel in the closure cell

Friction or Closure

DEFF Research Database (Denmark)

Lundahl, Mikela

2014-01-01

Heritage is a discourse that aims at closure. It fixates the narrative of the past through the celebration of specific material (or sometimes immaterial non-) ob-jects. It organizes temporality and construct events and freezes time. How does this unfold in the case of the UNESCO World Heritage si...

Closure Plan for Active Low Level Burial Grounds

Energy Technology Data Exchange (ETDEWEB)

SKELLY, W.A.

2000-11-16

This plan has been prepared in response to direction from the U.S. Department of Energy. The purpose of the plan is to define approaches that will be implemented to ensure protection of the public and the environment when active Low-Level Burial Grounds (LLBGs) at the Hanford Site are closed. Performance assessments for active burial grounds in the 200 East and West 200 Areas provide current estimates of potential environmental contamination and doses to the ''maximum exposed individual'' from burial ground operation and closure and compare dose estimates to performance objective dose limits for the facilities. This is an Operational Closure Plan. The intent of the guidance in DOE Order 435.1 is that this plan will be a living document, like the facility performance assessments, and will be revised periodically through the operational life of the LLBGs to reflect updated information on waste inventory. management practices, facility transition planning, schedule dates, assessments of post-closure performance, and environmental consequences. Out year dates identified in this plan are tentative. A Final Closure Plan will be prepared in the future when the timing and extent of closure-related activities for LLBGs can be established with greater certainty. After current operations at the LLBGs are concluded, this plan proposes transitioning of these facilities to the Environmental Restoration Program. This action will enable the Environmental Restoration Program to design and implement consistent and coordinated final remedial actions for active and inactive LLBGs. Active and inactive burial grounds in the 200 West and 200 East Areas are commingled. This plan describes approaches that will be implemented during Interim Closure, Final Closure, and Institutional Control Periods to prepare LLBGs for surface barriers, and the construction of barriers, as well as the scope of inspection, monitoring and maintenance practices that will be performed during

Dynamics of hERG closure allow novel insights into hERG blocking by small molecules.

Science.gov (United States)

Schmidtke, Peter; Ciantar, Marine; Theret, Isabelle; Ducrot, Pierre

2014-08-25

Today, drug discovery routinely uses experimental assays to determine very early if a lead compound can yield certain types of off-target activity. Among such off targets is hERG. The ion channel plays a primordial role in membrane repolarization and altering its activity can cause severe heart arrhythmia and sudden death. Despite routine tests for hERG activity, rather little information is available for helping medicinal chemists and molecular modelers to rationally circumvent hERG activity. In this article novel insights into the dynamics of hERG channel closure are described. Notably, helical pairwise closure movements have been observed. Implications and relations to hERG inactivation are presented. Based on these dynamics novel insights on hERG blocker placement are presented, compared to literature, and discussed. Last, new evidence for horizontal ligand positioning is shown in light of former studies on hERG blockers.

Regional neural tube closure defined by the Grainy head-like transcription factors.

Science.gov (United States)

Rifat, Yeliz; Parekh, Vishwas; Wilanowski, Tomasz; Hislop, Nikki R; Auden, Alana; Ting, Stephen B; Cunningham, John M; Jane, Stephen M

2010-09-15

Primary neurulation in mammals has been defined by distinct anatomical closure sites, at the hindbrain/cervical spine (closure 1), forebrain/midbrain boundary (closure 2), and rostral end of the forebrain (closure 3). Zones of neurulation have also been characterized by morphologic differences in neural fold elevation, with non-neural ectoderm-induced formation of paired dorso-lateral hinge points (DLHP) essential for neural tube closure in the cranial and lower spinal cord regions, and notochord-induced bending at the median hinge point (MHP) sufficient for closure in the upper spinal region. Here we identify a unifying molecular basis for these observations based on the function of the non-neural ectoderm-specific Grainy head-like genes in mice. Using a gene-targeting approach we show that deletion of Grhl2 results in failed closure 3, with mutants exhibiting a split-face malformation and exencephaly, associated with failure of neuro-epithelial folding at the DLHP. Loss of Grhl3 alone defines a distinct lower spinal closure defect, also with defective DLHP formation. The two genes contribute equally to closure 2, where only Grhl gene dosage is limiting. Combined deletion of Grhl2 and Grhl3 induces severe rostral and caudal neural tube defects, but DLHP-independent closure 1 proceeds normally in the upper spinal region. These findings provide a molecular basis for non-neural ectoderm mediated formation of the DLHP that is critical for complete neuraxis closure. (c) 2010 Elsevier Inc. All rights reserved.

Conversion of choledochojejunostomy stents to jejunal feeding tubes for postoperative enteral alimentation.

Science.gov (United States)

Burke, D R; Torosian, M H; McLean, G K; Meranze, S G; Rosato, E F

1988-01-01

The problem of protein calorie malnutrition following major gastrointestinal surgery can be treated with central venous or enteric alimentation, with the latter being preferred. The authors describe a simple technique for the conversion of biliary stents placed after pancreaticoduodenal surgery into jejunal feeding tubes when the stenting function is no longer needed. Three illustrative cases are presented. In each case, the procedure took less than 30 min and had no associated morbidity. This technique allows early conversion from central venous to enteric alimentation without the need to create a second surgical enterostomy.

300 Area waste acid treatment system closure plan

International Nuclear Information System (INIS)

LUKE, S.N.

1999-01-01

The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (document number DOERL-91-28) and a Unit-Specific Portion. The scope of the Unit-Specific Portion includes closure plan documentation submitted for individual, treatment, storage, and/or disposal units undergoing closure, such as the 300 Area Waste Acid Treatment System. Documentation contained in the General Information Portion is broader in nature and could be used by multiple treatment, storage, and/or disposal units (e.g., the glossary provided in the General Information Portion). Whenever appropriate, 300 Area Waste Acid Treatment System documentation makes cross-reference to the General Information Portion, rather than duplicating text. This 300 Area Waste Acid Treatment System Closure Plan (Revision 2) includes a Hanford Facility Dangerous Waste Permit Application, Part A, Form 3. Information provided in this closure plan is current as of April 1999

300 Area waste acid treatment system closure plan

Energy Technology Data Exchange (ETDEWEB)

LUKE, S.N.

1999-05-17

The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (document number DOERL-91-28) and a Unit-Specific Portion. The scope of the Unit-Specific Portion includes closure plan documentation submitted for individual, treatment, storage, and/or disposal units undergoing closure, such as the 300 Area Waste Acid Treatment System. Documentation contained in the General Information Portion is broader in nature and could be used by multiple treatment, storage, and/or disposal units (e.g., the glossary provided in the General Information Portion). Whenever appropriate, 300 Area Waste Acid Treatment System documentation makes cross-reference to the General Information Portion, rather than duplicating text. This 300 Area Waste Acid Treatment System Closure Plan (Revision 2) includes a Hanford Facility Dangerous Waste Permit Application, Part A, Form 3. Information provided in this closure plan is current as of April 1999.

Early versus delayed dressing removal after primary closure of clean and clean-contaminated surgical wounds.

Science.gov (United States)

Toon, Clare D; Lusuku, Charnelle; Ramamoorthy, Rajarajan; Davidson, Brian R; Gurusamy, Kurinchi Selvan

2015-09-03

Most surgical procedures involve a cut in the skin that allows the surgeon to gain access to the deeper tissues or organs. Most surgical wounds are closed fully at the end of the procedure (primary closure). The surgeon covers the closed surgical wound with either a dressing or adhesive tape. The dressing can act as a physical barrier to protect the wound until the continuity of the skin is restored (within about 48 hours) and to absorb exudate from the wound, keeping it dry and clean, and preventing bacterial contamination from the external environment. Some studies have found that the moist environment created by some dressings accelerates wound healing, although others believe that the moist environment can be a disadvantage, as excessive exudate can cause maceration (softening and deterioration) of the wound and the surrounding healthy tissue. The utility of dressing surgical wounds beyond 48 hours of surgery is, therefore, controversial. To evaluate the benefits and risks of removing a dressing covering a closed surgical incision site within 48 hours permanently (early dressing removal) or beyond 48 hours of surgery permanently with interim dressing changes allowed (delayed dressing removal), on surgical site infection. In March 2015 we searched the following electronic databases: The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. We also searched the references of included trials to identify further potentially-relevant trials. Two review authors independently identified studies for inclusion. We included all randomised clinical trials (RCTs) conducted with people of any age and sex, undergoing a surgical procedure, who had their wound closed and a dressing applied. We included only trials that compared

Predictors of successful closure of patent ductus arteriosus with indomethacin.

Science.gov (United States)

Ahamed, M F; Verma, P; Lee, S; Vega, M; Wang, D; Kim, M; Fuloria, M

2015-09-01

To determine whether platelet counts can predict the likelihood of successful closure of patent ductus arteriosus (PDA) with indomethacin. This was a retrospective cohort study of infants closure with indomethacin and those who failed were compared. Multivariable logistic regression was used to identify predictors of successful ductal closure. In infants with hemodynamically significant PDA, older GA (odds ratio=1.54; 95% confidence interval: 1.12 to 2.13), male gender (odds ratio=3.02; 95% confidence interval: 1.08 to 8.49) and higher platelet count (odds ratio=1.5; 95% confidence interval: 1.04 to 2.17) prior to indomethacin treatment were associated with successful ductal closure with indomethacin. Older GA, male gender and higher platelet count at time of treatment of hemodynamically significant PDA are predictors of successful ductal closure with indomethacin.

300 Area Process Trenches Closure Plan

International Nuclear Information System (INIS)

Luke, S.N.

1994-01-01

Since 1987, Westinghouse Hanford Company has been a major contractor to the US Department of Energy, Richland Operations Office and has served as co-operator of the 300 Area Process Trenches, the waste management unit addressed in this closure plan. For the purposes of the Resource Conservation and Recovery Act, Westinghouse Hanford Company is identified as ''co-operator.'' The 300 Area Process Trenches Closure Plan (Revision 0) consists of a Resource Conservation and Recovery Act Part A Dangerous Waste Permit Application, Form 3 and a Resource Conservation and Recovery Act Closure Plan. An explanation of the Part A Permit Application, Form 3 submitted with this document is provided at the beginning of the Part A Section. The closure plan consists of nine chapters and six appendices. The 300 Area Process Trenches received dangerous waste discharges from research and development laboratories in the 300 Area and from fuels fabrication processes. This waste consisted of state-only toxic (WT02), corrosive (D002), chromium (D007), spent halogenated solvents (F001, F002, and F003), and spent nonhalogented solvent (F005). Accurate records are unavailable concerning the amount of dangerous waste discharged to the trenches. The estimated annual quantity of waste (item IV.B) reflects the total quantity of both regulated and nonregulated waste water that was discharged to the unit

Catheter-based closure of the patent ductus arteriosus in lower weight infants.

Science.gov (United States)

Pavlek, Leeann R; Slaughter, Jonathan L; Berman, Darren P; Backes, Carl H

2018-06-13

Risks associated with drug therapy and surgical ligation have led health care providers to consider alternative strategies for patent ductus arteriosus (PDA) closure. Catheter-based PDA closure is the procedure of choice for ductal closure in adults, children, and infants ≥6kg. Given evidence among older counterparts, interest in catheter-based closure of the PDA in lower weight (closure devices; (3) review the technical success (feasibility); (4) review the risks (safety profile); (5) discuss the quality of evidence on procedural efficacy; (6) consider areas for future research. The review provided herein suggests that catheter-based PDA closure is technically feasible, but the lack of comparative trials precludes determination of the optimal strategy for ductal closure in this subgroup of infants. Copyright © 2018 Elsevier Inc. All rights reserved.

LXA4 actions direct fibroblast function and wound closure

International Nuclear Information System (INIS)

Herrera, Bruno S.; Kantarci, Alpdogan; Zarrough, Ahmed; Hasturk, Hatice; Leung, Kai P.; Van Dyke, Thomas E.

2015-01-01

Timely resolution of inflammation is crucial for normal wound healing. Resolution of inflammation is an active biological process regulated by specialized lipid mediators including the lipoxins and resolvins. Failure of resolution activity has a major negative impact on wound healing in chronic inflammatory diseases that is manifest as excess fibrosis and scarring. Lipoxins, including Lipoxin A 4 (LXA 4 ), have known anti-fibrotic and anti-scarring properties. The goal of this study was to elucidate the impact of LXA 4 on fibroblast function. Mouse fibroblasts (3T3 Mus musculus Swiss) were cultured for 72 h in the presence of TGF-β1, to induce fibroblast activation. The impact of exogenous TGF-β1 (1 ng/mL) on LXA 4 receptor expression (ALX/FPR2) was determined by flow cytometry. Fibroblast proliferation was measured by bromodeoxyuridine (BrdU) labeling and migration in a “scratch” assay wound model. Expression of α-smooth muscle actin (α-SMA), and collagen types I and III were measured by Western blot. We observed that TGF-β1 up-regulates LXA 4 receptor expression, enhances fibroblast proliferation, migration and scratch wound closure. α-SMA levels and Collagen type I and III deposition were also enhanced. LXA 4 slowed fibroblast migration and scratch wound closure at early time points (24 h), but wound closure was equal to TGF-β1 alone at 48 and 72 h. LXA 4 tended to slow fibroblast proliferation at both concentrations, but had no impact on α-SMA or collagen production by TGF-β1 stimulated fibroblasts. The generalizability of the actions of resolution molecules was examined in experiments repeated with resolvin D2 (RvD2) as the agonist. The activity of RvD2 mimicked the actions of LXA 4 in all assays, through an as yet unidentified receptor. The results suggest that mediators of resolution of inflammation enhance wound healing and limit fibrosis in part by modulating fibroblast function. - Highlights: • TGF-β1 up-regulates LXA 4 receptor (ALX

Oral Paracetamol for Patent Ductus Arteriosus Rescue Closure.

Science.gov (United States)

Pharande, Pramod; Watson, Hadley; Tan, Kenneth; Sehgal, Arvind

2018-01-01

The objective of this study was to ascertain the efficacy of oral paracetamol in closing a symptomatic patent ductus arteriosus (PDA) when used as 'rescue' option. After obtaining ethics approval, a retrospective appraisal of the data from April 2014 to July 2015 was performed. Infants who were administered oral paracetamol either after unsuccessful therapy with ibuprofen or where it was considered contraindicated were included. A previously published echocardiographic scoring schema to stratify for ductal disease severity was used. Using univariate analysis, characteristics of infants with successful closure were compared with partial (a priori reduction in composite score by ≥ 50% of pretreatment) or no closure. Twenty infants with gestation age and birthweight of 25.7 ± 1.5 weeks and 724.1 ± 143 g, respectively, were studied. Complete closure was noted in 10 (50%) infants with additional four infants showing a significant reduction in haemodynamic shunting. Gestational age at birth and at therapy, chronological age at therapy, birthweight and total fluid intake were comparable between the two groups. The pre-therapy composite score had a significant association with successful closure (the higher the echocardiographic score, the lesser the closure). Concomitant furosemide therapy and late-onset sepsis had a high likelihood ratio of unsuccessful closure (11.01 [2-tailed, p = 0.005] and 5.3 [2-tailed, p = 0.07]), respectively. Oral paracetamol may be a possible therapeutic option in premature infants where therapy with first-line agents is unsuccessful or contraindicated. Concomitant sepsis and furosemide administration may affect successful therapy.

Hanford Patrol Academy demolition sites closure plan

Energy Technology Data Exchange (ETDEWEB)

1993-09-30

The Hanford Site is owned by the U.S. Government and operated by the U.S. Department of Energy, Richland Operations Office. Westinghouse Hanford Company is a major contractor to the U.S. Department of Energy, Richland Operations Office and serves as co-operator of the Hanford Patrol Academy Demolition Sites, the unit addressed in this paper. This document consists of a Hanford Facility Dangerous Waste Part A Permit Application, Form 3 (Revision 4), and a closure plan for the site. An explanation of the Part A Form 3 submitted with this closure plan is provided at the beginning of the Part A section. This Hanford Patrol Academy Demolition Sites Closure Plan submittal contains information current as of December 15, 1994.

Impact of Vial Capping on Residual Seal Force and Container Closure Integrity.

Science.gov (United States)

Mathaes, Roman; Mahler, Hanns-Christian; Roggo, Yves; Ovadia, Robert; Lam, Philippe; Stauch, Oliver; Vogt, Martin; Roehl, Holger; Huwyler, Joerg; Mohl, Silke; Streubel, Alexander

2016-01-01

The vial capping process is a critical unit operation during drug product manufacturing, as it could possibly generate cosmetic defects or even affect container closure integrity. Yet there is significant variability in capping equipment and processes, and their relation to potential defects or container closure integrity has not been thoroughly studied. In this study we applied several methods-residual seal force tester, a self-developed system of a piezo force sensor measurement, and computed tomography-to characterize different container closure system combinations that had been sealed using different capping process parameter settings. Additionally, container closure integrity of these samples was measured using helium leakage (physical container closure integrity) and compared to characterization data. The different capping equipment settings lead to residual seal force values from 7 to 115 N. High residual seal force values were achieved with high capping pre-compression force and a short distance between the capping plate and plunge. The choice of container closure system influenced the obtained residual seal force values. The residual seal force tester and piezoelectric measurements showed similar trends. All vials passed physical container closure integrity testing, and no stopper rupture was seen with any of the settings applied, suggesting that container closure integrity was warranted for the studied container closure system with the chosen capping setting ranges. The vial capping process is a critical unit operation during drug product manufacturing, as it could possibly generate cosmetic defects or even affect container closure integrity. Yet there is significant variability in capping equipment and processes, and their relation to potential defects or container closure integrity has not been thoroughly studied. In this study we applied several methods-residual seal force tester, a self-developed system of a piezo force sensor measurement, and

Military Base Closures: Updated Status of Prior Base Realignments and Closures

Science.gov (United States)

As the Department of Defense (DOD) prepares for the 2005 base realignment and closure (BRAC) round, questions continue to be raised about the transfer and environmental cleanup of unneeded property arising from the prior four BRAC rounds and their impact on cost and savings and on local economies.

Transuranic Storage Area (TSA)-2 container storage unit RCRA closure plan

International Nuclear Information System (INIS)

Lodman, D.W.; Spry, M.J.; Nolte, E.P.; Barry, G.A.

1992-11-01

This document describes the proposed plans for closure of the Transuranic Storage Area (TSA)-2 container storage unit at the Idaho National Engineering Laboratory in accordance with the Resource Conservation and Recovery Act closure requirements. The location, size, capacity, history, and current status of the unit are described. Future plans for the unit include incorporating the earthen-covered portion of the TSA-2 pad into a TSA retrieval enclosure along with the TSA-1 and TSAR pads, and closure of the portion of the TSA-2 pad under the Air Support Weather Shield (ASWS-2). This plan addresses closure of the ASWS-2 by decontaminating structures and equipment that may have contacted the waste. Sufficient sampling and documentation of all closure activities will be performed to demonstrate clean closure. A tentative schedule is provided in the form of a milestone chart

Phenomenology of convection-parameterization closure

Directory of Open Access Journals (Sweden)

J.-I. Yano

2013-04-01

Full Text Available Closure is a problem of defining the convective intensity in a given parameterization. In spite of many years of efforts and progress, it is still considered an overall unresolved problem. The present article reviews this problem from phenomenological perspectives. The physical variables that may contribute in defining the convective intensity are listed, and their statistical significances identified by observational data analyses are reviewed. A possibility is discussed for identifying a correct closure hypothesis by performing a linear stability analysis of tropical convectively coupled waves with various different closure hypotheses. Various individual theoretical issues are considered from various different perspectives. The review also emphasizes that the dominant physical factors controlling convection differ between the tropics and extra-tropics, as well as between oceanic and land areas. Both observational as well as theoretical analyses, often focused on the tropics, do not necessarily lead to conclusions consistent with our operational experiences focused on midlatitudes. Though we emphasize the importance of the interplays between these observational, theoretical and operational perspectives, we also face challenges for establishing a solid research framework that is universally applicable. An energy cycle framework is suggested as such a candidate.

Crack closure and sequential effects in fatigue: A literature survey

Science.gov (United States)

Holmgren, M.

A literature survey of the phenomenon of crack closure is reported here. The state of the art is reviewed and several empirical formulas for determining the crack closure are compared with each other. Their properties, advantages and disadvantages are briefly discussed. Experimental techniques for determining the crack closure stress are presented and experimental data from the literature are reported.

303-K Storage Facility: Report on FY98 closure activities

International Nuclear Information System (INIS)

Adler, J.G.

1998-01-01

This report summarizes and evaluates the decontamination activities, sampling activities, and sample analysis performed in support of the closure of the 303-K Storage Facility. The evaluation is based on the validated data included in the data validation package (98-EAP-346) for the 303-K Storage Facility. The results of this evaluation will be used for assessing contamination for the purpose of closing the 303-K Storage Facility as described in the 303-K Storage Facility Closure Plan, DOE/RL-90-04. The closure strategy for the 303-K Storage Facility is to decontaminate the interior of the north half of the 303-K Building to remove known or suspected dangerous waste contamination, to sample the interior concrete and exterior soils for the constituents of concern, and then to perform data analysis, with an evaluation to determine if the closure activities and data meet the closure criteria. The closure criteria for the 303-K Storage Facility is that the concentrations of constituents of concern are not present above the cleanup levels. Based on the evaluation of the decontamination activities, sampling activities, and sample data, determination has been made that the soils at the 303-K Storage Facility meet the cleanup performance standards (WMH 1997) and can be clean closed. The evaluation determined that the 303-K Building cannot be clean closed without additional closure activities. An additional evaluation will be needed to determine the specific activities required to clean close the 303-K Storage Facility. The radiological contamination at the 303-K Storage Facility is not addressed by the closure strategy

Transvaginal bladder neck closure with posterior urethral flap for devastated urethra.

Science.gov (United States)

Rovner, Eric S; Goudelocke, Colin M; Gilchrist, Alienor; Lebed, Brett

2011-07-01

To present a modified transvaginal bladder neck closure (TV BNC) technique using a posterior urethral flap to minimize the potential risk of ureteral injury and fistula formation. Urethral and bladder neck destruction owing to chronic indwelling urethral catheters in female neurogenic patients is a devastating complication. A retrospective review was performed of all patients undergoing TV BNC at a single institution during a 3-year period. All patients had had a nonfunctional or destroyed urethra because of a long-term indwelling urethral catheter. In brief, the devastated outlet was closed using the dorsally bivalved urethra as a flap that was rotated cephalad onto the incised anterior bladder wall for closure, thereby rotating the suture line high into the retropubic space. A postoperative cystogram was obtained at 2-3 weeks. A total of 11 consecutive female patients with a devastated outlet underwent TV BNC, as described, with placement of a suprapubic tube. One patient experienced failure at 6 weeks postoperatively. The mean follow-up for the entire cohort was 9.6 months (range 1-36). Serial upper tract imaging at the last follow-up visit revealed no new hydroureteronephrosis. The results of our study have shown that TV BNC with a posterior urethral flap provides satisfactory early results. This technique creates a suture line far removed from the ureteral orifices, minimizing the risk of upper tract injury during closure. Also, the rotation of the posterior urethra onto the anterior bladder wall secures the suture line high into the retropubic space, minimizing the risk of failure and postoperative fistula formation. Copyright © 2011 Elsevier Inc. All rights reserved.

Percutaneous Patent Ductus Arteriosus (PDA) Closure in Very Preterm Infants: Feasibility and Complications.

Science.gov (United States)

Backes, Carl H; Cheatham, Sharon L; Deyo, Grace M; Leopold, Scott; Ball, Molly K; Smith, Charles V; Garg, Vidu; Holzer, Ralf J; Cheatham, John P; Berman, Darren P

2016-02-12

Percutaneous closure of patent ductus arteriosus (PDA) in term neonates is established, but data regarding outcomes in infants born very preterm (closure at weights closure. Twenty-five percent (13/52) of infants were closure. Compared to precatheterization trends, percutaneous PDA closure resulted in improved respiratory status, including less exposure to mechanical ventilation (mixed effects logistic model, Pclosure at weights closure versus alternative (surgical ligation) management strategies. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Mixed Waste Management Facility closure at the Savannah River Site

International Nuclear Information System (INIS)

Bittner, M.F.

1991-08-01

The Mixed Waste Management Facility of the Savannah River Plant received hazardous and solid low level radioactive wastes from 1972 until 1986. Because this facility did not have a permit to receive hazardous wastes, a Resource Conservation and Recovery Act closure was performed between 1987 and 1990. This closure consisted of dynamic compaction of the waste trenches and placement of a 3-foot clay cap, a 2-foot soil cover, and a vegetative layer. Operations of the waste disposal facility, tests performed to complete the closure design, and the construction of the closure cap are discussed herein

Cystic Duct Closure by Sealing With Bipolar Electrocoagulation

Science.gov (United States)

Damgaard, B.; Jorgensen, L. N.; Larsen, S. S.; Kristiansen, V. B.

2010-01-01

Background: Cystic duct leakage after cholecystectomy is not uncommon and is a potentially serious complication. The aim of this study was to assess a bipolar sealing system (LigaSure®) for closure of the cystic duct. Methods: The records from consecutive laparoscopic cholecystectomies performed in 2 hospitals with closure of the cystic duct with LigaSure after informed consent were recorded and complications and morbidity registered. The records were compared with those of patients undergoing laparoscopic cholecystectomy with closure of the cystic duct with clips during the same period. Results: During the study period, 218 laparoscopic cholecystectomies were performed; 102 of these were performed with the LigaSure. One patient was excluded due to violation of the protocol. We experienced no cases of cystic duct leakage, but in one patient, bile leakage from the gallbladder bed was observed probably due to a small aberrant duct. Conclusion: The LigaSure system was safe and effective for closure and division of the cystic duct in laparoscopic cholecystectomy. PMID:20412641

LLNL/YMP Waste Container Fabrication and Closure Project

International Nuclear Information System (INIS)

1990-10-01

The Department of Energy's Office of Civilian Radioactive Waste Management (OCRWM) Program is studying Yucca Mountain, Nevada as a suitable site for the first US high-level nuclear waste repository. Lawrence Livermore National Laboratory (LLNL) has the responsibility for designing and developing the waste package for the permanent storage of high-level nuclear waste. This report is a summary of the technical activities for the LLNL/YMP Nuclear Waste Disposal Container Fabrication and Closure Development Project. Candidate welding closure processes were identified in the Phase 1 report. This report discusses Phase 2. Phase 2 of this effort involved laboratory studies to determine the optimum fabrication and closure processes. Because of budget limitations, LLNL narrowed the materials for evaluation in Phase 2 from the original six to four: Alloy 825, CDA 715, CDA 102 (or CDA 122) and CDA 952. Phase 2 studies focused on evaluation of candidate material in conjunction with fabrication and closure processes

Stress analysis of closure bolts for shipping casks

International Nuclear Information System (INIS)

Mok, G.C.; Fischer, L.E.; Hsu, S.T.

1993-01-01

This report specifies the requirements and criteria for stress analysis of closure bolts for shipping casks containing nuclear spent fuels or high level radioactive materials. The specification is based on existing information conceming the structural behavior, analysis, and design of bolted joints. The approach taken was to extend the ASME Boiler and Pressure Vessel Code requirements and criteria for bolting analysis of nuclear piping and pressure vessels to include the appropriate design and load characteristics of the shipping cask. The characteristics considered are large, flat, closure lids with metal-to-metal contact within the bolted joint; significant temperature and impact loads; and possible prying and bending effects. Specific formulas and procedures developed apply to the bolt stress analysis of a circular, flat, bolted closure. The report also includes critical load cases and desirable design practices for the bolted closure, an in-depth review of the structural behavior of bolted joints, and a comprehensive bibliography of current information on bolted joints

Transcatheter closure of large atrial septal defects with deficient aortic or posterior rims using the "Greek maneuver". A multicenter study.

Science.gov (United States)

Thanopoulos, Basil D; Dardas, Petros; Ninios, Vlasis; Eleftherakis, Nicholaos; Karanasios, Evangelos

2013-10-09

We report a modification ("Greek maneuver") of the standard atrial septal defect (ASD) closure technique using the Amplatzer septal occluder (ASO) to facilitate closure of large ASDs with deficient aortic or posterior rims. 185 patients (median 10.8, range 3 to 52 years) with large ASDs (mean diameter 26±7 mm, range 20-40 mm) with a deficient aortic (134 patients) or posterior (51 patients) rim underwent catheter closure with the ASO using the "Greek maneuver" under transesophageal guidance. The Greek maneuver is applied when protrusion of the aortic edge of the deployed left disk of the device in to the right atrium is detected by echo. To circumvent this left disk is recaptured and the whole delivery system is pushed inward and leftward into the left atrium where the left disk and the 2/3 of right disk are simultaneously released. This maneuver forces the left disk to become parallel to the septum preventing the protrusion of the device into the right atrium. The ASO was successfully implanted and was associated with complete closure in 175/185 (95%) of the patients. There were no early or late complications related to the procedure during a follow-up period ranging from 6 months to 7 years. The "Greek maneuver" is a simple quite useful trick that facilitates closure of large ASDs associated with or without deficient aortic or posterior rims. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Complex bladder-exstrophy-epispadias management: Causes of failure of initial bladder closure

Directory of Open Access Journals (Sweden)

Kouame Dibi Bertin

2014-01-01

Full Text Available The success of the initial closure of the complex bladder-exstrophy remains a challenge in pediatric surgery. This study describes a personal experience of the causes of failure of the initial closure and operative morbidity during the surgical treatment of bladder-exstrophy complex. From April 2000 to March 2014, four patients aged 16 days to 7 years and 5 months underwent complex exstrophy-epispadias repair with pelvic osteotomies. There were three males and one female. Three of them had posterior pelvic osteotomy, one had anterior innominate osteotomy. Bladder Closure: Bladder closure was performed in three layers. Our first patient had initial bladder closure with polyglactin 4/0 (Vicryl ® 4/0, concerning the last three patients, initial bladder closure was performed with polydioxanone 4/0 (PDS ® 4/0. The bladder was repaired leaving the urethral stent and ureteral stents for full urinary drainage for three patients. In one case, only urethral stent was left, ureteral drainage was not possible, because stents sizes were more important than the ureteral diameter. Out of a total of four patients, initial bladder closure was completely achieved for three patients. At the immediate postoperative follow-up, two patients presented a complete disunion of the abdominal wall and bladder despite an appropriate postoperative care. The absorbable braided silk (polyglactin used for the bladder closure was considered as the main factor in the failure of the bladder closure. The second cause of failure of the initial bladder closure was the incomplete urine drainage, ureteral catheterisation was not possible because the catheters sizes were too large compared with the diameters of the ureters. The failure of the initial bladder-exstrophy closure may be reduced by a closure with an absorbable monofilament silk and efficient urine drainage via ureteral catheterisation.

Understanding the Risk Factors of Trauma Center Closures

Science.gov (United States)

Shen, Yu-Chu; Hsia, Renee Y.; Kuzma, Kristen

2011-01-01

Objectives We analyze whether hazard rates of shutting down trauma centers are higher due to financial pressures or in areas with vulnerable populations (such as minorities or the poor). Materials and Methods This is a retrospective study of all hospitals with trauma center services in urban areas in the continental US between 1990 and 2005, identified from the American Hospital Association Annual Surveys. These data were linked with Medicare cost reports, and supplemented with other sources, including the Area Resource File. We analyze the hazard rates of trauma center closures among several dimensions of risk factors using discrete-time proportional hazard models. Results The number of trauma center closures increased from 1990 to 2005, with a total of 339 during this period. The hazard rate of closing trauma centers in hospitals with a negative profit margin is 1.38 times higher than those hospitals without the negative profit margin (P lower hazard of shutting down trauma centers (ratio: 0.58, P penetration face a higher hazard of trauma center closure (ratio: 2.06, P < 0.01). Finally, hospitals in areas with higher shares of minorities face a higher risk of trauma center closure (ratio: 1.69, P < 0.01). Medicaid load and uninsured populations, however, are not risk factors for higher rates of closure after we control for other financial and community characteristics. Conclusions Our findings give an indication on how the current proposals to cut public spending could exacerbate the trauma closure particularly among areas with high shares of minorities. In addition, given the negative effect of health maintenance organizations on trauma center survival, the growth of Medicaid managed care population should be monitored. Finally, high shares of Medicaid or uninsurance by themselves are not independent risk factors for higher closure as long as financial pressures are mitigated. Targeted policy interventions and further research on the causes, are needed to

The Rising Rate of Rural Hospital Closures.

Science.gov (United States)

Kaufman, Brystana G; Thomas, Sharita R; Randolph, Randy K; Perry, Julie R; Thompson, Kristie W; Holmes, George M; Pink, George H

2016-01-01

Since 2010, the rate of rural hospital closures has increased significantly. This study is a preliminary look at recent closures and a formative step in research to understand the causes and the impact on rural communities. The 2009 financial performance and market characteristics of rural hospitals that closed from 2010 through 2014 were compared to rural hospitals that remained open during the same period, stratified by critical access hospitals (CAHs) and other rural hospitals (ORHs). Differences were tested using Pearson's chi-square (categorical variables) and Wilcoxon rank test of medians. The relationships between negative operating margin and (1) market factors and (2) utilization/staffing factors were explored using logistic regression. In 2009, CAHs that subsequently closed from 2010 through 2014 had, in general, lower levels of profitability, liquidity, equity, patient volume, and staffing. In addition, ORHs that closed had smaller market shares and operated in markets with smaller populations compared to ORHs that remained open. Odds of unprofitability were associated with both market and utilization factors. Although half of the closed hospitals ceased providing health services altogether, the remainder have since converted to an alternative health care delivery model. Financial and market characteristics appear to be associated with closure of rural hospitals from 2010 through 2014, suggesting that it is possible to identify hospitals at risk of closure. As closure rates show no sign of abating, it is important to study the drivers of distress in rural hospitals, as well as the potential for alternative health care delivery models. © 2015 National Rural Health Association.

The effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle-closure glaucoma (EAGLE): study protocol for a randomized controlled trial.

Science.gov (United States)

Azuara-Blanco, Augusto; Burr, Jennifer M; Cochran, Claire; Ramsay, Craig; Vale, Luke; Foster, Paul; Friedman, David; Quayyum, Zahidul; Lai, Jimmy; Nolan, Winnie; Aung, Tin; Chew, Paul; McPherson, Gladys; McDonald, Alison; Norrie, John

2011-05-23

Glaucoma is the leading cause of irreversible blindness. Although primary open-angle glaucoma is more common, primary angle-closure glaucoma (PACG) is more likely to result in irreversible blindness. By 2020, 5·3 million people worldwide will be blind because of PACG. The current standard care for PACG is a stepped approach of a combination of laser iridotomy surgery (to open the drainage angle) and medical treatment (to reduce intraocular pressure). If these treatments fail, glaucoma surgery (eg, trabeculectomy) is indicated. It has been proposed that, because the lens of the eye plays a major role in the mechanisms leading to PACG, early clear lens extraction will improve glaucoma control by opening the drainage angle. This procedure might reduce the need for drugs and glaucoma surgery, maintain good visual acuity, and improve quality of life compared with standard care.EAGLE aims to evaluate whether early lens extraction improves patient-reported, clinical outcomes, and cost-effectiveness, compared with standard care. EAGLE is a multicentre pragmatic randomized trial. All people presenting to the recruitment centres in the UK and east Asia with newly diagnosed PACG and who are at least 50 years old are eligible.The primary outcomes are EQ-5D, intraocular pressure, and incremental cost per quality adjusted life year (QALY) gained. Other outcomes are: vision and glaucoma-specific patient-reported outcomes, visual acuity, visual field, angle closure, number of medications, additional surgery (e.g., trabeculectomy), costs to the health services and patients, and adverse events.A single main analysis will be done at the end of the trial, after three years of follow-up. The analysis will be based on all participants as randomized (intention to treat). 400 participants (200 in each group) will be recruited, to have 90% power at 5% significance level to detect a difference in EQ-5D score between the two groups of 0·05, and a mean difference in intraocular pressure of

The effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle-closure glaucoma (EAGLE: study protocol for a randomized controlled trial

Directory of Open Access Journals (Sweden)

Chew Paul

2011-05-01

Full Text Available Abstract Background Glaucoma is the leading cause of irreversible blindness. Although primary open-angle glaucoma is more common, primary angle-closure glaucoma (PACG is more likely to result in irreversible blindness. By 2020, 5·3 million people worldwide will be blind because of PACG. The current standard care for PACG is a stepped approach of a combination of laser iridotomy surgery (to open the drainage angle and medical treatment (to reduce intraocular pressure. If these treatments fail, glaucoma surgery (eg, trabeculectomy is indicated. It has been proposed that, because the lens of the eye plays a major role in the mechanisms leading to PACG, early clear lens extraction will improve glaucoma control by opening the drainage angle. This procedure might reduce the need for drugs and glaucoma surgery, maintain good visual acuity, and improve quality of life compared with standard care. EAGLE aims to evaluate whether early lens extraction improves patient-reported, clinical outcomes, and cost-effectiveness, compared with standard care. Methods/Design EAGLE is a multicentre pragmatic randomized trial. All people presenting to the recruitment centres in the UK and east Asia with newly diagnosed PACG and who are at least 50 years old are eligible. The primary outcomes are EQ-5D, intraocular pressure, and incremental cost per quality adjusted life year (QALY gained. Other outcomes are: vision and glaucoma-specific patient-reported outcomes, visual acuity, visual field, angle closure, number of medications, additional surgery (e.g., trabeculectomy, costs to the health services and patients, and adverse events. A single main analysis will be done at the end of the trial, after three years of follow-up. The analysis will be based on all participants as randomized (intention to treat. 400 participants (200 in each group will be recruited, to have 90% power at 5% significance level to detect a difference in EQ-5D score between the two groups of 0·05

Closure of hazardous and mixed radioactive waste management units at DOE facilities

International Nuclear Information System (INIS)

1990-06-01

This is document addresses the Federal regulations governing the closure of hazardous and mixed waste units subject to Resource Conservation and Recovery Act (RCRA) requirements. It provides a brief overview of the RCRA permitting program and the extensive RCRA facility design and operating standards. It provides detailed guidance on the procedural requirements for closure and post-closure care of hazardous and mixed waste management units, including guidance on the preparation of closure and post-closure plans that must be submitted with facility permit applications. This document also provides guidance on technical activities that must be conducted both during and after closure of each of the following hazardous waste management units regulated under RCRA

Environmental considerations in mine closure planning

International Nuclear Information System (INIS)

Ricks, G.

1997-01-01

Mine closure planning considers the best ways to plan and manage the environmental changes and socio-economic effects associated with the closing of mines. While the criteria for judging successful closures may vary, it is particularly important for physical, chemical and biological stability to be achieved and for final land use to be appropriate. Trust funds are increasingly favoured as a practical means of fulfilling the requirement for a financial surety and of ensuring that financial provision is available at the end of the mine's life. (author)

Special closure for radioactive shipping container

International Nuclear Information System (INIS)

Otts, J.V.

1976-03-01

The objective of this program was to develop a special lid closure for radioactive material shipping containers, typically steel drums. Three closure techniques were designed, fabricated, and proven to be structurally adequate to protect 1000 lb when dropped 30 ft. The three designs were (1) a 6-in. lid extension (skirt), (2) a 6-in. inner lid, and (3) c-clamps used at the container/lid interface. Based upon structural integrity, economic impact, and minimal design change, the 6-in. lid extension is recommended

Association of iris crypts with acute primary angle closure.

Science.gov (United States)

Koh, Victor; Chua, Jacqueline; Shi, Yuan; Thakku, Sri Gowtham; Lee, Ryan; Nongpiur, Monisha E; Baskaran, Mani; Kumar, Rajesh S; Perera, Shamira; Aung, Tin; Cheng, Ching-Yu

2017-10-01

To determine the relationship between iris surface features and acute primary angle closure (APAC) in eyes with angle closure. Case-control study involving Asian patients diagnosed with previous APAC, primary angle closure suspect (PACS), primary angle closure (PAC) and primary angle closure glaucoma (PACG) at an eye centre in Singapore between August 2012 and January 2015. Participants underwent ophthalmic examination and digital slit-lamp iris photography. Iris surface features were graded based on crypts, furrows and colour. Fellow eyes of APAC were compared with PACS and PAC/PACG eyes with regard to their iris surface features. Occurrence of APAC. A total of 309 patients (71 APAC, 139 PACS, 47 PAC and 52 PACG) were included (mean age: 67.7±7.2 years and 36.6% male). Compared with PACS, higher crypt grade was significantly associated with lower odds of APAC (OR=0.58 for one grade higher in crypt grade; p=0.027, adjusted for age, gender, ethnicity and pupil diameter). The results remained similar when compared with PAC/PACG group (OR=0.58 for one grade higher in crypt grade; p=0.043). We did not observe any significant associations between iris furrows or colour with presence of APAC. Our study comprising Asian eyes with angle closure suggests that the presence of a higher crypt grading may be protective for APAC. As such, assessing iris surface architecture for crypts could be a new measure for risk stratification of developing APAC in eyes with angle closure. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

PFO closuRE and CryptogenIc StrokE (PRECISE) registry

DEFF Research Database (Denmark)

Wöhrle, Jochen; Bertrand, Bernard; Søndergaard, Lars

2012-01-01

The Premere™ PFO closure device has a special design for closure of patent foramen ovale (PFO) including a flexible distance and angulation between the right and left disc providing minimal septal distortion. The primary objective of the study was to determine the degree of risk for stroke or tra...... or transient ischemic attack (TIA) in patients after Premere™ PFO closure device implantation....

The effectiveness of eye-closure in repeated interviews

NARCIS (Netherlands)

Vredeveldt, A.; Baddeley, A.D.; Hitch, G.J.

2014-01-01

Purpose Closing the eyes during recall can help witnesses remember more about a witnessed event. This study examined the effectiveness of eye-closure in a repeated recall paradigm with immediate free recall followed 1 week later by both free and cued recall. We examined whether eye-closure was more

Percutaneous closure of patent foramen ovale in cryptogenic embolism.

Science.gov (United States)

Meier, Bernhard; Kalesan, Bindu; Mattle, Heinrich P; Khattab, Ahmed A; Hildick-Smith, David; Dudek, Dariusz; Andersen, Grethe; Ibrahim, Reda; Schuler, Gerhard; Walton, Antony S; Wahl, Andreas; Windecker, Stephan; Jüni, Peter

2013-03-21

The options for secondary prevention of cryptogenic embolism in patients with patent foramen ovale are administration of antithrombotic medications or percutaneous closure of the patent foramen ovale. We investigated whether closure is superior to medical therapy. We performed a multicenter, superiority trial in 29 centers in Europe, Canada, Brazil, and Australia in which the assessors of end points were unaware of the study-group assignments. Patients with a patent foramen ovale and ischemic stroke, transient ischemic attack (TIA), or a peripheral thromboembolic event were randomly assigned to undergo closure of the patent foramen ovale with the Amplatzer PFO Occluder or to receive medical therapy. The primary end point was a composite of death, nonfatal stroke, TIA, or peripheral embolism. Analysis was performed on data for the intention-to-treat population. The mean duration of follow-up was 4.1 years in the closure group and 4.0 years in the medical-therapy group. The primary end point occurred in 7 of the 204 patients (3.4%) in the closure group and in 11 of the 210 patients (5.2%) in the medical-therapy group (hazard ratio for closure vs. medical therapy, 0.63; 95% confidence interval [CI], 0.24 to 1.62; P=0.34). Nonfatal stroke occurred in 1 patient (0.5%) in the closure group and 5 patients (2.4%) in the medical-therapy group (hazard ratio, 0.20; 95% CI, 0.02 to 1.72; P=0.14), and TIA occurred in 5 patients (2.5%) and 7 patients (3.3%), respectively (hazard ratio, 0.71; 95% CI, 0.23 to 2.24; P=0.56). Closure of a patent foramen ovale for secondary prevention of cryptogenic embolism did not result in a significant reduction in the risk of recurrent embolic events or death as compared with medical therapy. (Funded by St. Jude Medical; ClinicalTrials.gov number, NCT00166257.).

Biological constraints do not entail cognitive closure.

Science.gov (United States)

Vlerick, Michael

2014-12-01

From the premise that our biology imposes cognitive constraints on our epistemic activities, a series of prominent authors--most notably Fodor, Chomsky and McGinn--have argued that we are cognitively closed to certain aspects and properties of the world. Cognitive constraints, they argue, entail cognitive closure. I argue that this is not the case. More precisely, I detect two unwarranted conflations at the core of arguments deriving closure from constraints. The first is a conflation of what I will refer to as 'representation' and 'object of representation'. The second confuses the cognitive scope of the assisted mind for that of the unassisted mind. Cognitive closure, I conclude, cannot be established from pointing out the (uncontroversial) existence of cognitive constraints. Copyright © 2014 Elsevier Ltd. All rights reserved.

Procedures and techniques for closure of near surface disposal facilities for radioactive waste

International Nuclear Information System (INIS)

2001-12-01

The overall objective of this report is to provide Member States with guidance on planning and implementation of closure of near surface disposal facilities for low and intermediate level radioactive waste. The specific objectives are to review closure concepts, requirements, and components of closure systems; to discuss issues and approaches to closure, including regulatory, economic, and technical aspects; and to present major examples of closure techniques used and/or considered by Member States. Some examples of closure experience from Member States are presented in the Appendix and were indexed separately

Exceptional closure of UNIQA office at CERN

CERN Multimedia

HR Department

2009-01-01

The UNIQA office at CERN will be closed from Wednesday 18 February to Friday 20 February due to painting work. During this closure, the Headquarters of UNIQA in Geneva will remain at the disposal of the members. See details https://cern.ch/chis/UNIQA_Offices.asp The CERN office will re-open on Monday 23 February according to the normal schedule. We apologise for any inconvenience caused by this closure.

Surgical treatment of complications associated with the Angio-Seal vascular closure device.

Science.gov (United States)

Cikirikcioglu, Mustafa; Cherian, Sanjay; Keil, Vera; Manzano, Norman; Gemayel, Gino; Theologou, Thomas; Kalangos, Afksendiyos

2011-05-01

Vascular closure devices are used to provide quick hemostasis and early ambulation after percutaneous interventions. The Angio-Seal (AS) vascular closure device forms a mechanical seal by closing the puncture site located between a bioabsorbable anchor within the lumen and a collagen sponge on the adventitia. Although morbidities associated with AS are reportedly infrequent, even the slightest inaccuracy in device implantation may result in displacement of these device components, leading to sudden and severe complications. We report the surgical treatment of complications associated with the use of AS in four patients, including acute limb ischemia, pseudoaneurysm formation, significant hemorrhage, and hypovolemic shock. A common factor in all these cases was that the components of the AS device were displaced from their original site of implantation, stressing the importance of proper device placement. All patients underwent successful surgical vascular repair. Our report highlights the need for exercising extreme care during device implantation, and also the requirement for vigilant inspection for any associated vascular complications commencing immediately after device implantation. It is vital that these device components are actively looked for and removed during surgical exploration so as to prevent future complications. Copyright © 2011. Published by Elsevier Inc.

Colostomy closure: how to avoid complications

Science.gov (United States)

Levitt, Marc A.; Lawal, Taiwo A.; Peña, Alberto

2010-01-01

Purpose Colostomy is an operation frequently performed in pediatric surgery. Despite its benefits, it can produce significant morbidity. In a previous publication we presented our experience with the errors and complications that occurred during cases of colostomy creation. We now have focused in the morbidity related to the colostomy closure. The technical details that might have contributed to the minimal morbidity we experienced are described. Methods The medical records of 649 patients who underwent colostomy closure over a 28-year period were retrospectively reviewed looking for complications following these procedures. Our perioperative protocol for colostomy closure consisted in: clear fluids by mouth and repeated proximal stoma irrigations 24 h prior to the operation. Administration of IV antibiotics during anesthesia induction and continued for 48 h. Meticulous surgical technique that included: packing of the proximal stoma, plastic drape to immobilize the surgical field, careful hemostasis, emphasis in avoiding contamination, cleaning the edge of the stomas to allow a good 2-layer, end-to-end anastomosis with separated long-term absorbable sutures, generous irrigation of the peritoneal cavity and subsequent layers with saline solution, closure by layers to avoid dead space, and avoidance of hematomas. No drains and no nasogastric tubes were used. Oral fluids were started the day after surgery and patients were discharged 48–72 h after the operation. Results The original diagnoses of the patients were: anorectal malformation (583), Hirschsprung’s disease (53), and others (13). 10 patients (1.5%) had complications: 6 had intestinal obstruction (5 due to small bowel adhesions, 1 had temporary delay of the function of the anastomosis due to a severe size discrepancy between proximal and distal stoma with a distal microcolon) and 4 incisional hernias. There were no anastomotic dehiscences or wound infection. There was no bleeding, no anastomotic

Colostomy closure: how to avoid complications.

Science.gov (United States)

Bischoff, Andrea; Levitt, Marc A; Lawal, Taiwo A; Peña, Alberto

2010-11-01

Colostomy is an operation frequently performed in pediatric surgery. Despite its benefits, it can produce significant morbidity. In a previous publication we presented our experience with the errors and complications that occurred during cases of colostomy creation. We now have focused in the morbidity related to the colostomy closure. The technical details that might have contributed to the minimal morbidity we experienced are described. The medical records of 649 patients who underwent colostomy closure over a 28-year period were retrospectively reviewed looking for complications following these procedures. Our perioperative protocol for colostomy closure consisted in: clear fluids by mouth and repeated proximal stoma irrigations 24 h prior to the operation. Administration of IV antibiotics during anesthesia induction and continued for 48 h. Meticulous surgical technique that included: packing of the proximal stoma, plastic drape to immobilize the surgical field, careful hemostasis, emphasis in avoiding contamination, cleaning the edge of the stomas to allow a good 2-layer, end-to-end anastomosis with separated long-term absorbable sutures, generous irrigation of the peritoneal cavity and subsequent layers with saline solution, closure by layers to avoid dead space, and avoidance of hematomas. No drains and no nasogastric tubes were used. Oral fluids were started the day after surgery and patients were discharged 48-72 h after the operation. The original diagnoses of the patients were: anorectal malformation (583), Hirschsprung's disease (53), and others (13). 10 patients (1.5%) had complications: 6 had intestinal obstruction (5 due to small bowel adhesions, 1 had temporary delay of the function of the anastomosis due to a severe size discrepancy between proximal and distal stoma with a distal microcolon) and 4 incisional hernias. There were no anastomotic dehiscences or wound infection. There was no bleeding, no anastomotic stricture and no mortality. Based on

Data-driven non-Markovian closure models

Science.gov (United States)

Kondrashov, Dmitri; Chekroun, Mickaël D.; Ghil, Michael

2015-03-01

This paper has two interrelated foci: (i) obtaining stable and efficient data-driven closure models by using a multivariate time series of partial observations from a large-dimensional system; and (ii) comparing these closure models with the optimal closures predicted by the Mori-Zwanzig (MZ) formalism of statistical physics. Multilayer stochastic models (MSMs) are introduced as both a generalization and a time-continuous limit of existing multilevel, regression-based approaches to closure in a data-driven setting; these approaches include empirical model reduction (EMR), as well as more recent multi-layer modeling. It is shown that the multilayer structure of MSMs can provide a natural Markov approximation to the generalized Langevin equation (GLE) of the MZ formalism. A simple correlation-based stopping criterion for an EMR-MSM model is derived to assess how well it approximates the GLE solution. Sufficient conditions are derived on the structure of the nonlinear cross-interactions between the constitutive layers of a given MSM to guarantee the existence of a global random attractor. This existence ensures that no blow-up can occur for a broad class of MSM applications, a class that includes non-polynomial predictors and nonlinearities that do not necessarily preserve quadratic energy invariants. The EMR-MSM methodology is first applied to a conceptual, nonlinear, stochastic climate model of coupled slow and fast variables, in which only slow variables are observed. It is shown that the resulting closure model with energy-conserving nonlinearities efficiently captures the main statistical features of the slow variables, even when there is no formal scale separation and the fast variables are quite energetic. Second, an MSM is shown to successfully reproduce the statistics of a partially observed, generalized Lotka-Volterra model of population dynamics in its chaotic regime. The challenges here include the rarity of strange attractors in the model's parameter

Autonomic Closure for Turbulent Flows Using Approximate Bayesian Computation

Science.gov (United States)

Doronina, Olga; Christopher, Jason; Hamlington, Peter; Dahm, Werner

2017-11-01

Autonomic closure is a new technique for achieving fully adaptive and physically accurate closure of coarse-grained turbulent flow governing equations, such as those solved in large eddy simulations (LES). Although autonomic closure has been shown in recent a priori tests to more accurately represent unclosed terms than do dynamic versions of traditional LES models, the computational cost of the approach makes it challenging to implement for simulations of practical turbulent flows at realistically high Reynolds numbers. The optimization step used in the approach introduces large matrices that must be inverted and is highly memory intensive. In order to reduce memory requirements, here we propose to use approximate Bayesian computation (ABC) in place of the optimization step, thereby yielding a computationally-efficient implementation of autonomic closure that trades memory-intensive for processor-intensive computations. The latter challenge can be overcome as co-processors such as general purpose graphical processing units become increasingly available on current generation petascale and exascale supercomputers. In this work, we outline the formulation of ABC-enabled autonomic closure and present initial results demonstrating the accuracy and computational cost of the approach.

304 Concretion Facility Closure Plan

International Nuclear Information System (INIS)

1991-10-01

The Hanford Site, located northwest of Richland, Washington, houses reactors, chemical-separation systems, and related facilities used for the production of special nuclear materials. The 300 Area of the Hanford Site contains reactor fuel manufacturing facilities and several research and development laboratories. Recyclable scrap uranium with Zircaloy-2 and copper silicon allo , uranium-titanium alloy, beryllium/Zircaloy-2 alloy, and Zircaloy-2 chips and fines were secured in concrete billets (7.5-gal containers) in the 304 Concretion Facility (304 Facility), located in the 300 Area. The beryllium/Zircaloy-2 alloy and Zircaloy-2 chips and fines are designated as low-level radioactive mixed waste (LLRMW) with the characteristic of ignitability. The concretion process reduced the ignitability of the fines and chips for safe storage and shipment. This process has been discontinued and the 304 Concretion Facility is now undergoing closure as defined in the Resource Conservation and Recovery Act of 1976 (RCRA) and the Washington Administrative Code (WAC) Dangerous Waste Regulations, WAC 173-303-040 (Ecology 1991). This closure plan presents a description of the facility, the history of materials and wastes managed, and the procedures that will be followed to close the 304 Facility. The strategy for closure of the 304 Facility is presented in Section 6.0

Development of an arid site closure plan

International Nuclear Information System (INIS)

Nyhan, J.W.; Barnes, F.J.

1987-01-01

This document describes the development of a prototype plan for the effective closure and stabilization of an arid low-level waste disposal site. This plan will provide demonstrated closure techniques for a trench in a disposal site at Los Alamos. The accuracy of modeling soil water storage by two hydrologic models, CREAMS and HELP, was tested by comparing simulation results with field measurements of soil moisture in eight experimental landfill cover systems having a range of well-defined soil profiles and vegetative covers. Regression analysis showed that CREAMS generally represented soil moisture more accurately than HELP simulations. Precautions for determining parameter values for model input and for interpreting simulation results are discussed. A specific example is presented showing how the field-validated hydrologic models can be used to develop a final prototype closure plan. 15 refs., 13 figs., 3 tabs

Bilateral Acute Angle-closure after Intraocular Surgery.

Science.gov (United States)

Hoskens, Kirsten; Pinto, Luis Abegão; Vandewalle, Evelien; Verdonk, Nancy; Stalmans, Ingeborg

2014-01-01

We report the case of a 75-year-old woman who developed an acute bilateral angle-closure associated with choroidal effusion a day after an uneventful cataract surgery. The same patient had undergone a similarly uneventful cataract surgery two weeks before, under the same protocol, with no postoperative complication in the other eye. Medical treatment, including the use of oral sulfamide-related drugs (acetazolamide), topical beta-blockers and steroids led to a gradual decrease in intraocular pressure (IOP) and choroidal effusion. Despite initial reports suggesting a link between sulfamide-exposure and these rare forms of angle-closure, our report would suggest a more complex pathophysiology behind this intriguing phenomenon. How to cite this article: Hoskens K, Pinto LA, Vandewalle E, Verdonk N, Stalmans I. Bilateral Acute Angle-closure after Intraocular Surgery. J Curr Glaucoma Pract 2014;8(3):113-114.

200 West Area Ash Pit Demolition Site closure plan. Revision 1

International Nuclear Information System (INIS)

Ruck, F.R.

1994-01-01

The Ash Pit Demolition Site had two known demolition events, the first occurred in November of 1984, and the second occurred in June of 1986. These demolition events were a form of thermal treatment for discarded explosive chemical products. Because the Ash Pit Demolition Site will no longer be used for this thermal activity, the site will be closed. Closure will be conducted pursuant to the requirements of the Washington State Department of Ecology (Ecology) ''Dangerous Waste Regulations'', Washington Administrative Code (WAC) 173-303-610 and 40 Code of Federal Regulations (CFR) 270.1. The 200 West Area Ash Pit Demolition Site Closure Plan consists of a Part A, Form 3, Dangerous Waste Permit Application (Revision 4) and a closure plan. An explanation of the Part A, Form 3, submitted with this closure plan is provided at the beginning of the Part A Section. The closure plan consists of nine chapters and five appendices. This closure plan presents a description of the Ash,Pit Demolition Site, the history of the waste treated, and the approach that will be followed to close the Ash Pit Demolition Site. Because there were no radioactively contaminated chemicals involved in the demolitions, the information on radionuclides is provided for ''information only''. Remediation of any radioactive contamination is not within the scope of this closure plan. Only dangerous constituents derived from Ash Pit Demolition Site operations will be addressed in this closure plan in accordance with WAC 173-303-610(2)(b)(i)

Household responses to school closure resulting from outbreak of influenza B, North Carolina.

Science.gov (United States)

Johnson, April J; Moore, Zack S; Edelson, Paul J; Kinnane, Lynda; Davies, Megan; Shay, David K; Balish, Amanda; McCarron, Meg; Blanton, Lenee; Finelli, Lyn; Averhoff, Francisco; Bresee, Joseph; Engel, Jeffrey; Fiore, Anthony

2008-07-01

School closure is a proposed strategy for reducing influenza transmission during a pandemic. Few studies have assessed how families respond to closures, or whether other interactions during closure could reduce this strategy's effect. Questionnaires were administered to 220 households (438 adults and 355 children) with school-age children in a North Carolina county during an influenza B virus outbreak that resulted in school closure. Closure was considered appropriate by 201 (91%) households. No adults missed work to solely provide childcare, and only 22 (10%) households required special childcare arrangements; 2 households incurred additional costs. Eighty-nine percent of children visited at least 1 public location during the closure despite county recommendations to avoid large gatherings. Although behavior and attitudes might differ during a pandemic, these results suggest short-term closure did not cause substantial hardship for parents. Pandemic planning guidance should address the potential for transmission in public areas during school closure.

[Epidemiologic and economic effectiveness of school closure during influenza epidemics and pandemics].

Science.gov (United States)

Gendon, Iu Z; Vasil'ev, Iu M

2012-01-01

Epidemiologic and economic effectiveness of school closure during influenza epidemics and pandemics is discussed. Optimal effect of school closure is observed when this measure is taken at the start of the epidemic or pandemic and for a sufficiently long time. School closure during high morbidity among schoolchildren, in the middle (at the peak) and by the end of epidemic or pandemic does not influence significantly the spread of influenza or morbidity. Significant economic losses and other negative consequences of school closure are noted. School closure may be the most appropriate during the emergence of influenza pandemic when the pandemic vaccine is not yet available, however timely mass immunization of schoolchildren against influenza may be a more appropriate measure than school closure for the reduction of influenza morbidity and spread during seasonal influenza epidemics.

Endoscopic full-thickness resection and defect closure in the colon.

Science.gov (United States)

von Renteln, Daniel; Schmidt, Arthur; Vassiliou, Melina C; Rudolph, Hans-Ulrich; Caca, Karel

2010-06-01

Endoscopic full-thickness resection (eFTR) is a minimally invasive method for en bloc resection of GI lesions. The aim of this pilot study was to evaluate the feasibility of a grasp-and-snare technique for eFTR combined with an over-the-scope clip (OTSC) for defect closure. Nonsurvival animal study. Animal laboratory. Fourteen female domestic pigs. The eFTR was performed in porcine colons using a novel tissue anchor in combination with a standard monofilament snare and 14 mm OTSC. In the first group (n = 20), closure of the colonic defects with OTSC was attempted after the resection. In the second group (n = 8), an endoloop was used to secure the resection base before eFTR was performed. In the first group (n = 20), eFTR specimens ranged from 2.4 to 5.5 cm in diameter. Successful closure was achieved in 9 out of 20 cases. Mean burst pressure for OTSC closure was 29.2 mm Hg (range, 2-90; SD, 29.92). Injury to adjacent organs occurred in 3 cases. Lumen obstruction due to the OTSC closure occurred in 3 cases. In the second group (n = 8), the diameter of specimens ranged from 1.2 to 2.2 cm. Complete closure was achieved in all cases, with a mean burst pressure of 76.6 mm Hg (range, 35-120; SD, 31). Lumen obstruction due to the endoloop closure occurred in one case. No other complications or injuries were observed in the second group. Nonsurvival setting. Colonic eFTR using the grasp-and-snare technique is feasible in an animal model. Ligation of the resection base with an endoloop before eFTR seems to reduce complication rates and improve closure success and leak test results despite yielding smaller specimens. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

The Finishing Touch: Anatomy of Expert Lesson Closures

Science.gov (United States)

Webster, Collin A.; Connolly, Graeme; Schempp, Paul G.

2009-01-01

Background: Based on the idea that students remember best what is presented last, the lesson closure is commonly identified as an important component of effective teaching and has recently surfaced as a routine practice of expert teachers in sport. Despite its link to both effective and expert instruction, the lesson closure has seen scarce…

Tracheocutaneous Fistula Closure with Turnover Flap and Polydioxanone Plate

Directory of Open Access Journals (Sweden)

Justin R. Bryant, DO, MBA

2017-10-01

Full Text Available Summary:. An alternative surgical treatment is proposed for closure of tracheocutaneous fistulas. The authors present a new technique for reconstruction of persistent tracheocutaneous fistula resultant from temporary tracheostomy. The single-stage closure under local anesthesia involves a fistulous tract turnover flap with a perforated 0.15 mm polydioxanone plate between the flap and the subcutaneous closure. This article presents 3 cases of persistent tracheocutaneous fistula treated by this method. At follow-up examination after follow-up, no recurrent fistula formation had occurred, and no respiratory deformity was present.

Clad vent set cup closure-weld-zone grinding evaluation

International Nuclear Information System (INIS)

Ulrich, G.B.; Woods, A.T.; Ohriner, E.K.

1996-04-01

Clad vent set (CVS) cups were ground in the closure-weld zone to reduce the wall-thickness variation created by the cup deep-drawing process. A significantly more uniform wall thickness would be beneficial for the CVS closure-weld operation. The goal was to reduce the average within-cup wall-thickness variation (defined as the range of wall thicknesses in the closure-weld zone) approximately 50% from the Cassini production value of 42 microm. This goal was shown to be achievable but, unfortunately, not with the existing blank and formed cup thicknesses

Sustainable closure of construction materials quarries in Cuba

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Julio Montero-Matos

2017-10-01

Full Text Available The inclusion of effective mine closure plans in the exploitation project is the way to compensate for the harmful effect of this activity. Based on a diagnosis carried out in 11 sites in operation, belonging to the company Canteras, a methodology was designed with a systemic and integral approach that consists of five stages and allows the execution of quarry closures in a sustainable manner. The Delphi method was applied to select the criteria that directly affect the sustainable closure of quarries in such a way that it considers the essential postulates of the Cuban Economic Model (MEC. The proposed methodology represents a contribution to the planning and design of the mining closure in Cuban non-metallic deposits to guarantee the reduction of the environmental impacts caused during its operation and the reduction, to the lesser extent possible, of negative socio-economic effects for the workers and the community located in the area of influence of the quarries. Currently applied in the quarry of San José, in Mayabeque province.

Review on improved seismic imaging with closure phase

KAUST Repository

Schuster, Gerard T.

2014-08-13

The timing and amplitudes of arrivals recorded in seismic traces are influenced by velocity variations all along the associated raypaths. Consequently, velocity errors far from the target can lead to blurred imaging of the target body. To partly remedy this problem, we comprehensively reviewed inverting differential traveltimes that satisfied the closure-phase condition. The result is that the source and receiver statics are completely eliminated in the data and velocities far from the target do not need to be known. We successfully used the phase closure equation for traveltime tomography, refraction statics, migration, refraction tomography, and earthquake location, all of which demonstrated the higher resolution achievable by processing data with differential traveltimes rather than absolute traveltimes. More generally, the stationary version of the closure-phase equation is equivalent to Fermat’s principle and can be derived from the equations of seismic interferometry. In summary, the general closure-phase equation is the mathematical foundation for approximately redatuming sources and/or receivers to the target of interest without the need to accurately know the statics or the velocity model away from the target.

GCFR 1/20-scale PCRV central core cavity closure model test

International Nuclear Information System (INIS)

Robinson, G.C.; Dougan, J.R.

1981-06-01

Oak Ridge National Laboratory has been conducting structural response tests of the prestressed concrete reactor vessel (PCRV) closures for the 300-MW(e) gas-cooled fast reactor demonstration power plant. This report describes the third in a series of tests of small-scale closure plug models. The model represents a redesign of the central core cavity closure plug. The primary objective was to demonstrate structural performance and ultimate load capacity of the closure plug. Secondary objectives included obtaining data on crack development and propagation and on mode of failure of the composite structure

Cleft Palate Fistula Closure Utilizing Acellular Dermal Matrix

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Omri Emodi, DMD

2018-03-01

Full Text Available Summary:. Fistulas represent failure of cleft palate repair. Secondary and tertiary fistula repair is challenging, with high recurrence rates. In the present retrospective study, we review the efficacy of using acellular dermal matrix as an interposition layer for cleft palate fistula closure in 20 consecutive patients between 2013 and 2016. Complete fistula closure was obtained in 16 patients; 1 patient had asymptomatic recurrent fistula; 2 patients had partial closure with reduction of fistula size and minimal nasal regurgitation; 1 patient developed a recurrent fistula without changes in symptoms (success rate of 85%. We conclude that utilizing acellular dermal matrix for cleft palate fistula repair is safe and simple with a high success rate.

Cleft Palate Fistula Closure Utilizing Acellular Dermal Matrix.

Science.gov (United States)

Emodi, Omri; Ginini, Jiriys George; van Aalst, John A; Shilo, Dekel; Naddaf, Raja; Aizenbud, Dror; Rachmiel, Adi

2018-03-01

Fistulas represent failure of cleft palate repair. Secondary and tertiary fistula repair is challenging, with high recurrence rates. In the present retrospective study, we review the efficacy of using acellular dermal matrix as an interposition layer for cleft palate fistula closure in 20 consecutive patients between 2013 and 2016. Complete fistula closure was obtained in 16 patients; 1 patient had asymptomatic recurrent fistula; 2 patients had partial closure with reduction of fistula size and minimal nasal regurgitation; 1 patient developed a recurrent fistula without changes in symptoms (success rate of 85%). We conclude that utilizing acellular dermal matrix for cleft palate fistula repair is safe and simple with a high success rate.

An Elongated Leading Edge Facilitates Rotation Flap Closure: In Vivo Demonstration.

Science.gov (United States)

Lichon, Vanessa; Barbosa, Naiara; Gomez, Doug; Goldman, Glenn

2016-01-01

Variation in the design of a rotation flap may affect wound closure tension. Lengthening the leading edge of a rotation flap has been a method of reducing the tension of closure in the primary motion. An in vitro study negating this tenant has been published. The authors set out to design an in vivo experiment to determine if lengthening the leading edge of a rotation flap has the effect of reducing closure tension in the primary motion of the repair. An animal study approved by Institutional Animal Care and Use Committee was undertaken in a pig model. A tension-measuring apparatus was designed using Teflon-coated wires and digital tensiometers. Rotation flaps of a standard design and with elongated leading edges were incised on the flanks of pigs under general anesthesia. Flap closure tensions were measured at points along the leading edge of the flap and in the secondary motion. Elongating the leading edge of a flap led to a statistically significant reduction in closure tension in the primary motion of the flap and at the flap tip. The secondary motion closure tensions were essentially unaffected. The authors confirm that elongating the leading edge of a standard rotation flap will reduce closure tension in the primary flap motion.

Systematic review and meta-analysis of published randomized controlled trials comparing purse-string vs conventional linear closure of the wound following ileostomy (stoma) closure.

Science.gov (United States)

Sajid, Muhammad Shafique; Bhatti, Muhammad I; Miles, William Fa

2015-05-01

The objective of this article is to systematically analyse the randomized, controlled trials comparing the effectiveness of purse-string closure (PSC) of an ileostomy wound with conventional linear closure (CLC). Randomized, controlled trials comparing the effectiveness of purse-string closure vs conventional linear closure (CLC) of ileostomy wound in patients undergoing ileostomy closure were analysed using RevMan®, and the combined outcomes were expressed as risk ratio (RR) and standardized mean difference (SMD). Three randomized, controlled trials, recruiting 206 patients, were retrieved from medical electronic databases. There were 105 patients in the PSC group and 101 patients in the CLC group. There was no heterogeneity among included trials. Duration of operation (SMD: -0.18; 95% CI: -0.45, 0.09; z = 1.28; P SMD: 0.01; 95% CI: -0.26, 0.28; z = 0.07; P infection (OR, 0.10; 95% CI: 0.03, 0.33; z = 3.78; P infection apparently without influencing the duration of operation and length of hospital stay. © The Author(s) 2014. Published by Oxford University Press and the Digestive Science Publishing Co. Limited.

The influence of deficient retro-aortic rim on technical success and early adverse events following device closure of secundum atrial septal defects: An Analysis of the IMPACT Registry®.

Science.gov (United States)

O'Byrne, Michael L; Gillespie, Matthew J; Kennedy, Kevin F; Dori, Yoav; Rome, Jonathan J; Glatz, Andrew C

2017-01-01

Concern regarding aortic erosion has focused attention on the retro-aortic rim in patients undergoing device closure of atrial septal defects (ASD), but its effect on early outcomes is not well studied. A multicenter retrospective cohort study of patients undergoing device occlusion of ASD between 1/2011-10/2014 was performed, using data from the IMproving Pediatric and Adult Congenital Treatment Registry. Subjects were divided between those with retro-aortic rim technical failure and major early adverse events. Case times were measured as surrogates of technical complexity. The effect of deficient retro-aortic rim on primary outcomes was assessed using hierarchical logistic regression, adjusting for other suspected covariates and assessing whether they represent independent risk factors RESULTS: 1,564 subjects (from 77 centers) were included, with deficient retro-aortic rim present in 40%. Technical failure occurred in 91 subjects (5.8%) and a major early adverse event in 64 subjects (4.1%). Adjusting for known covariates, the presence of a deficient retro-aortic rim was not significantly associated with technical failure (OR: 1.3, 95% CI: 0.9-2.1) or major early adverse event (OR: 0.7, 95% CI: 0.4-1. 2). Total case (P = 0.01) and fluoroscopy time (P = 0.02) were greater in subjects with deficient rim, but sheath time was not significantly different (P = 0.07). Additional covariates independently associated with these outcomes were identified. Deficient retro-aortic rim was highly prevalent but not associated with increased risk of technical failure or early adverse events. Studies with longer follow-up are necessary to assess other outcomes, including device erosion. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

LXA{sub 4} actions direct fibroblast function and wound closure

Energy Technology Data Exchange (ETDEWEB)

Herrera, Bruno S. [Department of Applied Oral Sciences, Center for Periodontology, The Forsyth Institute, Cambridge, MA (United States); Microbiology Branch, US Army Dental and Trauma Research Detachment, Institute of Surgical Research, JBSA Fort Sam Houston, TX (United States); Kantarci, Alpdogan; Zarrough, Ahmed; Hasturk, Hatice [Department of Applied Oral Sciences, Center for Periodontology, The Forsyth Institute, Cambridge, MA (United States); Leung, Kai P., E-mail: kai.p.leung.civ@mail.mil [Microbiology Branch, US Army Dental and Trauma Research Detachment, Institute of Surgical Research, JBSA Fort Sam Houston, TX (United States); Van Dyke, Thomas E., E-mail: tvandyke@forsyth.org [Department of Applied Oral Sciences, Center for Periodontology, The Forsyth Institute, Cambridge, MA (United States)

2015-09-04

Timely resolution of inflammation is crucial for normal wound healing. Resolution of inflammation is an active biological process regulated by specialized lipid mediators including the lipoxins and resolvins. Failure of resolution activity has a major negative impact on wound healing in chronic inflammatory diseases that is manifest as excess fibrosis and scarring. Lipoxins, including Lipoxin A{sub 4} (LXA{sub 4}), have known anti-fibrotic and anti-scarring properties. The goal of this study was to elucidate the impact of LXA{sub 4} on fibroblast function. Mouse fibroblasts (3T3 Mus musculus Swiss) were cultured for 72 h in the presence of TGF-β1, to induce fibroblast activation. The impact of exogenous TGF-β1 (1 ng/mL) on LXA{sub 4} receptor expression (ALX/FPR2) was determined by flow cytometry. Fibroblast proliferation was measured by bromodeoxyuridine (BrdU) labeling and migration in a “scratch” assay wound model. Expression of α-smooth muscle actin (α-SMA), and collagen types I and III were measured by Western blot. We observed that TGF-β1 up-regulates LXA{sub 4} receptor expression, enhances fibroblast proliferation, migration and scratch wound closure. α-SMA levels and Collagen type I and III deposition were also enhanced. LXA{sub 4} slowed fibroblast migration and scratch wound closure at early time points (24 h), but wound closure was equal to TGF-β1 alone at 48 and 72 h. LXA{sub 4} tended to slow fibroblast proliferation at both concentrations, but had no impact on α-SMA or collagen production by TGF-β1 stimulated fibroblasts. The generalizability of the actions of resolution molecules was examined in experiments repeated with resolvin D2 (RvD2) as the agonist. The activity of RvD2 mimicked the actions of LXA{sub 4} in all assays, through an as yet unidentified receptor. The results suggest that mediators of resolution of inflammation enhance wound healing and limit fibrosis in part by modulating fibroblast function. - Highlights: • TGF

Autocracy bias in informal groups under need for closure.

Science.gov (United States)

Pierro, Antonio; Mannetti, Lucia; De Grada, Eraldo; Livi, Stefano; Kruglanski, Arie W

2003-03-01

Two experiments investigated the tendency of groups with members under high (vs. low) need for cognitive closure to develop an autocratic leadership structure in which some members dominate the discussion, constitute the "hubs" of communication, and influence the group more than other members. The first experiment found that high (vs. low) need for closure groups, as assessed via dispositional measure of the need for closure, manifested greater asymmetry of conversational floor control, such that members with autocratic interactional style were more conversationally dominant and influential than less autocratic members. The second experiment manipulated the need for closure via time pressure and utilized a social network analysis. Consistent with expectation, groups under time pressure (vs. no pressure) showed a greater asymmetry of participation, of centrality, and of prestige among the group members, such that the more focal members were perceived to exert the greater influence over the groups' decisions.

BILATERAL ACUTE ANGLE CLOSURE GLAUCOMA AND MYOPIA INDUCED BY LOW DOSAGE TOPIRAMATE

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Busra S. Arica

2014-09-01

Full Text Available Introduction: Topiramate, a sulfamate-substituted monosaccharide, has been shown to be effective in the treatment of epilepsy and migraine prophylaxis. However, acute secondary angle closure glaucoma and myopia has been shown to develop, especially during the first two weeks of treatment, in a small subset of patients. Case presentation: In the current case report, a 23 year old female patient developed acute myopia and angle closure glaucoma after one week topiramate treatment (25 mg/day for prophylaxis of migraine without aura. The patient was found to have significant conjunctival hyperemia, shallow anterior chamber, and bulging iris in both eyes. Grade 1 acute angle was detected in both eyes during gonioscopic examination. There was no pupillary block and intraocular pressure was 40 mmHg in both eyes. Refraction values were measured at -7.00 and -8.00 in the right and left eye, respectively. The patient and #8217;s visual acuity was at 0.1 to 0.2. Topiramate treatment was promptly discontinued, topical antiglaucomatous treatment was initiated, and laser peripheral iridotomy was performed on each eye. Intraocular pressure has declined to normal limits, refractive values were zero in both eyes and patient and #8217;s visual acuity has restored at follow-up period at 10 days after treatment. Conclusion: Side effects associated with topiramate treatments are known to disappear without long-term damage when the discontinuation of therapy and effective interventions are started early. Therefore, patients and their physicians should be alert for symptoms associated with acute secondary angle closure glaucoma and myopia; especially in the first weeks of topiramate treatment also with low dosage. [J Contemp Med 2014; 4(3.000: 168-171

Closure properties of Watson-Crick grammars

Science.gov (United States)

Zulkufli, Nurul Liyana binti Mohamad; Turaev, Sherzod; Tamrin, Mohd Izzuddin Mohd; Azeddine, Messikh

2015-12-01

In this paper, we define Watson-Crick context-free grammars, as an extension of Watson-Crick regular grammars and Watson-Crick linear grammars with context-free grammar rules. We show the relation of Watson-Crick (regular and linear) grammars to the sticker systems, and study some of the important closure properties of the Watson-Crick grammars. We establish that the Watson-Crick regular grammars are closed under almost all of the main closure operations, while the differences between other Watson-Crick grammars with their corresponding Chomsky grammars depend on the computational power of the Watson-Crick grammars which still need to be studied.

Permanent Closure of MFC Biodiesel Underground Storage Tank 99ANL00013

Energy Technology Data Exchange (ETDEWEB)

Kerry L. Nisson

2012-10-01

This closure package documents the site assessment and permanent closure of the Materials and Fuels Complex biodiesel underground storage tank 99ANL00013 in accordance with the regulatory requirements established in 40 CFR 280.71, “Technical Standards and Corrective Action Requirements for Owners and Operators of Underground Storage Tanks: Out-of-Service UST Systems and Closure.”

The Availability of Judicial Review Regarding Military Base Closures and Realignments

Science.gov (United States)

2005-06-30

held that the President is not subject to the APA, due to separation of powers principles.37 Base Closure Act Claims The Dalton Court distinguished...that the 1988 Base Closure Act violated the non-delegation doctrine and the separation of powers doctrine.53 However, the Base Closure Act has not yet been held unconstitutional by any federal appellate courts.

218-E-8 Borrow Pit Demolition Site closure plan. Revision 1

International Nuclear Information System (INIS)

Ruck, F.R.

1994-01-01

The 218-E-8 Demolition Site was the site of a single demolition event in November of 1984. This demolition event was a form of thermal treatment for discarded explosive chemical products. Because the 218-E-8 Demolition Site will no longer be used for this thermal activity, the site will be closed. Closure will be conducted pursuant to the requirements of the Washington State Department of Ecology (Ecology) ''Dangerous Waste Regulations,'' Washington Administrative Code (WAC) 173-303-610 and 40 Code of Federal Regulations (CFR) 270.1. The 218-E-8 Borrow Pit Demolition Site Closure Plan consists of a Hanford Facility Dangerous Waste Part A Permit Application, Form 3, Revision 4, and a closure plan. An explanation of the Part A Form 3, submitted with this closure plan is provided at the beginning of the Part A Section. The closure plan consists of nine chapters and five appendices. This closure plan presents a description of the 218-E-8 Demolition Site, the history of the waste treated, and the approach that will be followed to close the 218-E-8 Demolition Site. Because there were no radioactively contaminated chemicals involved in t he demolitions at the 218-E-8 Borrow Pit site, the information on radionuclides is provided for ''information only.'' Remediation of any radioactive contamination is not within the scope of this closure plan. Only dangerous constituents derived from 218-E-8 Demolition Site operations will be addressed in this closure plan in accordance with WAC 173-303-610(2)(b)(i)

Vascularized fibular graft combined with vacuum assisted closure in ...

African Journals Online (AJOL)

The flowthrough fibular graft combined with Vacuum Assisted Closure (VAC) controlled the infection, shortened the course of treatment, and effectively restored limb function when applied to the treatment of tibial defects. Keywords: Tibial defect, Flow-through fibular graft, Vacuum Assisted Closure, Chronic Osteomyelitis ...

Structural analysis of closure bolts for shipping casks

International Nuclear Information System (INIS)

Mok, G.C.; Fischer, L.E.

1993-04-01

This paper identifies the active forces and moments in a closure bolt of a shipping cask. It examines the interactions of these forces/moments and suggest simplified methods for their analysis. The paper also evaluates the role that the forces and moments play in the structure integrity of the closure bolt and recommends stress limits and desirable practices to ensure its integrity

[Velopharyngeal closure pattern and speech performance among submucous cleft palate patients].

Science.gov (United States)

Heng, Yin; Chunli, Guo; Bing, Shi; Yang, Li; Jingtao, Li

2017-06-01

To characterize the velopharyngeal closure patterns and speech performance among submucous cleft palate patients. Patients with submucous cleft palate visiting the Department of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University between 2008 and 2016 were reviewed. Outcomes of subjective speech evaluation including velopharyngeal function, consonant articulation, and objective nasopharyngeal endoscopy including the mobility of soft palate, pharyngeal walls were retrospectively analyzed. A total of 353 cases were retrieved in this study, among which 138 (39.09%) demonstrated velopharyngeal competence, 176 (49.86%) velopharyngeal incompetence, and 39 (11.05%) marginal velopharyngeal incompetence. A total of 268 cases were subjected to nasopharyngeal endoscopy examination, where 167 (62.31%) demonstrated circular closure pattern, 89 (33.21%) coronal pattern, and 12 (4.48%) sagittal pattern. Passavant's ridge existed in 45.51% (76/167) patients with circular closure and 13.48% (12/89) patients with coronal closure. Among the 353 patients included in this study, 137 (38.81%) presented normal articulation, 124 (35.13%) consonant elimination, 51 (14.45%) compensatory articulation, 36 (10.20%) consonant weakening, 25 (7.08%) consonant replacement, and 36 (10.20%) multiple articulation errors. Circular closure was the most prevalent velopharyngeal closure pattern among patients with submucous cleft palate, and high-pressure consonant deletion was the most common articulation abnormality. Articulation error occurred more frequently among patients with a low velopharyngeal closure rate.

Transcatheter closure of post-operative residual ventricular septal defect using a patent ductus arteriosus closure device in an adult: a case report.

Science.gov (United States)

Djer, Mulyadi M; Idris, Nikmah S; Alwi, Idrus; Wijaya, Ika P

2014-07-01

Transcatheter closure of perimembranous and muscular ventricular septal defect (VSD) has been performed widely and it has more advantages compare to surgery. However, transcatheter closure of residual VSD post operation of complex congenital heart disease is still challenging because of the complexity of anatomy and concern about device stability, so the operator should meticulously choose the most appropriate technique and device. We would like to report a case of transcatheter closure of residual VSD post Rastelli operation in a patient with double outlet right ventricle (DORV), sub-aortic VSD, severe infundibulum pulmonary stenosis (PS) and single coronary artery. The patient had undergone operations for four times, but he still had intractable heart failure that did not response to medications. On the first attempt. we closed the VSD using a VSD occluder, unfortunately the device embolized into the descending aorta, but fortunately we was able to snare it out. Then we decided to close the VSD using a patent ductus arteriosus (PDA occluder). On transesophageal echocardiography (TEE) and angiography evaluation, the device position was stable. Post transcatheter VSD closure, the patient clinical condition improved significantly and he could finally be discharged after a long post-surgery hospitalization. Based on this experience we concluded that the transcatheter closure of residual VSD in complex CHD using PDA occluder could be an effective alternative treatment.

The open abdomen and temporary abdominal closure systems--historical evolution and systematic review.

Science.gov (United States)

Quyn, A J; Johnston, C; Hall, D; Chambers, A; Arapova, N; Ogston, S; Amin, A I

2012-08-01

Several techniques for temporary abdominal closure have been developed. We systematically review the literature on temporary abdominal closure to ascertain whether the method can be tailored to the indication. Medline, Embase, the Cochrane Central Register of Controlled Trials and relevant meeting abstracts until December 2009 were searched using the following headings: open abdomen, laparostomy, VAC (vacuum assisted closure), TNP (topical negative pressure), fascial closure, temporary abdominal closure, fascial dehiscence and deep wound dehiscence. The data were analysed by closure technique and aetiology. The primary end-points included delayed fascial closure and in-hospital mortality. The secondary end-points were intra-abdominal complications. The search identified 106 papers for inclusion. The techniques described were VAC (38 series), mesh/sheet (30 series), packing (15 series), Wittmann patch (eight series), Bogotá bag (six series), dynamic retention sutures (three series), zipper (15 series), skin only and locking device (one series each). The highest facial closure rates were seen with the Wittmann patch (78%), dynamic retention sutures (71%) and VAC (61%). Temporary abdominal closure has evolved from simple packing to VAC based systems. In the absence of sepsis Wittmann patch and VAC offered the best outcome. In its presence VAC had the highest delayed primary closure and the lowest mortality rates. However, due to data heterogeneity only limited conclusions can be drawn from this analysis. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

Risk Analysis of the Long-Term Outcomes of the Surgical Closure of Secundum Atrial Septal Defects

Directory of Open Access Journals (Sweden)

Hong Rae Kim

2017-04-01

Full Text Available Background: Closure of a secundum atrial septal defect (ASD is possible through surgical intervention or device placement. During surgical intervention, concomitant pathologies are corrected. The present study was conducted to investigate the outcomes of surgical ASD closure, to determine the risk factors of mortality, and establish the effects of concomitant disease correction. Methods: Between October 1989 and October 2009, 693 adults underwent surgery for secundum ASD. Their mean age was 40.9±13.1 years, and 199 (28.7% were male. Preoperatively, atrial fibrillation was noted in 39 patients (5.6% and significant tricuspid regurgitation (TR in 137 patients (19.8%. The mean follow-up duration was 12.4±4.7 years. Results: There was no 30-day mortality. The 1-, 5-, 10-, and 20-year survival rates were 99.4%, 96.8%, 94.5%, and 81.6%, respectively. In multivariate analysis, significant preoperative TR (hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.09 to 3.16; p=0.023 and preoperative age (HR, 1.04; 95% CI, 1.01 to 1.06; p=0.001 were independent risk factors for late mortality. The TR grade significantly decreased after ASD closure with tricuspid repair. However, in patients with more than mild TR, repair was not associated with improved long-term survival (p=0.518. Conclusion: Surgical ASD closure is safe. Significant preoperative TR and age showed a strong negative correlation with survival. Our data showed that tricuspid valve repair improved the TR grade effectively. However, no effect on long-term survival was found. Therefore, early surgery before the development of significant TR mat be beneficial for improving postoperative survival.

Guidance for closure of existing DOE LLW disposal sites

International Nuclear Information System (INIS)

Blanchfield, L.

1987-01-01

During FY 1986, a closure guidance document was developed. The purpose of this document is to provide guidance in support of DOE Order 5820.2 to site operating contractors for the stabilization and closure of existing low-level waste (LLW) shallow land disposal sites at US Department of Energy (DOE) facilities. Guidance is provided to aid operators in placing existing LLW sites in a closed conditions, i.e., a condition in which a nonoperational site meets postclosure performance requirements and can be shown, within a high degree of confidence, to perform as anticipated in the future, under the most cost-effective maintenance approach. Guidance is based on the philosophy that closure should be planned and performed using a systems approach. Plans for FY 1987 call for revision of the document to incorporate more information on closure of LLW sites also containing radioactive mixed waste and/or transuranic waste. 4 references, 3 figures, 2 tables

Repository Closure and Sealing Approach

International Nuclear Information System (INIS)

A.T. Watkins

2000-01-01

The scope of this analysis will be to develop the conceptual design of the closure seals and their locations in the Subsurface Facilities. The design will be based on the recently established program requirements for transitioning to the Site Recommendation (SR) design as outlined by ''Approach to Implementing the Site Recommendation Baseline'' (Stroupe 2000) and the ''Monitored Geologic Repository Project Description Document'' (CRWMS M andO 1999b). The objective of this analysis will be to assist in providing a description for the Subsurface Facilities System Description Document, Section 2 and finally to document any conclusions reached in order to contribute and provide support to the SR. This analysis is at a conceptual level and is considered adequate to support the SR design. The final closure barriers and seals for the ventilation shafts, and the north and south ramps will require these openings to be permanently sealed to limit excessive air and water inflows and prevent human intrusion. The major tasks identified with closure in this analysis are: (1) Developing the overall subsurface seal layout and identifying design and operational interfaces for the Subsurface Facilities. (2) Summarizing the general site conditions and general rock characteristic with respect to seal location and describing the seal selected. (3) Identify seal construction materials, methodology of construction and strategic locations including design of the seal and plugs. (4) Discussing methods to prevent human intrusion

Hormonal regulation of floret closure of rice (Oryza sativa.

Directory of Open Access Journals (Sweden)

Youming Huang

Full Text Available Plant hormones play important roles in regulating every aspect of growth, development, and metabolism of plants. We are interested in understanding hormonal regulation of floret opening and closure in plants. This is a particularly important problem for hybrid rice because regulation of flowering time is vitally important in hybrid rice seed production. However, little was known about the effects of plant hormones on rice flowering. We have shown that jasmonate and methyl jasmonate play significant roles in promoting rice floret opening. In this study, we investigated the effects of auxins including indole-3-acidic acid (IAA, indole-3-butyric acid (IBA, 1-naphthalene-acetic acid (NAA, 2,4-dichlorophenoxy acetic acid (2,4-D and 3,6-dichloro-2-methoxybenzoic acid (DIC and abscisic acid (ABA on floret closure of four fertile and three sterile varieties of rice. The results from field studies in three growing seasons in 2013-2015 showed that the percentages of closed florets were significantly lower in plants treated with IAA, IBA, 2,4-D, DIC and NAA and that the durations of floret opening were significantly longer in plants treated with the same auxins. The auxins exhibited time- and concentration-dependant effects on floret closure. ABA displayed opposite effects of auxins because it increased the percentages of floret closure and decreased the length of floret opening of rice varieties. The degree of auxin-inhibiting and ABA-promoting effects on floret closure was varied somewhat but not significantly different among the rice varieties. Endogenous IAA levels were the highest in florets collected shortly before opening followed by a sharp decline in florets with maximal angles of opening and a significant jump of IAA levels shortly after floret closure in both fertile and sterile rice plants. ABA levels showed an opposite trend in the same samples. Our results showed that auxins delayed but ABA promoted the closure of rice floret regardless of

Hormonal regulation of floret closure of rice (Oryza sativa)

Science.gov (United States)

Huang, Youming; Zeng, Xiaochun

2018-01-01

Plant hormones play important roles in regulating every aspect of growth, development, and metabolism of plants. We are interested in understanding hormonal regulation of floret opening and closure in plants. This is a particularly important problem for hybrid rice because regulation of flowering time is vitally important in hybrid rice seed production. However, little was known about the effects of plant hormones on rice flowering. We have shown that jasmonate and methyl jasmonate play significant roles in promoting rice floret opening. In this study, we investigated the effects of auxins including indole-3-acidic acid (IAA), indole-3-butyric acid (IBA), 1-naphthalene-acetic acid (NAA), 2,4-dichlorophenoxy acetic acid (2,4-D) and 3,6-dichloro-2-methoxybenzoic acid (DIC) and abscisic acid (ABA) on floret closure of four fertile and three sterile varieties of rice. The results from field studies in three growing seasons in 2013–2015 showed that the percentages of closed florets were significantly lower in plants treated with IAA, IBA, 2,4-D, DIC and NAA and that the durations of floret opening were significantly longer in plants treated with the same auxins. The auxins exhibited time- and concentration-dependant effects on floret closure. ABA displayed opposite effects of auxins because it increased the percentages of floret closure and decreased the length of floret opening of rice varieties. The degree of auxin-inhibiting and ABA-promoting effects on floret closure was varied somewhat but not significantly different among the rice varieties. Endogenous IAA levels were the highest in florets collected shortly before opening followed by a sharp decline in florets with maximal angles of opening and a significant jump of IAA levels shortly after floret closure in both fertile and sterile rice plants. ABA levels showed an opposite trend in the same samples. Our results showed that auxins delayed but ABA promoted the closure of rice floret regardless of the varieties

Comparison of different moment-closure approximations for stochastic chemical kinetics

Energy Technology Data Exchange (ETDEWEB)

Schnoerr, David [School of Biological Sciences, University of Edinburgh, Edinburgh (United Kingdom); School of Informatics, University of Edinburgh, Edinburgh (United Kingdom); Sanguinetti, Guido [School of Informatics, University of Edinburgh, Edinburgh (United Kingdom); Grima, Ramon [School of Biological Sciences, University of Edinburgh, Edinburgh (United Kingdom)

2015-11-14

In recent years, moment-closure approximations (MAs) of the chemical master equation have become a popular method for the study of stochastic effects in chemical reaction systems. Several different MA methods have been proposed and applied in the literature, but it remains unclear how they perform with respect to each other. In this paper, we study the normal, Poisson, log-normal, and central-moment-neglect MAs by applying them to understand the stochastic properties of chemical systems whose deterministic rate equations show the properties of bistability, ultrasensitivity, and oscillatory behaviour. Our results suggest that the normal MA is favourable over the other studied MAs. In particular, we found that (i) the size of the region of parameter space where a closure gives physically meaningful results, e.g., positive mean and variance, is considerably larger for the normal closure than for the other three closures, (ii) the accuracy of the predictions of the four closures (relative to simulations using the stochastic simulation algorithm) is comparable in those regions of parameter space where all closures give physically meaningful results, and (iii) the Poisson and log-normal MAs are not uniquely defined for systems involving conservation laws in molecule numbers. We also describe the new software package MOCA which enables the automated numerical analysis of various MA methods in a graphical user interface and which was used to perform the comparative analysis presented in this paper. MOCA allows the user to develop novel closure methods and can treat polynomial, non-polynomial, as well as time-dependent propensity functions, thus being applicable to virtually any chemical reaction system.

Closure behavior of spherical void in slab during hot rolling process

Science.gov (United States)

Cheng, Rong; Zhang, Jiongming; Wang, Bo

2018-04-01

The mechanical properties of steels are heavily deteriorated by voids. The influence of voids on the product quality should be eliminated through rolling processes. The study on the void closure during hot rolling processes is necessary. In present work, the closure behavior of voids at the center of a slab at 800 °C during hot rolling processes has been simulated with a 3D finite element model. The shape of the void and the plastic strain distribution of the slab are obtained by this model. The void decreases along the slab thickness direction and spreads along the rolling direction but hardly changes along the strip width direction. The relationship between closure behavior of voids and the plastic strain at the center of the slab is analyzed. The effects of rolling reduction, slab thickness and roller diameter on the closure behavior of voids are discussed. The larger reduction, thinner slab and larger roller diameter all improve the closure of voids during hot rolling processes. Experimental results of the closure behavior of a void in the slab during hot rolling process mostly agree with the simulation results..

Security option file - After closure (DOS-AF)

International Nuclear Information System (INIS)

2016-01-01

A first volume presents the context and scope of the Cigeo project, and the scope of this document. It proposes a general presentation of Cigeo, the regulatory framework and standards. It describes the different aspects and components of the security strategy: principles, security functions after closure, objectives of protection, global approach. It proposes a security assessment: objectives, consistency with international practices, assessment steps, scenarios, scenario quantitative assessment. The next part addresses security management. The second volume contains a description of the storage system: site characteristics, types of stored parcels, the future of the installation after its closure. The third volume proposes a security assessment. It addresses the management of risks and uncertainties, describes a scenario of normal evolution and also scenarios of altered evolutions, scenarios of unintentional human intrusion, and what-if type scenarios. The fourth volume reports lessons at the current stage of the project, and gives an overview of important activities from storage design to storage closure

Mail Office annual closure

CERN Multimedia

2013-01-01

On the occasion of the annual closure of CERN, there will be no mail distributed on Friday 20 December 2013 but mail will be collected in the morning. Nevertheless, you will still be able to bring your outgoing mail to Building 555-R-002 until 12 noon.  

Interim status of closure/post-closure plan for 183-H solar evaporation basins

International Nuclear Information System (INIS)

1988-03-01

This report describes a plan for decommissioning several solar evaporation basins on the Hanford reservation. The document describes procedures for sampling during decommissioning and a plan for certification of the resulting completed landfill. Additional plans deal with the training, security of the site, and post-closure monitoring

Closure certification report: TA-35 TSL-125 surface impoundment

International Nuclear Information System (INIS)

1991-01-01

This closure report documents closure activities for the TA-35 TSL-125 surface impoundment and associated structures at Los Alamos National Laboratory (the Laboratory). Prior to formal approval of the closure plan, the decision was made to proceed with closure activities to prevent any further releases from the site following informal discussions with New Mexico Environment Department (NMED) personnel. The closure plan is a revision of the previously submitted draft dated July 1988. Clean closure of the TSL-125 site was accomplished through: Removal and proper disposal of all wastes contained within the surface impoundment system; Decontamination and/or removal and proper disposal of the surface impoundment, its associated structures, and contaminated soil underlying the impoundment area; Sampling and analysis of soil to determine the presence and concentrations of any hazardous constituents remaining in the soil at the TSL-125 site; and Demonstration through a risk assessment that any constituents remaining in the soil at the TSL-125 site pose no threat to human health and the environment. All remaining soil concentrations of hazardous constituents were below health-based action levels. Analytical results indicated that benzidine, n-nitrosodimethylamine, and n-nitrosodi-n-propylamine were not detected at or above their limits of quantitation and beryllium was not present at or above its laboratory detection limit. However, the limits of quantitation and detection for these constituents were greater than their calculated health-based action levels. To demonstrate that these constituents were not present, historical data was researched and it was determined that the constituents were not utilized at the Building 125 site. 4 refs., 8 figs., 1 tab

Stochastic particle acceleration and statistical closures

International Nuclear Information System (INIS)

Dimits, A.M.; Krommes, J.A.

1985-10-01

In a recent paper, Maasjost and Elsasser (ME) concluded, from the results of numerical experiments and heuristic arguments, that the Bourret and the direct-interaction approximation (DIA) are ''of no use in connection with the stochastic acceleration problem'' because (1) their predictions were equivalent to that of the simpler Fokker-Planck (FP) theory, and (2) either all or none of the closures were in good agreement with the data. Here some analytically tractable cases are studied and used to test the accuracy of these closures. The cause of the discrepancy (2) is found to be the highly non-Gaussian nature of the force used by ME, a point not stressed by them. For the case where the force is a position-independent Ornstein-Uhlenbeck (i.e., Gaussian) process, an effective Kubo number K can be defined. For K << 1 an FP description is adequate, and conclusion (1) of ME follows; however, for K greater than or equal to 1 the DIA behaves much better qualitatively than the other two closures. For the non-Gaussian stochastic force used by ME, all common approximations fail, in agreement with (2)

Closure of the vertebral canal in human embryos and fetuses.

Science.gov (United States)

Mekonen, Hayelom K; Hikspoors, Jill P J M; Mommen, Greet; Kruepunga, Nutmethee; Köhler, S Eleonore; Lamers, Wouter H

2017-08-01

The vertebral column is the paradigm of the metameric architecture of the vertebrate body. Because the number of somites is a convenient parameter to stage early human embryos, we explored whether the closure of the vertebral canal could be used similarly for staging embryos between 7 and 10 weeks of development. Human embryos (5-10 weeks of development) were visualized using Amira 3D ® reconstruction and Cinema 4D ® remodelling software. Vertebral bodies were identifiable as loose mesenchymal structures between the dense mesenchymal intervertebral discs up to 6 weeks and then differentiated into cartilaginous structures in the 7th week. In this week, the dense mesenchymal neural processes also differentiated into cartilaginous structures. Transverse processes became identifiable at 6 weeks. The growth rate of all vertebral bodies was exponential and similar between 6 and 10 weeks, whereas the intervertebral discs hardly increased in size between 6 and 8 weeks and then followed vertebral growth between 8 and 10 weeks. The neural processes extended dorsolaterally (6th week), dorsally (7th week) and finally dorsomedially (8th and 9th weeks) to fuse at the midthoracic level at 9 weeks. From there, fusion extended cranially and caudally in the 10th week. Closure of the foramen magnum required the development of the supraoccipital bone as a craniomedial extension of the exoccipitals (neural processes of occipital vertebra 4), whereas a growth burst of sacral vertebra 1 delayed closure until 15 weeks. Both the cranial- and caudal-most vertebral bodies fused to form the basioccipital (occipital vertebrae 1-4) and sacrum (sacral vertebrae 1-5). In the sacrum, fusion of its so-called alar processes preceded that of the bodies by at least 6 weeks. In conclusion, the highly ordered and substantial changes in shape of the vertebral bodies leading to the formation of the vertebral canal make the development of the spine an excellent, continuous staging system for

Experience with Vacuum-assisted closure of sternal wound infections following cardiac surgery and evaluation of chronic complications associated with its use.

Science.gov (United States)

Bapat, Vinayak; El-Muttardi, Naguib; Young, Christopher; Venn, Graham; Roxburgh, James

2008-01-01

with recurrent problems of the sternal wound. Strategy of use of VAC for a short duration followed by early surgical closure appears favorable.

Straight line closure of congenital macrostomia

Directory of Open Access Journals (Sweden)

Schwarz Richard

2004-01-01

Full Text Available The results of patients operated on by Nepal Cleft Lip and Palate Association (NECLAPA surgeons for congenital macrostomia were prospectively studied between January 2000 and December 2002. There were four males and three females with a median age of 10 years. Three had an associated branchial arch syndrome. In all patients an overlapping repair of orbicularis oris was done. Six patients had a straight line closure with excellent cosmetic results and one a Z-plasty with a more obvious scar. All had a normal appearing commissure. Overlapping orbicularis repair with straight line skin closure for this rare congenital anomaly is recommended.

Closure of patent ductus arteriosus in children, small infants, and premature babies with Amplatzer duct occluder II additional sizes: multicenter study.

Science.gov (United States)

Sungur, Metin; Karakurt, Cemsit; Ozbarlas, Nazan; Baspinar, Osman

2013-08-01

To evaluate safety and efficacy of closure of patent ductus arteriosus (PDA) with Amplatzer duct occluder II Additional Sizes (ADO II AS) and to report early and midterm results of the device in children and very young symptomatic infants. Retrospective analysis of angiographic data of 60 children from four pediatric cardiology centers. The median patient age and weight were 6.5 (0.5-168) months and 6.8 (1.19-57) kg, respectively. In the study, 26 children had a body weight of ≤ 6 kg. Of these 26 children, 9 had a body weight of ≤ 3 kg. The median narrowest diameter of PDA was 2 (1.2-4) mm. Ductal anatomy was Type A in 29, Type B in 2, Type C in 11, Type D in 1, and Type E in 16 patients, and a residual PDA after surgery in 1 patient. Closure with ADO II AS was achieved in 58 (96.6%) of 60 attempted cases. In two infants, the device was not released because of significant residual shunt. ADO II was used in one, and the other was sent to surgery. Complete closure was observed in all ADO II AS deployed children by the next day on echocardiography. Median follow-up was 12 (1-18) months. Neither death nor any major complications occurred. Our study shows that closure of medium and small sized PDA by using ADO II AS device is effective and safe in children. The use of the device will expand the field of application of PDA closure in small infants. © 2013 Wiley Periodicals, Inc.

A randomized clinical trial to compare three methods of orthodontic space closure.

Science.gov (United States)

Dixon, V; Read, M J F; O'Brien, K D; Worthington, H V; Mandall, N A

2002-03-01

To compare the rates of orthodontic space closure for: Active ligatures, polyurethane powerchain (Rocky Mountain Orthodontics, RMO Europe, Parc d'Innovation, Rue Geiler de Kaysersberg, 67400 Illkirch-Graffenstaden, Strasbourg, France) and nickel titanium springs. Patients entering the space closure phase of fixed orthodontic treatment attending six orthodontic providers. Twelve patients received active ligatures (48 quadrants), 10 patients received powerchain (40 quadrants) and 11 patients, nickel-titanium springs (44 quadrants). Patients were randomly allocated for treatment with active ligatures, powerchain or nickel titanium springs. Upper and lower study models were collected at the start of space closure (T(o)) and 4 months later (T(1)). We recorded whether the patient wore Class II or Class III elastics. Space present in all four quadrants was measured, by a calibrated examiner, using Vernier callipers at T(o) and T(1.) The rate of space closure, in millimetres per month (4 weeks) and a 4-monthly rate, was then calculated. Examiner reliability was assessed at least 2 weeks later. Mean rates of space closure were 0.35 mm/month for active ligatures, 0.58 mm/month for powerchain, and 0.81 mm/month for NiTi springs. No statistically significant differences were found between any methods with the exception of NiTi springs showing more rapid space closure than active ligatures (P space closure. NiTi springs gave the most rapid rate of space closure and may be considered the treatment of choice. However, powerchain provides a cheaper treatment option that is as effective. The use of inter-arch elastics does not appear to influence rate of space closure.

Reactor vessel closure head replacements in 1997

International Nuclear Information System (INIS)

Anon.

1997-01-01

The Framatome-Jeumont Industrie consortium have completed in 1997 28 reactor vessel (RV) closure head replacements, including five on 1300 MWe class PWR units. Framatome manages the operations and handles removal and reinstallation of equipment (not including the control rod drive mechanisms (CRDM)) and the requalification tests, while JI, which manufactures the CRDMs, is involved in the CRDM cutting, re-machining and welding operations, using tools of original design, in order to optimize the RV closure head operation in terms of costs, schedule and dosage

Estimating the costs of school closure for mitigating an influenza pandemic

Directory of Open Access Journals (Sweden)

Adams Elisabeth J

2008-04-01

Full Text Available Abstract Background School closure is a key component of many countries' plans to mitigate the effect of an influenza pandemic. Although a number of studies have suggested that such a policy might reduce the incidence, there are no published studies of the cost of such policies. This study attempts to fill this knowledge gap Methods School closure is expected to lead to significant work absenteeism of working parents who are likely to be the main care givers to their dependent children at home. The cost of absenteeism due to school closure is calculated as the paid productivity loss of parental absenteeism during the period of school closure. The cost is estimated from societal perspective using a nationally representative survey. Results The results show that overall about 16% of the workforce is likely to be the main caregiver for dependent children and therefore likely to take absenteeism. This rises to 30% in the health and social care sector, as a large proportion of the workforce are women. The estimated costs of school closure are significant, at £0.2 bn – £1.2 bn per week. School closure is likely to significantly exacerbate the pressures on the health system through staff absenteeism. Conclusion The estimates of school closure associated absenteeism and the projected cost would be useful for pandemic planning for business continuity, and for cost effectiveness evaluation of different pandemic influenza mitigation strategies.

Closure of the concrete supercontainer in hot cell under thermal load

Energy Technology Data Exchange (ETDEWEB)

Craeye, Bart, E-mail: bart.craeye@artesis.b [Artesis Univerity College of Antwerp, Applied Engineering and Technology, Antwerp (Belgium); De Schutter, Geert [Magnel Laboratory for Concrete Research, Ghent University, Technologiepark-Zwijnaarde 904, 9052 Ghent (Belgium); Wacquier, William; Van Humbeeck, Hughes [ONDRAF/NIRAS, Belgian Agency for Radioactive Waste and Enriched Fissile Materials (Belgium); Van Cotthem, Alain [Tractebel Development Engineering, Consulting Company (Belgium); Areias, Lou [SCK.CEN, Belgian Nuclear Research Center (Belgium)

2011-05-15

Research highlights: We model the behaviour of the supercontainer for the disposal of high-level waste and spent fuel assemblies during fabrication at ground surface. We study the early-age cracking behaviour of the buffer and evaluate the crack creating mechanisms. In case accurate measures are taken, cracking of the buffer can be avoided. - Abstract: For the final disposal of long-lived, heat-emitting vitrified high-level waste (HLW) in a clayey host rock, an intensive study is conducted to investigate the early-age behaviour of concrete supercontainers. Self-compacting concrete (SCC) is taken as the reference concrete type as it facilitates the casting process in combination with an improved homogeneity compared to the traditional concrete compositions. A laboratory characterization program is conducted to obtain the relevant thermal, mechanical and maturity-related properties of the SCC. These obtained data are implemented into the material database of the finite element tool HEAT to study the behaviour of the concrete layers during the different construction stages of the supercontainer: (i) Stage 1: Fabrication of the concrete buffer inside a stainless steel envelope. No early-age cracking is expected in case accurate measures are taken to reduce the thermal gradient between the outer surface and the middle of the buffer, e.g. by providing insulation and excluding wind. (ii) Stages 2-4: Emplacement of the carbon steel overpack containing the HLW canisters, filling the remaining annular gap with cementitious filler and closure by fitting the lid under thermal load. The construction stages (2-4) for the closure of the supercontainer are executed in hot cell. In this study, the crack creating mechanism and the behaviour of the concrete supercontainer during these construction stages in hot cell are investigated. In case precautionary measures are taken, such as reducing the coefficient of thermal expansion (CTE) of the overpack, prolonging the preceding cooling

Closure of the concrete supercontainer in hot cell under thermal load

International Nuclear Information System (INIS)

Craeye, Bart; De Schutter, Geert; Wacquier, William; Van Humbeeck, Hughes; Van Cotthem, Alain; Areias, Lou

2011-01-01

Research highlights: → We model the behaviour of the supercontainer for the disposal of high-level waste and spent fuel assemblies during fabrication at ground surface. → We study the early-age cracking behaviour of the buffer and evaluate the crack creating mechanisms. → In case accurate measures are taken, cracking of the buffer can be avoided. - Abstract: For the final disposal of long-lived, heat-emitting vitrified high-level waste (HLW) in a clayey host rock, an intensive study is conducted to investigate the early-age behaviour of concrete supercontainers. Self-compacting concrete (SCC) is taken as the reference concrete type as it facilitates the casting process in combination with an improved homogeneity compared to the traditional concrete compositions. A laboratory characterization program is conducted to obtain the relevant thermal, mechanical and maturity-related properties of the SCC. These obtained data are implemented into the material database of the finite element tool HEAT to study the behaviour of the concrete layers during the different construction stages of the supercontainer: (i) Stage 1: Fabrication of the concrete buffer inside a stainless steel envelope. No early-age cracking is expected in case accurate measures are taken to reduce the thermal gradient between the outer surface and the middle of the buffer, e.g. by providing insulation and excluding wind. (ii) Stages 2-4: Emplacement of the carbon steel overpack containing the HLW canisters, filling the remaining annular gap with cementitious filler and closure by fitting the lid under thermal load. The construction stages (2-4) for the closure of the supercontainer are executed in hot cell. In this study, the crack creating mechanism and the behaviour of the concrete supercontainer during these construction stages in hot cell are investigated. In case precautionary measures are taken, such as reducing the coefficient of thermal expansion (CTE) of the overpack, prolonging the

CLOSURE REPORT FOR CORRECTIVE ACTION UNIT 528: POLYCHLORINATED BIPHENYLS CONTAMINATION NEVADA TEST SITE, NEVADA

Energy Technology Data Exchange (ETDEWEB)

BECHTEL NEVADA

2006-09-01

This Closure Report (CR) describes the closure activities performed at CAU 528, Polychlorinated Biphenyls Contamination, as presented in the Nevada Division of Environmental Protection (NDEP)-approved Corrective Action Plan (CAP) (US. Department of Energy, National Nuclear Security Administration Nevada Site Office [NNSAINSO], 2005). The approved closure alternative was closure in place with administrative controls. This CR provides a summary of the completed closure activities, documentation of waste disposal, and analytical data to confirm that the remediation goals were met.

Resource Conservation and Recovery Act Closure Plan for the Y-12 9409-5 Tank Storage Facility

International Nuclear Information System (INIS)

1995-02-01

This document presents information on the closure of the Y-12 9409-5 Tank Storage Facility. Topics discussed include: facility description; closure history; closure performance standard; partial closure; maximum waste inventory; closure activities; schedule; and postclosure care

Does velopharyngeal closure pattern affect the success of pharyngeal flap pharyngoplasty?

Science.gov (United States)

Armour, Alexis; Fischbach, Simone; Klaiman, Paula; Fisher, David M

2005-01-01

Historically at The Hospital for Sick Children in Toronto, pharyngeal flap pharyngoplasty has been the treatment of choice for treatment of velopharyngeal insufficiency, regardless of velopharyngeal closure pattern. The authors hypothesize that pharyngeal flap pharyngoplasty is more effective in treating velopharyngeal insufficiency in patients with circular or sagittal velopharyngeal closure and less effective in treating the coronal closure pattern. Ninety-three patients who underwent superiorly based pharyngeal flap surgery for velopharyngeal insufficiency were evaluated in a retrospective chart review. Closure pattern was determined preoperatively by nasopharyngoscopy or multiview videofluoroscopy. Nasalance was assessed preoperatively and at 6 weeks and 1 year postoperatively. Nasalance during nonnasal speech was decreased on average, for all closure patterns, postoperatively. However, a significantly higher percentage of patients were corrected to normal nasalance scores in thenoncoronal group than in the coronal group (57 percent versus 35 percent, respectively) at 1 year postoperatively (p approach to the management of velopharyngeal insufficiency and are more inclined to treat coronal pattern velopharyngeal insufficiency with sphincter pharyngoplasty.

Automated analysis of angle closure from anterior chamber angle images.

Science.gov (United States)

Baskaran, Mani; Cheng, Jun; Perera, Shamira A; Tun, Tin A; Liu, Jiang; Aung, Tin

2014-10-21

To evaluate a novel software capable of automatically grading angle closure on EyeCam angle images in comparison with manual grading of images, with gonioscopy as the reference standard. In this hospital-based, prospective study, subjects underwent gonioscopy by a single observer, and EyeCam imaging by a different operator. The anterior chamber angle in a quadrant was classified as closed if the posterior trabecular meshwork could not be seen. An eye was classified as having angle closure if there were two or more quadrants of closure. Automated grading of the angle images was performed using customized software. Agreement between the methods was ascertained by κ statistic and comparison of area under receiver operating characteristic curves (AUC). One hundred forty subjects (140 eyes) were included, most of whom were Chinese (102/140, 72.9%) and women (72/140, 51.5%). Angle closure was detected in 61 eyes (43.6%) with gonioscopy in comparison with 59 eyes (42.1%, P = 0.73) using manual grading, and 67 eyes (47.9%, P = 0.24) with automated grading of EyeCam images. The agreement for angle closure diagnosis between gonioscopy and both manual (κ = 0.88; 95% confidence interval [CI), 0.81-0.96) and automated grading of EyeCam images was good (κ = 0.74; 95% CI, 0.63-0.85). The AUC for detecting eyes with gonioscopic angle closure was comparable for manual and automated grading (AUC 0.974 vs. 0.954, P = 0.31) of EyeCam images. Customized software for automated grading of EyeCam angle images was found to have good agreement with gonioscopy. Human observation of the EyeCam images may still be needed to avoid gross misclassification, especially in eyes with extensive angle closure. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

Design Alternative Evaluation No. 3: Post-Closure Ventilation

International Nuclear Information System (INIS)

Logan, R.C.

1999-01-01

The objective of this study is to provide input to the Enhanced Design Alternatives (EDA) for License Application Design Selection (LADS). Its purpose is to develop and evaluate conceptual designs for post-closure ventilation alternatives that enhance repository performance. Post-closure ventilation is expected to enhance repository performance by limiting the amount of water contacting the waste packages. Limiting the amount of water contacting the waste packages will reduce corrosion

Transcatheter Device Closure of Patent Ductus Arteriosus

International Nuclear Information System (INIS)

Sultan, M.; Ullah, M.; Sadiq, N.; Akhtar, K.; Akbar, H.

2014-01-01

Objective: To determine the efficacy, safety and immediate complications encountered during percutaneous device closure of patent ductus arteriosus (PDA). Study Design: Case series. Place and Duration of Study: Department of Paediatric Cardiology, AFIC/NIHD, Rawalpindi, from January 2005 to December 2010. Methodology: Consecutive 500 patients who underwent attempted transcatheter PDA device closure were included in the study. Device type position, success of closure and complications were described as frequency percentage. Results: In 491 cases (98.2%), PDA was successfully occluded including 4 cases (0.8%) where devices were dislodged but retrieved and redeployed in Cath laboratory. PDA occluder devices used in 448 cases (91%) while coils (single or multiple) were used in 42 cases (8.5%) and in one case (0.2%) ASD occluder device was used to occlude the PDA. There were 09 (1.8%) unsuccessful cases, 06 (1.2%) were abandoned as ducts were considered unsuitable for device closure, 02 (0.4%) devices dislodged and needed surgical retrieval and one case (0.2%) was abandoned due to faulty equipment. The narrowest PDA diameter ranged from 0.5 - 14 mm with mean of 4.5 +- 2.4 mm. There was a single (0.2%) mortality. Conclusion: Transcatheter occlusion of PDA by coil or occluder device is an effective therapeutic option with high success rate. Complication rate is low in the hands of skilled operators yet paediatric cardiac surgical back-up cover is mandatory. (author)

Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke

DEFF Research Database (Denmark)

Søndergaard, Lars; Kasner, Scott E; Rhodes, John F

2017-01-01

BACKGROUND: The efficacy of closure of a patent foramen ovale (PFO) in the prevention of recurrent stroke after cryptogenic stroke is uncertain. We investigated the effect of PFO closure combined with antiplatelet therapy versus antiplatelet therapy alone on the risks of recurrent stroke and new...... brain infarctions. METHODS: In this multinational trial involving patients with a PFO who had had a cryptogenic stroke, we randomly assigned patients, in a 2:1 ratio, to undergo PFO closure plus antiplatelet therapy (PFO closure group) or to receive antiplatelet therapy alone (antiplatelet-only group......). Imaging of the brain was performed at the baseline screening and at 24 months. The coprimary end points were freedom from clinical evidence of ischemic stroke (reported here as the percentage of patients who had a recurrence of stroke) through at least 24 months after randomization and the 24-month...

Records for radioactive waste management up to repository closure: Managing the primary level information (PLI) set

International Nuclear Information System (INIS)

2004-07-01

The objective of this publication is to highlight the importance of the early establishment of a comprehensive records system to manage primary level information (PLI) as an integrated set of information, not merely as a collection of information, throughout all the phases of radioactive waste management. Early establishment of a comprehensive records system to manage Primary Level Information as an integrated set of information throughout all phases of radioactive waste management is important. In addition to the information described in the waste inventory record keeping system (WIRKS), the PLI of a radioactive waste repository consists of the entire universe of information, data and records related to any aspect of the repository's life cycle. It is essential to establish PLI requirements based on integrated set of needs from Regulators and Waste Managers involved in the waste management chain and to update these requirements as needs change over time. Information flow for radioactive waste management should be back-end driven. Identification of an Authority that will oversee the management of PLI throughout all phases of the radioactive waste management life cycle would guarantee the information flow to future generations. The long term protection of information essential to future generations can only be assured by the timely establishment of a comprehensive and effective RMS capable of capturing, indexing and evaluating all PLI. The loss of intellectual control over the PLI will make it very difficult to subsequently identify the ILI and HLI information sets. At all times prior to the closure of a radioactive waste repository, there should be an identifiable entity with a legally enforceable financial and management responsibility for the continued operation of a PLI Records Management System. The information presented in this publication will assist Member States in ensuring that waste and repository records, relevant for retention after repository closure

Prediction of left ventricular dysfunction after device closure of patent ductus arteriosus: proposal for a new functional classification.

Science.gov (United States)

Kiran, Viralam S; Tiwari, Ashish

2018-04-06

The aims of this study were to determine the incidence and correlates of left ventricular (LV) dysfunction amongst percutaneous patent ductus arteriosus (PDA) device closure patients, and to propose an indexed parameter for predicting LV dysfunction. In a retrospective cross-sectional analysis of 30 months duration, 447 patients who underwent PDA device closure were studied. The diameter of the PDA at the pulmonary artery end was measured in the angiograms in all patients and was indexed for their body surface area. The indexed PDA size was categorised into group A (1-2.9 mm/m², 35/447), B (3-5.9 mm/m², 254/447), C (6-8.9 mm/m², 66/447) and D (>9 mm/m², 35/447). Systolic LV function was evaluated using echocardiography at frequent intervals. Overall, 62.63% of the patients were female (280/447). At baseline, all 447 patients had normal LV function. LV dysfunction was seen in 102/447 (22.8%) patients with 2.8% in category A (1/35), 10.6% in category B (27/254), 34.1% in category C (42/123) and 91.4% in category D (32/35) after PDA device closure. Correlation of indexed PDA size and LV dysfunction was statistically significant (pclosures. Indexed PDA size correlates well with post-procedural LV dysfunction. The authors propose a new classification of PDA utilising this accurate, reproducible and easy to perform parameter, which does not involve any extra cost, for risk stratification and early management in device closure of PDA.

The value of vacuum-assisted closure in septic patients treated with laparostomy.

Science.gov (United States)

Pliakos, Ioannis; Papavramidis, Theodossis S; Michalopoulos, Nick; Deligiannidis, Nickolaos; Kesisoglou, Isaak; Sapalidis, Konstantinos; Papavramidis, Spiros

2012-09-01

The ideal method of temporary abdominal closure (TAC) should allow rapid closure, easy maintenance, and wound repair with minimal tissue damage. The aim of this retrospective study is to compare open abdomen outcomes between patients managed with vacuum-assisted closure (VAC), and patients managed with other methods of TAC, when septic abdomen is present. Two groups of patients with septic open abdomen: 27 treated with VAC versus 31 treated with other techniques of TAC. We studied open abdomen duration, number of dressing changes, re-exploration rate, successful abdominal closure rate, overall mortality, and development of enteroatmospheric fistulas. The VAC device demonstrated its superiority concerning open abdomen duration (P advantages concerning clinical feasibility. The high rates of direct fascia closure with an acceptable rate of ventral hernias are further benefits of this technique.

Model-Based Comprehensive Analysis of School Closure Policies for Mitigating Influenza Epidemics and Pandemics.

Science.gov (United States)

Fumanelli, Laura; Ajelli, Marco; Merler, Stefano; Ferguson, Neil M; Cauchemez, Simon

2016-01-01

School closure policies are among the non-pharmaceutical measures taken into consideration to mitigate influenza epidemics and pandemics spread. However, a systematic review of the effectiveness of alternative closure policies has yet to emerge. Here we perform a model-based analysis of four types of school closure, ranging from the nationwide closure of all schools at the same time to reactive gradual closure, starting from class-by-class, then grades and finally the whole school. We consider policies based on triggers that are feasible to monitor, such as school absenteeism and national ILI surveillance system. We found that, under specific constraints on the average number of weeks lost per student, reactive school-by-school, gradual, and county-wide closure give comparable outcomes in terms of optimal infection attack rate reduction, peak incidence reduction or peak delay. Optimal implementations generally require short closures of one week each; this duration is long enough to break the transmission chain without leading to unnecessarily long periods of class interruption. Moreover, we found that gradual and county closures may be slightly more easily applicable in practice as they are less sensitive to the value of the excess absenteeism threshold triggering the start of the intervention. These findings suggest that policy makers could consider school closure policies more diffusely as response strategy to influenza epidemics and pandemics, and the fact that some countries already have some experience of gradual or regional closures for seasonal influenza outbreaks demonstrates that logistic and feasibility challenges of school closure strategies can be to some extent overcome.

Influence of fatigue crack wake length and state of stress on crack closure

Science.gov (United States)

Telesman, Jack; Fisher, Douglas M.

1988-01-01

The location of crack closure with respect to crack wake and specimen thickness under different loading conditions was determined. The rate of increase of K sub CL in the crack wake was found to be significantly higher for plasticity induced closure in comparison to roughness induced closure. Roughness induced closure was uniform throughout the thickness of the specimen while plasticity induced closure levels were 50 percent higher in the near surface region than in the midthickness. The influence of state of stress on low-high load interaction effects was also examined. Load interaction effects differed depending upon the state of stress and were explained in terms of delta K sub eff.

Parents' Attitudes to the Closure of Small Rural Primary Schools

Science.gov (United States)

Archbold, A.; Nisbet, J.

1977-01-01

Attitudes of 134 parents of children from 10 rural schools threatened with closure, and 56 parents of children from seven schools recently closed, were assessed by interview. Most parents opposed closure, and most gave educational reasons for their attitudes. (Author)

MCO closure welding process parameter development and qualification

International Nuclear Information System (INIS)

CANNELL, G.R.

2003-01-01

One of the key elements in the SNF process is final closure of the MCO by welding. Fuel is loaded into the MCO (approximately 2 ft. in diameter and 13 ft. long) and a heavy shield plug is inserted into the top, creating a mechanical seal. The plug contains several process ports for various operations, including vacuum drying and inert-gas backfilling of the packaged fuel. When fully processed, the Canister Cover Assembly (CCA) is placed over the shield plug and final closure made by welding. The following reports the effort between the Amer Industrial Technology (AIT) and Fluor Hanford (FH) to develop and qualify the welding process for making the final closure--with primary emphasis on developing a set of robust parameters for deposition of the root pass. Work was carried out in three phases: (1) Initial welding process and equipment selection with subsequent field demonstration testing; (2) Development and qualification of a specific process technique and parameters; and (3) Validation of the process and parameters at the CSB under mock production conditions. This work establishes the process technique and parameters that provide a high level of confidence that acceptable MCO closure welds will be made on a consistent and repeatable basis

Multivariate moment closure techniques for stochastic kinetic models

International Nuclear Information System (INIS)

Lakatos, Eszter; Ale, Angelique; Kirk, Paul D. W.; Stumpf, Michael P. H.

2015-01-01

Stochastic effects dominate many chemical and biochemical processes. Their analysis, however, can be computationally prohibitively expensive and a range of approximation schemes have been proposed to lighten the computational burden. These, notably the increasingly popular linear noise approximation and the more general moment expansion methods, perform well for many dynamical regimes, especially linear systems. At higher levels of nonlinearity, it comes to an interplay between the nonlinearities and the stochastic dynamics, which is much harder to capture correctly by such approximations to the true stochastic processes. Moment-closure approaches promise to address this problem by capturing higher-order terms of the temporally evolving probability distribution. Here, we develop a set of multivariate moment-closures that allows us to describe the stochastic dynamics of nonlinear systems. Multivariate closure captures the way that correlations between different molecular species, induced by the reaction dynamics, interact with stochastic effects. We use multivariate Gaussian, gamma, and lognormal closure and illustrate their use in the context of two models that have proved challenging to the previous attempts at approximating stochastic dynamics: oscillations in p53 and Hes1. In addition, we consider a larger system, Erk-mediated mitogen-activated protein kinases signalling, where conventional stochastic simulation approaches incur unacceptably high computational costs

Multivariate moment closure techniques for stochastic kinetic models

Energy Technology Data Exchange (ETDEWEB)

Lakatos, Eszter, E-mail: e.lakatos13@imperial.ac.uk; Ale, Angelique; Kirk, Paul D. W.; Stumpf, Michael P. H., E-mail: m.stumpf@imperial.ac.uk [Department of Life Sciences, Centre for Integrative Systems Biology and Bioinformatics, Imperial College London, London SW7 2AZ (United Kingdom)

2015-09-07

Stochastic effects dominate many chemical and biochemical processes. Their analysis, however, can be computationally prohibitively expensive and a range of approximation schemes have been proposed to lighten the computational burden. These, notably the increasingly popular linear noise approximation and the more general moment expansion methods, perform well for many dynamical regimes, especially linear systems. At higher levels of nonlinearity, it comes to an interplay between the nonlinearities and the stochastic dynamics, which is much harder to capture correctly by such approximations to the true stochastic processes. Moment-closure approaches promise to address this problem by capturing higher-order terms of the temporally evolving probability distribution. Here, we develop a set of multivariate moment-closures that allows us to describe the stochastic dynamics of nonlinear systems. Multivariate closure captures the way that correlations between different molecular species, induced by the reaction dynamics, interact with stochastic effects. We use multivariate Gaussian, gamma, and lognormal closure and illustrate their use in the context of two models that have proved challenging to the previous attempts at approximating stochastic dynamics: oscillations in p53 and Hes1. In addition, we consider a larger system, Erk-mediated mitogen-activated protein kinases signalling, where conventional stochastic simulation approaches incur unacceptably high computational costs.

Contemporary Approach to the Diagnosis and Management of Primary Angle-Closure Disease.

Science.gov (United States)

Razeghinejad, M Reza; Myers, Jonathan S

2018-05-16

Primary angle closure disease spectrum varies from a narrow angle to advanced glaucoma. A variety of imaging technologies may assist the clinician in determining the pathophysiology and diagnosis of primary angle closure, but gonioscopy remains a mainstay of clinical evaluation. Laser iridotomy effectively eliminates the pupillary block component of angle closure; however, studies show that in many patients the iridocorneal angle remains narrow from underlying anatomic issues, and increasing lens size often leads to further narrowing over time. Recent studies have further characterized the role of the lens in angle closure disease, and cataract or clear lens extraction is increasingly used earlier in its management. As a first surgical step in angle closure glaucoma, lens extraction alone often effectively controls the pressure with less risk of complications than concurrent or stand alone glaucoma surgery, but may not be sufficient in more advanced or severe disease. We provide a comprehensive review on the primary angle-closure disease nomenclature, imaging, and current laser and surgical management. Copyright © 2018. Published by Elsevier Inc.

Calcined solids storage facility closure study

International Nuclear Information System (INIS)

Dahlmeir, M.M.; Tuott, L.C.; Spaulding, B.C.

1998-02-01

The disposal of radioactive wastes now stored at the Idaho National Engineering and Environmental Laboratory is currently mandated under a open-quotes Settlement Agreementclose quotes (or open-quotes Batt Agreementclose quotes) between the Department of Energy and the State of Idaho. Under this agreement, all high-level waste must be treated as necessary to meet the disposal criteria and disposed of or made road ready to ship from the INEEL by 2035. In order to comply with this agreement, all calcined waste produced in the New Waste Calcining Facility and stored in the Calcined Solids Facility must be treated and disposed of by 2035. Several treatment options for the calcined waste have been studied in support of the High-Level Waste Environmental Impact Statement. Two treatment methods studied, referred to as the TRU Waste Separations Options, involve the separation of the high-level waste (calcine) into TRU waste and low-level waste (Class A or Class C). Following treatment, the TRU waste would be sent to the Waste Isolation Pilot Plant (WIPP) for final storage. It has been proposed that the low-level waste be disposed of in the Tank Farm Facility and/or the Calcined Solids Storage Facility following Resource Conservation and Recovery Act closure. In order to use the seven Bin Sets making up the Calcined Solids Storage Facility as a low-level waste landfill, the facility must first be closed to Resource Conservation and Recovery Act (RCRA) standards. This study identifies and discusses two basic methods available to close the Calcined Solids Storage Facility under the RCRA - Risk-Based Clean Closure and Closure to Landfill Standards. In addition to the closure methods, the regulatory requirements and issues associated with turning the Calcined Solids Storage Facility into an NRC low-level waste landfill or filling the bin voids with clean grout are discussed

Calcined solids storage facility closure study

Energy Technology Data Exchange (ETDEWEB)

Dahlmeir, M.M.; Tuott, L.C.; Spaulding, B.C. [and others

1998-02-01

The disposal of radioactive wastes now stored at the Idaho National Engineering and Environmental Laboratory is currently mandated under a {open_quotes}Settlement Agreement{close_quotes} (or {open_quotes}Batt Agreement{close_quotes}) between the Department of Energy and the State of Idaho. Under this agreement, all high-level waste must be treated as necessary to meet the disposal criteria and disposed of or made road ready to ship from the INEEL by 2035. In order to comply with this agreement, all calcined waste produced in the New Waste Calcining Facility and stored in the Calcined Solids Facility must be treated and disposed of by 2035. Several treatment options for the calcined waste have been studied in support of the High-Level Waste Environmental Impact Statement. Two treatment methods studied, referred to as the TRU Waste Separations Options, involve the separation of the high-level waste (calcine) into TRU waste and low-level waste (Class A or Class C). Following treatment, the TRU waste would be sent to the Waste Isolation Pilot Plant (WIPP) for final storage. It has been proposed that the low-level waste be disposed of in the Tank Farm Facility and/or the Calcined Solids Storage Facility following Resource Conservation and Recovery Act closure. In order to use the seven Bin Sets making up the Calcined Solids Storage Facility as a low-level waste landfill, the facility must first be closed to Resource Conservation and Recovery Act (RCRA) standards. This study identifies and discusses two basic methods available to close the Calcined Solids Storage Facility under the RCRA - Risk-Based Clean Closure and Closure to Landfill Standards. In addition to the closure methods, the regulatory requirements and issues associated with turning the Calcined Solids Storage Facility into an NRC low-level waste landfill or filling the bin voids with clean grout are discussed.

Infering and Calibrating Triadic Closure in a Dynamic Network

Science.gov (United States)

Mantzaris, Alexander V.; Higham, Desmond J.

In the social sciences, the hypothesis of triadic closure contends that new links in a social contact network arise preferentially between those who currently share neighbours. Here, in a proof-of-principle study, we show how to calibrate a recently proposed evolving network model to time-dependent connectivity data. The probabilistic edge birth rate in the model contains a triadic closure term, so we are also able to assess statistically the evidence for this effect. The approach is shown to work on data generated synthetically from the model. We then apply this methodology to some real, large-scale data that records the build up of connections in a business-related social networking site, and find evidence for triadic closure.

Transcatheter closure, mini-invasive closure and open-heart surgical repair for treatment of perimembranous ventricular septal defects in children: a protocol for a network meta-analysis.

Science.gov (United States)

You, Tao; Yi, Kang; Ding, Zhao-Hong; Hou, Xiao-Dong; Liu, Xing-Guang; Wang, Xin-Kuan; Ge, Long; Tian, Jin-Hui

2017-06-21

Both transcatheter device closure and surgical repair are effective treatments with excellent midterm outcomes for perimembranous ventricular septal defects (pmVSDs) in children. The mini-invasive periventricular device occlusion technique has become prevalent in research and application, but evidence is limited for the assessment of transcatheter closure, mini-invasive closure and open-heart surgical repair. This study comprehensively compares the efficacy, safety and costs of transcatheter closure, mini-invasive closure and open-heart surgical repair for treatment of pmVSDs in children using Bayesian network meta-analysis. A systematic search will be performed using Chinese Biomedical Literature Database, China National Knowledge Infrastructure, PubMed, EMBASE.com and the Cochrane Central Register of Controlled Trials to include random controlled trials, prospective or retrospective cohort studies comparing the efficacy, safety and costs of transcatheter closure, mini-invasive closure and open-heart surgical repair. The risk of bias for the included prospective or retrospective cohort studies will be evaluated according to the risk of bias in non-randomised studies of interventions (ROBINS-I). For random controlled trials, we will use risk of bias tool from Cochrane Handbook version 5.1.0. A Bayesian network meta-analysis will be conducted using R-3.3.2 software. Ethical approval and patient consent are not required since this study is a network meta-analysis based on published trials. The results of this network meta-analysis will be submitted to a peer-reviewed journal for publication. CRD42016053352. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Shell closure in stable and unstable Fermion systems

International Nuclear Information System (INIS)

Lombard, R.J.

1991-01-01

Some of the findings of calculations performed with the density functional method in connection with shell closure are presented. In nuclei, some evidences seam to confirm the existence of a shell closure at N or Z=16, for Z or N<11. More data, particularly spectroscopic measurements would provide further information. Single particle energies for Z=16 isotopes as function of the neutron number N are given. (G.P.) 9 refs.; 6 figs

Multicentre study on capsular closure versus non-capsular closure during hip arthroscopy in Danish patients with femoroacetabular impingement (FAI)

DEFF Research Database (Denmark)

Dippmann, Christian; Kraemer, Otto; Lund, Bent

2018-01-01

in patients without additional risk factors for instability such as hypermobility or dysplasia of the hip. We hypothesised that capsular closure will lead to a superior outcome in hip arthroscopy for femoroacetabular impingement syndrome (FAIS) compared with non-capsular closure. METHODS AND ANALYSIS...... years and FAIS according to the Warwick agreement. Exclusion criteria are: previous hip surgery in either hip, previous conditions of Legg-Calvé-Perthes or slipped capital femoral epiphysis, malignant disease, recent hip or pelvic fractures, arthritis, Ehlers-Danlos or Marfan disease, recent (within 6...

Patient Satisfaction After Femoral Arterial Access Site Closure Using the ExoSeal® Vascular Closure Device Compared to Manual Compression: A Prospective Intra-individual Comparative Study

International Nuclear Information System (INIS)

Pieper, Claus Christian; Thomas, Daniel; Nadal, Jennifer; Willinek, Winfried A.; Schild, Hans Heinz; Meyer, Carsten

2016-01-01

PurposeTo intra-individually compare discomfort levels and patient satisfaction after arterial access closure using the ExoSeal ® vascular closure device (VCD) and manual compression (MC) in a prospective study design.MethodsPatients undergoing two planned interventions from 07/2013 to 09/2014 could participate in the study. Access closure was performed with an ExoSeal ® -VCD in one and MC in the other intervention. Patients were clinically and sonographically examined and were given questionnaires 1 day after intervention [groin- and back-pain during bedrest (100-point visual analog scale; 0: no pain); comfortability of bedrest (10-point Likert scale, 1: comfortable), satisfaction with closure (10-point Likert scale, 1: very satisfied)]. Results were analyzed in a cross-over design.Results48 patients (29 male, median age 62.5 (32–88) years) were included. An ExoSeal ® -VCD was used first in 25 cases. As four of these subsequently refused MC as second intervention, data from 44 patients could be analyzed. All closures were technically successful (successful device deployment) without major complications. Groin- and back-pain after VCD-use/MC was 0 (0–15) vs. 10 (0–80) and 0 (0–75) vs. 25 (0–90), respectively (p < 0.0001). Bedrest after VCD-use was more comfortable than after MC [1 (range 1–7) vs. 6 (2–10); p < 0.0001]. Satisfaction with the closure procedure and with the intervention in general was higher after VCD-use compared to MC [1 (1–3) vs. 5 (2–10) and 1 (1–2) vs. 2 (1–4), respectively; p < 0.0001].ConclusionIntra-individual comparison showed pain levels and discomfort to be significantly lower after ExoSeal ® use compared to MC. VCD closure was associated with higher satisfaction both with the closure itself and with the intervention in general

Guinea pig ductus arteriosus. II - Irreversible closure after birth.

Science.gov (United States)

Fay, F. S.; Cooke, P. H.

1972-01-01

To investigate the mechanism underlying irreversibility of ductal closure after birth, studies were undertaken to determine the exact time course for the onset of irreversible closure of the guinea pig ductus arteriosus. Parallel studies of the reactivity of ductal smooth muscle to oxygen and studies of the postpartum cellular changes within the vessel were also carried out.

Rating the Effectiveness of Fishery Closures With Visible Infrared Imaging Radiometer Suite Boat Detection Data

Directory of Open Access Journals (Sweden)

Christopher D. Elvidge

2018-04-01

Full Text Available Fishery closures are widely used to promote the sustainability of fish stocks. Fishery agencies typically have very little data relevant to planning closure enforcement actions and evaluating the effectiveness of closures, due in part to the vast expanse and remote nature of many closures. In some cases the effectiveness of closures can be evaluated using data from GPS based beacons, such as Automatic Identification System (AIS or Vessel Monitoring Systems (VMS installed on fishing boats. In fisheries where few boats are equipped with AIS or VMS, the rating of closures relies on other data sources capable of detecting or inferring fishing activity. One such source comes from low light imaging data collected by the NASA/NOAA Visible Infrared Imaging Radiometer Suite (VIIRS, which can detect fishing boats using lights to attract catch. This is a widely used practice in Asia and several other regions. NOAA has developed an automatic system for reporting the locations of VIIRS boat detections with a nominal 4 h temporal latency. VIIRS boat detection alerts are running for more than 900 fishery closures in the Philippines, with email and SMS transmission modes. These alerts are being actively used in the Philippines to plan enforcement actions and there is a growing list of apprehensions that occurred based on tip-offs from VIIRS. The VIIRS boat detection archive extends back to April 2012. A VIIRS closure index (VCI has been developed to rate the effectiveness of closures on monthly increments in terms of a percentage. The VCI analysis was performed on three types of closures: an ad hoc fishery closure associated with a toxic industrial discharge, a seasonal fishery closure and a permanent closure in restricted coastal waters. The VCI results indicate that it is possible to rank the effectiveness of different closure, year-to-year differences in compliance levels, and to identify closure encroachments which may warrant additional enforcement effort.

Limited utility of preoperative studies in preparation for colostomy closure.

Science.gov (United States)

Pokorny, R M; Heniford, T; Allen, J W; Tuckson, W B; Galandiuk, S

1999-04-01

Numerous diagnostic and therapeutic practices are used in an attempt to reduce the morbidity of colostomy closures. Our principal aim was to evaluate the role of preoperative studies, specifically barium enemas and endoscopic examinations, performed before colostomy closures. Additionally, we wished to identify other practices involved in the perioperative management of patients undergoing colostomy closure that influenced morbidity. The records of 100 consecutive patients who underwent elective colostomy closure at University of Louisville Hospital between January 1989 and July 1995 were reviewed. Wound infection was the most common complication (12%). Various bowel preparations were equivalent in efficacy and did not influence the complication rate. Intermittent wound irrigation with antibiotics for 3 days postoperatively, via subcutaneous drains, was associated with a low incidence of incision infection. Preoperative barium enema or sigmoidoscopy were often performed but rarely useful. Performing these examinations merely increased hospital cost without a corresponding decline in morbidity.

Procedures adopted by orthodontists for space closure and anchorage control.

Science.gov (United States)

Monini, André da Costa; Gandini Júnior, Luiz Gonzaga; dos Santos-Pinto, Ary; Maia, Luiz Guilherme Martins; Rodrigues, Willian Caetano

2013-01-01

The aim of this study was to identify the procedures adopted by Brazilian orthodontists in the following situations: extraction space closure, anchorage control in case of necessary anchorage for group A and frequency of skeletal anchorage use, especially in the upper jaw. A questionnaire was sent to the e-mail address of all dentists registered in the Brazilian Federal Council of Dentistry. The results showed that most Brazilian orthodontists usually perform extraction space closure by means of sliding mechanics. The use of palatal bar, inclusion of second molars in the archwire and space closure performed in two phases are the most used techniques for anchorage control in the upper jaw. The skeletal anchorage is referenced by 36.5% of specialists as a routine practice for the upper arch anchorage. There is a wide variety of procedures adopted by Brazilian orthodontists for orthodontic space closure and anchorage control.

Amnioserosa cell constriction but not epidermal actin cable tension autonomously drives dorsal closure.

Science.gov (United States)

Pasakarnis, Laurynas; Frei, Erich; Caussinus, Emmanuel; Affolter, Markus; Brunner, Damian

2016-11-01

Tissue morphogenesis requires coordination of multiple force-producing components. During dorsal closure in fly embryogenesis, an epidermis opening closes. A tensioned epidermal actin/MyosinII cable, which surrounds the opening, produces a force that is thought to combine with another MyosinII force mediating apical constriction of the amnioserosa cells that fill the opening. A model proposing that each force could autonomously drive dorsal closure was recently challenged by a model in which the two forces combine in a ratchet mechanism. Acute force elimination via selective MyosinII depletion in one or the other tissue shows that the amnioserosa tissue autonomously drives dorsal closure while the actin/MyosinII cable cannot. These findings exclude both previous models, although a contribution of the ratchet mechanism at dorsal closure onset remains likely. This shifts the current view of dorsal closure being a combinatorial force-component system to a single tissue-driven closure event.

Successful Treatment of Anterior Tracheal Necrosis after Total Thyroidectomy Using Vacuum-Assisted Closure Therapy

Directory of Open Access Journals (Sweden)

Grégory Philippe

2012-01-01

Full Text Available Total thyroidectomy involving the adjacent structures of the trachea can cause tracheal damage such as early tracheal necrosis. The authors describe the first case of anterior tracheal necrosis following total thyroidectomy treated using vacuum-assisted closure device. After two weeks of VAC  therapy, there was no evidence of ongoing infection and the trachea was partially closed around a tracheotomy cannula, removed after 3 months. The use of a VAC  therapy to reduce and close the tracheal rent and to create a rapid granulation tissue over tracheal structure appeared as a good opportunity after anterior tracheal necrosis.

Wound infection following stoma takedown: primary skin closure versus subcuticular purse-string suture.

Science.gov (United States)

Marquez, Thao T; Christoforidis, Dimitrios; Abraham, Anasooya; Madoff, Robert D; Rothenberger, David A

2010-12-01

Stoma closure has been associated with a high rate of surgical site infection (SSI) and the ideal stoma-site skin closure technique is still debated. The aim of this study was to compare the rate of SSI following primary skin closure (PC) versus a skin-approximating, subcuticular purse-string closure (APS). All consecutive patients undergoing stoma closure between 2002 and 2007 by two surgeons at a single tertiary-care institution were retrospectively assessed. Patients who had a new stoma created at the same site or those without wound closure were excluded. The end point was SSI, determined according to current CDC guidelines, at the stoma closure site and/or the midline laparotomy incision. There were 61 patients in the PC group (surgeon A: 58 of 61) and 17 in the APS group (surgeon B: 16 of 17). The two groups were similar in baseline and intraoperative characteristics, except that patients in the PC group were more often diagnosed with benign disease (p = 0.0156) and more often had a stapled anastomosis (p = 0.002). The overall SSI rate was 14 of 78 (18%). All SSIs occurred in the PC group (14 of 61 vs. 0 of 17, p = 0.03). Our study suggests that a skin-approximating closure with a subcuticular purse-string of the stoma site leads to less SSI than a primary closure. Randomized studies are needed to confirm our findings and assess additional end points such as healing time, cost, and patient satisfaction.

Cost comparison of transcatheter and operative closures of ostium secundum atrial septal defects

Science.gov (United States)

O’Byrne, Michael L.; Gillespie, Matthew J.; Shinohara, Russell T.; Dori, Yoav; Rome, Jonathan J.; Glatz, Andrew C.

2015-01-01

Background Clinical outcomes for transcatheter and operative closures of atrial septal defects (ASDs) are similar. Economic cost for each method has not been well described. Methods A single-center retrospective cohort study of children and adults cost of operative and transcatheter closures of ASD. A propensity score weight-adjusted multivariate regression model was used in an intention-to-treat analysis. Costs for reintervention and crossover admissions were included in primary analysis. Results A total of 244 subjects were included in the study (64% transcatheter and 36% operative), of which 2% (n = 5) were ≥18 years. Crossover rate from transcatheter to operative group was 3%. Risk of reintervention (P = .66) and 30-day mortality (P = .37) were not significantly different. In a multivariate model, adjusted cost of operative closure was 2012 US $60,992 versus 2012 US $55,841 for transcatheter closure (P cost favoring transcatheter closure were length of stay, medications, and follow-up radiologic and laboratory testing, overcoming higher costs of procedure and echocardiography. Professional costs did not differ. The rate of 30-day readmission was greater in the operative cohort, further increasing the cost advantage of transcatheter closure. Sensitivity analyses demonstrated that costs of follow-up visits influenced relative cost but that device closure remained favorable over a broad range of crossover and reintervention rates. Conclusion For single secundum ASD, cost comparison analysis favors transcatheter closure over the short term. The cost of follow-up regimens influences the cost advantage of transcatheter closure. PMID:25965721

The safety and efficacy of the Angio-Seal closure device in diagnostic and interventional neuroangiography setting: a single-center experience with 1,443 closures

Energy Technology Data Exchange (ETDEWEB)

Geyik, Serdar; Yavuz, Kivilcim; Akgoz, Ayca; Koc, Osman; Peynircioglu, Bora; Cil, Barbaros; Cekirge, Saruhan; Saatci, Isil [Hacettepe University Hospitals, Radiology Department, Ankara (Turkey)

2007-09-15

We evaluated the safety and efficacy of the Angio-Seal closure device used to close arterial puncture sites in patients who had undergone diagnostic cerebral angiography and neurointerventional procedures. A total of 1,443 Angio-Seal devices were placed in 1,099 patients in the Interventional Neuroradiology Unit between May 2005 and August 2006. Of these, 670 were interventional and 745 were diagnostic cerebral angiographic procedures. In 28 patients bilateral puncture of the femoral arteries was performed for endovascular treatment. In 167 patients 286 repeat diagnostic procedures were performed and 30 interventional procedures were followed by re-closure with an Angio-Seal device at the time of repeat puncture. The procedural success rate for antegrade closures was 99.7% for all procedures. The device failed in 5 of 745 diagnostic procedures (0.7%). Major complication occurred in one patient only (0.13%) in the diagnostic group. No minor complications were observed in this group. In the interventional group, the major complication rate was 1.4% (10 of 698 closures) and the minor complication rate was 2.4% (17 of 698 closures). However, in the subgroup of patients with cerebral aneurysms who received heparin in combination with antiplatelet agents after the procedure, the major complication rate was 5.3%, but in the carotid/vertebral stenting group it was 0.8%. Our experience in a relatively large series of patients shows that the use of the Angio-Seal STS vascular closure device is safe and effective in patients undergoing cerebral diagnostic angiography and neurointerventional procedures with an acceptable rate of complications, although the complication rate was higher in the group of patients who received heparin and/or antiplatelet medication. (orig.)

27 CFR 27.61 - Containers of distilled spirits to bear closures.

Science.gov (United States)

2010-04-01

... BEER General Requirements Closures for Containers of Distilled Spirits § 27.61 Containers of distilled spirits to bear closures. No person shall transport, buy, possess, or sell, or transfer any imported...

Cranial Suture Closure in Domestic Dog Breeds and Its Relationships to Skull Morphology.

Science.gov (United States)

Geiger, Madeleine; Haussman, Sinah

2016-04-01

Bulldog-type brachycephalic domestic dog breeds are characterized by a relatively short and broad skull with a dorsally rotated rostrum (airorhynchy). Not much is known about the association between a bulldog-type skull conformation and peculiar patterns of suture and synchondrosis closure in domestic dogs. In this study, we aim to explore breed-specific patterns of cranial suture and synchondrosis closure in relation to the prebasial angle (proxy for airorhynchy and thus bulldog-type skull conformation) in domestic dogs. For this purpose, we coded closure of 18 sutures and synchondroses in 26 wolves, that is, the wild ancestor of all domestic dogs, and 134 domestic dogs comprising 11 breeds. Comparisons of the relative amount of closing and closed sutures and synchondroses (closure scores) in adult individuals showed that bulldog-type breeds have significantly higher closure scores than non-bulldog-type breeds and that domestic dogs have significantly higher closure scores than the wolf. We further found that the prebasial angle is significantly positively correlated with the amount of closure of the basispheno-presphenoid synchondrosis and sutures of the nose (premaxillo-nasal and maxillo-nasal) and the palate (premaxillo-maxillary and interpalatine). Our results show that there is a correlation between patterns of suture and synchondrosis closure and skull shape in domestic dogs, although the causal relationships remain elusive. © 2016 Wiley Periodicals, Inc.

Effects of genistein on early-stage cutaneous wound healing

Energy Technology Data Exchange (ETDEWEB)

Park, Eunkyo [Department of Home Economics Education, Chung-Ang University, Seoul 156-756 (Korea, Republic of); Lee, Seung Min [Research Institute of Health Sciences, Korea University, Seoul 136-701 (Korea, Republic of); Jung, In-Kyung [Department of Home Economics Education, Chung-Ang University, Seoul 156-756 (Korea, Republic of); Lim, Yunsook [Department of Foods and Nutrition, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Kim, Jung-Hyun, E-mail: jjhkim@cau.ac.kr [Department of Home Economics Education, Chung-Ang University, Seoul 156-756 (Korea, Republic of)

2011-07-08

Highlights: {yields} We examine the effect of genistein on cutaneous wound healing. {yields} Genistein enhanced wound closure during the early stage of wound healing. {yields} These genistein effects on wound closure were induced by reduction of oxidative stress through increasing antioxidant capacity and modulation of pro-inflammatory cytokine expression. -- Abstract: Wound healing occurs in three sequential phases: hemostasis and inflammation, proliferation, and remodeling. Inflammation, the earliest phase, is considered a critical period for wound healing because immune cells remove damaged tissues, foreign debris, and remaining dead tissue. Wound healing would be delayed without inflammation, and this phase is affected by antioxidation capacity. Therefore, we hypothesized that genistein, which has an antioxidant effect, might modulate the wound healing process by altering the inflammatory response. After three days of acclimation, mice were divided into three groups: control, 0.025% genistein, and 0.1% genistein. After two weeks of an experimental diet, skin wounds were induced. Wounded skin areas were imaged, and the healing rate calculated. To measure lipid peroxidation, antioxidant enzyme expression and activity, and pro-inflammatory cytokine expression, skin and liver tissues were harvested at 12, 24, 48, and 72 h. Genistein did not affect body weight. The rate of wound closure in mice fed genistein was significantly faster than in the control group during the early stage of wound healing, especially in first three days. Cu, Zn-SOD and Mn-SOD expression in wound skin tissue in the 0.1% genistein group was lower than in the control group. However, CAT expression did not differ among groups. We also found that genistein modulated NF-{kappa}B and TNF-{alpha} expression during the early stage of wound healing. The genistein group had significantly lower hepatic lipid peroxidation and higher SOD, CAT, and GPx activities than the control group. These results

Infiltration experiment for closure cap evaluation at the Savannah River Site

International Nuclear Information System (INIS)

Roddy, N.S.; Cook, J.R.

1990-01-01

This document discusses several large waste disposal facilities at the Savannah River Site which are being closed. These facilities include two seepage basins and the low-level waste disposal facility. The key element of the closures is the construction of a cap system to limit the infiltration of water which might reach the disposed waste. Cap designs have been modeled using the Hydrologic Evaluation of Landfill Performance (HELP) computer code. This code was developed by the US Army Corps of Engineers for the Environmental Protection Agency to model the effects of various cap and liner designs on the water balance at landfills. A field experiment has been set up which will allow the results of the HELP Code to be verified at the Savannah River Site (SRS) by measuring the actual water balance created by closure cap configurations which will be used in waste site closures at SRS. Two of the caps will be similar to those used for the planned closure activities. Each one has a specific closure arrangement. Once operational, the experiment will be evaluated for a five-year period

Cracked Vases and Untidy Seams: Narrative Structure and Closure ...

African Journals Online (AJOL)

The TRC reveals a tension between a desire to open up the story of the past and to “close the chapter on our past”. I explore this tension by considering both the TRC's relation to closure and those of selected fictional narratives that explicitly respond to the TRC. I argue that the tidy closure of reconciliation both excludes the ...

Self-testing security sensor for monitoring closure of vault doors and the like

International Nuclear Information System (INIS)

Cawthorne, D.C.

1997-01-01

A self-testing device is provided for a monitoring system for monitoring whether a closure member such as a door or window is closed. The monitoring system includes a switch unit mounted on the frame of the closure member being monitored and including magnetically biased switches connected in one or more electrical monitoring circuits, and a door magnet unit mounted on the closure member being monitored. The door magnet includes one or more permanent magnets that produce a magnetic field which, when the closure member is closed, cause said switches to assume a first state. When the closure member is opened, the switches switch to a second, alarm state. The self-testing device is electrically controllable from a remote location and produces a canceling or diverting magnetic field which simulates the effect of movement of the closure member from the closed position thereof without any actual movement of the member. 5 figs

Procedures adopted by orthodontists for space closure and anchorage control

Directory of Open Access Journals (Sweden)

André da Costa Monini

2013-12-01

Full Text Available OBJECTIVE: The aim of this study was to identify the procedures adopted by Brazilian orthodontists in the following situations: extraction space closure, anchorage control in case of necessary anchorage for group A and frequency of skeletal anchorage use, especially in the upper jaw. METHOD: A questionnaire was sent to the e-mail address of all dentists registered in the Brazilian Federal Council of Dentistry. RESULTS: The results showed that most Brazilian orthodontists usually perform extraction space closure by means of sliding mechanics. The use of palatal bar, inclusion of second molars in the archwire and space closure performed in two phases are the most used techniques for anchorage control in the upper jaw. The skeletal anchorage is referenced by 36.5% of specialists as a routine practice for the upper jaw anchorage. CONCLUSIONS: There is a wide variety of procedures adopted by Brazilian orthodontists for orthodontic space closure and anchorage control.

Closure and ratio correlation analysis of lunar chemical and grain size data

Science.gov (United States)

Butler, J. C.

1976-01-01

Major element and major element plus trace element analyses were selected from the lunar data base for Apollo 11, 12 and 15 basalt and regolith samples. Summary statistics for each of the six data sets were compiled, and the effects of closure on the Pearson product moment correlation coefficient were investigated using the Chayes and Kruskal approximation procedure. In general, there are two types of closure effects evident in these data sets: negative correlations of intermediate size which are solely the result of closure, and correlations of small absolute value which depart significantly from their expected closure correlations which are of intermediate size. It is shown that a positive closure correlation will arise only when the product of the coefficients of variation is very small (less than 0.01 for most data sets) and, in general, trace elements in the lunar data sets exhibit relatively large coefficients of variation.

RCRA closure of eight land-based units at the Y-12 plant

International Nuclear Information System (INIS)

Stone, J.E.; Welch, S.H.

1988-01-01

Eight land-based hazardous waste management units at the Oak Ridge Y-12 Plant are being closed under an integrated multi-year program. Closure plans for the units have been submitted and are in various stages of revision and regulatory review. These units will be closed by various combinations of methods, including liquid removal and treatment, sludge stabilization, contaminated sludge and/or soil removal, and capping. The closure of these sites will be funded by a new Department of Energy budget category, the Environmental Restoration Budget Category (ERBC), which is intended to provide greater flexibility in the response to closure and remedial activities. A major project, Closure and Post-Closure Activities (CAPCA), has been identified for ERBC funding to close and remediate the land units in accordance with RCRA requirements. Establishing the scope of this program has required the development of risk assessments and the preparation of an integrated schedule

RCRA closures at Rocky Flats Plant: A programmatic perspective and case study

International Nuclear Information System (INIS)

Ogg, Randy T.; Peterman, Bruce D.

1992-01-01

The Interagency Agreement (IAG) integrates a unique mechanism for remediating hazardous waste sites at the Rocky Flats Plant (RFP), which include utilizing RCRA and CERCLA technical/regulatory processes. Pursuant to the IAG signed by the Department of Energy (DOE), Environmental Protection Agency (EPA), and the Colorado Department of Health (CDH) on January 22, 1991, sixteen operable units (OUs) were defined for characterization and remediation at RFP. Of the sixteen OUs, six are classified as Resource Conservation and Recovery Act (RCRA) closure units. The six RCRA interim status closure units are: Solar Evaporation Ponds-OU 4, Present LandfUl-OU 7, Original Process Waste Lines-OU 9, Other Outside Closures-OU 10, West Spray Field-OU II, and Inside Building Closures-OU 15. The IAG will function as a technical/regulatory mechanism for managing/complying with all aspects of the RCRA interim status closure units at RFP. (author)

Revisiting the Landau fluid closure.

Science.gov (United States)

Hunana, P.; Zank, G. P.; Webb, G. M.; Adhikari, L.

2017-12-01

Advanced fluid models that are much closer to the full kinetic description than the usual magnetohydrodynamic description are a very useful tool for studying astrophysical plasmas and for interpreting solar wind observational data. The development of advanced fluid models that contain certain kinetic effects is complicated and has attracted much attention over the past years. Here we focus on fluid models that incorporate the simplest possible forms of Landau damping, derived from linear kinetic theory expanded about a leading-order (gyrotropic) bi-Maxwellian distribution function f_0, under the approximation that the perturbed distribution function f_1 is gyrotropic as well. Specifically, we focus on various Pade approximants to the usual plasma response function (and to the plasma dispersion function) and examine possibilities that lead to a closure of the linear kinetic hierarchy of fluid moments. We present re-examination of the simplest Landau fluid closures.

Double-lock technique: a simple method to secure abdominal wall closure

International Nuclear Information System (INIS)

Jategaonkar, P.A.; Yadav, S.P.

2013-01-01

Secure closure of a laparotomy incision remains an important aspect of any abdominal operation with the aim to avoid the postoperative morbidity and hasten the patient's recovery. Depending on the operator's preference and experience, it may be done by the continuous or the interrupted methods either using a non-absorbable or delayed-absorbable suture. We describe a simple, secure and quick technique of abdominal wall closure which involves continuous suture inter-locked doubly after every third bite. This simple and easy to use mass closure technique can be easily mastered by any member of the surgical team and does not need any assistant. It amalgamates the advantages of both, the continuous and the interrupted methods of closures. To our knowledge, such a technique has not been reported in the literature. (author)

Transcatheter closure of patent ductus arteriosus using the angled duct occluder

Energy Technology Data Exchange (ETDEWEB)

Yongwen, Qin; Xianxian, Zhao; Hong, Wu; Xing, Zheng; Jijun, Ding; Jianqiang, Hu [Second Military Medical Univ., Shanghai (China). Changhai Hospital, Dept. of Cardiology

2004-04-01

Objective: To assess the immediate efficacy of transcatheter closure of patent ductus arteriosus(PDA) using the angled duct occluder (ADO). Methods: 9 patients (1 male, 8 female) underwent transcatheter closure of PDA using the ADO. The mean PDA diameter at its narrowest segment was (5.8 {+-} 1.9) mm, ranging 3 to 10 mm. A 6 - 9F long sheath was used for the delivery of ADO. Results: The devices were deployed successfully in all patients. Angiographies showed no shunt across the device 15 min after the implantation of ADO. Within 1 week, echocardiography revealed complete closure in all patients. There were no complications. Conclusions: The transcatheter closure of PDA using ADO is an effective and safe procedure. The device matches with the shape of aortic cavity much more precisely than Amplatzer duct occluder. (authors)

Application of statistical dynamical turbulence closures to data assimilation

International Nuclear Information System (INIS)

O'Kane, Terence J; Frederiksen, Jorgen S

2010-01-01

We describe the development of an accurate yet computationally tractable statistical dynamical closure theory for general inhomogeneous turbulent flows, coined the quasi-diagonal direct interaction approximation closure (QDIA), and its application to problems in data assimilation. The QDIA provides prognostic equations for evolving mean fields, covariances and higher-order non-Gaussian terms, all of which are also required in the formulation of data assimilation schemes for nonlinear geophysical flows. The QDIA is a generalization of the class of direct interaction approximation theories, initially developed by Kraichnan (1959 J. Fluid Mech. 5 497) for isotropic turbulence, to fully inhomogeneous flows and has been further generalized to allow for both inhomogeneous and non-Gaussian initial conditions and long integrations. A regularization procedure or empirical vertex renormalization that ensures correct inertial range spectra is also described. The aim of this paper is to provide a coherent mathematical description of the QDIA turbulence closure and closure-based data assimilation scheme we have labeled the statistical dynamical Kalman filter. The mathematical formalism presented has been synthesized from recent works of the authors with some additional material and is presented in sufficient detail that the paper is of a pedagogical nature.

29 CFR 2701.2 - Open meetings policy; closure of meetings.

Science.gov (United States)

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Open meetings policy; closure of meetings. 2701.2 Section... GOVERNMENT IN THE SUNSHINE ACT REGULATIONS § 2701.2 Open meetings policy; closure of meetings. (a) Policy. Commission meetings will generally be open to public observation, including meetings concerning the...

Radiographic study of distal radial physeal closure in thoroughbred horses

International Nuclear Information System (INIS)

Vulcano, L.C.; Mamprim, M.J.; Muniz, L.M.R.; Moreira, A.F.; Luna, S.P.L.

1997-01-01

Monthly radiography was performed to study distal radial physeal closure in ten male and ten female Throughbred horses. The height, thoracic circumference and metacarpus circumference were also measured, Distal radial physeal closure time was sooner in females than males, and took 701 +/- 37 and 748 +/- 55 days respectively

Patient Satisfaction After Femoral Arterial Access Site Closure Using the ExoSeal{sup ®} Vascular Closure Device Compared to Manual Compression: A Prospective Intra-individual Comparative Study

Energy Technology Data Exchange (ETDEWEB)

Pieper, Claus Christian, E-mail: claus.christian.pieper@ukb.uni-bonn.de; Thomas, Daniel, E-mail: daniel.thomas@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany); Nadal, Jennifer, E-mail: jennifer.nadal@ukb.uni-bonn.de [University of Bonn, Institute for Medical Biometry, Informatics and Epidemiology (Germany); Willinek, Winfried A., E-mail: w.willinek@bk-trier.de; Schild, Hans Heinz, E-mail: hans.schild@ukb.uni-bonn.de; Meyer, Carsten, E-mail: carsten.meyer@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany)

2016-01-15

PurposeTo intra-individually compare discomfort levels and patient satisfaction after arterial access closure using the ExoSeal{sup ®} vascular closure device (VCD) and manual compression (MC) in a prospective study design.MethodsPatients undergoing two planned interventions from 07/2013 to 09/2014 could participate in the study. Access closure was performed with an ExoSeal{sup ®}-VCD in one and MC in the other intervention. Patients were clinically and sonographically examined and were given questionnaires 1 day after intervention [groin- and back-pain during bedrest (100-point visual analog scale; 0: no pain); comfortability of bedrest (10-point Likert scale, 1: comfortable), satisfaction with closure (10-point Likert scale, 1: very satisfied)]. Results were analyzed in a cross-over design.Results48 patients (29 male, median age 62.5 (32–88) years) were included. An ExoSeal{sup ®}-VCD was used first in 25 cases. As four of these subsequently refused MC as second intervention, data from 44 patients could be analyzed. All closures were technically successful (successful device deployment) without major complications. Groin- and back-pain after VCD-use/MC was 0 (0–15) vs. 10 (0–80) and 0 (0–75) vs. 25 (0–90), respectively (p < 0.0001). Bedrest after VCD-use was more comfortable than after MC [1 (range 1–7) vs. 6 (2–10); p < 0.0001]. Satisfaction with the closure procedure and with the intervention in general was higher after VCD-use compared to MC [1 (1–3) vs. 5 (2–10) and 1 (1–2) vs. 2 (1–4), respectively; p < 0.0001].ConclusionIntra-individual comparison showed pain levels and discomfort to be significantly lower after ExoSeal{sup ®} use compared to MC. VCD closure was associated with higher satisfaction both with the closure itself and with the intervention in general.

Positive Catch & Economic Benefits of Periodic Octopus Fishery Closures: Do Effective, Narrowly Targeted Actions 'Catalyze' Broader Management?

Science.gov (United States)

Oliver, Thomas A; Oleson, Kirsten L L; Ratsimbazafy, Hajanaina; Raberinary, Daniel; Benbow, Sophie; Harris, Alasdair

2015-01-01

Eight years of octopus fishery records from southwest Madagascar reveal significant positive impacts from 36 periodic closures on: (a) fishery catches and (b) village fishery income, such that (c) economic benefits from increased landings outweigh costs of foregone catch. Closures covered ~20% of a village's fished area and lasted 2-7 months. Octopus landings and catch per unit effort (CPUE) significantly increased in the 30 days following a closure's reopening, relative to the 30 days before a closure (landings: +718%, poctopus fishery income doubled in the 30 days after a closure, relative to 30 days before (+132%, p<0.001, n = 28). Control villages not implementing a closure showed no increase in income after "no ban" closures and modest increases after "ban" closures. Villages did not show a significant decline in income during closure events. Landings in closure sites generated more revenue than simulated landings assuming continued open-access fishing at that site (27/36 show positive net earnings; mean +$305/closure; mean +57.7% monthly). Benefits accrued faster than local fishers' time preferences during 17-27 of the 36 closures. High reported rates of illegal fishing during closures correlated with poor economic performance. We discuss the implications of our findings for broader co-management arrangements, particularly for catalyzing more comprehensive management.

Comparison of two spectral domain optical coherence tomography devices for angle-closure assessment.

Science.gov (United States)

Quek, Desmond T; Narayanaswamy, Arun K; Tun, Tin A; Htoon, Hla M; Baskaran, Mani; Perera, Shamira A; Aung, Tin

2012-08-03

To compare two spectral domain optical coherence tomography (SD-OCT) devices for the identification of angle structures and the presence of angle closure. This was a prospective comparative study. Consecutive patients underwent gonioscopy and anterior segment imaging using two SD-OCT devices (iVue and Cirrus). Images were evaluated for the ability to detect angle structures such as Schwalbe's line (SL), trabecular meshwork (TM), Schlemm's canal (SC), and scleral spur (SS), and the presence of angle closure. Angle closure was defined as iris contact with the angle wall anterior to the SS on SD-OCT, and nonvisibility of the posterior TM on gonioscopy. Angle closure in an eye was defined as ≥two quadrants of closed angles. AC1 statistic was used to assess the agreement between devices. Of the 69 subjects studied (46.4% male, 84.1% Chinese, mean age 64.0 ± 10.5 years), 40 subjects (40 eyes, 58.0%) had angle closure on gonioscopy. The most identifiable structure on Cirrus SD-OCT was the SS (82.2%) and SL on iVue SD-OCT (74.5%). Angle closure was indeterminable in 14.5% and 50.7% of Cirrus and iVue scans (P gonioscopy was only fair (AC1 = 0.35 and 0.50 for Cirrus and iVue, respectively). It was more difficult to determine angle closure status with iVue compared with Cirrus SD-OCT. There was fair agreement between both devices with gonioscopy for identifying angle closure.

A comparison of two endoscopic closures: over-the-scope clip (OTSC) versus KING closure (endoloop plus clips) in a randomized long-term experimental study

Czech Academy of Sciences Publication Activity Database

Doležel, R.; Ryska, O.; Kollár, M.; Juhásová, Jana; Kalvach, J.; Ryska, M.; Martínek, J.

2016-01-01

Roč. 30, č. 11 (2016), s. 4910-4916 ISSN 0930-2794 R&D Projects: GA MZd(CZ) NT13634; GA MŠk ED2.1.00/03.0124 Institutional support: RVO:67985904 Keywords : NOTES * endoscopic closure * KING closure * over-the-scope clip Subject RIV: FJ - Surgery incl. Transplants Impact factor: 3.747, year: 2016

Ostomy creation in neonates with acute abdominal disease: friend or foe?

Science.gov (United States)

van Zoonen, Anne G J F; Schurink, Maarten; Bos, Arend F; Heineman, Erik; Hulscher, Jan B F

2012-08-01

An ostomy seems a safe alternative in neonates with an acute abdomen when immediate restoration of bowel continuity is deemed undesirable. Faced with several complications in our center, and the feeling we are not the only center with these complications, we decided to assess the rate and type of complications after both ostomy creation and closure. All data regarding neonates (ostomy take down, and complications and mortality directly related to both creation and closure of the ostomy. A total of 155 patients who underwent a laparotomy for suspect acute abdomen were identified. Median gestational age was 33 weeks (range 25 to 40) and median birth weight was 1926 g (range 560 to 4380). Median age at laparotomy was 8 days (range 0 to 30). Indications for surgery were necrotizing enterocolitis (n = 38), spontaneous intestinal perforation (n = 11), intestinal atresia (n = 9) or obstruction (n = 5), and volvulus (n = 4). An ostomy was created in 67 patients (67/155: 43%): 38 boys and 29 girls. There were 8 jejuno-, 49 ileo-, and 10 colostomies created. In almost all cases (94%), a mucous fistula was also constructed.In 23 patients (23/67: 34%) ostomy-related complications occurred. Most frequent were high output ostomy (n = 10) and necrosis of the enterostomy (n = 7). Due to either one of the complications, nine patients (9/67: 13%) needed a reoperation.In this study, 11 patients died before ostomy closure could occur. In 53 patients, the ostomy was closed after a median of 107 days (range 4 to 299).After ostomy closure, complications occurred in 13 cases (13/53: 25%). Seven patients (7/53: 13%) needed another reoperation because of anastomotic leakage (n = 4), adhesions (n = 2), or incisional hernia (n = 1). There was no closure-related mortality. Although creating a temporary ostomy in newborns is preferable in certain situations, there is a considerable occurrence of complications and reoperations. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001

CORNEAL ENDOTHELIAL CELL DENSITY IN ACUTE ANGLE CLOSURE GLAUCOMA

Directory of Open Access Journals (Sweden)

Nishat Sultana K

2016-09-01

Full Text Available BACKGROUND Angle closure is characterised by apposition of the peripheral iris against the trabecular meshwork resulting in obstruction of aqueous outflow. Acute angle-closure glaucoma is characterised by pain, redness and blurred vision. The pain is typically a severe deep ache that follows the trigeminal distribution and maybe associated with nausea, vomiting, bradycardia and profuse sweating. The blurred vision, which is typically marked maybe caused by stretching of the corneal lamellae initially and later oedema of the cornea as well as a direct effect of the IOP on the optic nerve head. The modifications in corneal endothelial cell density after a crisis of angle-closure glaucoma is being evaluated. AIMS AND OBJECTIVES The objective of the study is to assess the corneal endothelial cell count (density by specular microscopy in patients presenting with acute angle-closure glaucoma. METHODS Corneal endothelial cell counts of 20 eyes of patients with PACG with an earlier documented symptomatic acute attack unilaterally were compared with 20 fellow eyes. Evaluation of patient included visual acuity, intraocular pressure, gonioscopy, disc findings and specular microscopy. RESULTS The mean endothelial cell density was 2104 cells/mm2 in the eye with acute attack and 2615 cells/mm2 in the fellow eye. The average endothelial cell count when the duration of attack lasted more than 72 hours was 1861 cells/mm2 . CONCLUSION Corneal endothelial cell density was found to be significantly reduced in eyes following an acute attack of primary angle closure glaucoma.

Decontamination Study for Mixed Waste Storage Tanks RCRA Closure

International Nuclear Information System (INIS)

Leaphart, D.M.; Reed, S.R.; Rankin, W.N.

1995-01-01

The Savannah River Site (SRS) plans to close six underground tanks storing mixed waste under RCRA regulations. In support of this closure effort, a study was performed to determine the optimal method of decontaminating these tanks to meet the closure requirements. Items consaidered in the evaluation of the decontamination methods included effectiveness, compatibility with existing waste residues, possible cleaning solution disposal methods, and cost

Resource Conservation and Recovery Act (RCRA) closure sumamry for the Uranium Treatment Unit

International Nuclear Information System (INIS)

1996-05-01

This closure summary has been prepared for the Uranium Treatment Unit (UTU) located at the Y-12 Plant in Oak Ridge, Tennessee. The actions required to achieve closure of the UTU area are outlined in the Closure Plan, submitted to and approved by the Tennessee Department of Environmental and Conservation staff, respectively. The UTU was used to store and treat waste materials that are regulated by the Resource Conservation and Recovery Act. This closure summary details all steps that were performed to close the UTU in accordance with the approved plan

A study on closure performance in geological disposal of high-level radioactive waste (H14)

International Nuclear Information System (INIS)

Sugita, Yutaka; Kawakami, Susumu; Yui, Mikazu; Makino, Hitoshi; Sawada, Atsushi; Kurihara, Yuji; Mihara, Morihiro

2003-04-01

Regarding closure technology of underground facilities in geological disposal of the HLW in H12 report, the fundamental concept that closure technology has no impact against the engineered barrier system (EBS) was described. Performance Assessment (PA) has been performed without considering of the barrier function of closure elements. Following H12 report, the various in-situ data of the closure elements (ex. plug, backfill) have been obtained. Therefore, we considered that the PA of the EBS considering the expecting performance of the closure elements from the view points of both the engineering technology and the PA should be examined. First, the characteristics of rock mass and the function of the closure elements were summarized. Then, the closure scenario was developed preliminarily based on hydrological analysis between a hydraulic fracture and a disposal panel, the fault tree analysis, and so on. (author)

Rash with DERMABOND PRINEO Skin Closure System Use in Bilateral Reduction Mammoplasty: A Case Series.

Science.gov (United States)

Knackstedt, R W; Dixon, J A; O'Neill, P J; Herrera, F A

2015-01-01

Background. Bilateral reduction mammoplasty is a common plastic surgery procedure that can be complicated by unfavorable scar formation along incision sites. Surgical adhesives can be utilized as an alternative or as an adjunct to conventional suture closures to help achieve good wound tension and provide an adequate barrier with excellent cosmesis. The recently introduced DERMABOND PRINEO Skin Closure System Skin Closure System combines the skin adhesive 2-octyl cyanoacrylate with a self-adhering polyester-based mesh. Proposed benefits of wound closure with DERMABOND PRINEO Skin Closure System, used with or without sutures, include its watertight seal, easy removal, microbial barrier, even distribution of tension, and reduction in wound closure time. Although allergic reactions to 2-octyl cyanoacrylate have been reported, few allergic reactions to DERMABOND PRINEO Skin Closure System have been noted in the literature. This case series describes three patients who experienced an allergic reaction to DERMABOND PRINEO Skin Closure System after undergoing elective bilateral reduction mammoplasties at our institution to further explore this topic. Methods. Retrospective chart review of bilateral reduction mammoplasty patients who received DERMABOND PRINEO Skin Closure System dressing at our institution was performed. Results. Three patients were identified as having a rash in reaction to DERMABOND PRINEO Skin Closure System after bilateral reduction mammoplasty. All three patients required systemic steroid treatment to resolve the rash. One patient was identified as having a prior adhesive reaction. Conclusions. DERMABOND PRINEO Skin Closure System has demonstrated its efficacy in optimizing scar healing and appearance. However, as we demonstrate these three allergic reactions to DERMABOND PRINEO Skin Closure System, caution must be utilized in its usage, namely, in patients with a prior adhesive allergy and in sites where moisture or friction may be apparent.

Rash with DERMABOND PRINEO Skin Closure System Use in Bilateral Reduction Mammoplasty: A Case Series

Directory of Open Access Journals (Sweden)

R. W. Knackstedt

2015-01-01

Full Text Available Background. Bilateral reduction mammoplasty is a common plastic surgery procedure that can be complicated by unfavorable scar formation along incision sites. Surgical adhesives can be utilized as an alternative or as an adjunct to conventional suture closures to help achieve good wound tension and provide an adequate barrier with excellent cosmesis. The recently introduced DERMABOND PRINEO Skin Closure System Skin Closure System combines the skin adhesive 2-octyl cyanoacrylate with a self-adhering polyester-based mesh. Proposed benefits of wound closure with DERMABOND PRINEO Skin Closure System, used with or without sutures, include its watertight seal, easy removal, microbial barrier, even distribution of tension, and reduction in wound closure time. Although allergic reactions to 2-octyl cyanoacrylate have been reported, few allergic reactions to DERMABOND PRINEO Skin Closure System have been noted in the literature. This case series describes three patients who experienced an allergic reaction to DERMABOND PRINEO Skin Closure System after undergoing elective bilateral reduction mammoplasties at our institution to further explore this topic. Methods. Retrospective chart review of bilateral reduction mammoplasty patients who received DERMABOND PRINEO Skin Closure System dressing at our institution was performed. Results. Three patients were identified as having a rash in reaction to DERMABOND PRINEO Skin Closure System after bilateral reduction mammoplasty. All three patients required systemic steroid treatment to resolve the rash. One patient was identified as having a prior adhesive reaction. Conclusions. DERMABOND PRINEO Skin Closure System has demonstrated its efficacy in optimizing scar healing and appearance. However, as we demonstrate these three allergic reactions to DERMABOND PRINEO Skin Closure System, caution must be utilized in its usage, namely, in patients with a prior adhesive allergy and in sites where moisture or friction may

Closure Strategy Nevada Test Site Area 5 Radioactive Waste Management Site

Energy Technology Data Exchange (ETDEWEB)

NSTec Environmental Management

2007-03-01

This paper presents an overview of the strategy for closure of part of the Area 5 Radioactive Waste Management Site (RWMS) at the Nevada Test Site (NTS), which is about 65 miles northwest of Las Vegas, Nevada (Figure 1). The Area 5 RWMS is in the northern part of Frenchman Flat, approximately 14 miles north of Mercury. The Area 5 RWMS encompasses 732 acres subdivided into quadrants, and is bounded by a 1,000-foot (ft)-wide buffer zone. The northwest and southwest quadrants have not been developed. The northeast and southeast quadrants have been used for disposal of unclassified low-level radioactive waste (LLW) and indefinite storage of classified materials. This paper focuses on closure of the 38 waste disposal and classified material storage units within the southeast quadrant of the Area 5 RWMS, called the ''92-Acre Area''. The U.S Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) is currently planning to close the 92-Acre Area by 2011. Closure planning for this site must take into account the regulatory requirements for a diversity of waste streams, disposal and storage configurations, disposal history, and site conditions. For ease of discussion, the 92-Acre Area has been subdivided into six closure units defined by waste type, location, and similarity in regulatory requirements. Each of the closure units contains one or more waste disposal units; waste disposal units are also called waste disposal cells. The paper provides a brief background of the Area 5 RWMS, identifies key closure issues for the 92-Acre Area, recommends actions to address the issues, and provides the National Security Technologies, LLC (NSTec), schedule for closure.

Effectiveness of percutaneous closure of patent foramen ovale for hypoxemia.

Science.gov (United States)

Fenster, Brett E; Nguyen, Bryant H; Buckner, J Kern; Freeman, Andrew M; Carroll, John D

2013-10-15

The aim of this study was to evaluate the ability of percutaneous patent foramen ovale (PFO) closure to improve systemic hypoxemia. Although PFO-mediated right-to-left shunt (RTLS) is associated with hypoxemia, the ability of percutaneous closure to ameliorate hypoxemia is unknown. Between 2004 and 2009, 97 patients who underwent PFO closure for systemic hypoxemia and dyspnea that was disproportionate to underlying lung disease were included for evaluation. All patients exhibited PFO-mediated RTLS as determined by agitated saline echocardiography. Procedural success was defined as implantation of a device without major complications and mild or no residual shunt at 6 months. Clinical success was defined as a composite of an improvement in New York Heart Association (NYHA) functional class, reduction of dyspnea symptoms, or decreased oxygen requirement. Procedural success was achieved in 96 of 97 (99%), and clinical success was achieved in 68 of 97 (70%). The presence of any moderate or severe interatrial shunt by agitated saline study (odds ratio [OR] = 4.7; p gender (OR = 0.30; p <0.017) decreased the likelihood of success. In conclusion, based on the largest single-center experience of patients referred for PFO closure for systemic hypoxemia, PFO closure was a mechanically effective procedure with an associated improvement in echocardiographic evidence of RTLS, NYHA functional class, and oxygen requirement. Copyright © 2013 Elsevier Inc. All rights reserved.

Land use-based landscape planning and restoration in mine closure areas.

Science.gov (United States)

Zhang, Jianjun; Fu, Meichen; Hassani, Ferri P; Zeng, Hui; Geng, Yuhuan; Bai, Zhongke

2011-05-01

Landscape planning and restoration in mine closure areas is not only an inevitable choice to sustain mining areas but also an important path to maximize landscape resources and to improve ecological function in mine closure areas. The analysis of the present mine development shows that many mines are unavoidably facing closures in China. This paper analyzes the periodic impact of mining activities on landscapes and then proposes planning concepts and principles. According to the landscape characteristics in mine closure areas, this paper classifies available landscape resources in mine closure areas into the landscape for restoration, for limited restoration and for protection, and then summarizes directions for their uses. This paper establishes the framework of spatial control planning and design of landscape elements from "macro control, medium allocation and micro optimization" for the purpose of managing and using this kind of special landscape resources. Finally, this paper applies the theories and methods to a case study in Wu'an from two aspects: the construction of a sustainable land-use pattern on a large scale and the optimized allocation of typical mine landscape resources on a small scale.

Land Use-Based Landscape Planning and Restoration in Mine Closure Areas

Science.gov (United States)

Zhang, Jianjun; Fu, Meichen; Hassani, Ferri P.; Zeng, Hui; Geng, Yuhuan; Bai, Zhongke

2011-05-01

Landscape planning and restoration in mine closure areas is not only an inevitable choice to sustain mining areas but also an important path to maximize landscape resources and to improve ecological function in mine closure areas. The analysis of the present mine development shows that many mines are unavoidably facing closures in China. This paper analyzes the periodic impact of mining activities on landscapes and then proposes planning concepts and principles. According to the landscape characteristics in mine closure areas, this paper classifies available landscape resources in mine closure areas into the landscape for restoration, for limited restoration and for protection, and then summarizes directions for their uses. This paper establishes the framework of spatial control planning and design of landscape elements from "macro control, medium allocation and micro optimization" for the purpose of managing and using this kind of special landscape resources. Finally, this paper applies the theories and methods to a case study in Wu'an from two aspects: the construction of a sustainable land-use pattern on a large scale and the optimized allocation of typical mine landscape resources on a small scale.

Drafting of the closure of the Asse salt mine. Final report

International Nuclear Information System (INIS)

Schneefuss, J.U.

2001-01-01

The report of the R and D-project 'Drafting of the closure of the Asse salt mine' contains the results of the first phases 'Basic findings' and 'Predrafting'. These phases were started after the backfilling of the south flank of the Asse salt mine was permitted in accordance to 2.2 of the operating program 'Future work at the Asse salt mine'. The knowledge status of May 2000 is reported. The result obtained in this program provides the basis for future drafting the closure of the Asse salt mine. The final results will include the long-term safety assessment to obtain the permission of the mining authorities for the closure of the Asse salt mine. The evaluation of the basic data has shown that further investigations are necessary. During the predrafting period the method for backfilling of the cavities, transport of the backfill and backfill and closure of the shafts were developed. Other parts of the concept for the closure are not finalized (control of the brine inflow when starting backfilling above the 658-m-level, minimizing of the possible effects of dissolution of carnallitite, avoiding of squeezing brines from deeper cavities through the disposal chambers etc.). (orig.) [de

Periodic Closures as Adaptive Coral Reef Management in the Indo-Pacific

Directory of Open Access Journals (Sweden)

Josh Cinner

2006-06-01

Full Text Available This study explores the social, economic, and ecological context within which communities in Papua New Guinea and Indonesia use adaptive coral reef management. We tested whether periodic closures had positive effects on reef resources, and found that both the biomass and the average size of fishes commonly caught in Indo-Pacific subsistence fisheries were greater inside areas subject to periodic closures compared to sites with year-round open access. Surprisingly, both long-lived and short-lived species benefited from periodic closures. Our study sites were remote communities that shared many socioeconomic characteristics; these may be crucial to the effectiveness of adaptive management of reef resources through periodic closures. Some of these factors include exclusive tenure over marine resources, a body of traditional ecological knowledge that allows for the rapid assessment of resource conditions, social customs that facilitate compliance with closures, relatively small human populations, negligible migration, and a relatively low dependence on fisheries. This dynamic adaptive management system, in which communities manage their resources among multiple social and ecological baselines, contrasts with western fisheries management practices, centered on maintaining exploited populations at stable levels in which net production is maximized.

The collision of healthcare and corporate law in a hospital closure case.

Science.gov (United States)

Himes, S M

2001-01-01

This Article analyzes potential conflicts that arise from both the judicial and administrative approval processes that govern the closure of charitable hospitals through a sale of all or substantially all of their assets. Examining the recent closure attempt by the Manhattan Eye, Ear & Throat Hospital as an example, the Article highlights the various public health and corporate law issues that are raised when a not-for-profit hospital seeks closure. The Article thoroughly discusses both the statutorily and judicially required approval schemes applicable to the closure of charitable hospitals. The Article also suggests ways in which these conflicts might be avoided or remedied, as well as gives advice regarding hospital board decisionmaking.

Manufacturing and properties of closure head forging integrated with flange for PWR reactor pressure vessel

International Nuclear Information System (INIS)

Tomoharu Sasaki; Iku Kurihara; Etsuo Murai; Yasuhiko Tanaka; Koumei Suzuki

2003-01-01

Closure head forging (SA508, Gr.3 Cl.1) integrated with flange for PWR reactor pressure vessel has been developed. This is intended to enhance structural integrity of closure head resulted in elimination of ISI, by eliminating weld joint between closure head and flange in the conventional design. Manufacturing procedures have been established so that homogeneity and isotropy of the material properties can be assured in the closure head forging integrated with flange. Acceptance tensile and impact test specimens are taken and tested regarding the closure head forging integrated with flange as very thick and complex forgings. This paper describes the manufacturing technologies and material properties of the closure head forging integrated with flange. (orig.)

European Hernia Society guidelines on the closure of abdominal wall incisions

DEFF Research Database (Denmark)

Muysoms, F E; Antoniou, S A; Bury, K

2015-01-01

using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and methodological guidance was taken from Scottish Intercollegiate Guidelines Network (SIGN). The literature search included publications up to April 2014. The guidelines were written using the AGREE II...... of rapidly absorbable sutures. It is suggested using a slowly absorbable monofilament suture in a single layer aponeurotic closure technique without separate closure of the peritoneum. A small bites technique with a suture to wound length (SL/WL) ratio at least 4/1 is the current recommended method......, it is suggested using the smallest trocar size adequate for the procedure and closure of the fascial defect if trocars larger or equal to 10 mm are used. For single incision laparoscopic surgery, we suggest meticulous closure of the fascial incision to avoid an increased risk of incisional hernias....

Transcatheter closure of patent ductus arteriosus using the angled duct occluder

International Nuclear Information System (INIS)

Qin Yongwen; Zhao Xianxian; Wu Hong; Zheng Xing; Ding Jijun; Hu Jianqiang

2004-01-01

Objective: To assess the immediate efficacy of transcatheter closure of patent ductus arteriosus(PDA) using the angled duct occluder (ADO). Methods: 9 patients (1 male, 8 female) underwent transcatheter closure of PDA using the ADO. The mean PDA diameter at its narrowest segment was (5.8 ± 1.9) mm, ranging 3 to 10 mm. A 6 - 9F long sheath was used for the delivery of ADO. Results: The devices were deployed successfully in all patients. Angiographies showed no shunt across the device 15 min after the implantation of ADO. Within 1 week, echocardiography revealed complete closure in all patients. There were no complications. Conclusions: The transcatheter closure of PDA using ADO is an effective and safe procedure. The device matches with the shape of aortic cavity much more precisely than Amplatzer duct occluder. (authors)

Closure Report for Corrective Action Unit 240: Area 25 Vehicle Washdown Nevada Test Site, Nevada

International Nuclear Information System (INIS)

Gustafason, D.L.

2001-01-01

The Area 25 Vehicle Washdown, Corrective Action Unit (CAU) 240, was clean-closed following the approved Corrective Action Decision Document closure alternative and in accordance with the Federal Facility Agreement and Consent Order (FFACO, 1996). The CAU consists of thee Corrective Action Sites (CASs): 25-07-01 - Vehicle Washdown Area (Propellant Pad); 25-07-02 - Vehicle Washdown Area (F and J Roads Pad); and 25-07-03 - Vehicle Washdown Station (RADSAFE Pad). Characterization activities indicated that only CAS 25-07-02 (F and J Roads Pad) contained constituents of concern (COCs) above action levels and required remediation. The COCs detected were Total Petroleum Hydrocarbons (TPH) as diesel, cesium-137, and strontium-90. The F and J Roads Pad may have been used for the decontamination of vehicles and possibly disassembled engine and reactor parts from Test Cell C. Activities occurred there during the 1960s through early 1970s. The F and J Roads Pad consisted of a 9- by 5-meter (m) (30- by 15-foot [ft]) concrete pad and a 14- by 13-m (46-by 43-ft) gravel sump. The clean-closure corrective action consisted of excavation, disposal, verification sampling, backfilling, and regrading. Closure activities began on August 21, 2000, and ended on September 19, 2000. Waste disposal activities were completed on December 12, 2000. A total of 172 cubic meters (223 cubic yards) of impacted soil was excavated and disposed. The concrete pad was also removed and disposed. Verification samples were collected from the bottom and sidewalls of the excavation and analyzed for TPH diesel and 20-minute gamma spectroscopy. The sample results indicated that all impacted soil above remediation standards was removed. The closure was completed following the approved Corrective Action Plan. All impacted waste was disposed in the Area 6 Hydrocarbon Landfill. All non-impacted debris was disposed in the Area 9 Construction Landfill and the Area 23 Sanitary Landfill

Transient left ventricular systolic dysfunction following surgical closure of large patent ductus arteriosus among children and adolescents operated at the cardiac centre, Ethiopia.

Science.gov (United States)

Tilahun, Birkneh; Tefera, Endale

2013-05-31

Patent ductus arteriosus (PDA) is one of the commonest congenital heart diseases that require closure within the first few months after birth. The residential area of patients affects the size of the PDA: living in highlands, like most places in Ethiopia, is a risk for having larger sized PDA. Closure of these congenital heart defects is usually performed at an early age in places where capable centers are available. In Ethiopia, closure of these defects is done on mission basis often at an older age. Recently, limited reports came about the occurrence of postoperative left ventricular systolic dysfunction (POLVD) following closure of PDA though full explanation is still lacking. To determine the rate of and time to improvement of POLVD and the factors associated with it in children and adolescents who underwent surgical closure of PDA. All children and adolescents who underwent surgical closure of PDA at the Cardiac Center, Ethiopia (CCE) had postoperative follow up with echocardiography. Serial left ventricular ejection fraction (LVEF) and fiber shortening (FS) values were recorded for all of them. SPSS 20 was used to analyze the data. A total of 36 children and adolescents who underwent surgical closure of PDA from January 2009 to December 2012 and who fulfilled the inclusion criteria were studied. Their mean age at intervention was 8.52 years (SD = 5.23 years), 77.80% were females. The mean duct size as determined by either echocardiography or intra-operative by the surgeon was 10.31 mm (SD = 3.20 mm). They were followed for a mean duration of 24.80 months (SD = 12.36 months) following surgical closure of PDA. The mean LVEF and FS decreased from 65.06% and 35.28% preoperatively to 54.83% and 28.40% post-operatively respectively. Fifteen (42.86%) of the patients had a post-operative LVEF of less than 55%. The mean time to normalization of systolic function was 5.11 weeks (SD = 3.30 weeks). Having an associated cardiac lesion was an independent

Closure Plan for the E-Area Low-Level Waste Facility

Energy Technology Data Exchange (ETDEWEB)

Cook, J.R.

2000-10-30

A closure plan has been developed to comply with the applicable requirements of the U.S. Department of Energy Order 435.2 Manual and Guidance. The plan is organized according to the specifications of the Format and Content Guide for U.S. Department of Energy Low-Level Waste Disposal Facility Closure Plans.

Closure Plan for the E-Area Low-Level Waste Facility

International Nuclear Information System (INIS)

Cook, J.R.

2000-01-01

A closure plan has been developed to comply with the applicable requirements of the U.S. Department of Energy Order 435.2 Manual and Guidance. The plan is organized according to the specifications of the Format and Content Guide for U.S. Department of Energy Low-Level Waste Disposal Facility Closure Plans

Transuranic Storage Area (TSA)-3 container storage unit RCRA closure plan

International Nuclear Information System (INIS)

Barry, G.A.; Lodman, D.L.; Spry, M.J.; Poor, K.J.

1992-11-01

This document describes the proposed plan for closure of the Transuranic Storage Area (TSA)-3 container storage unit at the Idaho National Engineering Laboratory in accordance with the Resource Conservation and Recovery Act closure requirements. The location, size, capacity, history, and current status of the unit are described. The unit will be closed by decontaminating structures and equipment that may have contacted waste. Sufficient sampling and documentation of all activities will be performed to demonstrate clean closure. A tentative schedule is provided in the form of a milestone chart

Decontamination and inspection plan for Phase 3 closure of the 300 area waste acid treatment system

International Nuclear Information System (INIS)

LUKE, S.N.

1999-01-01

This decontamination and inspection plan (DIP) describes decontamination and verification activities in support of Phase 3 closure of the 300 Area Waste Acid Treatment System (WATS). Phase 3 is the third phase of three WATS closure phases. Phase 3 attains clean closure conditions for WATS portions of the 334 and 311 Tank Farms (TF) and the 333 and 303-F Buildings. This DIP also describes designation and management of waste and debris generated during Phase 3 closure activities. Information regarding Phase 1 and Phase 2 for decontamination and verification activities closure can be found in WHC-SD-ENV-AP-001 and HNF-1784, respectively. This DIP is provided as a supplement to the closure plan (DOE/RL-90-11). This DIP provides the documentation for Ecology concurrence with Phase 3 closure methods and activities. This DIP is intended to provide greater detail than is contained in the closure plan to satisfy Ecology Dangerous Waste Regulations, Washington Administrative Code (WAC) 173-303-610 requirement that closure documents describe the methods for removing, transporting, storing, and disposing of all dangerous waste at the unit. The decontamination and verification activities described in this DIP are based on the closure plan and on agreements reached between Ecology and the U.S. Department of Energy, Richland Operations Office (DOE-RL) during Phase 3 closure activity workshops and/or project manager meetings (PMMs)

CRITICAL ASSUMPTIONS IN THE F-TANK FARM CLOSURE OPERATIONAL DOCUMENTATION REGARDING WASTE TANK INTERNAL CONFIGURATIONS

Energy Technology Data Exchange (ETDEWEB)

Hommel, S.; Fountain, D.

2012-03-28

The intent of this document is to provide clarification of critical assumptions regarding the internal configurations of liquid waste tanks at operational closure, with respect to F-Tank Farm (FTF) closure documentation. For the purposes of this document, FTF closure documentation includes: (1) Performance Assessment for the F-Tank Farm at the Savannah River Site (hereafter referred to as the FTF PA) (SRS-REG-2007-00002), (2) Basis for Section 3116 Determination for Closure of F-Tank Farm at the Savannah River Site (DOE/SRS-WD-2012-001), (3) Tier 1 Closure Plan for the F-Area Waste Tank Systems at the Savannah River Site (SRR-CWDA-2010-00147), (4) F-Tank Farm Tanks 18 and 19 DOE Manual 435.1-1 Tier 2 Closure Plan Savannah River Site (SRR-CWDA-2011-00015), (5) Industrial Wastewater Closure Module for the Liquid Waste Tanks 18 and 19 (SRRCWDA-2010-00003), and (6) Tank 18/Tank 19 Special Analysis for the Performance Assessment for the F-Tank Farm at the Savannah River Site (hereafter referred to as the Tank 18/Tank 19 Special Analysis) (SRR-CWDA-2010-00124). Note that the first three FTF closure documents listed apply to the entire FTF, whereas the last three FTF closure documents listed are specific to Tanks 18 and 19. These two waste tanks are expected to be the first two tanks to be grouted and operationally closed under the current suite of FTF closure documents and many of the assumptions and approaches that apply to these two tanks are also applicable to the other FTF waste tanks and operational closure processes.

Temporary abdominal closure in the critically ill patients with an open abdomen.

Directory of Open Access Journals (Sweden)

Ghodratollah Maddah

2014-05-01

Full Text Available The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags (Bogotá bag. The study population comprised of 11 (57.9% male and 8 (42.1% female with an average age of 32.26+14.8 years. The main indications for temporary abdominal coverage were as follows: planned reoperation in 11 (57.9% patients, subjective judgment that the fascia closure is too tight in 6 (31.6% patient's damage control surgery in one patient (5.3% and development of abdominal compartment surgery in one patient (5.3%. Surgical conditions requiring temporary abdominal closure was severe post operative peritonitis in 9 (47.4% patients, post operative intestinal fistula in 4 (21.1% patients, post traumatic intra abdominal bleeding in 3 (15.8% patients and intestinal obstructions in 3 (15.8% patients. Length of hospitalization was 45+23.25 days and the mean total number of laparotomies was 6.2+3.75 times per patient. Three bowel fistulas occurred due to a missed injury at the time of initial operation that was discovered during changing the plastic sheet. They were unrelated to coverage technique. All of them were treated by repair of the defect and serosal patch by adjacent bowel loop. Only one (10.0% patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. There were 4 (%21.1 early postoperative deaths that were not related to the abdominal coverage technique. Also, there were 5 (26.3% late deaths that were due to dissemination of malignancy with a mean survival time of 20.8+13 (range 2-54 months. Currently 10 patients (52.6% are alive at a follow up of 45 (range 1

Interventional closure of RPA-to-LA communication in an oligosymptomatic neonate.

Science.gov (United States)

Benz, Dominik C; Burkhardt, Barbara; Quandt, Daniel; Stambach, Dominik; Knirsch, Walter; Kretschmar, Oliver

2014-12-01

Direct communication between the right pulmonary artery (RPA) and the left atrium (LA) is a very rare cardiac malformation. Clinical presentation of RPA-to-LA communication depends on the size of the communication, the amount of right-to-left shunt, the patient's age, and pulmonary vascular resistance. Patients with small communications usually present oligosymptomatic and are diagnosed at an older age. A delay of diagnosis bears the risk of severe complications and needs to be prevented by proper work-up of oligosymptomatic neonates. Treatment of RPA-to-LA communications used to be performed by surgical closure, and the interventional approach has only been established as a less invasive alternative in recent years. Although patients with small RPA-to-LA communications usually present oligosymptomatic, early diagnosis and treatment is essential to prevent life-threatening complications.

Modeling and Simulating Passenger Behavior for a Station Closure in a Rail Transit Network

Science.gov (United States)

Yin, Haodong; Han, Baoming; Li, Dewei; Wu, Jianjun; Sun, Huijun

2016-01-01

A station closure is an abnormal operational situation in which the entrances or exits of a rail transit station have to be closed for some time due to an unexpected incident. A novel approach is developed to estimate the impacts of the alternative station closure scenarios on both passenger behavioral choices at the individual level and passenger demand at the disaggregate level in a rail transit network. Therefore, the contributions of this study are two-fold: (1) A basic passenger behavior optimization model is mathematically constructed based on 0–1 integer programming to describe passengers’ responses to alternative origin station closure scenarios and destination station closure scenarios; this model also considers the availability of multi-mode transportation and the uncertain duration of the station closure; (2) An integrated solution algorithm based on the passenger simulation is developed to solve the proposed model and to estimate the effects of a station closure on passenger demand in a rail transit network. Furthermore, 13 groups of numerical experiments based on the Beijing rail transit network are performed as case studies with 2,074,267 records of smart card data. The comparisons of the model outputs and the manual survey show that the accuracy of our proposed behavior optimization model is approximately 80%. The results also show that our model can be used to capture the passenger behavior and to quantitatively estimate the effects of alternative closure scenarios on passenger flow demand for the rail transit network. Moreover, the closure duration and its overestimation greatly influence the individual behavioral choices of the affected passengers and the passenger demand. Furthermore, if the rail transit operator can more accurately estimate the closure duration (namely, as g approaches 1), the impact of the closure can be somewhat mitigated. PMID:27935963

Modeling and Simulating Passenger Behavior for a Station Closure in a Rail Transit Network.

Directory of Open Access Journals (Sweden)

Haodong Yin

Full Text Available A station closure is an abnormal operational situation in which the entrances or exits of a rail transit station have to be closed for some time due to an unexpected incident. A novel approach is developed to estimate the impacts of the alternative station closure scenarios on both passenger behavioral choices at the individual level and passenger demand at the disaggregate level in a rail transit network. Therefore, the contributions of this study are two-fold: (1 A basic passenger behavior optimization model is mathematically constructed based on 0-1 integer programming to describe passengers' responses to alternative origin station closure scenarios and destination station closure scenarios; this model also considers the availability of multi-mode transportation and the uncertain duration of the station closure; (2 An integrated solution algorithm based on the passenger simulation is developed to solve the proposed model and to estimate the effects of a station closure on passenger demand in a rail transit network. Furthermore, 13 groups of numerical experiments based on the Beijing rail transit network are performed as case studies with 2,074,267 records of smart card data. The comparisons of the model outputs and the manual survey show that the accuracy of our proposed behavior optimization model is approximately 80%. The results also show that our model can be used to capture the passenger behavior and to quantitatively estimate the effects of alternative closure scenarios on passenger flow demand for the rail transit network. Moreover, the closure duration and its overestimation greatly influence the individual behavioral choices of the affected passengers and the passenger demand. Furthermore, if the rail transit operator can more accurately estimate the closure duration (namely, as g approaches 1, the impact of the closure can be somewhat mitigated.

Modeling and Simulating Passenger Behavior for a Station Closure in a Rail Transit Network.

Science.gov (United States)

Yin, Haodong; Han, Baoming; Li, Dewei; Wu, Jianjun; Sun, Huijun

2016-01-01

A station closure is an abnormal operational situation in which the entrances or exits of a rail transit station have to be closed for some time due to an unexpected incident. A novel approach is developed to estimate the impacts of the alternative station closure scenarios on both passenger behavioral choices at the individual level and passenger demand at the disaggregate level in a rail transit network. Therefore, the contributions of this study are two-fold: (1) A basic passenger behavior optimization model is mathematically constructed based on 0-1 integer programming to describe passengers' responses to alternative origin station closure scenarios and destination station closure scenarios; this model also considers the availability of multi-mode transportation and the uncertain duration of the station closure; (2) An integrated solution algorithm based on the passenger simulation is developed to solve the proposed model and to estimate the effects of a station closure on passenger demand in a rail transit network. Furthermore, 13 groups of numerical experiments based on the Beijing rail transit network are performed as case studies with 2,074,267 records of smart card data. The comparisons of the model outputs and the manual survey show that the accuracy of our proposed behavior optimization model is approximately 80%. The results also show that our model can be used to capture the passenger behavior and to quantitatively estimate the effects of alternative closure scenarios on passenger flow demand for the rail transit network. Moreover, the closure duration and its overestimation greatly influence the individual behavioral choices of the affected passengers and the passenger demand. Furthermore, if the rail transit operator can more accurately estimate the closure duration (namely, as g approaches 1), the impact of the closure can be somewhat mitigated.

Surgical Experience with Closure of an Isolated PDA at Muhimbili ...

African Journals Online (AJOL)

Results: A total of 52 patients with clinical diagnosis of PDA, 26 patients in each treatment group of either standard closure or new closure technique. ... string on the ampulla of the PDA followed by a silk ligature has proved to be efficient and reliable technique that leaves no residual lesion with no long term complications.

3718-F Alkali Metal Treatment and Storage Facility Closure Plan

International Nuclear Information System (INIS)

1992-11-01

The Hanford Site, located northwest of the city of Richland, Washington, houses reactors, chemical-separation systems, and related facilities used for the production of special nuclear materials, as well as for activities associated with nuclear energy development. The 300 Area of the Hanford Site contains reactor fuel manufacturing facilities and several research and development laboratories. The 3718-F Alkali Metal Treatment and Storage Facility (3718-F Facility), located in the 300 Area, was used to store and treat alkali metal wastes. Therefore, it is subject to the regulatory requirements for the storage and treatment of dangerous wastes. Closure will be conducted pursuant to the requirements of the Washington Administrative Code (WAC) 173-303-610 (Ecology 1989) and 40 CFR 270.1. Closure also will satisfy the thermal treatment facility closure requirements of 40 CFR 265.381. This closure plan presents a description of the 3718-F Facility, the history of wastes managed, and the approach that will be followed to close the facility. Only hazardous constituents derived from 3718-F Facility operations will be addressed

Closure Report for Corrective Action Unit 145: Wells and Storage Holes, Nevada Test Site, Nevada

International Nuclear Information System (INIS)

2008-01-01

The purpose of this Closure Report is to provide a summary of the completed closure activities, to document waste disposal, and to present information confirming that the remediation goals were met. The closure alternatives consisted of closure in place with administrative controls for one CAS, and no further action with implementation of best management practices (BMPs) for the remaining five CASs

Teaching advanced wound closure techniques using cattle digits.

Science.gov (United States)

Khalil, Philipe N; Kanz, Karl-Georg; Siebeck, Matthias; Mutschler, Wolf

2011-03-01

To evaluate a model used to impart advanced wound closure skills because available models do not meet the necessary requirements to a substantial degree. Seventy-one residents were asked to evaluate a 75-minute-long skills course using cadaveric cattle digits to learn Z-plasty, V-Y-plasty, and oval-shaped rotational flaps. A short film and the course instructor demonstrated each technique first. A Likert rating scale ranging from 1 to 6 was used for questions in the survey given to the residents. There was strong agreement among residents (1.65 ± 1.17 years of experience) that advanced wound closure training courses are necessary (5.73 ± 0.73), which corresponded to the residents' low level of knowledge and self-assessment of practical skills and present experience (2.84 ± 1.01). The course was evaluated with high acceptance, even though it was found to be demanding for the trainees (5.84 ± 0.40). This might also be related to the high rating of the model itself, which was found to be a suitable method for teaching advanced wound closure techniques (5.50 ± 0.71) that was easily comprehensible (5.73 ± 0.53). Skills training courses for young trainees are warranted to impart advanced wound closure techniques. The curriculum using cattle digits presented here is recommended. The authors have indicated no significant interest with commercial supporters. © 2011 by the American Society for Dermatologic Surgery, Inc.

Argon laser peripheral iridoplasty for angle-closure glaucoma in sibilings with weill-marchesani syndrome.

Science.gov (United States)

Ritch, R; Solomon, L D

1992-01-01

A patient with Weill-Marchesani syndrome and angle-closure glaucoma had persistent appositional closure after laser iridotomy that was unrelieved by topical application of either miotic or cycloplegic agents. Argon laser peripheral iridoplasty successfully opened the angle. The patient's sister also had Weill-Marchesani syndrome and angle closure unrelieved by laser iridotomy. Angle closure in Weill-Marchesani syndrome and the response to laser iridotomy and treatment with either miotic or cycloplegic agents may be complex and depends on the relative proportion of pupillary block as a mechanism underlying the angle closure, the functional status of the zonular apparatus, and the degree of angle crowding by the peripheral iris in the presence or absence of peripheral anterior synechiae.

Defining Higher-Order Turbulent Moment Closures with an Artificial Neural Network and Random Forest

Science.gov (United States)

McGibbon, J.; Bretherton, C. S.

2017-12-01

Unresolved turbulent advection and clouds must be parameterized in atmospheric models. Modern higher-order closure schemes depend on analytic moment closure assumptions that diagnose higher-order moments in terms of lower-order ones. These are then tested against Large-Eddy Simulation (LES) higher-order moment relations. However, these relations may not be neatly analytic in nature. Rather than rely on an analytic higher-order moment closure, can we use machine learning on LES data itself to define a higher-order moment closure?We assess the ability of a deep artificial neural network (NN) and random forest (RF) to perform this task using a set of observationally-based LES runs from the MAGIC field campaign. By training on a subset of 12 simulations and testing on remaining simulations, we avoid over-fitting the training data.Performance of the NN and RF will be assessed and compared to the Analytic Double Gaussian 1 (ADG1) closure assumed by Cloudy Layers Unified By Binormals (CLUBB), a higher-order turbulence closure currently used in the Community Atmosphere Model (CAM). We will show that the RF outperforms the NN and the ADG1 closure for the MAGIC cases within this diagnostic framework. Progress and challenges in using a diagnostic machine learning closure within a prognostic cloud and turbulence parameterization will also be discussed.

The levels of disclosure relating to mine closure obligations by platinum mining companies

Directory of Open Access Journals (Sweden)

Joline Sturdy

2017-06-01

Aim: The aim of this study is to establish the extent to which platinum mines listed on the Johannesburg Stock Exchange (JSE comply with a recommended disclosure framework. Setting: South Africa is the largest producer of platinum in the world. The study covers all platinum mines listed on the JSE. Methods: Using a framework, a census of the annual financial statements, integrated annual reports and sustainability reports or websites was conducted to determine the level of compliance of disclosure relating to mine closure obligations to the recommended disclosure framework. Results: The results show disclosure relating to mine closure obligations of platinum mines listed on the JSE is inconsistent and not sufficient for stakeholders to understand the scope, key assumptions, parameters or reliability of the assessment and calculation of mine closure obligations. Conclusion: The assumptions used to determine mine closure obligations are specialised and multi-disciplinary. The accuracy and reliability of mine closure obligations will improve dramatically through greater transparency and access to information. It is recommended that the JSE listings for mining companies should require a competent person’s report to provide disclosure on assumptions, key values and processes applied to determine the mine closure obligations. Furthermore, it is recommended that the Department of Mineral Resources implements a mechanism of independent assessment of mine closure obligations by experts on an ongoing basis.

Early intraocular pressure change after peripheral iridotomy with ultralow fluence pattern scanning laser and Nd:YAG laser in primary angle-closure suspect: Kowloon East Pattern Scanning Laser Study Report No. 3.

Science.gov (United States)

Chan, Jeffrey Chi Wang; Choy, Bonnie Nga Kwan; Chan, Orlando Chia Chieh; Li, Kenneth Kai Wang

2018-02-01

Our purpose was to assess the early intraocular pressure (IOP) changes of ultralow fluence laser iridotomy using pattern scanning laser followed by neodymium:yttrium-aluminum-gamet (Nd:YAG) laser. This is a prospective interventional study. Thirty-three eyes of 33 adult Chinese primary angle-closure suspect subjects were recruited for prophylactic laser peripheral iridotomy. Sequential laser peripheral iridotomy was performed using pattern scanning laser followed by Nd:YAG laser. Visual acuity (VA) and IOP were measured before treatment, at 1 h, 1 day, 1 week, 1 month, 3 months and 6 months after laser. Laser energy used and complications were documented. Corneal endothelial cell count was examined at baseline and 6 months. Patency of the iridotomy was assessed at each follow-up visit. All subjects achieved patent iridotomy in a single session. The mean energy used was 0.335+/-0.088 J for the pattern scanning laser, and 4.767+/-5.780 mJ for the Nd:YAG laser. The total mean energy was 0.339+/-0.089 J. None of the eyes developed a clinically significant IOP spike (≥ 8 mmHg) at 1 h and 1 day after laser use. Only four eyes developed higher IOP at 1 h and all were ≤3 mmHg compared to baseline. The mean IOP was 13.8+/-2.5 mmHg at 1 h and 11.5+/-2.2 mmHg at 1 day, both were significantly lower than baseline (15.8+/-2.1 mmHg) (P laser compared to baseline (0.23 vs 0.26). There was also no statistically significant difference in mean VA at other follow-up visits compared to baseline. Peripheral iridotomy closure was encountered in two (6.1%) eyes, one at 1 month and another at 6 months follow-up. There were no complications including hyphema, peripheral anterior synechia formation nor prolonged inflammation throughout the follow-up period. There was no significant loss in corneal endothelial cell counts at 6 months (2255+/-490) compared to baseline (2303+/-386) (P = 0.347). Sequential LPI using an ultralow fluence pattern scanning laser

Method for estimating steam hammer effects on swing-check valves during closure

International Nuclear Information System (INIS)

Uram, E.M.

1976-01-01

Relationships are developed for estimating the disk impact velocity resulting from a free swing closure of swing-check valves in normal flow and for pipe rupture. They derive from a phase-plane solution of the differential equation for the disk motion that accounts for the nature of the valve pressure drop variation due to steam-hammer effects during closure. For closure in normal flow, the method presented has a more correct foundation than that given in reference where a constant, average valve pressure differential based upon the steady-state pressure drop for the total piping system (which has no real relationship to the steam-hammer-induced valve pressure changes during the closure transient) is used in the valve disk motion equation

Control of aperture closure during reach-to-grasp movements in Parkinson's disease.

Science.gov (United States)

Rand, M K; Smiley-Oyen, A L; Shimansky, Y P; Bloedel, J R; Stelmach, G E

2006-01-01

This study examined whether the pattern of coordination between arm-reaching toward an object (hand transport) and the initiation of aperture closure for grasping is different between PD patients and healthy individuals, and whether that pattern is affected by the necessity to quickly adjust the reach-to-grasp movement in response to an unexpected shift of target location. Subjects reached for and grasped a vertical dowel, the location of which was indicated by illuminating one of the three dowels placed on a horizontal plane. In control conditions, target location was fixed during the trial. In perturbation conditions, target location was shifted instantaneously by switching the illumination to a different dowel during the reach. The hand distance from the target at which the subject initiated aperture closure (aperture closure distance) was similar for both the control and perturbation conditions within each group of subjects. However, that distance was significantly closer to the target in the PD group than in the control group. The timing of aperture closure initiation varied considerably across the trials in both groups of subjects. In contrast, aperture closure distance was relatively invariant, suggesting that aperture closure initiation was determined by spatial parameters of arm kinematics rather than temporal parameters. The linear regression analysis of aperture closure distance showed that the distance was highly predictable based on the following three parameters: the amplitude of maximum grip aperture, hand velocity, and hand acceleration. This result implies that a control law, the arguments of which include the above parameters, governs the initiation of aperture closure. Further analysis revealed that the control law was very similar between the subject groups under each condition as well as between the control and perturbation conditions for each group. Consequently, the shorter aperture closure distance observed in PD patients apparently is a

Closure Plan for the Area 5 Radioactive Waste Management Site at the Nevada Test Site

International Nuclear Information System (INIS)

NSTec Environmental Management

2008-01-01

The Area 5 Radioactive Waste Management Site (RMWS) at the Nevada Test Site (NTS) is managed and operated by National Security Technologies, LLC (NSTec), for the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO). This document is the first update of the preliminary closure plan for the Area 5 RWMS at the NTS that was presented in the Integrated Closure and Monitoring Plan (DOE, 2005a). The major updates to the plan include a new closure schedule, updated closure inventory, updated site and facility characterization data, the Title II engineering cover design, and the closure process for the 92-Acre Area of the RWMS. The format and content of this site-specific plan follows the Format and Content Guide for U.S. Department of Energy Low-Level Waste Disposal Facility Closure Plans (DOE, 1999a). This interim closure plan meets closure and post-closure monitoring requirements of the order DOE O 435.1, manual DOE M 435.1-1, Title 40 Code of Federal Regulations (CFR) Part 191, 40 CFR 265, Nevada Administrative Code (NAC) 444.743, and Resource Conservation and Recovery Act (RCRA) requirements as incorporated into NAC 444.8632. The Area 5 RWMS accepts primarily packaged low-level waste (LLW), low-level mixed waste (LLMW), and asbestiform low-level waste (ALLW) for disposal in excavated disposal cells

Closure Plan for the Area 5 Radioactive Waste Management Site at the Nevada Test Site

Energy Technology Data Exchange (ETDEWEB)

NSTec Environmental Management

2008-09-01

The Area 5 Radioactive Waste Management Site (RMWS) at the Nevada Test Site (NTS) is managed and operated by National Security Technologies, LLC (NSTec), for the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO). This document is the first update of the preliminary closure plan for the Area 5 RWMS at the NTS that was presented in the Integrated Closure and Monitoring Plan (DOE, 2005a). The major updates to the plan include a new closure schedule, updated closure inventory, updated site and facility characterization data, the Title II engineering cover design, and the closure process for the 92-Acre Area of the RWMS. The format and content of this site-specific plan follows the Format and Content Guide for U.S. Department of Energy Low-Level Waste Disposal Facility Closure Plans (DOE, 1999a). This interim closure plan meets closure and post-closure monitoring requirements of the order DOE O 435.1, manual DOE M 435.1-1, Title 40 Code of Federal Regulations (CFR) Part 191, 40 CFR 265, Nevada Administrative Code (NAC) 444.743, and Resource Conservation and Recovery Act (RCRA) requirements as incorporated into NAC 444.8632. The Area 5 RWMS accepts primarily packaged low-level waste (LLW), low-level mixed waste (LLMW), and asbestiform low-level waste (ALLW) for disposal in excavated disposal cells.

Percutaneous ASD and VSD closure of 4-month-old infant in the same session

Directory of Open Access Journals (Sweden)

Nazmi Narin

2015-09-01

In conclusion, percutaneous ASD, VSD closure is being done safely in children, but for the first time, percutaneous VSD closure was done in an infant with low body weight in the same session with ASD closure successfully. This case will be an encouraging example for the future.

Environmental aspects of hard coal mines closure in Poland

International Nuclear Information System (INIS)

Chaber, M.; Krogulski, K.; Gawlik, L.

1998-01-01

The environmental problems that arise during the closure processes of hard coal mines in Poland are undertaken in the paper. The problems of changes in water balance in rock mass are described with a stress put on underground water management. Regulation concerning ground reclamation and utilisation and removal of existing heat and power plants which after the mines closure will continue to supply surrounding consumers are stressed and the possible solutions are shown. 13 refs

RCRA land unit closures at the Y-12 Plant, Oak Ridge, Tennessee

International Nuclear Information System (INIS)

Welch, S.H.; Kelly, B.A.; Delozier, M.F.P.; Manrod, W.E.

1987-01-01

Eight land-based hazardous waste management units at the Y-12 Plant are being closed under an integrated multi-year program. Closure plans for the units have been submitted and are in various stages of revision and regulatory review. These units will be closed by various combinations of methods, including liquid removal and treatment, sludge stabilization, contaminated sludge and/or soil removal, and capping. The closure of these sites will be funded by a new Department of Energy budget category, the Environmental Restoration Budget Category (ERBC), which is intended to provide greater flexibility in the response to closure and remedial activities. A major project, Closure and Post-Closure Activities (CAPCA), has been identified for ERBC funding to close and remediate the land units in accordance with RCRA requirements. Establishing the scope of this program has required the development of a detailed set of assumptions and a confirmation program for each assumption. Other significant activities in the CAPCA program include the development of risk assessments and the preparation of an integrated schedule

Treatment of severe refractory epistaxis in hereditary hemorrhagic telangiectasia using a two-flap nasal closure method

Science.gov (United States)

Timmins, Benjamin H.; Hunter, Benjamin N.; Wilson, Kevin F.; Ward, P. Daniel

2016-01-01

Background Nasal closure has been shown to effectively manage severe epistaxis refractory to other treatments in patients with hereditary hemorrhagic telangiectasia (HHT). The nasal closure procedure may be underutilized due to its surgical complexity and flap breakdown. Methods Retrospective review of thirteen HHT patients treated for severe epistaxis with nasal closure between 2005 and 2013. Operating room (OR) time, need for revision surgery, pre- and post-procedure epistaxis severity score (ESS), complete blood count values, and Glasgow Benefit Inventory (GBI) questionnaire results were collected for each patient. The technique is described. We characterize a typical nasal closure patient and compare outcomes based on our experience with the traditional three-flap closure and a simplified two-flap nasal closure procedure. Results The average candidate for nasal closure in this series had an ESS of 7.88, Hgb of 8.3 g/dL, and received multiple transfusions, iron therapy, and cautery/coagulation procedures. Average ESS subsequent to nasal closure using the two flap method is 0.92 and mean GBI score is 56.3. Comparison of five patients who underwent the traditional three-flap nasal closure procedure and eight patients receiving the two flap nasal closure showed no significant difference in post-op ESS or GBI metrics. Mean operating room times of the traditional and simplified methods were 3.12 hours and 1.44 hours (p=0.0001). Mean time to first revision for eight nasal closure patients is 21.5 months. Conclusion In short-term follow-up, the two-flap procedure has shown comparable effectiveness with significantly reduced complexity and operative time compared to the traditional nasal closure method. PMID:26751606

Relevant closure: a new form of defeasible reasoning for description logics

CSIR Research Space (South Africa)

Casini, G

2014-09-01

Full Text Available Relevant Closure and Minimal Relevant Closure. As the names suggest, both rely on defining a version of relevance. Our formalisation of relevance in this context is based on the notion of a justification (a minimal subset of sentences implying a given...

Transcatheter closure of large patent ductus arteriosus using custom made devices.

Science.gov (United States)

Rohit, Manoj Kumar; Gupta, Ankur

2017-05-01

There has been a paradigm shift in the transcatheter closure of patent ductus arteriosus (PDA) over the last 45 years. With the availability of various coils, plugs and occluders, PDA of almost all shapes and sizes are amenable to transcatheter closure. However, very large PDA diagnosed late in life are being referred for surgical closure in the absence of availability of large size devices, especially in developing countries. In this case series, we have described four patients with large PDA, three of which were closed by transcatheter custom made PDA occluders. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

Timing and rate of spheno-occipital synchondrosis closure and its relationship to puberty

Science.gov (United States)

Vargas, Eduardo; Palomo, J. Martin; Hans, Mark; Latimer, Bruce; Simpson, Scott

2017-01-01

Objectives This study examines the relationship between spheno-occipital synchondrosis (SOS) closure and puberty onset in a modern American population. It also investigates the timing and the rate of SOS closure in males and females. Materials and methods The sample includes cross-sectional and longitudinal 3D Cone Beam Computed Tomography (CBCT) scans of 741 individuals (361 males and 380 females) aged 6–20 years. Each CBCT scan is visualized in the mid-sagittal plane, and the spheno-occipital synchondrosis (SOS) is scored as completely open, partially fused, mostly fused, and completely fused. The Menarche commencement is used as an indicator of puberty onset in females. Results Mean ages of open, partially-fused, mostly-fused, and completely fused SOS were 11.07, 12.95, 14.44, and 16.41 years in males, and 9.75, 11.67, 13.25, and 15.25 in females, respectively. The results show there is a significant association between the SOS closure stage and the commencement of menarche (Fisher's Exact Test p < 0.001). It was found that females had a higher SOS closure rate (38.60%) per year than males at the age of 10 years. The closure rate in males appears slower than females at age 10, but it lasts a longer time, ranging between 22 and 26% per year from age 11 to 14 years. Conclusion There is a significant relationship between puberty onset and SOS closure, suggesting its closure is at least partially affected by systemic, hormonal changes in the growing adolescent. Also, SOS closure occurs at a faster rate and at an earlier age in females compared to males. PMID:28827837

Defense Base Realignment and Closure Budget Data for the Closure of Marine Corps Air Station El Toro and Tustin, California, and the Realignment to Naval Air Station Miramar, California

National Research Council Canada - National Science Library

1994-01-01

... requested for each military construction project associated with base realignment and closure does not exceed the original estimated cost provided to the Commission on Defense Base Closure and Realignment (the Commission...

Successful completion of a RCRA closure for the Fernald Environmental Management Project

International Nuclear Information System (INIS)

Lippitt, J.M.; Kolthoff, K.

1995-01-01

This paper discusses the successful completion of a RCRA (Resource Conservation and Recovery Act) closure of a HF (hydrofluoric acid) tank car at FEMP, which is on the national priorities list of hazardous waste sites and is undergoing CERCLA remediation. The HF tank car closure was conducted by FERMCO. Through a combination of sound planning and team work, the HF tank car was closed safely and ahead of schedule. During > 22,000 hr field work required for construction modifications and neutralization of 9,600 gallons of HF and decontamination rinseates, there were no OSHA recordable incidents. The system design avoided additional costs by maximizing use of existing equipment and facilities. This successful closure of the HF tank car demonstrates FEMP's commitment to reducing risks and cleaning up the facility in a manner consistent with objectives of RCRA regulations and the Ohio EPA hazardous waste rules. This in turn facilitated ongoing negotiations with Ohio EPA to integrate RCRA closure and the ongoing CERCLA remediation activities. This paper addresses why the unit was clean closed under an approved RCRA Closure Plan. Integration of EPA regulations for RCRA and CERCLA programs and the DOE-Orders impacting design, construction and operation of an acid neutralization system is also reviewed. The paper concludes with a discussion of lessons learned in the process in preparing the closure plant and through final project close out

Fontan fenestration closure and event-free survival.

Science.gov (United States)

Imielski, Bartlomiej R; Woods, Ronald K; Mussatto, Kathleen A; Cao, Yumei; Simpson, Pippa M; Tweddell, James S

2013-01-01

The purpose of the present study was to evaluate the association of open and closed Fontan fenestration status with event-free survival. All patients who underwent a fenestrated Fontan procedure at our institution from January 1994 through June 2007 were reviewed. Patient information was obtained from the medical records. The patients were assigned to 1 of 2 study groups, open or closed, according to their most recent fenestration status. Clinically relevant morbid events were tabulated, and Kaplan-Meier event analysis was used to create event-free probability curves with log-rank comparisons. A total of 161 patients were classified as open and 51 as closed. The median interval to an event was 1.1 years (interquartile range, 0.1-3.3 years) after the Fontan procedure. The median interval to closure was 1.2 years (interquartile range, 0.7-3.3 years). The median interval to an event was 1.5 years (interquartile range, 0.1-4.6 years) in the closed group and 1.1 years (interquartile range, 0.1-3.3 years) in the open group. Event-free probability analysis revealed no significant difference between the 2 groups (P = .15). The median follow-up arterial oxygen saturation was greater in the closed group (96.0%; interquartile range, 94.0%-97.0%) than in the open group (91.0%; interquartile range, 86.0%-95.0%; P < .0001). Fenestration closure was associated with greater arterial oxygen saturation but not greater event-free survival. The interval to an event was slightly less than the interval to fenestration closure, suggesting potential merit in the evaluation of earlier fenestration closure. Adoption of specific fenestration management guidelines might help improve the overall outcomes and enhance the quality of future studies. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Evaluation of Two Energy Balance Closure Parametrizations

Science.gov (United States)

Eder, Fabian; De Roo, Frederik; Kohnert, Katrin; Desjardins, Raymond L.; Schmid, Hans Peter; Mauder, Matthias

2014-05-01

A general lack of energy balance closure indicates that tower-based eddy-covariance (EC) measurements underestimate turbulent heat fluxes, which calls for robust correction schemes. Two parametrization approaches that can be found in the literature were tested using data from the Canadian Twin Otter research aircraft and from tower-based measurements of the German Terrestrial Environmental Observatories (TERENO) programme. Our analysis shows that the approach of Huang et al. (Boundary-Layer Meteorol 127:273-292, 2008), based on large-eddy simulation, is not applicable to typical near-surface flux measurements because it was developed for heights above the surface layer and over homogeneous terrain. The biggest shortcoming of this parametrization is that the grid resolution of the model was too coarse so that the surface layer, where EC measurements are usually made, is not properly resolved. The empirical approach of Panin and Bernhofer (Izvestiya Atmos Oceanic Phys 44:701-716, 2008) considers landscape-level roughness heterogeneities that induce secondary circulations and at least gives a qualitative estimate of the energy balance closure. However, it does not consider any feature of landscape-scale heterogeneity other than surface roughness, such as surface temperature, surface moisture or topography. The failures of both approaches might indicate that the influence of mesoscale structures is not a sufficient explanation for the energy balance closure problem. However, our analysis of different wind-direction sectors shows that the upwind landscape-scale heterogeneity indeed influences the energy balance closure determined from tower flux data. We also analyzed the aircraft measurements with respect to the partitioning of the "missing energy" between sensible and latent heat fluxes and we could confirm the assumption of scalar similarity only for Bowen ratios 1.

78 FR 23952 - Notice of Temporary Closure on Public Lands in Elmore County, ID

Science.gov (United States)

2013-04-23

...] Notice of Temporary Closure on Public Lands in Elmore County, ID AGENCY: Bureau of Land Management, Interior. ACTION: Notice of temporary closure. SUMMARY: Notice is hereby given that the Stout Fire closure to motorized vehicle use is in effect on public lands administered by the Four Rivers Field Office...

Interim Status Closure Plan Open Burning Treatment Unit Technical Area 16-399 Burn Tray

Energy Technology Data Exchange (ETDEWEB)

Vigil-Holterman, Luciana R. [Los Alamos National Laboratory

2012-05-07

This closure plan describes the activities necessary to close one of the interim status hazardous waste open burning treatment units at Technical Area (TA) 16 at the Los Alamos National Laboratory (LANL or the Facility), hereinafter referred to as the 'TA-16-399 Burn Tray' or 'the unit'. The information provided in this closure plan addresses the closure requirements specified in the Code of Federal Regulations (CFR), Title 40, Part 265, Subparts G and P for the thermal treatment units operated at the Facility under the Resource Conservation and Recovery Act (RCRA) and the New Mexico Hazardous Waste Act. Closure of the open burning treatment unit will be completed in accordance with Section 4.1 of this closure plan.

Remotely operated closure device for a pipeline with a fixed pipeline flange

International Nuclear Information System (INIS)

Westendorf, H.

1987-01-01

The remotely operated closure is set by suspension centring on the circumference of a blank flange on the fixed pipeline flange to be closed. By operating a central actuating mechanism at the closure, the clamping levers are adjusted so that the blank flange is clamped to the pipeline flange and the two flanges are pressed together. The spring-loaded clamping levers are particularly suitable for actuating the closure with the pliers of a manipulator of a large cell. (DG) [de

Improving environmental performance through mine closure planning

International Nuclear Information System (INIS)

McKee, W.; McKenna, G.

1998-01-01

Syncrude has been investigating landscape redevelopment concepts since 1995 after a two-year tailings technology selection study resulted in a major shift in their long-term tailings disposal strategy. The change from fluid disposal to solid disposal of tailings leads to a different landscape, incorporating a new water material type, new landforms and a new schedule of reclamation activity. A multidisciplinary approach was needed to assess, design and develop the final landscape. Planning approach in progress at Syncrude Canada was described, and the basic concepts and tools of closure planning discovered to date were outlined. The economic impacts of closure planning on mining and tailings operations in general, were discussed. 14 refs