Emotion Knowledge and Attentional Differences in Preschoolers Showing Context-Inappropriate Anger.

Science.gov (United States)

Locke, Robin L; Lang, Nichole J

2016-08-01

Some children show anger inappropriate for the situation based on the predominant incentives, which is called context-inappropriate anger. Children need to attend to and interpret situational incentives for appropriate emotional responses. We examined associations of context-inappropriate anger with emotion recognition and attention problems in 43 preschoolers (42% male; M age = 55.1 months, SD = 4.1). Parents rated context-inappropriate anger across situations. Teachers rated attention problems using the Child Behavior Checklist-Teacher Report Form. Emotion recognition was ability to recognize emotional faces using the Emotion Matching Test. Anger perception bias was indicated by anger to non-anger situations using an adapted Affect Knowledge Test. 28% of children showed context-inappropriate anger, which correlated with lower emotion recognition (β = -.28) and higher attention problems (β = .36). Higher attention problems correlated with more anger perception bias (β = .32). This cross-sectional, correlational study provides preliminary findings that children with context-inappropriate anger showed more attention problems, which suggests that both "problems" tend to covary and associate with deficits or biases in emotion knowledge. © The Author(s) 2016.

Potentially inappropriate prescribing in older patients admitted to psychiatric hospital

NARCIS (Netherlands)

Rongen, S.; Kramers, C.; O'Mahony, D.; Feuth, T.; Olde Rikkert, M.G.M.; Ahmed, A.I.A.

2016-01-01

OBJECTIVES: The objectives of this study are to determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs) and to assess related risk factors in older people with major psychiatric illness.

High level waste storage tank farms/242-A evaporator Standards/Requirements Identification Document (S/RID), Volume 6

Energy Technology Data Exchange (ETDEWEB)

1994-04-01

The High-Level Waste Storage Tank Farms/242-A Evaporator Standards/Requirements Identification Document (S/RID) is contained in multiple volumes. This document (Volume 6) outlines the standards and requirements for the sections on: Environmental Restoration and Waste Management, Research and Development and Experimental Activities, and Nuclear Safety.

High level waste storage tank farms/242-A evaporator Standards/Requirements Identification Document (S/RID), Volume 6

International Nuclear Information System (INIS)

1994-04-01

The High-Level Waste Storage Tank Farms/242-A Evaporator Standards/Requirements Identification Document (S/RID) is contained in multiple volumes. This document (Volume 6) outlines the standards and requirements for the sections on: Environmental Restoration and Waste Management, Research and Development and Experimental Activities, and Nuclear Safety

Predictors of Inappropriate Use of Diagnostic Tests and Management of Bronchiolitis

Science.gov (United States)

Sarmiento, Lorena; Rojas-Soto, Gladys E.

2017-01-01

Background The aim of the present study was to determine predictors of inappropriate use of diagnostic tests and management of bronchiolitis in a population of hospitalized infants. Methods In an analytical cross-sectional study, we determined independent predictors of the inappropriate use of diagnostic tests and management of bronchiolitis in a population of hospitalized infants. We defined a composite outcome score as the main outcome variable. Results Of the 303 included patients, 216 (71.3%) experienced an inappropriate use of diagnostic tests and treatment of bronchiolitis. After controlling for potential confounders, it was found that atopic dermatitis (OR 5.30; CI 95% 1.14–24.79; p = 0.034), length of hospital stay (OR 1.48; CI 95% 1.08–2.03; p = 0.015), and the number of siblings (OR 1.92; CI 95% 1.13–3.26; p = 0.015) were independent predictors of an inappropriate use of diagnostic tests and treatment of the disease. Conclusions Inappropriate use of diagnostic tests and treatment of bronchiolitis was a highly prevalent outcome in our population of study. Participants with atopic dermatitis, a longer hospital stay, and a greater number of siblings were at increased risk for inappropriate use of diagnostic tests and management of the disease. PMID:28758127

Discontinuing Inappropriate Medication Use in Nursing Home Residents : A Cluster Randomized Controlled Trial

NARCIS (Netherlands)

Wouters, Hans; Scheper, Jessica; Koning, Hedi; Brouwer, Chris; Twisk, Jos W.; van der Meer, Helene; Boersma, Froukje; Zuidema, Sytse U.; Taxis, Katja

2017-01-01

Background: Inappropriate prescribing is a well-known clinical problem in nursing home residents, but few interventions have focused on reducing inappropriate medication use. Objective: To examine successful discontinuation of inappropriate medication use and to improve prescribing in nursing home

High-level waste storage tank farms/242-A evaporator Standards/Requirements Identification Document (S/RID), Volume 7. Revision 1

Energy Technology Data Exchange (ETDEWEB)

Burt, D.L.

1994-04-01

The High-Level Waste Storage Tank Farms/242-A Evaporator Standards/Requirements Identification Document (S/RID) is contained in multiple volumes. This document (Volume 7) presents the standards and requirements for the following sections: Occupational Safety and Health, and Environmental Protection.

High-level waste storage tank farms/242-A evaporator Standards/Requirements Identification Document (S/RID), Volume 7. Revision 1

International Nuclear Information System (INIS)

Burt, D.L.

1994-04-01

The High-Level Waste Storage Tank Farms/242-A Evaporator Standards/Requirements Identification Document (S/RID) is contained in multiple volumes. This document (Volume 7) presents the standards and requirements for the following sections: Occupational Safety and Health, and Environmental Protection

Understanding inappropriate hospital admissions of patients presenting to the Emergency Department.

Directory of Open Access Journals (Sweden)

Roberta Siliquini

2005-06-01

Full Text Available

Objectives. To identify 1 the characteristics of patients receiving non acute (inappropriate care and 2 the variables associated to inappropriate hospital use, in order to 3 estimate the relevance of the problem and to 4 focus future concurrent reviews and efforts to allocate patients to alternative health care settings.

Design. A prospective review of a random sample of adult patients who presented to the Emergency Department of the Molinette Hospital. Patients were assessed at admission and on day 3, 5and 8 using the Appropriateness Evaluation Protocol (Italian validated version. Patients: 490 overall; 312 (64 % medical and 178 (36 % surgical.

Outcome measures. Acute (appropriate and non acute (inappropriate admissions, Major Disease Category, costs, mean weights of Diagnosis Related Groups, and length of stay (days.

Results. The proportion of patients requiring acute care declined rapidly from presentation (84.5% to the fifth day of admission (60.9%. Patients admitted during weekends showed a higher rate of inappropriate stay on day 5 (P=0.04. The proportion of inappropriate admissions was higher for medical rather than surgical patients (P=0.07 at presentation and at day 5 (P < 0.01. Traditional social-demographic variables were not significant risk indicators for inappropriate admissions. The likelihood ratio for inappropriate admission at presentation was significantly higher for minor illnesses and disturbances (P=0.03.

Inappropriate stay on day 5 was significantly associated with lower cost (P < 0.01, lower mean DRG weight (P < 0.01 and shorter length of stay (P=0.05 for medical but not for surgical admissions.

Conclusions. Traditional epidemiological indicators are inadequate to target prospective concurrent reviews. Qualitative studies focusing on patient physician dialogue in different situations and contexts could

Inappropriateness of cardiovascular radiological imaging testing; a tertiary care referral center study.

Directory of Open Access Journals (Sweden)

Clara Carpeggiani

Full Text Available AIMS: Radiological inappropriateness in medical imaging leads to loss of resources and accumulation of avoidable population cancer risk. Aim of the study was to audit the appropriateness rate of different cardiac radiological examinations. METHODS AND PRINCIPAL FINDINGS: With a retrospective, observational study we reviewed clinical records of 818 consecutive patients (67 ± 12 years, 75% males admitted from January 1-May 31, 2010 to the National Research Council - Tuscany Region Gabriele Monasterio Foundation cardiology division. A total of 940 procedures were audited: 250 chest x-rays (CXR; 240 coronary computed tomographies (CCT; 250 coronary angiographies (CA; 200 percutaneous coronary interventions (PCI. For each test, indications were rated on the basis of guidelines class of recommendation and level of evidence: definitely appropriate (A, including class I, appropriate, and class IIa, probably appropriate, uncertain (U, class IIb, probably inappropriate, or inappropriate (I, class III, definitely inappropriate. Appropriateness was suboptimal for all tests: CXR (A = 48%, U = 10%, I = 42%; CCT (A = 58%, U = 24%, I = 18%; CA (A = 45%, U = 25%, I = 30%; PCI (A = 63%, U = 15%, I = 22%. Top reasons for inappropriateness were: routine on hospital admission (70% of inappropriate CXR; first line application in asymptomatic low-risk patients (42% of CCT or in patients with unchanged clinical status post-revascularization (20% of CA; PCI in patients either asymptomatic or with miscellaneous symptoms and without inducible ischemia on non-invasive testing (36% of inappropriate PCI. CONCLUSION AND SIGNIFICANCE: Public healthcare system--with universal access paid for with public money--is haemorrhaging significant resources and accumulating avoidable long-term cancer risk with inappropriate cardiovascular imaging prevention.

Primary Sjogren's syndrome associated with inappropriate ...

African Journals Online (AJOL)

A patient in whom primary Sjogren's syndrome and inappropriate antiduretic hormone secretion were associated is reported. This is the first report of such an association. The possible pathophysiological mechanisms are discussed and vasculitis proposed as the underlying pathogenetic mechanism.

Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities

Directory of Open Access Journals (Sweden)

Yamada Yukari

2006-01-01

Full Text Available Abstract Background The prevalence and risk factors of potentially inappropriate medication use among the elderly patients have been studied in various countries, but because of the difficulty of obtaining data on patient characteristics and medications they have not been studied in Japan. Methods We conducted a retrospective cross-sectional study in 17 Japanese long-term care (LTC facilities by collecting data from the comprehensive MDS assessment forms for 1669 patients aged 65 years and over who were assessed between January and July of 2002. Potentially inappropriate medications were identified on the basis of the 2003 Beers criteria. Results The patients in the sample were similar in terms of demographic characteristics to those in the national survey. Our study revealed that 356 (21.1% of the patients were treated with potentially inappropriate medication independent of disease or condition. The most commonly inappropriately prescribed medication was ticlopidine, which had been prescribed for 107 patients (6.3%. There were 300 (18.0% patients treated with at least 1 inappropriate medication dependent on the disease or condition. The highest prevalence of inappropriate medication use dependent on the disease or condition was found in patients with chronic constipation. Multiple logistic regression analysis revealed psychotropic drug use (OR = 1.511, medication cost of per day (OR = 1.173, number of medications (OR = 1.140, and age (OR = 0.981 as factors related to inappropriate medication use independent of disease or condition. Neither patient characteristics nor facility characteristics emerged as predictors of inappropriate prescription. Conclusion The prevalence and predictors of inappropriate medication use in Japanese LTC facilities were similar to those in other countries.

Prevalence and predictors of potentially inappropriate medications among home care elderly patients in Qatar.

Science.gov (United States)

Alhmoud, Eman; Khalifa, Sabah; Bahi, Asma Abdulaziz

2015-10-01

Older patients receiving home health care are particularly at risk of receiving potentially inappropriate medications compared to community-dwelling population. Data on appropriateness of prescribing in these patients is limited. To investigate the prevalence, patterns and determinants of potentially inappropriate medications among elderly patients receiving Home Health Care Services in Qatar. Home Health Care Services department in Hamad Medical Corporation-Qatar. A cross-sectional study, conducted over a 3 months period. Patients 65 years and older, taking at least one medication and receiving home care services were included. Potentially inappropriate medications were identified and classified in accordance with the American Geriatrics Society 2012 Beers Criteria. Prevalence of potentially inappropriate medications using updated Beers criteria. A total of 191 patients (38.2%) had at least one potentially inappropriate medication. As per Beers criteria, 35% of medications were classified as medications to be avoided in older adults regardless of conditions and 9% as potentially inappropriate medications when used with certain diseases or syndromes. The majority of potentially inappropriate medications (56%) were classified as medications to be used with caution. The two leading classes of potentially inappropriate medications were antipsychotics (27.4%) and selective serotonin reuptake inhibitors (16%). Significant predictors of inappropriate prescribing were hypertension [adjusted OR 1.7; 95% CI (1.0, 2.8)], dementia [adjusted OR 2.0; 95% CI (1.2, 3.1)], depression [adjusted OR 21.6; 95% CI (2.8, 168.4)], and taking more than ten prescribed medications [adjusted OR 1.9; 95% CI (1.3, 2.8)]. Prescribing potentially inappropriate medications is common among older adults receiving home health care services in Qatar, a finding that warrants further attention. Polypharmacy, hypertension, depression and dementia were significantly associated with potentially

Identification of new genes involved in human adipogenesis and fat storage.

Directory of Open Access Journals (Sweden)

Jörn Söhle

Full Text Available Since the worldwide increase in obesity represents a growing challenge for health care systems, new approaches are needed to effectively treat obesity and its associated diseases. One prerequisite for advances in this field is the identification of genes involved in adipogenesis and/or lipid storage. To provide a systematic analysis of genes that regulate adipose tissue biology and to establish a target-oriented compound screening, we performed a high throughput siRNA screen with primary (preadipocytes, using a druggable siRNA library targeting 7,784 human genes. The primary screen showed that 459 genes affected adipogenesis and/or lipid accumulation after knock-down. Out of these hits, 333 could be validated in a secondary screen using independent siRNAs and 110 genes were further regulated on the gene expression level during adipogenesis. Assuming that these genes are involved in neutral lipid storage and/or adipocyte differentiation, we performed InCell-Western analysis for the most striking hits to distinguish between the two phenotypes. Beside well known regulators of adipogenesis and neutral lipid storage (i.e. PPARγ, RXR, Perilipin A the screening revealed a large number of genes which have not been previously described in the context of fatty tissue biology such as axonemal dyneins. Five out of ten axonemal dyneins were identified in our screen and quantitative RT-PCR-analysis revealed that these genes are expressed in preadipocytes and/or maturing adipocytes. Finally, to show that the genes identified in our screen are per se druggable we performed a proof of principle experiment using an antagonist for HTR2B. The results showed a very similar phenotype compared to knock-down experiments proofing the "druggability". Thus, we identified new adipogenesis-associated genes and those involved in neutral lipid storage. Moreover, by using a druggable siRNA library the screen data provides a very attractive starting point to identify anti

Inappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients.

LENUS (Irish Health Repository)

Barry, P J

2012-02-03

BACKGROUND: In appropriate prescribing is a significant and persistent problem in elderly people, both in hospital and the community and has been described in several countries in Europe and also the USA. The problem of inappropriate prescribing has not been quantified in the Republic of Ireland. The most commonly used criteria for the identification of inappropriate prescribing are the Beers\\' criteria [both independent of diagnosis (ID) and considering diagnosis (CD) - 2003 version]. The Beers\\' criteria ID includes 48 different categories of either single medications or multiple medications of a similar class identified as inappropriate prescriptions and the Beers\\' criteria CD contains 19 different categories containing possible drug-disease interactions. A second tool, the improved prescribing in the elderly tool (IPET) has also been validated and used in hospital and community studies and has 14 categories of either explicitly contraindicated medications or possible drug-disease interactions. OBJECTIVES: The primary aim of the study is to measure the incidence of inappropriate prescribing among older community-dwelling individuals presenting to an acute hospital in the Republic of Ireland. A secondary aim of this study was also therefore to compare the efficacy of the above two tools in identifying inappropriate prescribing. METHODS: A prospective, consecutive observational cohort study was carried out over a 4-month period. The setting was an urban-based university hospital acute geriatric medicine assessment unit. Subjects in this study (n = 350) were consecutively screened on admission to hospital (mean age = 80.3 +\\/- 6.1 years) and all patients had both Beers\\' criteria ID and CD and IPET applied to their list of prescription drugs on admission, cross-referenced with their list of current active medical diagnosis. RESULTS: The results of the study identified a high rate of inappropriate prescribing among this population of community

Functional Analysis of Inappropriate Social Interactions in Students with Asperger's Syndrome

Science.gov (United States)

Roantree, Christina F.; Kennedy, Craig H.

2012-01-01

We analyzed the inappropriate social interactions of 3 students with Asperger's syndrome whose behavior was maintained by social positive reinforcement. We tested whether inappropriate social behavior was sensitive to social positive reinforcement contingencies and whether such contingencies could be reversed to increase the probability of…

[Inappropriate prescription in older patients: the STOPP/START criteria].

LENUS (Irish Health Repository)

Delgado Silveira, Eva

2009-09-01

Older people are a heterogeneous group of patients, often with multiple comorbidities for which they are prescribed a large number of drugs, leading to an increased risk of adverse drug reactions (ADR) and drug interactions. This risk is compounded by physiological age-related changes in physiology, changes in drug pharmacokinetics and pharmacodynamics, as well as by disease-related, functional and social issues. Inappropriate prescription of drugs is common in the older individuals and contributes to the increased risk of ADR. Several tools have been developed to detect potentially inappropriate prescription, the most frequently used in Spain being Beers\\' criteria. However, the value of these criteria is limited, especially as they were developed in a different healthcare system. In this article, the Spanish version of a new tool to detect potentially inappropriate prescriptions-STOPP (Screening Tool of Older Person\\'s Prescriptions) and START (Screening Tool to Alert doctors to Right i.e. appropriate, indicated Treatment) criteria-is presented. The creation, development, reliability, and use of these criteria in routine practice is described and discussed. These criteria have shown better sensitivity than Beers\\' criteria in detecting prescription problems and have the added value of being able to detect not only inappropriate prescription of some drugs, but also the omission of well indicated drugs. The STOPP\\/START criteria could become a useful screening tool to improve prescription in older people.

Low disease prevalence and inappropriate implantable cardioverter defibrillator shock rate in Brugada syndrome

DEFF Research Database (Denmark)

Holst, Anders Gaarsdal; Jensen, Henrik Kjærulf; Eschen, Ole

2012-01-01

AimsBrugada syndrome (BrS) is an inherited channelopathy that predisposes to malignant ventricular arrhythmias and thereby syncope and sudden cardiac death. Prior studies characterizing BrS patients have used highly selected referral populations from tertiary centres and prevalence estimates have...... been carried out using electrocardiogram (ECG) surveys only. We aimed to identify and characterize all diagnosed BrS patients in Denmark (population 5.4 million).Methods and resultsBrugada syndrome patients were identified using several modalities including identification in all Danish tertiary......%) experienced inappropriate shocks during a median follow-up of 47 months. No patient died or experienced aborted sudden cardiac death during follow-up.ConclusionsWe report the first nationwide study of BrS patients. We found a low incidence of diagnosed definite BrS compared with estimates from ECG surveys...

Inappropriate gestational weight gain among teenage pregnancies: prevalence and pregnancy outcomes.

Science.gov (United States)

Vivatkusol, Yada; Thavaramara, Thaovalai; Phaloprakarn, Chadakarn

2017-01-01

To study the prevalence and pregnancy outcomes of inappropriate gestational weight gain (GWG) among teenage pregnant women. A retrospective descriptive study was conducted on 2,165 teenage pregnant women who attended our antenatal clinic between January 2007 and August 2015. Adverse pregnancy outcomes, including maternal and neonatal outcomes of women with inappropriate GWG, including underweight and overweight, were studied and compared with those of women with appropriate GWG. Complete data of 1,943 women were obtained. Among these women, the mean age was 17.4±1.4 years and mean body mass index at first visit was 19.1±3.0 kg/m 2 . The prevalence of inappropriate GWG was 61.7%. Underweight women were more likely to experience anemia and preterm delivery, whereas overweight women required more cesarean sections because of cephalopelvic disproportion and preeclampsia, compared to women with appropriate weight gain (all P teenage pregnancies showed inappropriate GWG. GWG had a significant impact on pregnancy outcomes.

Potentially inappropriate medication prescribed to elderly outpatients at a general medicine unit

Directory of Open Access Journals (Sweden)

Christine Grützmann Faustino

2011-03-01

Full Text Available Objective: To establish the prevalence of potentially inappropriate medications prescribed for elderly patients, to identify the most commonly involved drugs, and to investigate whether age, sex and number of medications were related with the prescription of these drugs. Methods: Prescriptions for 1,800 elderly patients (≥ 60 years were gathered from a database. These prescriptions were written by general physicians at a tertiary level university hospital in the city of Sao Paulo, Brazil, from February to May 2008. Only one prescription per patient was considered. The prescriptions were classified according to sex and age (60-69, 70-79 and ≥ 80. The Beers criteria (2003 version were used to evaluate potentially inappropriate medications. Results: Most of the sample comprised women (66.6% with a mean age of 71.3 years. The mean prevalence of potentially inappropriate medication prescriptions was 37.6%. The 60-69 age group presented the highest prevalence (49.9%. The most frequently prescribed potentially inappropriate medications to women were carisoprodol, amitriptyline, and fluoxetine; amitriptyline, carisoprodol, fluoxetine and clonidine were prescribed more often to men. The female sex (p<0.001; OR=2.0 and number of medications prescribed (p<0.001 were associated with prescription of potentially inappropriate medications. The chance of having a prescription of these drugs was lower among patients aged over 80 years (OR=0.7. The mean number of prescribed medications for both sexes and all age groups was 7.1. The mean number of medications per patient was higher among females (p<0.001; this result was not age-dependent (p=0.285. Conclusion: The prevalence of potentially inappropriate medications was similar to previously reported values in the literature and was correlated with the female sex. The chance of having a potentially inappropriate medication prescription was lower among patients aged over 80 years. The chance of having a

Individual and hospital-related determinants of potentially inappropriate admissions emerging from administrative records.

Science.gov (United States)

Fusco, Marco; Buja, Alessandra; Piergentili, Paolo; Golfetto, Maria Teresa; Serafin, Gianni; Gallo, Silvia; Dalla Barba, Livio; Baldo, Vincenzo

2016-11-01

The appropriate use of health care is an important issue in developed countries. The purpose of this study was to ascertain the extent of potentially inappropriate hospital admissions and their individual, clinical and hospital-related determinants. Medical records were analyzed for the year 2014 held by the Local Heath Unit n. 13 in the Veneto Region of north-east Italy (19,000 records). The outcomes calculated were: admissions for conditions amenable to day hospital care; brief medical admissions; outlier lengths of stay for elderly patients' medical admissions; and medical admissions to surgical wards. Univariate analyses and logistic regression models were used to test associations with demographic, clinical and hospital ward covariates, including organizational indicators. Inappropriate reliance on acute care beds ranged from 6% to 28%, depending on the type of quality indicator analyzed. Some individual features, and wards' specific characteristics were associated with at least one of the phenomena of inappropriate hospital resource usage. In particular, male gender, younger age and transferals seemed to affect inappropriate admissions to surgical wards. Potentially avoidable admissions featuring inpatients amenable to day hospital care were associated with subjects with fewer comorbidities and lower case-mix wards, while inappropriately short medical stays were influenced by patients' higher functional status and local residency and by lower bed occupancy rates. In conclusion, inappropriately long hospital stays for elderly cases were associated with patients with multiple pathologies in wards with a low bed-occupancy. Education level and citizenship did not seem to influence inappropriate admissions. Some individual, clinical ad structural characteristics of patients and wards emerging from administrative records could be associated with inappropriate reliance on acute hospital beds. Analyzing the indicators considered in this study could generate

Inappropriate gestational weight gain among teenage pregnancies: prevalence and pregnancy outcomes

Directory of Open Access Journals (Sweden)

Vivatkusol Y

2017-05-01

Full Text Available Yada Vivatkusol, Thaovalai Thavaramara, Chadakarn Phaloprakarn Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand Objective: To study the prevalence and pregnancy outcomes of inappropriate gestational weight gain (GWG among teenage pregnant women.Methods: A retrospective descriptive study was conducted on 2,165 teenage pregnant women who attended our antenatal clinic between January 2007 and August 2015. Adverse pregnancy outcomes, including maternal and neonatal outcomes of women with inappropriate GWG, including underweight and overweight, were studied and compared with those of women with appropriate GWG.Results: Complete data of 1,943 women were obtained. Among these women, the mean age was 17.4±1.4 years and mean body mass index at first visit was 19.1±3.0 kg/m2. The prevalence of inappropriate GWG was 61.7%. Underweight women were more likely to experience anemia and preterm delivery, whereas overweight women required more cesarean sections because of cephalopelvic disproportion and preeclampsia, compared to women with appropriate weight gain (all P<0.001. The rates of gestational diabetes mellitus among women who were underweight, overweight, or appropriate weight were not significantly different.Conclusion: More than 60% of teenage pregnancies showed inappropriate GWG. GWG had a significant impact on pregnancy outcomes. Keywords: prevalence, pregnancy outcome, inappropriate gestational weight gain, teenage pregnancy

High-level waste storage tank farms/242-A evaporator standards/requirements identification document (S/RID), Vol. 7

Energy Technology Data Exchange (ETDEWEB)

1994-04-01

This Requirements Identification Document (RID) describes an Occupational Health and Safety Program as defined through the Relevant DOE Orders, regulations, industry codes/standards, industry guidance documents and, as appropriate, good industry practice. The definition of an Occupational Health and Safety Program as specified by this document is intended to address Defense Nuclear Facilities Safety Board Recommendations 90-2 and 91-1, which call for the strengthening of DOE complex activities through the identification and application of relevant standards which supplement or exceed requirements mandated by DOE Orders. This RID applies to the activities, personnel, structures, systems, components, and programs involved in maintaining the facility and executing the mission of the High-Level Waste Storage Tank Farms.

High-level waste storage tank farms/242-A evaporator standards/requirements identification document (S/RID), Vol. 7

International Nuclear Information System (INIS)

1994-04-01

This Requirements Identification Document (RID) describes an Occupational Health and Safety Program as defined through the Relevant DOE Orders, regulations, industry codes/standards, industry guidance documents and, as appropriate, good industry practice. The definition of an Occupational Health and Safety Program as specified by this document is intended to address Defense Nuclear Facilities Safety Board Recommendations 90-2 and 91-1, which call for the strengthening of DOE complex activities through the identification and application of relevant standards which supplement or exceed requirements mandated by DOE Orders. This RID applies to the activities, personnel, structures, systems, components, and programs involved in maintaining the facility and executing the mission of the High-Level Waste Storage Tank Farms

Discontinuing Inappropriate Medication in Nursing Home Residents (DIM-NHR study): A cluster randomized controlled trial

NARCIS (Netherlands)

Wouters, H.; Scheper, J.; Koning, H.; Brouwer, C.; Twisk, J.; Van Der Meer, H.; Boersma, F.; Zuidema, S.; Taxis, K.

2017-01-01

Introduction: Inappropriate prescribing is a prevalent problem in nursing home residents that is associated with cognitive and physical impairment. Few interventions have been shown to reduce inappropriate prescribing. The aim was therefore to examine successful discontinuation of inappropriate

The challenge of sustainability in healthcare systems: Frequency and cost of inappropriate patterns of breast cancer care (the E.Pic.A study).

Science.gov (United States)

Massa, Ilaria; Balzi, William; Burattini, Costanza; Gentili, Nicola; Bucchi, Lauro; Nanni, Oriana; Gallegati, Davide; Pierini, Andrea; Amadori, Dino; Falcini, Fabio; Altini, Mattia

2017-08-01

In a context of decreasing economic health resources and a rise in health needs, it is urgent to face this sustainability crisis through the analysis of healthcare expenditures. Wastages, deriving from inappropriate interventions, erode resources which could be reallocated to high-value activities. To identify these areas of wastages, we developed a method for combining and analyzing data from multiple sources. Here we report the preliminary results of a retrospective cohort study evaluating the performance of breast cancer (BC) care at IRST, an Italian cancer institute. Four data sources gathered in a real-world setting (a clinical database, two administrative databases and a cancer registry) were linked. Essential Key Performance Indexes (KPIs) in the pattern of BC diagnosis (KPI 1 and 2) and treatment (KPI 3 and 4) based on current guidelines were developed by a board of professionals. The costs of inappropriate examinations were associated with the diagnostic KPIs. We found that 2798 patients treated at IRST from January 2010 to June 2016 received a total of 2516 inappropriate examinations accounting for € 573,510.80. Linkage from multiple routine healthcare data sources is feasible: it allows the measurement of important KPIs specifically designed for BC care, and the identification of areas of low-value use of the resources. If systematically applied, this method could help provide a complete picture of inappropriateness and waste, redirect these resources to higher-value interventions for patients, and fill the gap between proper use of the resources and the best clinical results. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Prevalence and Predictors of Inappropriate Medications Prescribing ...

African Journals Online (AJOL)

Data analysis involved use of World Health Organization (WHO) prescribing indicators, Updated 2002 Beer's criteria and DRUG-REAX® system software package of MICROMEDEX (R) Healthcare Series to assess the prescribing pattern, identify potentially inappropriate medications and potential drug-drug interactions, ...

Emergency readmissions to paediatric surgery and urology: The impact of inappropriate coding.

Science.gov (United States)

Peeraully, R; Henderson, K; Davies, B

2016-04-01

Introduction In England, emergency readmissions within 30 days of hospital discharge after an elective admission are not reimbursed if they do not meet Payment by Results (PbR) exclusion criteria. However, coding errors could inappropriately penalise hospitals. We aimed to assess the accuracy of coding for emergency readmissions. Methods Emergency readmissions attributed to paediatric surgery and urology between September 2012 and August 2014 to our tertiary referral centre were retrospectively reviewed. Payment by Results (PbR) coding data were obtained from the hospital's Family Health Directorate. Clinical details were obtained from contemporaneous records. All readmissions were categorised as appropriately coded (postoperative or nonoperative) or inappropriately coded (planned surgical readmission, unrelated surgical admission, unrelated medical admission or coding error). Results Over the 24-month period, 241 patients were coded as 30-day readmissions, with 143 (59%) meeting the PbR exclusion criteria. Of the remaining 98 (41%) patients, 24 (25%) were inappropriately coded as emergency readmissions. These readmissions resulted in 352 extra bed days, of which 117 (33%) were attributable to inappropriately coded cases. Conclusions One-quarter of non-excluded emergency readmissions were inappropriately coded, accounting for one-third of additional bed days. As a stay on a paediatric ward costs up to £500 a day, the potential cost to our institution due to inappropriate readmission coding was over £50,000. Diagnoses and the reason for admission for each care episode should be accurately documented and coded, and readmission data should be reviewed at a senior clinician level.

Comparative analysis of storage conditions and homogenization methods for tick and flea species for identification by MALDI-TOF MS.

Science.gov (United States)

Nebbak, A; El Hamzaoui, B; Berenger, J-M; Bitam, I; Raoult, D; Almeras, L; Parola, P

2017-12-01

Ticks and fleas are vectors for numerous human and animal pathogens. Controlling them, which is important in combating such diseases, requires accurate identification, to distinguish between vector and non-vector species. Recently, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) was applied to the rapid identification of arthropods. The growth of this promising tool, however, requires guidelines to be established. To this end, standardization protocols were applied to species of Rhipicephalus sanguineus (Ixodida: Ixodidae) Latreille and Ctenocephalides felis felis (Siphonaptera: Pulicidae) Bouché, including the automation of sample homogenization using two homogenizer devices, and varied sample preservation modes for a period of 1-6 months. The MS spectra were then compared with those obtained from manual pestle grinding, the standard homogenization method. Both automated methods generated intense, reproducible MS spectra from fresh specimens. Frozen storage methods appeared to represent the best preservation mode, for up to 6 months, while storage in ethanol is also possible, with some caveats for tick specimens. Carnoy's buffer, however, was shown to be less compatible with MS analysis for the purpose of identifying ticks or fleas. These standard protocols for MALDI-TOF MS arthropod identification should be complemented by additional MS spectrum quality controls, to generalize their use in monitoring arthropods of medical interest. © 2017 The Royal Entomological Society.

What is inappropriate hospital use for elderly people near the end of life?

DEFF Research Database (Denmark)

Cardona-Morrell, Magnolia; Kim, James C H; Brabrand, Mikkel

2017-01-01

: English language publications in Medline, EMBASE, PubMed, Cochrane library, and the grey literature (January 1995-December 2016) covering community and nursing home residents aged ≥60years admitted to hospital. OUTCOMES: measurements of inappropriateness. A 17-item quality score was estimated...... estimation of clinical inappropriateness. CONCLUSIONS: Clinical inappropriateness and system factors that preclude alternative community care must be measured separately. They are two very different justifications for hospital admissions, requiring different solutions. Society has a duty to ensure...

Frequent Home Monitoring of ICD Is Effective to Prevent Inappropriate Defibrillator Shock Delivery

Directory of Open Access Journals (Sweden)

Paolo Bifulco

2014-01-01

Full Text Available Recently, in the context of telemedicine, telemonitoring services are gaining attention. They are offered, for example, to patients with implantable cardioverter defibrillators (ICDs. A major problem associated with ICD therapy is the occurrence of inappropriate shocks which impair patients’ quality of life and may also be arrhythmogenic. The telemonitoring can provide a valid support to intensify followup visits, in order to improve the prevention of inappropriate defibrillator shock, thus enhancing patient safety. Inappropriate shock generally depends on atrial fibrillation, supraventricular tachycardia, and abnormal sensing (such as those caused by electromagnetic interferences. As a practical example, an unusual case of an ICD patient who risked an inappropriate shock while taking a shower is reported. Continuous remote telemonitoring was able to timely warn cardiologist via GSM-SMS, who were able to detect improper sensing examining the intracardiac electrogram via Web. Patient was promptly contacted and warned to not further come in contact with the hydraulic system and any electrical appliance to prevent an inappropriate defibrillator shock. This demonstrates the effectiveness and usefulness of continuous remote telemonitoring in supporting ICD patients.

Risk factors for inappropriate blood requisition among hospitals in Tanzania.

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Mauka, Wilhellmuss I; Mtuy, Tara B; Mahande, Michael J; Msuya, Sia E; Mboya, Innocent B; Juma, Abdul; Philemon, Rune N

2018-01-01

Blood is a critical aspect of treatment in life saving situations, increasing demand. Blood requisition practices greatly effect sufficient supply in blood banks. This study aimed to determine the risk factors for inappropriate blood requisition in Tanzania. This was a cross sectional study using secondary data of 14,460 patients' blood requests from 42 transfusion hospitals. Primary data were obtained by using cluster-sampling design. Data were analysed using a two-level mixed-effects Poisson regression to determine fixed-effects of individual-level factors and hospital level factors associated with inappropriate blood requests. P-value Factors significantly associated with inappropriate requisition were; reporting pulse rate and capillary refill decrease the risk (RR 0.74; 95% CI 0.64, 0.84) and (RR 0.73; 95% CI 0.63, 0.85) respectively and the following increased the risk; having surgery during hospital stay (RR 1.22; 95% CI 1.06, 1.4); being in general surgical ward (RR 3.3; 95% CI 2.7, 4.2), paediatric ward (RR 1.8; 95% CI 1.2, 2.7), obstetric ward (RR 2.5; 95% CI 2.0, 3.1), gynaecological ward (RR 2.1; 95% CI 1.5, 2.9), orthopaedics ward (RR 3.8; 95% CI 2.2, 6.7). Age of the patient, pallor and confirmation of pre-transfusion haemoglobin level were also significantly associated with inappropriate requisition. Majority of appropriate requisitions within the wards were marked in internal medicine (91.7%) and gynaecological wards (77.8%). The proportion of inappropriate blood requests was high. Blood requisition was determined by clinical and laboratory findings and the ward patients were admitted to. Adherence to transfusion guidelines is recommended to assure the best use of limited blood supply.

Design and methods of the Echo WISELY (Will Inappropriate Scenarios for Echocardiography Lessen SignificantlY) study: An investigator-blinded randomized controlled trial of education and feedback intervention to reduce inappropriate echocardiograms.

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Bhatia, R Sacha; Ivers, Noah; Yin, Cindy X; Myers, Dorothy; Nesbitt, Gillian; Edwards, Jeremy; Yared, Kibar; Wadhera, Rishi; Wu, Justina C; Wong, Brian; Hansen, Mark; Weinerman, Adina; Shadowitz, Steven; Johri, Amer; Farkouh, Michael; Thavendiranathan, Paaladinesh; Udell, Jacob A; Rambihar, Sherryn; Chow, Chi-Ming; Hall, Judith; Thorpe, Kevin E; Rakowski, Harry; Weiner, Rory B

2015-08-01

Appropriate use criteria (AUC) for transthoracic echocardiography (TTE) were developed to address concerns regarding inappropriate use of TTE. A previous pilot study suggests that an educational and feedback intervention can reduce inappropriate TTEs ordered by physicians in training. It is unknown if this type of intervention will be effective when targeted at attending level physicians in a variety of clinical settings. The aim of this international, multicenter study is to evaluate the hypothesis that an AUC-based educational and feedback intervention will reduce the proportion of inappropriate echocardiograms ordered by attending physicians in the ambulatory environment. In an ongoing multicentered, investigator-blinded, randomized controlled trial across Canada and the United States, cardiologists and primary care physicians practicing in the ambulatory setting will be enrolled. The intervention arm will receive (1) a lecture outlining the AUC and most recent available evidence highlighting appropriate use of TTE, (2) access to the American Society of Echocardiography mobile phone app, and (3) individualized feedback reports e-mailed monthly summarizing TTE ordering behavior including information on inappropriate TTEs and brief explanations of the inappropriate designation. The control group will receive no education on TTE appropriate use and order TTEs as usual practice. The Echo WISELY (Will Inappropriate Scenarios for Echocardiography Lessen Significantly in an education RCT) study is the first multicenter randomized trial of an AUC-based educational intervention. The study will examine whether an education and feedback intervention will reduce the rate of outpatient inappropriate TTEs ordered by attending level cardiologists and primary care physicians (www.clinicaltrials.gov identifier NCT02038101). Copyright © 2015 Elsevier Inc. All rights reserved.

Grain Handling and Storage.

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Harris, Troy G.; Minor, John

This text for a secondary- or postecondary-level course in grain handling and storage contains ten chapters. Chapter titles are (1) Introduction to Grain Handling and Storage, (2) Elevator Safety, (3) Grain Grading and Seed Identification, (4) Moisture Control, (5) Insect and Rodent Control, (6) Grain Inventory Control, (7) Elevator Maintenance,…

Development of new taxonomy of inappropriate communication and its application to operating teams in nuclear power plants

International Nuclear Information System (INIS)

Kim, Ar Ryum; Lee, Seung Woo; Jang, In Seok; Kang, Hyun Gook; Seong, Poong Hyun; Park, Jin Kyun

2012-01-01

Inappropriate communications can cause a lack of necessary information exchange between operators and lead to serious consequences in large process systems such as nuclear power plants (NPPs). In this regard, various kinds of taxonomies of inappropriate communications have been developed to prevent inappropriate communications. However, there seems to be difficult to identify inappropriate communications from verbal protocol data between operators. Because the existing taxonomies were developed for use in report analysis, there is a problem of 'uncertainty'. In consequence, this paper proposes a new taxonomy of inappropriate communications and provides some insights to prevent inappropriate communications. In order to develop the taxonomy, existing taxonomies for four industries from 1980 to 2010 were collected and a new taxonomy is developed based on the simplified one-way communication model. In addition, the ratio of inappropriate communications from 8 samples of audio-visual format verbal protocol data recorded during emergency training sessions by operating teams is compared with performance scores calculated based on the task analysis. As a result, inappropriate communications can be easily identified from the verbal protocol data using the suggested taxonomy, and teams with a higher ratio of inappropriate communications tend to have a lower performance score.

Development of new taxonomy of inappropriate communication and its application to operating teams in nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Kim, Ar Ryum; Lee, Seung Woo; Jang, In Seok; Kang, Hyun Gook; Seong, Poong Hyun [Dept. of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Park, Jin Kyun [Integrated Safety Assessment Division, Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2012-12-15

Inappropriate communications can cause a lack of necessary information exchange between operators and lead to serious consequences in large process systems such as nuclear power plants (NPPs). In this regard, various kinds of taxonomies of inappropriate communications have been developed to prevent inappropriate communications. However, there seems to be difficult to identify inappropriate communications from verbal protocol data between operators. Because the existing taxonomies were developed for use in report analysis, there is a problem of 'uncertainty'. In consequence, this paper proposes a new taxonomy of inappropriate communications and provides some insights to prevent inappropriate communications. In order to develop the taxonomy, existing taxonomies for four industries from 1980 to 2010 were collected and a new taxonomy is developed based on the simplified one-way communication model. In addition, the ratio of inappropriate communications from 8 samples of audio-visual format verbal protocol data recorded during emergency training sessions by operating teams is compared with performance scores calculated based on the task analysis. As a result, inappropriate communications can be easily identified from the verbal protocol data using the suggested taxonomy, and teams with a higher ratio of inappropriate communications tend to have a lower performance score.

[Impact of potentially inappropriate drug usage on health insurance business results].

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Kirschke, Malin; Böhme, Jacqueline

2014-09-01

In Germany a list was drawn up that included 83 potentially inappropriate drugs. The PRISCUS list published in 2010 was intended to highlight certain problems in the pharmakotherapy of elderly patients and serve as a support for improved medicine safety. Almost a third of the insurance portfolio of the HALLESCHE Krankenversicherung aged over 75 years takes drugs that are on the PRISCUS list. Benzodiazepine and Z-drugs are taken most frequently. The costs per insurant with potentially inappropriate medication are on average higher than for policyholders who do not take drugs on the PRISCUS list. The costs per insurant are rising, with an increase in the number of PRISCUS agents being taken as well. However, there is still no scientific proof that potentially inappropriate drugs lead to adverse drug events.

Missed opportunities and inappropriately given vaccines reduce ...

African Journals Online (AJOL)

Objectives: To quantify missed opportunities for immunisation, document reasons for their occurrence and evaluate the extent of inappropriately given vaccine doses. Design: A cross sectional study of children under two years of age attending health facilities. Setting: Six health facilities predominantly serving the slums of ...

The Association between Inappropriate Weight Control Behaviors and Suicide Ideation and Attempt among Korean Adolescents.

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Lee, Sang Ah; Jang, Suk Yong; Shin, Jaeyong; Ju, Yeong Jun; Nam, Jin Young; Park, Eun Cheol

2016-10-01

Suicide is a leading cause of death among adolescents globally, and body weight is also a recognized reason for adolescent suicide. Therefore, we investigated the association between weight control behaviors (WCB) and suicide ideation and attempt, focusing on inappropriate weight control measures. We used data from the 2014 Korea Youth Risk Behavior Web-based Survey, representing a total of 35,224 boys and 34,361 girls aged 12 to 18 years. Adolescents were classified into groups based on WCB: appropriate WCB, inappropriate WCB, and no WCB. We performed logistic regression models to examine associations between WCB and suicide ideation and attempt, controlling for covariates. Both boys and girls with inappropriate WCB were more likely to report suicide ideation and attempt. Underweight and normal weight boys with inappropriate WCB were more likely to think or attempt suicide, and underweight girls with inappropriate WCB were also more likely to attempt suicide. Among five common WCB combinations, the combination of "regular exercise, fasting, eating less" was highly associated with suicide ideation and attempt. We confirmed that inappropriate WCB is associated with suicide ideation and attempt among Korean adolescents. Given the high incidence rate of suicide among adolescents and the adverse effect of inappropriate WCB, encouraging adolescents to control their weight in healthy ways is imperative.

Inappropriate secretion of antidiuretic hormone treated with frusemide.

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Decaux, G; Waterlot, Y; Genette, F; Hallemans, R; Demanet, J C

1982-07-10

Seven out of nine patients with chronic inappropriate secretion of antidiuretic hormone were successfully treated with 40 mg frusemide daily. One patient needed 80 mg, and the remaining patient achieved only a small increase in diuresis after 40 mg frusemide; this was probably related to his low creatinine clearance. In order to maintain a salt intake high enough to compensate for the loss of urine electrolytes 3 to 6 g sodium chloride was added as tablets to the sodium-free diet in six patients. Hypokalaemia occurred in five patients but was easily corrected with either supplements of potassium chloride or a potassium-sparing diuretic. These findings add further weight to evidence that Frusemide is a good alternative for the treatment of patients with inappropriate secretion of antidiuretic hormone who cannot tolerate water restriction.

Solar applications analysis for energy storage

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Blanchard, T.

1980-01-01

The role of energy storage as it relates to solar energy systems is considered. Storage technologies to support solar energy applications, the status of storage technologies, requirements and specifications for storage technologies, and the adequacy of the current storage research and development program to meet these requirements are among the factors discussed. Emphasis is placed on identification of where the greatest potential exists for energy storage in support of those solar energy systems which could have a significant impact on the U.S. energy mix.

Children's Context Inappropriate Anger and Salivary Cortisol

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Locke, Robin L.; Davidson, Richard J.; Kalin, Ned H.; Goldsmith, H. Hill

2009-01-01

Some children show emotion that is not consistent with normative appraisal of the context and can therefore be defined as context inappropriate (CI). The authors used individual growth curve modeling and hierarchical multiple regression analyses to examine whether CI anger predicts differences in hypothalamic-pituitary-adrenal axis activity, as…

Potentially inappropriate medication use: the Beers' Criteria used among older adults with depressive symptoms

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Lee D

2013-09-01

Full Text Available INTRODUCTION: The ageing population means prescribing for chronic illnesses in older people is expected to rise. Comorbidities and compromised organ function may complicate prescribing and increase medication-related risks. Comorbid depression in older people is highly prevalent and complicates medication prescribing decisions. AIM: To determine the prevalence of potentially inappropriate medication use in a community-dwelling population of older adults with depressive symptoms. METHODS: The medications of 191 community-dwelling older people selected because of depressive symptoms for a randomised trial were reviewed and assessed using the modified version of the Beers' Criteria. The association between inappropriate medication use and various population characteristics was assessed using Chi-square statistics and logistic regression analyses. RESULTS: The mean age was 81 (±4.3 years and 59% were women. The median number of medications used was 6 (range 1-21 medications. The most commonly prescribed potentially inappropriate medications were amitriptyline, dextropropoxyphene, quinine and benzodiazepines. Almost half (49% of the participants were prescribed at least one potentially inappropriate medication; 29% were considered to suffer significant depressive symptoms (Geriatric Depression Scale ≥5 and no differences were found in the number of inappropriate medications used between those with and without significant depressive symptoms (Chi-square 0.005 p=0.54. DISCUSSION: Potentially inappropriate medication use, as per the modified Beers' Criteria, is very common among community-dwelling older people with depressive symptoms. However, the utility of the Beers' Criteria is lessened by lack of clinical correlation. Ongoing research to examine outcomes related to apparent inappropriate medication use is needed.

Potentially inappropriate medication use among institutionalized elderly individuals in southeastern Brazil

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Mauro Cunha Xavier Pinto

2013-12-01

Full Text Available In recent decades, the elderly population in Brazil has grown rapidly, as has concern for the health of this population. Institutionalization in nursing homes has appeared as an alternative form of health care for frail elderly that live alone. The present study evaluated the pharmacotherapy and inappropriate drug prescriptions for institutionalized elderly patients living in long-term institutions in southeastern Brazil. This research was conducted at five institutions with a total sample of 151 individuals aged at least 60 years. Databases were used to identify drug interactions, defined daily dose and inappropriate prescriptions. The prevalence of drug intake among the elderly was 95.36%, and there were an average of 3.31 ± 1.80 drug prescriptions per individual. Based on Beers criteria, the prevalence of inappropriate prescriptions was 25.83%. In addition, 70.2% of prescriptions were prescribed at a higher dosage than the defined daily dose (ATC/WHO. Potential drug interactions were identified for 54.11% of prescriptions; 81.42% of these were of moderate severity. The main inappropriate drugs were prescribed for cardiovascular and nervous system problems. Institutionalized elderly individuals presented a high consumption and misuse of medications, requiring professional intervention to monitor prescriptions and improve the quality of service for this population.

Electromagnetic Interference from Swimming Pool Generator Current Causing Inappropriate ICD Discharges

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Edward Samuel Roberto

2017-01-01

Full Text Available Electromagnetic interference (EMI includes any electromagnetic field signal that can be detected by device circuitry, with potentially serious consequences: incorrect sensing, pacing, device mode switching, and defibrillation. This is a unique case of extracardiac EMI by alternating current leakage from a submerged motor used to recycle chlorinated water, resulting in false rhythm detection and inappropriate ICD discharge. A 31-year-old female with arrhythmogenic right ventricular cardiomyopathy and Medtronic dual-chamber ICD placement presented after several inappropriate ICD shocks at the public swimming pool. Patient had never received prior shocks and device was appropriate at all regular follow-ups. Intracardiac electrograms revealed unique, high-frequency signals at exactly 120 msec suggestive of EMI from a strong external source of alternating current. Electrical artifact was incorrectly sensed as a ventricular arrhythmia which resulted in discharge. ICD parameters including sensing, pacing thresholds, and impedance were all normal suggesting against device malfunction. With device failure and intracardiac sources excluded, EMI was therefore strongly suspected. Avoidance of EMI source brought complete resolution with no further inappropriate shocks. After exclusion of intracardiac interference, device malfunction, and abnormal settings, extracardiac etiologies such as EMI must be thoughtfully considered and excluded. Elimination of inappropriate shocks is to “first, do no harm.”

Functional Analysis and Reduction of Inappropriate Spitting

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Carter, Stacy L.; Wheeler, John J.

2007-01-01

Functional analysis was used to determine the possible function of inappropriate spitting behavior of an adult woman who had been diagnosed with profound mental retardation. Results of an initial descriptive assessment indicated a possible attention function and led to an attention-based intervention, which was deemed ineffective at reducing the…

Inappropriate self-medication among adolescents and its association with lower medication literacy and substance use.

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Chun-Hsien Lee

Full Text Available While self-medication is common, inappropriate self-medication has potential risks. This study assesses inappropriate self-medication among adolescents and examines the relationships among medication literacy, substance use, and inappropriate self-medication.In 2016, a national representative sample of 6,226 students from 99 primary, middle, and high schools completed an online self-administered questionnaire. Multiple logistic regression analysis was used to examine factors related to inappropriate self-medication.The prevalence of self-medication in the past year among the adolescents surveyed was 45.8%, and the most frequently reported drugs for self-medication included nonsteroidal anti-inflammatory drugs or pain relievers (prevalence = 31.1%, cold or cough medicines (prevalence = 21.6%, analgesics (prevalence = 19.3%, and antacids (prevalence = 17.3%. Of the participants who practiced self-medication, the prevalence of inappropriate self-medication behaviors included not reading drug labels or instructions (10.1%, using excessive dosages (21.6%, and using prescription and nonprescription medicine simultaneously without advice from a health provider (polypharmacy (30.3%. The results of multiple logistic regression analysis showed that after controlling for school level, gender, and chronic diseases, the participants with lower medication knowledge, lower self-efficacy, lower medication literacy, and who consumed tobacco or alcohol were more likely to engage in inappropriate self-medication.Lower medication literacy and substance use were associated with inappropriate self-medication among adolescents.

The inappropriate use of lumbar magnetic resonance imaging in a health service area

International Nuclear Information System (INIS)

Rodriguez Recio, F. J.; Sanz, J. C.; Vera, S.; Peiro, S.

1999-01-01

To identify the percentage of inappropriate lumbar spine magnetic resonance imaging in the Soria Health Service, to quantify the costs and the possible association between inadequate use, the characteristics of the patient and the services requested. A descriptive study of the inappropriate use of MRI of the lumbar spine, taken from the retrospective examination, carried out by a radiologist, of the 233 MRI's requested between 1995 and 1998. For the valuation, the criteria of the American College of Radiology (ACR) and the Basque Agency for the Evaluation of Technologies (OSTEBA) were used. All the MRI's were carried out at an approved centre, the costs were calculated taken form the expenses paid by the Insalud, including the transport costs, calculated at prices applicable for the year in question. 11.7% of the studies were values as inappropriate, 2.1% debatable and the remainder adequate according to the ACR criteria, concentrating the inadequacy on studies for lumbago, that reached 80% of the inappropriate requests. The ACR and OSTEBA criteria coincided to a high degree (kappa statistics: 0.87). The expense related to the unnecessary studies was a litter higher than a million pesetas. No differences were found in the proportion of inappropriate studies according to the characteristics of the patient or the service requested, except the one already mentioned for the supposition diagnosis. Although the results of the study cannot be generalised to other environments, they suggest the possibility of a significant proportion of inappropriate use of lumbar spine MRI that could have an important repercussion on health care expenses. (Author) 11 refs

Heart failure severity, inappropriate ICD therapy, and novel ICD programming: a MADIT-RIT substudy.

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Daimee, Usama A; Vermilye, Katherine; Rosero, Spencer; Schuger, Claudio D; Daubert, James P; Zareba, Wojciech; McNitt, Scott; Polonsky, Bronislava; Moss, Arthur J; Kutyifa, Valentina

2017-12-01

The effects of heart failure (HF) severity on risk of inappropriate implantable cardioverter-defibrillator (ICD) therapy have not been thoroughly investigated. We aimed to study the association between HF severity and inappropriate ICD therapy in MADIT-RIT. MADIT-RIT randomized 1,500 patients to three ICD programming arms: conventional (Arm A), high-rate cut-off (Arm B: ≥200 beats/min), and delayed therapy (Arm C: 60-second delay for ≥170 beats/min). We evaluated the association between New York Heart Association (NYHA) class III (n = 256) versus class I-II (n = 251) and inappropriate ICD therapy in Arm A patients with ICD-only and cardiac resynchronization therapy with defibrillator (CRT-D). We additionally assessed benefit of novel ICD programming in Arms B and C versus Arm A by NYHA classification. In Arm A, the risk of inappropriate therapy was significantly higher in those with NYHA III versus NYHA I-II for both ICD (hazard ratio [HR] = 2.55, confidence interval [CI]: 1.51-4.30, P programming significantly reduced inappropriate therapy in patients with both NYHA III (Arm B vs Arm A: HR = 0.08, P programming with high-rate cut-off or delayed detection reduces inappropriate ICD therapies in both mild and moderate HF. © 2017 Wiley Periodicals, Inc.

Cost analysis of inappropriate treatments for suspected dermatomycoses

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Emanuela Fiammenghi

2015-06-01

Full Text Available Superficial mycoses are estimated to affect more than 20-25% of the world’s population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1 to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2 to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital “ Federico II” in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination were defined as inappropriate: (1 cortisone in a patient with at least one positive site; (2 antifungals in (a patients with all negative sites or (b ineffective antifungal treatment (in terms of drug chosen, dose or duration in those with all positive sites; or (3 antibiotics; (4 antivirals or (5 antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease

Using a social story intervention to decrease inappropriate behavior of preschool children with autism

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Angkhana Khantreejitranon

2018-01-01

Full Text Available This research investigated the inappropriate behavior of preschool children with autism in a classroom and examined the effectiveness of the use of social stories to decrease inappropriate autistic behavior. An A-B-A-B single subject design was used across the five participants selected for the study. Investigating the problematic social skills and developing a social story intervention for the preschool autistic children was completed, followed by an examination of the effectiveness of the social story intervention. Ten common problematic social skills among the autistic children in preschool were identified—walking around, making loud noises, not sharing their toys with others, showing frustration when feeling unsatisfied, having no patience, not putting toys away when finished, taking other people's belongings without permission, not knowing how to greet others, destroying things when feeling frustrated, and giving a hug to other people at inappropriate times. It was found that the social story intervention helped to decrease inappropriate behavior in children with autism. The social story intervention consisted of five social story books and five e-books (one story per child using a single subject design with an A-B-A-B pattern. The autistic children preferred social stories from the hardcopy books compared with stories from the e-books. A fourth stage time trial was used over 6 weeks, five times per week, for a total of 30 times. The findings suggested that the use of properly constructed social stories can be effective in decreasing the inappropriate behavior of children with autism. However, each story intervention should be applied with caution because of individual differences between children. The social story intervention should be designed only for autistic children who exhibit specific inappropriate social behavior. Keywords: autistic child, inappropriate behavior, social skills, social story

Explicit versus implicit evaluation to detect inappropriate medication use in geriatric outpatients.

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Bahat, Gulistan; Ilhan, Birkan; Bay, Ilker; Kilic, Cihan; Kucukdagli, Pinar; Oren, Meryem Merve; Karan, Mehmet Akif

2018-04-19

The rates and reasons why clinicians decide not to follow recommendations from explicit-criteria have been studied scarce. We aimed to compare STOPP version 2 representing one of the most commonly used excplicit tool with the implicit comprehensive geriatric assessment mediated clinical evaluation considered as gold standard. Two hundred and six (n = 206) outpatients ≥65 years old were included. The study was designed as retrospective, cross-sectional, and randomised. STOPP version 2 criteria were systematically used to assess pre-admission treatments followed by implicit clinical evaluation regarding two questions: Were the STOPP criteria recommendations valid for the individual patient and were there any potentially inappropriate-prescription other than depicted by STOPP version 2 criteria? The underlying reason(s) and associated clinical-features were noted. About 62.6% potentially inappropriate-prescriptions were identified (0.6 per-subject) according to systematic application of STOPP v2 while it was 53.4% (0.5 potentially inappropriate-prescriptions per subject) by clinician's application of STOPP v2. Prevalence of non-compliance was 14.7% in 18 (21.7%) of 83 patients identified by systematic application. Suggestion to stop a drug was not accepted because of need of treatment despite likelihood of anticipated side-effects in about 2/3 and with no-anticipated side-effects in about 1/3 of non-compliances. Not following STOPP v2 was significantly associated with lower functional level. According to clinician's implicit-evaluation, there were an extra 59.2% potentially inappropriate-prescriptions (0.6 per subject) in 80 (38.8%) patients yielding a total of 112.6% potentially inappropriate-prescription. Most of the STOPP v2 directed drug cessations are decided valid by the clinicians. In patients with higher functional dependency, it is likely that they are not followed due to palliation focussed care/patient-family preferences. There may be as much as STOPP

Potentially inappropriate prescribing in elderly population: A study in medicine out-patient department

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Ajit Kumar Sah

2017-03-01

Full Text Available Background & Objectives: Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The study was conducted with objectives to determine the prevalence of potentially inappropriate medicine (PIM prescribing in older Nepalese patients in a medicine outpatient department.Materials & Methods: A prospective observational analysis of drugs prescribed in medicine out-patient department (OPD of a tertiary hospital of central Nepal was conducted during November 2012 to October 2013 among 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM in elderly patients was analysed using Beer’s Criteria updated to 2013. Results: In the 869 patients included, the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%, amlodipine (23.16%, paracetamol (17.6%, salbutamol (15.72% and vitamin B complex (13.26%. The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Conclusion: Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with number of medications prescribed. Further research is warranted to study the impact of PIMs towards health related outcomes in these elderly.

Unveiling common responses of Medicago truncatula to appropriate and inappropriate rust species

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Vaz Patto, Maria Carlota; Rubiales, Diego

2014-01-01

Little is known about the nature of effective defense mechanisms in legumes to pathogens of remotely related plant species. Some rust species are among pathogens with broad host range causing dramatic losses in various crop plants. To understand and compare the different host and nonhost resistance (NHR) responses of legume species against rusts, we characterized the reaction of the model legume Medicago truncatula to one appropriate (Uromyces striatus) and two inappropriate (U. viciae-fabae and U. lupinicolus) rusts. We found that similar pre and post-haustorial mechanisms of resistance appear to be operative in M. truncatula against appropriate and inappropriate rust fungus. The appropriate U. striatus germinated better on M. truncatula accessions then the inappropriate U. viciae-fabae and U. lupinicolus, but once germinated, germ tubes of the three rusts had a similar level of success in finding stomata and forming an appressoria over a stoma. However, responses to different inappropriate rust species also showed some specificity, suggesting a combination of non-specific and specific responses underlying this legume NHR to rust fungi. Further genetic and expression analysis studies will contribute to the development of the necessary molecular tools to use the present information on host and NHR mechanisms to breed for broad-spectrum resistance to rust in legume species. PMID:25426128

Unveiling common responses of Medicago truncatula to appropriate and inappropriate rust species

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Maria Carlota eVaz Patto

2014-11-01

Full Text Available Little is known about the nature of effective defense mechanisms in legumes to pathogens of remotely related plant species. Some rust species are among pathogens with broad host range causing dramatic losses in various crop plants. To understand and compare the different host and nonhost resistance responses of legume species against rusts, we characterized the reaction of the model legume Medicago truncatula to one appropriate (Uromyces striatus and two inappropriate (U. viciae-fabae and U. lupinicolus rusts. We found that similar pre and post-haustorial mechanisms of resistance appear to be operative in M. truncatula against appropriate and inappropriate rust fungus. The appropriate U. striatus germinated better on M. truncatula accessions then the inappropriate U. viciae-fabae and U. lupinicolus, but once germinated, germ tubes of the three rusts had a similar level of success in finding stomata and forming an appressoria over a stoma. However responses to different inappropriate rust species also showed some specificity, suggesting a combination of non specific and specific responses underlying this legume nonhost resistance to rust fungi. Further genetic and expression analysis studies will contribute to the development of the necessary molecular tools to use the present information on host and nonhost resistance mechanisms to breed for broad-spectrum resistance to rust in legume species.

Utilization of potentially inappropriate medications in elderly patients in a tertiary care teaching hospital in India

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Binit N Jhaveri

2014-01-01

Full Text Available Aim: To evaluate the use of potentially inappropriate medicines in elderly inpatients in a tertiary care teaching hospital. Materials and Methods: Retrospective analysis was performed for cases of elderly patients admitted between January 2010 and December 2010. Data on age, gender, diagnosis, duration of hospital stay, treatment, and outcome were collected. Prescriptions were assessed for the use of potentially inappropriate medications in geriatric patients by using American Geriatric Society Beer′s criteria (2012 and PRISCUS list (2010. Results: A total of 676 geriatric patients (52.12% females were admitted in the medicine ward. The average age of geriatric patients was 72.69 years. According to Beer′s criteria, at least one inappropriate medicine was prescribed in 590 (87.3% patients. Metoclopramide (54.3%, alprazolam (9%, diazepam (8%, digoxin > 0.125 mg/day (5%, and diclofenac (3.7% were the commonly used inappropriate medications. Use of nonsteroidal anti-inflammatory drugs (NSAIDs in heart and renal failure patients was the commonly identified drug-disease interaction. According to PRISCUS list, at least one inappropriate medication was prescribed in 210 (31.06% patients. Conclusion: Use of inappropriate medicines is highly prevalent in elderly patients.

Factors predisposing nursing home resident to inappropriate transfer to emergency department. The FINE study protocol

Directory of Open Access Journals (Sweden)

Amélie Perrin

2017-09-01

Full Text Available Background: Each year, around one out of two nursing home (NH residents are hospitalized in France, and about half to the emergency department (ED. These transfers are frequently inappropriate. This paper describes the protocol of the FINE study. The first aim of this study is to identify the factors associated with inappropriate transfers to ED. Methods/design: FINE is a case-control observational study. Sixteen hospitals participate. Inclusion period lasts 7 days per season in each center for a total period of inclusion of one year. All the NH residents admitted in ED during these periods are included. Data are collected in 4 times: before transfer in the NH, at the ED, in hospital wards in case of patient's hospitalization and at the patient's return to NH. The appropriateness of ED transfers (i.e. case versus control NH residents is determined by a multidisciplinary team of experts. Results: Our primary objective is to determine the factors predisposing NH residents to inappropriate transfer to ED. Our secondary objectives are to assess the cost of the transfers to ED; study the evolution of NH residents' functional status and the psychotropic and inappropriate drugs prescription between before and after the transfer; calculate the prevalence of potentially avoidable transfers to ED; and identify the factors predisposing NH residents to potentially avoidable transfer to ED. Discussion: A better understanding of the determinant factors of inappropriate transfers to ED of NH residents may lead to proposals of recommendations of better practice in NH and would allow implementing quality improvement programs in the health organization. Keywords: Inappropriate transfer, Nursing home resident, Emergency department transfer, Potentially avoidable transfer, Appropriateness of transfer, Inappropriate hospitalization

Impact of a warning CPOE system on the inappropriate pill splitting of prescribed medications in outpatients.

Directory of Open Access Journals (Sweden)

Chia-Chen Hsu

Full Text Available Prescribing inappropriate pill splitting is not rare in clinical practice. To reduce inappropriate pill splitting, we developed an automatic warning system linked to a computerized physician order entry (CPOE system for special oral formulation drugs in outpatient settings. We examined the impact of the warning system on inappropriate prescribing of pill splitting and assess prescribers' responses to the warnings.Drugs with extended-release or enteric-coated formulations that were not originally intended to be split were recognized as "special oral formulations". A hard-stop system which could examine non-integer doses of drugs with special oral formulations, provide warnings to interrupt inappropriate prescriptions was integrated in CPOE in a medical center since June 2010. We designed an intervention study to compare the inappropriate splitting before and after the implementation of the warning system (baseline period 2010 January to May vs. intervention period 2010 June to 2011 August. During the intervention period, prescription changes in response to a warning were logged and analyzed.A total of 470,611 prescribed drug items with 34 different drugs with special oral formulations were prescribed in the study period. During the 15-month intervention period, 909 warnings for 26 different drugs were triggered among 354,523 prescribed drug items with special oral formulations. The warning rate of inappropriate splitting in the late intervention period was lower than those in baseline period (0.16% vs. 0.61%, incidence rate ratio 0.27, 95% CI 0.23-0.31, P<0.001. In respond to warnings, physicians had to make adjustments, of which the majority was changing to an unsplit pill (72.9%.The interruptive warning system could avoid the prescriptions with inappropriate pill splitting. Accordingly, physicians changed their behavior of prescribing special oral formulations regarding inappropriate pill splitting. We suggest the establishment of such system

Novel ICD Programming and Inappropriate ICD Therapy in CRT-D Versus ICD Patients: A MADIT-RIT Sub-Study.

Science.gov (United States)

Kutyifa, Valentina; Daubert, James P; Schuger, Claudio; Goldenberg, Ilan; Klein, Helmut; Aktas, Mehmet K; McNitt, Scott; Stockburger, Martin; Merkely, Bela; Zareba, Wojciech; Moss, Arthur J

2016-01-01

The Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate therapy (MADIT-RIT) trial showed a significant reduction in inappropriate implantable cardioverter defibrillator (ICD) therapy in patients programmed to high-rate cut-off (Arm B) or delayed ventricular tachycardia therapy (Arm C), compared with conventional programming (Arm A). There is limited data on the effect of cardiac resynchronization therapy with a cardioverter defibrillator (CRT-D) on the effect of ICD programming. We aimed to elucidate the effect of CRT-D on ICD programming to reduce inappropriate ICD therapy in patients implanted with CRT-D or an ICD, enrolled in MADIT-RIT. The primary end point of this study was the first inappropriate ICD therapy. Secondary end points were inappropriate anti-tachycardia pacing and inappropriate ICD shock. The study enrolled 742 (49%) patients with an ICD and 757 (51%) patients with a CRT-D. Patients implanted with a CRT-D had 62% lower risk of inappropriate ICD therapy than those with an ICD only (hazard ratio [HR] =0.38, 95% confidence interval: 0.25-0.57; Pprogramming significantly reduced the risk of inappropriate ICD therapy compared with conventional ICD programming in ICD (HR=0.14 [B versus A]; HR=0.21 [C versus A]) and CRT-D patients (HR=0.15 [B versus A]; HR=0.23 [C versus A]; Pprogramming significantly reduces the risk of inappropriate ICD therapy in both ICD and CRT-D patients. http://clinicaltrials.gov; Unique identifier: NCT00947310. © 2016 American Heart Association, Inc.

[Reasons for inappropriate prescribing of antibiotics in a high-complexity pediatric hospital].

Science.gov (United States)

Ruvinsky, Silvina; Mónaco, Andrea; Pérez, Guadalupe; Taicz, Moira; Inda, Laura; Kijko, Ivana; Constanzo, Patricia; Bologna, Rosa

2011-12-01

Determine the reasons for inappropriate prescription of antibiotics and identify opportunities to improve prescription of these drugs in pediatric patients hospitalized in intermediate and intensive care units. A prospective, descriptive longitudinal study was conducted of pediatric patients in intermediate and intensive care units who received parenteral administration of antibiotics, with the exception of newborns, burn unit patients, and surgical prophylaxis patients. A univariate analysis and multiple logistic regression were performed. A total of 376 patients with a median of age of 50 months were studied (interquartile range [IQR] 14.5-127 months). Out of the total patients studied, 75% had one or more underlying conditions. A total of 40.6% of these patients had an oncologic pathology and 33.5% had neurological conditions. The remaining 25.9% had other underlying conditions. Antibiotic treatment was inappropriate in 35.6% of the patients studied (N = 134). In 73 (54.4%) of the 134 cases, inappropriate use was due to the type of antibiotic prescribed, the dose administered, or the treatment period. The 61 (45.5%) remaining cases did not require antibiotic treatment. In the multivariate analysis, the risk factors for inappropriate use of antibiotics were: administration of ceftriaxone OR 2 (95% CI, 1.3-3.7; P = 0.02); acute lower respiratory tract infection OR 1.8 (95% CI, 1.1-3.3; P < 0.04); onset of fever of unknown origin in hospital inpatients OR 5.55 (95% CI, 2.5-12; P < 0.0001); and febrile neutropenia OR 0.3 (95% CI, 0.1-0.7; P = 0.009). Inappropriate use of antibiotics was less common in the clinical conditions that were well-characterized. Prescribing practices that could be improved were identified through the preparation and circulation of guidelines for antibiotic use in hospital inpatients.

Inappropriate use of urinary catheters in patients admitted to medical wards in a university hospital.

Science.gov (United States)

Fernández-Ruiz, Mario; Calvo, Beatriz; Vara, Rebeca; Villar, Rocío N; Aguado, José María

2013-10-01

The prevalence and predisposing factors were determined for inappropriate urinary catheterization (UC) among inpatients in medical wards. A cross-sectional study was conducted including all patients aged ≥ 18 years admitted to medical wards in a 1300-bed tertiary-care centre, and who had a urinary catheter in place on the day of the survey. Of 380 patients observed, 46 (12.1%) had a urinary catheter in place. Twelve of them (26.1%) were inappropriately catheterized. The most common indication for inappropriate UC was urine output monitoring in a cooperative, non-critically ill patient. Inappropriateness was associated with increased age, poor functional status, urinary incontinence, dementia, and admission from a long-term care facility. Further educational efforts should be focused on improving catheterization prescribing practices by physicians. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Inappropriate prescribing of proton pump inhibitors among patients ...

African Journals Online (AJOL)

By comparing the patients according to their site of care, 52.4 % (43/82) of ICU patients compared to 87.4 % (97/111) of medically hospitalized patient (non-ICU) were inappropriately receiving PPIs (p = 0.000). Conclusion: Adherence to the current practice guidelines for safe prescription of PPIs is poor. Thus, updating ...

Identification of energy storage rate components. Theoretical and experimental approach

International Nuclear Information System (INIS)

Oliferuk, W; Maj, M

2010-01-01

The subject of the present paper is decomposition of energy storage rate into terms related to different mode of deformation. The stored energy is the change in internal energy due to plastic deformation after specimen unloading. Hence, this energy describes the state of the cold-worked material. Whereas, the ratio of the stored energy increment to the appropriate increment of plastic work is the measure of energy conversion process. This ratio is called the energy storage rate. Experimental results show that the energy storage rate is dependent on plastic strain. This dependence is influenced by different microscopic deformation mechanisms. It has been shown that the energy storage rate can be presented as a sum of particular components. Each of them is related to the separate internal microscopic mechanism. Two of the components are identified. One of them is the storage rate of statistically stored dislocation energy related to uniform deformation. Another one is connected with non-uniform deformation at the grain level. It is the storage rate of the long range stresses energy and geometrically necessary dislocation energy. The maximum of energy storage rate, that appeared at initial stage of plastic deformation is discussed in terms of internal micro-stresses.

Cryptography from noisy storage.

Science.gov (United States)

Wehner, Stephanie; Schaffner, Christian; Terhal, Barbara M

2008-06-06

We show how to implement cryptographic primitives based on the realistic assumption that quantum storage of qubits is noisy. We thereby consider individual-storage attacks; i.e., the dishonest party attempts to store each incoming qubit separately. Our model is similar to the model of bounded-quantum storage; however, we consider an explicit noise model inspired by present-day technology. To illustrate the power of this new model, we show that a protocol for oblivious transfer is secure for any amount of quantum-storage noise, as long as honest players can perform perfect quantum operations. Our model also allows us to show the security of protocols that cope with noise in the operations of the honest players and achieve more advanced tasks such as secure identification.

Polypharmacy and Potentially Inappropriate Medication in People with Dementia

DEFF Research Database (Denmark)

Kristensen, Rachel Underlien; Nørgaard, Ane; Jensen-Dahm, Christina

2018-01-01

BACKGROUND: Polypharmacy (use of ≥5 different medications) and potentially inappropriate medication (PIM) are well-known risk factors for numerous negative health outcomes. However, the use of polypharmacy and PIM in people with dementia is not well-described. OBJECTIVE: To examine the prevalence...

Impact of 2015 Update to the Beers Criteria on Estimates of Prevalence and Costs Associated with Potentially Inappropriate Use of Antimuscarinics for Overactive Bladder.

Science.gov (United States)

Suehs, Brandon T; Davis, Cralen; Ng, Daniel B; Gooch, Katherine

2017-07-01

Research has demonstrated that the use of potentially inappropriate medication (PIM) is highly prevalent among older individuals and may lead to increased healthcare costs, adverse drug reactions, hospitalizations, and mortality. The purpose of this study was to examine the impact of the 2015 updates to the Beers Criteria on estimates of prevalence and cost associated with potentially inappropriate use of antimuscarinic medications indicated for treatment of overactive bladder (OAB). A retrospective database analysis was conducted using a historical cohort design and including data collected between 2007 and 2013. Claims data were used to identify Medicare Advantage patients aged ≥65 years newly initiated on antimuscarinic OAB treatment. Patients were classified with potentially inappropriate use of antimuscarinic OAB drugs based on either the 2012 Beers Criteria or the 2015 Beers Criteria. Prevalence of PIM at the time of antimuscarinic initiation was determined. Bivariate comparisons of healthcare costs and medical condition burden were conducted to compare the marginal groups of patients (who qualified based on the 2012 Beers Criteria only or the 2015 Beers Criteria only). Differences in healthcare costs for patients with and without potentially inappropriate use of urinary antimuscarinics based on the 2012 and 2015 Beers Criteria were also examined. Of 66,275 patients, overall prevalence of potentially inappropriate use of OAB antimuscarinics was higher using 2015 Beers Criteria than when using the 2012 Beers Criteria (25.0 vs. 20.6%). Dementia was the most common PIM-qualifying condition under both versions. The 2015 Beers Criteria identified more females, more White people, and a younger population with PIM. Comorbid medical condition burden was lower using the 2015 Beers Criteria. The 2015 Beers Criteria only group had lower median unadjusted healthcare costs ($7104 vs. 8301; p cost associated with potentially inappropriate use of antimuscarinic

Inappropriate prescribing in geriatric patients.

LENUS (Irish Health Repository)

Barry, Patrick J

2012-02-03

Inappropriate prescribing in older people is a common condition associated with significant morbidity, mortality, and financial costs. Medication use increases with age, and this, in conjunction with an increasing disease burden, is associated with adverse drug reactions. This review outlines why older people are more likely to develop adverse drug reactions and how common the problem is. The use of different tools to identify and measure the problem is reviewed. Common syndromes seen in older adults (eg, falling, cognitive impairment, sleep disturbance) are considered, and recent evidence in relation to medication use for these conditions is reviewed. Finally, we present a brief summary of significant developments in the recent literature for those caring for older people.

Inappropriate prescribing in an acutely ill population of elderly patients as determined by Beers' Criteria.

LENUS (Irish Health Repository)

Gallagher, Paul F

2012-02-03

INTRODUCTION: Adverse drug events (ADEs) are associated with inappropriate prescribing (IP) and result in increased morbidity, mortality and resource utilisation. We used Beers\\' Criteria to determine the three-month prevalence of IP in a non-selected community-dwelling population of acutely ill older people requiring hospitalisation. METHODS: A prospective, observational study of 597 consecutive acute admissions was performed. Diagnoses and concurrent medications were recorded before hospital physician intervention, and Beers\\' Criteria applied. RESULTS: Mean patient age (SD) was 77 (7) years. Median number of medications was 5, range 0-13. IP occurred in 32% of patients (n = 191), with 24%, 6% and 2% taking 1, 2 and 3 inappropriate medications respectively. Patients taking >5 medications were 3.3 times more likely to receive an inappropriate medication than those taking < or =5 medications (OR 3.34: 95%, CI 2.37-4.79; P<0.001). Forty-nine per cent of patients with inappropriate prescriptions were admitted with adverse effects of the inappropriate medications. Sixteen per cent of all admissions were associated with such adverse effects. CONCLUSION: IP is highly prevalent in acutely ill older patients and is associated with polypharmacy and hospitalisation. However, Beers\\' Criteria cannot be used as a gold standard as they do not comprehensively address all aspects of IP in older people.

Inappropriate use of urinary catheters and its common complications in different hospital wards

Directory of Open Access Journals (Sweden)

Parivash Davoodian

2012-01-01

Full Text Available Inappropriate use of indwelling urinary catheters (IUCs and their related complications is one of the most important problems in hospital wards. The aim of this study was to evaluate inappropriate use of IUCs and their complications among patients in Tehran, Iran. Two hundred and six consecutive patients hospitalized in the intensive care unit (ICU as well as medical and surgical wards at the Shahid Mohammadi Hospital in Bandarabbas from September 1 to 30, 2005 and in whom IUCs were used, were studied. Data collected included age of the patients, diagnoses, reason for use of IUC and the complications related to it. Overall, 164 patients (79.6% had IUCs used appropriately while 42 of them (20.6% were catheterized unjustifiably. Inappropriate use of IUCs in the ICU, medical and surgical wards was reported in 12 (18.5%, 16 (19.0% and 14 patients (24.6%, respectively. The most common complication of IUCs was urinary tract infection, which occurred in 91 patients (44.2% and hematuria, which was seen in 3.9% of the patients. Our study suggests that inappropriate use of IUCs is prevalent, particularly in the surgical wards, and the most common complication observed was catheter-associated urinary tract infection.

An automated technique to identify potential inappropriate traditional Chinese medicine (TCM) prescriptions.

Science.gov (United States)

Yang, Hsuan-Chia; Iqbal, Usman; Nguyen, Phung Anh; Lin, Shen-Hsien; Huang, Chih-Wei; Jian, Wen-Shan; Li, Yu-Chuan

2016-04-01

Medication errors such as potential inappropriate prescriptions would induce serious adverse drug events to patients. Information technology has the ability to prevent medication errors; however, the pharmacology of traditional Chinese medicine (TCM) is not as clear as in western medicine. The aim of this study was to apply the appropriateness of prescription (AOP) model to identify potential inappropriate TCM prescriptions. We used the association rule of mining techniques to analyze 14.5 million prescriptions from the Taiwan National Health Insurance Research Database. The disease and TCM (DTCM) and traditional Chinese medicine-traditional Chinese medicine (TCMM) associations are computed by their co-occurrence, and the associations' strength was measured as Q-values, which often referred to as interestingness or life values. By considering the number of Q-values, the AOP model was applied to identify the inappropriate prescriptions. Afterwards, three traditional Chinese physicians evaluated 1920 prescriptions and validated the detected outcomes from the AOP model. Out of 1920 prescriptions, 97.1% of positive predictive value and 19.5% of negative predictive value were shown by the system as compared with those by experts. The sensitivity analysis indicated that the negative predictive value could improve up to 27.5% when the model's threshold changed to 0.4. We successfully applied the AOP model to automatically identify potential inappropriate TCM prescriptions. This model could be a potential TCM clinical decision support system in order to improve drug safety and quality of care. Copyright © 2016 John Wiley & Sons, Ltd.

Performance of high-resolution position-sensitive detectors developed for storage-ring decay experiments

International Nuclear Information System (INIS)

Yamaguchi, T.; Suzaki, F.; Izumikawa, T.; Miyazawa, S.; Morimoto, K.; Suzuki, T.; Tokanai, F.; Furuki, H.; Ichihashi, N.; Ichikawa, C.; Kitagawa, A.; Kuboki, T.; Momota, S.; Nagae, D.; Nagashima, M.; Nakamura, Y.; Nishikiori, R.; Niwa, T.; Ohtsubo, T.; Ozawa, A.

2013-01-01

Highlights: • Position-sensitive detectors were developed for storage-ring decay spectroscopy. • Fiber scintillation and silicon strip detectors were tested with heavy ion beams. • A new fiber scintillation detector showed an excellent position resolution. • Position and energy detection by silicon strip detectors enable full identification. -- Abstract: As next generation spectroscopic tools, heavy-ion cooler storage rings will be a unique application of highly charged RI beam experiments. Decay spectroscopy of highly charged rare isotopes provides us important information relevant to the stellar conditions, such as for the s- and r-process nucleosynthesis. In-ring decay products of highly charged RI will be momentum-analyzed and reach a position-sensitive detector set-up located outside of the storage orbit. To realize such in-ring decay experiments, we have developed and tested two types of high-resolution position-sensitive detectors: silicon strips and scintillating fibers. The beam test experiments resulted in excellent position resolutions for both detectors, which will be available for future storage-ring experiments

Inappropriate use of payment weights to risk adjust readmission rates.

Science.gov (United States)

Fuller, Richard L; Goldfield, Norbert I; Averill, Richard F; Hughes, John S

2012-01-01

In this article, the authors demonstrate that the use of relative weights, as incorporated within the National Quality Forum-endorsed PacifiCare readmission measure, is inappropriate for risk adjusting rates of hospital readmission.

Inappropriate prescribing in the older population: need for new criteria.

LENUS (Irish Health Repository)

O'Mahony, Denis

2012-02-03

Inappropriate prescribing (IP) is a common and serious global healthcare problem in elderly people, leading to increased risk of adverse drug reactions (ADRs), polypharmacy being the main risk factor for both IP and ADRs. IP in older people is highly prevalent but preventable; hence screening tools for IP have been devised, principally Beers\\' Criteria and the Inappropriate Prescribing in the Elderly Tool (IPET). Although Beers\\' Criteria have become the most widely cited IP criteria in the literature, nevertheless, they have serious deficiencies, including several drugs that are rarely prescribed nowadays, a lack of structure in the presentation of the criteria and omission of several important and common IP instances. New, more up-to-date, systems-based and easily applicable criteria are needed that can be applied in the routine clinical setting.

Age-Related Differences in Judgments of Inappropriate Behavior are Related to Humor Style Preferences

Science.gov (United States)

Stanley, Jennifer Tehan; Lohani, Monika; Isaacowitz, Derek M.

2014-01-01

Identifying social gaffes is important for maintaining relationships. Older adults are less able than young to discriminate between socially appropriate and inappropriate behavior in video clips. One open question is how these social appropriateness ratings relate to potential age differences in the perception of what is actually funny or not. In the present study, young, middle-aged, and older adults were equally able to discriminate between appropriate and inappropriate social behavior in a diverse set of clips relevant to both age groups. However, young and middle-aged adults rated the gaffe clips as funnier than control clips and young adults smiled more during the inappropriate clips than the control clips. Older adults did not show this pattern, suggesting that they did not find the inappropriate clips funny. Additionally, young adults endorsed a more aggressive humor style than middle-aged and older adults and aggressive humor style endorsement mediated age differences in social appropriateness ratings. Results are discussed in terms of possible mechanisms such as cohort differences in humor and developmental prioritization of certain humor styles, as well as the importance of investigating age differences in both abilities and preferences. PMID:25244473

Amusia results in abnormal brain activity following inappropriate intonation during speech comprehension.

Science.gov (United States)

Jiang, Cunmei; Hamm, Jeff P; Lim, Vanessa K; Kirk, Ian J; Chen, Xuhai; Yang, Yufang

2012-01-01

Pitch processing is a critical ability on which humans' tonal musical experience depends, and which is also of paramount importance for decoding prosody in speech. Congenital amusia refers to deficits in the ability to properly process musical pitch, and recent evidence has suggested that this musical pitch disorder may impact upon the processing of speech sounds. Here we present the first electrophysiological evidence demonstrating that individuals with amusia who speak Mandarin Chinese are impaired in classifying prosody as appropriate or inappropriate during a speech comprehension task. When presented with inappropriate prosody stimuli, control participants elicited a larger P600 and smaller N100 relative to the appropriate condition. In contrast, amusics did not show significant differences between the appropriate and inappropriate conditions in either the N100 or the P600 component. This provides further evidence that the pitch perception deficits associated with amusia may also affect intonation processing during speech comprehension in those who speak a tonal language such as Mandarin, and suggests music and language share some cognitive and neural resources.

Amusia results in abnormal brain activity following inappropriate intonation during speech comprehension.

Directory of Open Access Journals (Sweden)

Cunmei Jiang

Full Text Available Pitch processing is a critical ability on which humans' tonal musical experience depends, and which is also of paramount importance for decoding prosody in speech. Congenital amusia refers to deficits in the ability to properly process musical pitch, and recent evidence has suggested that this musical pitch disorder may impact upon the processing of speech sounds. Here we present the first electrophysiological evidence demonstrating that individuals with amusia who speak Mandarin Chinese are impaired in classifying prosody as appropriate or inappropriate during a speech comprehension task. When presented with inappropriate prosody stimuli, control participants elicited a larger P600 and smaller N100 relative to the appropriate condition. In contrast, amusics did not show significant differences between the appropriate and inappropriate conditions in either the N100 or the P600 component. This provides further evidence that the pitch perception deficits associated with amusia may also affect intonation processing during speech comprehension in those who speak a tonal language such as Mandarin, and suggests music and language share some cognitive and neural resources.

Potentially inappropriate prescribing to older patients in primary care in the Netherlands: a retrospective longitudinal study

NARCIS (Netherlands)

Bruin-Huisman, Linette; Abu-Hanna, Ameen; van Weert, Henk C. P. M.; Beers, Erna

2017-01-01

potentially inappropriate prescribing (PIP) is associated with adverse health effects in older patients. PIP comprises prescription of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). to estimate the prevalence of PIMs and PPOs among older patients in primary

Inappropriate sexual behaviour in adolescents with autism spectrum disorder: what education is recommended and why.

Science.gov (United States)

Beddows, Nicola; Brooks, Rachel

2016-08-01

Autism spectrum disorder (ASD) is a neurodevelopmental disorder impairing social skills and communication. Adolescents with ASD have sexual needs, but may not understand their physical and emotional development resulting in inappropriate sexual behaviour. The aim of this review is to describe the type of inappropriate behaviour that presents in these adolescents, explain why such behaviours occur, suggest what education is suitable and identify current gaps in research. The databases EMBASE, OVID MEDLINE and PSYCINFO were searched for relevant articles. In total, 5241 articles were found, with an additional 15 sources found via soft searches, of which 42 met inclusion criteria and were subsequently reviewed. Sexual behaviours that occur in these adolescents with ASD include hypermasturbation, public masturbation, inappropriate romantic gestures, inappropriate arousal and exhibitionism. Such behaviours are thought to be caused via a lack of understanding of normal puberty, the absence of appropriate sex education, the severity of their ASD and other associated problems. It is suggested that individualized, repetitive education should be started from an early age in an accessible form. Social skills development is also important before more technical aspects of sex education are taught. Despite being such a common problem for schools, institutions and families to manage, it is surprising how sparse literature is particularly regarding why inappropriate behaviour occurs and what education is effective. © 2015 Wiley Publishing Asia Pty Ltd.

Evaluation of potentially inappropriate medications among older residents of Malaysian nursing homes.

Science.gov (United States)

Chen, Li Li; Tangiisuran, Balamurugan; Shafie, Asrul Akmal; Hassali, Mohamed Azmi Ahmad

2012-08-01

There is an increasing evidence of medicines related issues such as inappropriate prescribing among older people. Inappropriate prescribing is an important risk factor for adverse drug reactions and hospitalizations in the older people. To assess and characterize the prevalence of Potentially Inappropriate Medications (PIMs) in nursing home care in Malaysia as defined by Screening Tool of Older Peoples Prescriptions (STOPP) and Beers criteria. Four Nursing Homes situated in Penang, Malaysia. A multicenter and cross-sectional study was conducted over 2 months period at four large non-governmental organizations nursing homes in Penang, Malaysia. The study population included older residents (≥65 years old) taking at least one medication. Residents who had been diagnosed with dementia or taking anti dementia drugs, delirium, too frail or refused to give consent were excluded. Demographic, clinical data and concurrent medications were collected through direct interview and also by reviewing medical records. STOPP and Beers criteria were applied in the medical review to screen for PIMs. Potentially Inappropriate Medication using STOPP and Beers criteria. Two hundred eleven residents were included in the study with the median age of 77 (inter quartile range (IQR) 72-82) years. Median number of prescription medicines was 4 (IQR 1-14). STOPP identified less residents (50 residents, 23.7 %) being prescribed on PIMs compared with Beers criteria (69 residents, 32.7 %) (p older residents living in the nursing homes and are associated with number of medications and longer nursing home stay. Further research is warranted to study the impact of PIMs towards health related outcomes in these elderly.

Storage of catch crops to produce biogas

DEFF Research Database (Denmark)

Molinuevo-Salces, Beatriz; Ahring, Birgitte Kiær; Uellendahl, Hinrich

2014-01-01

. On the contrary, the poor quality of IR silage, due to its high TS content, made it inappropriate as feedstock for biogas production. A TS content of 25-35% is preferable, to obtain a proper fermentation avoid leachate run-off and growth of Clostridium sp. or mold formation. Avoiding soil particles in the bales......Catch crop biomass is a promising co-substrate for manure-based biogas plants in Denmark since the cultivation of catch crops is mandatory to retain nutrients in the soil, contributing to protect the aquatic environment. In general, the growth period for catch crops is from harvest of the previous...... crop in July-August to the end of the growing season and harvest in late October. Hence, for use of the biomass in biogas production there is a need for storage of the biomass. Storage as silage would guarantee the availability of the feedstock for biogas production during the whole year. A proper...

Detecting Inappropriate Access to Electronic Health Records Using Collaborative Filtering.

Science.gov (United States)

Menon, Aditya Krishna; Jiang, Xiaoqian; Kim, Jihoon; Vaidya, Jaideep; Ohno-Machado, Lucila

2014-04-01

Many healthcare facilities enforce security on their electronic health records (EHRs) through a corrective mechanism: some staff nominally have almost unrestricted access to the records, but there is a strict ex post facto audit process for inappropriate accesses, i.e., accesses that violate the facility's security and privacy policies. This process is inefficient, as each suspicious access has to be reviewed by a security expert, and is purely retrospective, as it occurs after damage may have been incurred. This motivates automated approaches based on machine learning using historical data. Previous attempts at such a system have successfully applied supervised learning models to this end, such as SVMs and logistic regression. While providing benefits over manual auditing, these approaches ignore the identity of the users and patients involved in a record access. Therefore, they cannot exploit the fact that a patient whose record was previously involved in a violation has an increased risk of being involved in a future violation. Motivated by this, in this paper, we propose a collaborative filtering inspired approach to predicting inappropriate accesses. Our solution integrates both explicit and latent features for staff and patients, the latter acting as a personalized "finger-print" based on historical access patterns. The proposed method, when applied to real EHR access data from two tertiary hospitals and a file-access dataset from Amazon, shows not only significantly improved performance compared to existing methods, but also provides insights as to what indicates an inappropriate access.

Inappropriate Practices in Fitness Testing and Reporting: Alternative Strategies

Science.gov (United States)

Zhu, Xihe; Davis, Summer; Kirk, T. Nicole; Haegele, Justin A.; Knott, Stephen E.

2018-01-01

Fitness education is becoming an integrated component for many physical education programs. As such, many physical educators conduct health-related fitness tests on a regular basis. Some states even mandate certain types of physical fitness tests to be administered and reported annually or by semester. Yet, inappropriate practices have been…

On the ''circular vacuum noise'' in electron storage rings

International Nuclear Information System (INIS)

Rosu, H.

1992-02-01

We clarify in some essential points the proposal of Bell and Leinaas to measure the circular Unruh effect in storage rings. In particular the term 'circular Unruh effect' is inappropriate and should be replaced by the better 'circular vacuum noise'. This concept has been used by Takagi in his PTP Supplement of 1986 and corresponds best to the BL discussion. The BL resonance behavior does not fit to the SPEAR first order betatron resonance at 3.605 GeV, but of course, the real experimental situation is much more complicated, corresponding, as a matter of fact, to the rather general term 'synchrotron noise'. The detailed aspects of the synchrotron noise are, as yet, not very well understood. Besides, the much more practical accelerator jargon is to be preferred. We also include a section with comments on radiometry at storage rings. (author). 27 refs

Clinical pharmacist evaluation of medication inappropriateness in the emergency department of a teaching hospital in Malta

Directory of Open Access Journals (Sweden)

West LM

2012-12-01

Full Text Available Appropriate prescribing remains an important priority in all medical areas of practice. Objective: The objective of this study was to apply a Medication Appropriateness Index (MAI to identify issues of inappropriate prescribing amongst patients admitted from the Emergency Department (ED.Method: This study was carried out at Malta’s general hospital on 125 patients following a two-week pilot period on 10 patients. Patients aged 18 years and over and on medication therapy were included. Medication treatment for inappropriateness was assessed by using the MAI. Under-prescribing was also screened for. Results: Treatment charts of 125 patients, including 697 medications, were assessed using a MAI. Overall, 115 (92% patients had one or more medications with one or more MAI criteria rated as inappropriate, giving a total of 384 (55.1% medications prescribed inappropriately. The mean SD MAI score per drug was 1.78 (SD=2.19. The most common medication classes with appropriateness problems were supplements (20.1%, antibiotics (20.0% and steroids (19.8%. The most common problems involved incorrect directions (26% and incorrect dosages (18.5%. There were 36 omitted medications with untreated indications. Conclusion: There is considerable inappropriate prescribing which could have significant negative effects regarding patient care.

[The forensic medical aspects of the inappropriate medical care in the modern-day Ukraine].

Science.gov (United States)

Franchuk, V V

2018-01-01

Despite the fact that the ever growing relevance of the problem of the inappropriate medical care was long ago brought to the worldwide attention, it has not been practically addressed in the Ukraine since the country gained independence in 1991. The objective of the present study was to consider the specific features of expert examination of the cases of inappropriate medical care as exemplified by the materials of the legal actions and lawsuits instituted against healthcare specialists violating their occupational duties. The results of forensic medical examination by the local Bureaux of forensic medical expertise concerning the 350 so-called malpractice suits instituted in the Ternopol, Zhitomir, and Chernovtsy regions during the period from 207 to 2016 were available for the analysis. The facts of inadequate and inappropriate medical care were documented in 245 (72.0%) cases. The frequency of diagnostic and therapeutic errors amounted to 29.7% and 26.9% respectively while the improper formulation of the medical documentation was recorded in 21.3% of the cases. The cases of poor organization of the diagnostic and treatment process accounted for 14.6% of the total whereas the improper behaviour of the medical personnel was reported in 7.5% of all the known cases of provision of the healthcare services. It is concluded that in the majority of the cases, the citizens of the modern-day Ukraine receive the inappropriate (insufficient and untimely) medical care. Over 80% of the cases of the inappropriate medical care currently provided in the country can be accounted for by the objective reasons, with each fifths case being due to the violation of professional responsibilities by the healthcare providers.

Inappropriate shocks in the subcutaneous ICD: Incidence, predictors and management

NARCIS (Netherlands)

Olde Nordkamp, Louise R. A.; Brouwer, Tom F.; Barr, Craig; Theuns, Dominic A. M. J.; Boersma, Lucas V. A.; Johansen, Jens B.; Neuzil, Petr; Wilde, Arthur A. M.; Carter, Nathan; Husby, Michael; Lambiase, Pier D.; Knops, Reinoud E.

2015-01-01

The entirely subcutaneous implantable cardioverter-defibrillator (S-ICD) eliminates the need for transvenous leads, and therefore has the potential to improve lead-longevity and reduce lead-related complications. The S-ICD has a morphology-based sensing algorithm of which inappropriate shocks have

Inappropriate medication use and risk of falls – A prospective study in a large community-dwelling elderly cohort

Directory of Open Access Journals (Sweden)

Fourrier Annie

2009-07-01

Full Text Available Abstract Background Explicit criteria for determining potentially inappropriate medication consumption in elderly were elaborated by Beers et al. These lists have been used worldwide to evaluate medical prescriptions but there is little epidemiologic evidence demonstrating negative consequences of inappropriate medication use. It has been reported that some drugs could increase the risk of falls, which are a frequent and serious problem in elderly population. We aimed to evaluate the association between the use of potentially inappropriate medications and the risk of falls. Methods The 3C Study is a multicentre prospective cohort study conducted in France with 4 years of follow-up. Non-institutionalized men and women aged 65 years or over (N = 6343 were randomly selected from electoral rolls. Data on socio-demographic, medical characteristics and medication use (based on self-reports and data from the national healthcare insurance were collected. Use of inappropriate medication for elderly was defined from established criteria. Data about falls were collected at the two follow-up examinations (2 years and 4 years after baseline. The association between the exposure to inappropriate medications and the risk of falls was evaluated using multivariate models (Cox model and logistic regression. Results 32% of subjects reported inappropriate medication use at baseline and 29% at least two of the three examinations; 22% had fallen 2 times or more during follow-up. Overall, inappropriate medication users had an increased risk of falling. This increase was mainly due to the use of long-acting benzodiazepines (adjusted odds ratio (OR = 1.4, 95% confidence interval: [1.1–1.8], in both occasional and regular users, other inappropriate psychotropics (adjusted OR = 1.7 [1.7–2.7] in regular users, or medication with anticholinergic properties (adjusted OR = 1.6 [1.2–2.1] in regular users. Neither occasional, nor regular use of short- or intermediate

Standardized programming to reduce the burden of inappropriate therapies in implantable cardioverter defibrillators - Single centre follow up results

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U. Boles

2018-03-01

Full Text Available Background: Current algorithms and device morphology templates have been proposed in current Implantable Cardioverter-Defibrillators (ICDs to minimize inappropriate therapies (ITS, but this has not been completely successful. Aim: Assess the impact of a deliberate strategy of using an atrial lead implant with standardized parameters; based on all current ICD discriminators and technologies, on the burden of ITS. Method: A retrospective single-centre analysis of 250 patients with either dual chamber (DR ICDs or biventricular ICDs (CRTDs over a (41.9 ± 27.3 month period was performed. The incidence of ITS on all ICD and CRTD patients was chronicled after the implementation of standardized programming. Results: 39 events of anti-tachycardial pacing (ATP and/or shocks were identified in 20 patients (8% incidence rate among patients. The total number of individual therapies was 120, of which 34% were inappropriate ATP, and 36% were inappropriate shocks. 11 patients of the 250 patients received ITS (4.4%. Of the 20 patients, four had ICDs for primary prevention and 16 for a secondary prevention. All the episodes in the primary indication group were inappropriate, while seven patients (43% of the secondary indication group experienced inappropriate therapies. Conclusions: The burden of ITS in the population of patients receiving ICDs was 4.4% in the presence of atrial leads. The proposed rationalized programming criteria seems an effective strategy to minimize the burden of inappropriate therapies and will require further validation. Keywords: Implantable cardioverter-defibrillator (ICDs, Inappropriate therapies, Standardized programming

Quetiapine effective in treatment of inappropriate sexual behavior of lewy body disease with predominant frontal lobe signs.

Science.gov (United States)

Prakash, Ravi; Pathak, Amit; Munda, Sanjay; Bagati, Dhruv

2009-01-01

Dementia of Lewy body disease is the second most common degenerative cause of dementia after Alzheimer's disease, among all the dementias. The core features are a progressive dementia, fluctuations in cognitive functions, visual hallucinations, and spontaneous parkinsonism. Rapid eye movement sleep behavior disorder, severe neuroleptic sensitivity, and low dopamine transporter uptake in basal ganglia are other suggestive features. Behavioral abnormalities are commonly present in the form of aggressive behavior, irritability, and uninhibited behaviors. These are mostly seen in the advanced stages of dementia. However, inappropriate sexual behavior is uncommonly seen in such cases. Three types of inappropriate sexual behaviors commonly found in cases of dementia are sex talks, sexual acts, and implied sexual acts. Such inappropriate sexual behaviors have not been described adequately in dementia of Lewy body disease. We report inappropriate sexual behaviors in a case of dementia of Lewy body disease, which improved rapidly after treatment with quetiapine.

Identification and capacity quantification of CO{sub 2} storage sites

Energy Technology Data Exchange (ETDEWEB)

Bachu, Stefan [Energy Resources Conservation Board (Canada)

2008-07-15

In this presentation the subject of scales of evaluation of the sites of CO{sub 2} storage is commented. Also the criteria to identify river basins and sites appropriated for the CO{sub 2} storage are analyzed and finally the matter of the estimation of the capacities of CO{sub 2} storage is analyzed. [Spanish] En esta presentacion se comenta sobre las escalas de evaluacion de los sitios de almacenamiento de CO{sub 2}. Tambien se analizan los criterios para identificar cuencas y lugares adecuados para el almacenamiento de CO{sub 2} y por ultimo se habla sobre la estimacion de las capacidades de almacenamiento de CO{sub 2}.

Assessment of inappropriate antibiotic prescribing among a large cohort of general dentists in the United States.

Science.gov (United States)

Durkin, Michael J; Feng, Qianxi; Warren, Kyle; Lockhart, Peter B; Thornhill, Martin H; Munshi, Kiraat D; Henderson, Rochelle R; Hsueh, Kevin; Fraser, Victoria J

2018-05-01

The purpose of this study was to assess dental antibiotic prescribing trends over time, to quantify the number and types of antibiotics dentists prescribe inappropriately, and to estimate the excess health care costs of inappropriate antibiotic prescribing with the use of a large cohort of general dentists in the United States. We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between January 1, 2013, and December 31, 2015, with the use of data from Express Scripts Holding Company, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription. Overall, the number and rate of antibiotic prescriptions prescribed by general dentists remained stable in our cohort. During the 3-year study period, approximately 14% of antibiotic prescriptions were deemed inappropriate, based on the antibiotic prescribed, antibiotic treatment duration, or both indicators. The quasi-Poisson regression model, which adjusted for number of beneficiaries covered, revealed a small but statistically significant decrease in the monthly rate of inappropriate antibiotic prescriptions by 0.32% (95% confidence interval, 0.14% to 0.50%; P = .001). Overall antibiotic prescribing practices among general dentists in this cohort remained stable over time. The rate of inappropriate antibiotic prescriptions by general dentists decreased slightly over time. From these authors' definition of appropriate antibiotic prescription choice and duration, inappropriate antibiotic prescriptions are common (14% of all antibiotic prescriptions) among general dentists. Further analyses with the use of chart review, administrative data sets, or other approaches are needed to better evaluate antibiotic prescribing practices among dentists. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All

Impact of carvedilol and metoprolol on inappropriate implantable cardioverter-defibrillator therapy

DEFF Research Database (Denmark)

Ruwald, Martin H; Abu-Zeitone, Abeer; Jons, Christian

2013-01-01

The goal of this study was to evaluate the effects of carvedilol and metoprolol on the endpoint of inappropriate implantable cardioverter-defibrillator therapy in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation With Cardiac Resynchronization Therapy) study....

Dementia and inappropriate sexual behavior: What we know and what we need to know

Directory of Open Access Journals (Sweden)

Josep Fabà

2012-06-01

Full Text Available Traditionally, there has been no place for sexuality in older age. However, research has shown that sexuality plays an important role in older people’s life, even in situations such as dementia. The goal of the article is to review the scientific literature regarding the inappropriate sexual behavior that these kind of patients might present. In order to do so, we will firstly address the definition of inappropriate sexual behavior or, more precisely, its multiple definitions. After that, we will deal with other issues such as its prevalence, factors that can cause its appearance, its consequences and some of the available therapeutic options. Finally, in the last section some recommendations for future research will be provided, such as the need to clarify the concept of inappropriate sexual behavior, to find more efficient ways to address this problem, and the desirability of considering sexuality as a human dimension with a high potential for adaptation in old age.

Special storage of leaking fuel at Paks NPP

International Nuclear Information System (INIS)

Biro, Janos; Szőke, L.; Burján, T.; Lukács, R.; Hózer, H.

2015-01-01

In this paper the activities related with spent, hermetic as well as leaking fuel handling and storage, including: Spent fuel pool; Transportation criteria for the spent fuel assemblies and Interim spent fuel dry storage; Short-term storage in the spent fuel pool; Identification of the leaking assemblies by the TS-device; Present conception of Identification, handling of the leaking FAs; Modified transport procedure for the leaking FAs; Calculation of solved activity inside the leaking fuel rod; Solved activity limit values for the leaking FAs; Long-term storage in the interim spent Fuel dry storage are presented. At the end authors’ concluded that: 1) The leaking FA can be transported to the interim dry storage together with the other spent fuel assemblies in the transport container. 2) The transport-documentation of the leaking FA has to contain: isotope inventory, calculated solved activity values of the failed FA and the quantity of failed fuel rods. 3) Performing three leakage tests of the identified leaking FA before the transportation in the 5FP. it is useful to decrease the solved activity concentration inside the leaking FA and give additional information about the extent of the leakage. 4) We can calculate simply the solved activity of the leaking FA. 5) The modified transport procedure will have to be authorized. 6) The radiological effects of the leaking FA are negligible relative to the natural background radiation

The frequency of agitation due to inappropriate use of naltrexone in addicts

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Sima Siadat

2014-01-01

Conclusion: Considering the high prevalence of agitation in the poisoning emergency department due to inappropriate use of naltrexone, more accurate planning for administration of naltrexone in addicts seems necessary.

Brief Report: Reduction of Inappropriate Vocalizations for a Child with Autism Using a Self-Management Treatment Program.

Science.gov (United States)

Mancina, Catherine; Tankersley, Melody; Kamps, Debra; Kravits, Tammy; Parrett, Jean

2000-01-01

A study examined the effects of a self-management program used to reduce high rates of inappropriate vocalizations (e.g., humming, tongue clucking, perseveration, and echolalic words/phases) in a 12-year-old girl with autism. When self-management was applied to inappropriate vocalizations during leisure, prevocational, and reading tasks, the…

The Use of Grid Storage Protocols for Healthcare Applications

CERN Document Server

Donno, F; CERN. Geneva. IT Department

2008-01-01

Grid computing has attracted worldwide attention for a variety of domains. Healthcare projects focus on data mining and standardization techniques, the issue of data accessibility and transparency over the storage systems on the Grid has seldom been tackled. In this position paper, we identify the key issues and requirements imposed by Healthcare applications and point out how Grid Storage Technology can be used to satisfy those requirements. The main contribution of this work is the identification of the characteristics and protocols that make Grid Storage technology attractive for building a Healthcare data storage infrastructure.

Sudden Onset of Life-Threatening Methaemoglobinaemia After Intake of Inappropriately Stored Vegetable (Collard Greens Meal in a 2.5-Year-Old Child

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Ozlem Cakmak Yilmaz

2015-06-01

Full Text Available Acquired methaemoglobinaemia most commonly occurs due to intake of or contact to certain drugs, such as local anesthetics. However, intake of certain vegetables which are essential for a healthy diet may also cause methaemoglobinaemia due to their high nitrate or nitrite content, and prolonged and inappropriate storage after preparation of vegetable meals increases the risk. We present a 2.5-year-old girl with Down's syndrome who presented with central cyanosis due to severe methaemoglobinemiae with a methaemoglobin level of 62% after intake of collard greens (Brassica oleracea var. acephala soup. Although development of methaemoglobinaemia after food intake has been reported rarely before, recognition of this potentially life-threatening condition early in its course may be life-saving. [Cukurova Med J 2015; 40(2.000: 353-357

Inappropriate drug donations: what has happened since the 1999 WHO guidelines?

Science.gov (United States)

van Dijk, D P; Dinant, G; Jacobs, J A

2011-08-01

Drug donations to developing countries may be part of medical relief operations in acute emergencies, development aid in non-emergency situations, or a corporate donations programme. After a number of documented inappropriate drug donations, the World Health Organization developed the 'Guidelines for Drug Donations', with the second and final version published in 1999. We reviewed the medical literature on drug donations since the Guidelines publication in 1999. Literature was retrieved from PubMed and other on-line databases as well as from relevant websites providing medical literature for use in developing countries. We considered the following donations to be inappropriate: (i) essential drugs in excessive quantities; (ii) mixed unused drugs (unsorted medicines and free samples); and (iii) drug dumping (large quantities of useless medicines). We retrieved 25 publications dated after 1999, including 20 and 5 from the scientific literature and 'grey' literature (technical reports, working papers), respectively. New information concerned emergencies in East Timor, Mozambique, El Salvador, Gujarat State (India), Aceh (Indonesia) and Sri Lanka. Except for East Timor and Gujarat, inappropriate donations still occurred, accounting for 85%, 37%, 70% and 80% of donations in Mozambique, El Salvador, Aceh and Sri Lanka, respectively. Very little information was found on drug donations in non-emergency situations. There are few recent reports on the compliance of drug donations with the World Health Organization guidelines. For emergency situations, there is still room for improvement. Drug donations in non-emergency situations need to be evaluated. A reform of drug donations policy is needed.

Clinical hyperthyroidism due to non-neoplastic inappropriate thyrotrophin secretion.

OpenAIRE

Chan, A. W.; MacFarlane, I. A.; van Heyningen, C.; Foy, P. M.

1990-01-01

We report a case of hyperthyroidism due to inappropriate thyrotrophin (TSH) secretion in a patient with selective pituitary resistance to thyroid hormone action. Symptoms of hyperthyroidism in patients with this disorder are usually mild, implying some peripheral tissue resistance to the metabolic effects of thyroid hormone. Our patient had unusually severe symptoms, including marked weight loss and cardiac arrythmias which required carbimazole and beta-blocker therapy for control. Somatostat...

Attributes and circumstances that induce inappropriate health services demand: a study of the health sector in Brazil.

Science.gov (United States)

Guimarães, Djalma S; Soares, Eduardo J O; Júnior, Gileno Ferraz; Medeiros, Denise D

2015-02-18

The current economic and social context has required health systems to provide top quality services and to be efficient in controlling costs. An obstacle to achieve these goals is the inappropriate health services demand. This study aims to present these inappropriate health service demand determinants from data on telephone calls made to a medical advice call centre. This study used a Brazilian medical advice call centre data sample in the period of November and December 2012 (n = 19690), which supplied data on the user's initial request, the physician's recommendation, information on the patient and circumstances (the day and time of the day of the telephone call). The convergence between user intent and medical recommendation consists in adequate demand; otherwise the divergence consists in an inadequate one. In this way, using a logistic regression model, the critical factors that determine inappropriate health services request could be estimated. In general, the user's initial intent is the most critical for the inappropriate health system demand occurrence: the greater the complexity of the patient's initial intent, the greater the chance the intent is wrong: (OR: 1.160; 95% CI: 1.113-1.210). With regard to the social characteristics, men are more likely to make inappropriate requests (OR: 1.102; 95% CI: 1038-1169); as well as youngsters are more likely to use the system incorrectly (OR = .993; 95% CI: .992 - .994). Regarding the circumstances (day and time of the call), requests in the final hours of the day and on days close to the weekend are more likely to be the inappropriate ones (OR: 1.082 for each six hour increase; 95% CI: 1.049-1.116) and weekday (OR: 1.017 for each day increase; 95% CI: 1.002-1.032). The critical profile for the inappropriate use occurrence consists of males and youngsters, who use the health service in the final hours of the day and at weekends, and mainly want to use more complex services. A practical implication of this

Impact of oncology-related direct-to-consumer advertising: association with appropriate and inappropriate prescriptions.

Science.gov (United States)

Abel, Gregory A; Chen, Kun; Taback, Nathan; Hassett, Michael J; Schrag, Deborah; Weeks, Jane C

2013-03-01

Little is known about the impact of direct-to-consumer advertising (DTCA) on appropriate versus inappropriate prescribing. Aromatase inhibitor (AI) therapy for breast cancer provides an ideal paradigm for studying this issue, because AIs have been the focus of substantial DTCA, and because they should only be used in postmenopausal women, age can serve as a simple surrogate marker of appropriateness. Data regarding national DTCA spending for the AIs were obtained from TNS Multimedia; hormonal therapy prescription data were obtained from IMS Health. Time series analyses were performed to characterize the association between monthly changes in DTCA spending for the AIs and monthly changes in the proportion of all new hormonal therapy prescriptions represented by the AIs from October 2005 to September 2007. Analyses were stratified by age, considering prescriptions for women ≤ 40 (likely premenopausal) to be inappropriate and those for women > 60 (likely postmenopausal) to be appropriate. Monthly dollars spent on AI-associated DTCA varied considerably ($118,600 to $22,019,660). Time series analysis revealed that for every million dollars spent on DTCA for the AIs, there was an associated increase 3 months later in the new AI prescription proportion of 0.15% for all ages (P 60 years (P < .0001), but no significant change for those ≤ 40 at any time from 0 to 6 months. DTCA for the AIs was associated with increases in appropriate prescriptions with no significant effect on inappropriate prescriptions, suggesting that DTCA may not foster inappropriate medication use for certain drug classes. Copyright © 2012 American Cancer Society.

Clinical analysis of asthenopia caused by wearing inappropriate glasses in college students

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Li Wang

2015-01-01

Full Text Available AIM: To proposed control measures by exploring visual fatigue caused by college students wearing inappropriate glasses.METHODS: A total of 124 cases of asthenopia patients underwent optometry students audition, checked the original spectacles; TOPCON-CL100 computer center was used to checked the original mirror glasses(glasses, the distance between the optical center; with near vision as the standard examination table nearly with vergence and regulation near point, and checked the visual function. RESULTS: All 124 cases(248 eyeshad refractive errors, 77% were spherical mirror and 69% column mirror with error ≥±0.50D, and the pupil center distance from the lens had significant difference(U=5.27, PCONCLUSION: Students wearing inappropriate spectacle asthenopia is caused by one of the main scientific wearing glasses can effectively control asthenopia.

Portable exhauster POR-007/Skid E and POR-008/Skid F storage plan

International Nuclear Information System (INIS)

Nelson, O.D.

1998-01-01

This document provides storage requirements for 1,000 CFM portable exhausters POR-O07/Skid E and POR-008/Skid F. These requirements are presented in three parts: preparation for storage, storage maintenance and testing, and retrieval from storage. The exhauster component identification numbers listed in this document contain the prefix POR-007 or POR-008 depending on which exhauster is being used

Potentially inappropriate prescribing in institutionalised older patients in Spain: the STOPP-START criteria compared with the Beers criteria

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Bonet M

2012-06-01

Full Text Available Objective: The aims of this study were to identify potentially inappropriate prescribing using the Beers and STOPP criteria. The START criteria were applied to detect prescription omission in the geriatric population. We compared the utility of these criteria in institutionalised older people.Methods: Descriptive study reviewing the medication and clinical records of 81 residents (aged 65 years and more by pharmacists in a nursing home in the Lleida region (Spain.Results: The mean patients’ age was 84 (SD=8 years, with an average of 5 drugs per resident (total prescriptions: 416 medicines. The Beers criteria identified potentially inappropriate medication use in 25% of patients and 48% of patients used at least 1 inappropriate medication according to STOPP criteria. The most frequent potentially inappropriate medications for both criteria were long-acting benzodiazepines and NSAIDs. START detected 58 potential prescribing omissions in 44% of patients. Calcium-vitamin D supplementation in osteoporosis was the most frequent rule (15%, but omissions corresponding to the cardiovascular system implied 23% of patients.Conclusion: The STOPP-START criteria reveal that potentially inappropriate prescribing (PIP is a highly prevalent problem among Spanish nursing home residents, and a statistically significant positive correlation was found between the number of medicines prescribed and the number of PIP detected in this study. The STOPP criteria detect a larger number of PI medications in this geriatric population than the Beers criteria. The prescribing omissions detected by the START criteria are relevant and require intervention. Pharmacists’ review of medications may help identify potentially inappropriate prescribing and, through an interdisciplinary approach, working with physicians may improve prescribing practices among geriatric residents of nursing homes.

Identification methods for irradiated wheat

International Nuclear Information System (INIS)

Zhu Shengtao; Kume, Tamikazu; Ishigaki, Isao.

1992-02-01

The effect of irradiation on wheat seeds was examined using various kinds of analytical methods for the identification of irradiated seeds. In germination test, the growth of sprouts was markedly inhibited at 500Gy, which was not affected by storage. The decrease in germination percentage was detected at 3300Gy. The results of enzymatic activity change in the germ measured by Vita-Scope germinator showed that the seeds irradiated at 10kGy could be identified. The content of amino acids in ungerminated and germinated seeds were analyzed. Irradiation at 10kGy caused the decrease of lysine content but the change was small which need very careful operation to detect it. The chemiluminescence intensity increased with radiation dose and decreased during storage. The wheat irradiated at 10kGy could be identified even after 3 months storage. In the electron spin resonance (ESR) spectrum analysis, the signal intensity with the g value f 2.0055 of skinned wheat seeds increased with radiation dose. Among these methods, germination test was the most sensitive and effective for identification of irradiated wheat. (author)

Long-Term Outcomes in a Family with Nephrogenic Syndrome of Inappropriate Antidiuresis

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Yoon Hi Cho

2009-01-01

Full Text Available We report a familial case of the nephrogenic syndrome of inappropriate antidiuresis (NSIAD, including 30-year followup data on two patients. The proband and one maternal uncle presented in their infancy with severe recurrent hyponatremia, and clinical pictures consistent with the syndrome of inappropriate antidiuretic hormone (SIADH in the absence of an elevated ADH level. They were both confirmed to be hemizygous for the R137C mutation on the V2R gene (AVPR2, the same locus of the gain of function mutation demonstrated in the original reports of this condition. The proband's mother was identified as an asymptomatic carrier of this X-linked condition. Our case describes a favourable long-term outcome for NSIAD, in particular, successful treatment with oral urea during the infancy period, and with self-regulated precautions on fluid intake into adult life.

Long-Term Outcomes in a Family with Nephrogenic Syndrome of Inappropriate Antidiuresis

Directory of Open Access Journals (Sweden)

Rosenthal Stephen

2009-12-01

Full Text Available We report a familial case of the nephrogenic syndrome of inappropriate antidiuresis (NSIAD, including 30-year followup data on two patients. The proband and one maternal uncle presented in their infancy with severe recurrent hyponatremia, and clinical pictures consistent with the syndrome of inappropriate antidiuretic hormone (SIADH in the absence of an elevated ADH level. They were both confirmed to be hemizygous for the R137C mutation on the V2R gene (AVPR2, the same locus of the gain of function mutation demonstrated in the original reports of this condition. The proband's mother was identified as an asymptomatic carrier of this X-linked condition. Our case describes a favourable long-term outcome for NSIAD, in particular, successful treatment with oral urea during the infancy period, and with self-regulated precautions on fluid intake into adult life.

Isolation of Protein Storage Vacuoles and Their Membranes.

Science.gov (United States)

Shimada, Tomoo; Hara-Nishimura, Ikuko

2017-01-01

Protein-storage vacuoles (PSVs) are specialized vacuoles that sequester large amounts of storage proteins. During seed development, PSVs are formed de novo and/or from preexisting lytic vacuoles. Seed PSVs can be subdivided into four distinct compartments: membrane, globoid, matrix, and crystalloid. In this chapter, we introduce easy methods for isolation of PSVs and their membranes from pumpkin seeds. These methods facilitate the identification and characterization of PSV components.

Substantial reduction of inappropriate tablet splitting with computerised decision support: a prospective intervention study assessing potential benefit and harm

Directory of Open Access Journals (Sweden)

Quinzler Renate

2009-06-01

Full Text Available Abstract Background Currently ambulatory patients break one in four tablets before ingestion. Roughly 10% of them are not suitable for splitting because they lack score lines or because enteric or modified release coating is destroyed impairing safety and effectiveness of the medication. We assessed impact and safety of computerised decision support on the inappropriate prescription of split tablets. Methods We performed a prospective intervention study in a 1680-bed university hospital. Over a 15-week period we evaluated all electronically composed medication regimens and determined the fraction of tablets and capsules that demanded inappropriate splitting. In a subsequent intervention phase of 15 weeks duration for 10553 oral drugs divisibility characteristics were indicated in the system. In addition, an alert was generated and displayed during the prescription process whenever the entered dosage regimen demanded inappropriate splitting (splitting of capsules, unscored tablets, or scored tablets unsuitable for the intended fragmentation. Results During the baseline period 12.5% of all drugs required splitting and 2.7% of all drugs (257/9545 required inappropriate splitting. During the intervention period the frequency of inappropriate splitting was significantly reduced (1.4% of all drugs (146/10486; p = 0.0008. In response to half of the alerts (69/136 physicians adjusted the medication regimen. In the other half (67/136 no corrections were made although a switch to more suitable drugs (scored tablets, tablets with lower strength, liquid formulation was possible in 82% (55/67. Conclusion This study revealed that computerised decision support can immediately reduce the frequency of inappropriate splitting without introducing new safety hazards.

Urea for long-term treatment of syndrome of inappropriate secretion of antidiuretic hormone.

Science.gov (United States)

Decaux, G; Genette, F

1981-10-24

The efficacy of oral urea in producing a sufficiently high osmotic diuresis was tested in seven patients with the syndrome of inappropriate secretion of antidiuretic hormone. In all patients urea corrected the hyponatraemia despite a normal fluid intake. Five patients were controlled (serum sodium concentration greater than 128 mmol(mEq)/1) with a dose of 30 g urea daily, and two with 60 g daily. The patients who needed 30 g drank 1-2 1 of fluid daily, while those who needed 60 g drank up to 3.1 per day. No major side effects were noted, even after treatment periods of up to 270 days. These findings suggest that urea is a safe and efficacious treatment of the syndrome of inappropriate secretion of antidiuretic hormone.

Health IT and inappropriate utilization of outpatient imaging: A cross-sectional study of U.S. hospitals.

Science.gov (United States)

Appari, Ajit; Johnson, M Eric; Anthony, Denise L

2018-01-01

To determine whether the use of information technology (IT), measured by Meaningful Use capability, is associated with lower rates of inappropriate utilization of imaging services in hospital outpatient settings. A retrospective cross-sectional analysis of 3332 nonfederal U.S. hospitals using data from: Hospital Compare (2011 outpatient imaging efficiency measures), HIMSS Analytics (2009 health IT), and Health Indicator Warehouse (market characteristics). Hospitals were categorized for their health IT infrastructure including EHR Stage-1 capability, and three advanced imaging functionalities/systems including integrated picture archiving and communication system, Web-based image distribution, and clinical decision support (CDS) with physician pathways. Three imaging efficiency measures suggesting inappropriate utilization during 2011 included: percentage of "combined" (with and without contrast) computed tomography (CT) studies out of all CT studies for abdomen and chest respectively, and percentage of magnetic resonance imaging (MRI) studies of lumbar spine without antecedent conservative therapy within 60days. For each measure, three separate regression models (GLM with gamma-log link function, and denominator of imaging measure as exposure) were estimated adjusting for hospital characteristics, market characteristics, and state fixed effects. Additionally, Heckman's Inverse Mills Ratio and propensity for Stage-1 EHR capability were used to account for selection bias. We find support for association of each of the four health IT capabilities with inappropriate utilization rates of one or more imaging modality. Stage-1 EHR capability is associated with lower inappropriate utilization rates for chest CT (incidence rate ratio IRR=0.72, p-value value value value value value value use of Stage-1 Meaningful Use capable EHR systems along with advanced imaging related functionalities could have a beneficial impact on reducing some of the inappropriate utilization of

Identification and characterisation of seed storage protein transcripts from Lupinus angustifolius

Directory of Open Access Journals (Sweden)

Goggin Danica E

2011-04-01

Full Text Available Abstract Background In legumes, seed storage proteins are important for the developing seedling and are an important source of protein for humans and animals. Lupinus angustifolius (L., also known as narrow-leaf lupin (NLL is a grain legume crop that is gaining recognition as a potential human health food as the grain is high in protein and dietary fibre, gluten-free and low in fat and starch. Results Genes encoding the seed storage proteins of NLL were characterised by sequencing cDNA clones derived from developing seeds. Four families of seed storage proteins were identified and comprised three unique α, seven β, two γ and four δ conglutins. This study added eleven new expressed storage protein genes for the species. A comparison of the deduced amino acid sequences of NLL conglutins with those available for the storage proteins of Lupinus albus (L., Pisum sativum (L., Medicago truncatula (L., Arachis hypogaea (L. and Glycine max (L. permitted the analysis of a phylogenetic relationships between proteins and demonstrated, in general, that the strongest conservation occurred within species. In the case of 7S globulin (β conglutins and 2S sulphur-rich albumin (δ conglutins, the analysis suggests that gene duplication occurred after legume speciation. This contrasted with 11S globulin (α conglutin and basic 7S (γ conglutin sequences where some of these sequences appear to have diverged prior to speciation. The most abundant NLL conglutin family was β (56%, followed by α (24%, δ (15% and γ (6% and the transcript levels of these genes increased 103 to 106 fold during seed development. We used the 16 NLL conglutin sequences identified here to determine that for individuals specifically allergic to lupin, all seven members of the β conglutin family were potential allergens. Conclusion This study has characterised 16 seed storage protein genes in NLL including 11 newly-identified members. It has helped lay the foundation for efforts to use

Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients.

LENUS (Irish Health Repository)

Hamilton, Hilary

2011-06-13

Previous studies have not demonstrated a consistent association between potentially inappropriate medicines (PIMs) in older patients as defined by Beers criteria and avoidable adverse drug events (ADEs). This study aimed to assess whether PIMs defined by new STOPP (Screening Tool of Older Persons\\' potentially inappropriate Prescriptions) criteria are significantly associated with ADEs in older people with acute illness.

Potentially Inappropriate Medication Use Among Elderly Home Care Patients in Europe

Czech Academy of Sciences Publication Activity Database

Fialová, D.; Topinková, E.; Gambassi, G.; Finne-Soveri, H.; Jónsson, P.; Carpenter, I.; Schroll, M.; Onder, G.; Sorbye, L.W.; Wagner, C.; Reissigová, Jindra; Bernabei, R.

2005-01-01

Roč. 293, č. 11 (2005), s. 1348-1358 ISSN 0098-7484 Institutional research plan: CEZ:AV0Z10300504 Keywords : potentially inappropriate medication * prevalence * independent correlates Subject RIV: FQ - Public Health Care , Social Medicine Impact factor: 23.332, year: 2005 http://jama.ama-assn.org/cgi/content/abstract/293/11/1348

Real-Time Clinical Decision Support Decreases Inappropriate Plasma Transfusion.

Science.gov (United States)

Shah, Neil; Baker, Steven A; Spain, David; Shieh, Lisa; Shepard, John; Hadhazy, Eric; Maggio, Paul; Goodnough, Lawrence T

2017-08-01

To curtail inappropriate plasma transfusions, we instituted clinical decision support as an alert upon order entry if the patient's recent international normalized ratio (INR) was 1.7 or less. The alert was suppressed for massive transfusion and within operative or apheresis settings. The plasma order was automatically removed upon alert acceptance while clinical exception reasons allowed for continued transfusion. Alert impact was studied comparing a 7-month control period with a 4-month intervention period. Monthly plasma utilization decreased 17.4%, from a mean ± SD of 3.40 ± 0.48 to 2.82 ± 0.6 plasma units per hundred patient days (95% confidence interval [CI] of difference, -0.1 to 1.3). Plasma transfused below an INR of 1.7 or less decreased from 47.6% to 41.6% (P = .0002; odds ratio, 0.78; 95% CI, 0.69-0.89). The alert recommendation was accepted 33% of the time while clinical exceptions were chosen in the remaining cases (active bleeding, 31%; other clinical indication, 33%; and apheresis, 2%). Alert acceptance rate varied significantly among different provider specialties. Clinical decision support can help curtail inappropriate plasma use but needs to be part of a comprehensive strategy including audit and feedback for comprehensive, long-term changes. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

[Prevalence of potentially inappropriate drug prescription in the elderly].

Science.gov (United States)

Fajreldines, A; Insua, J; Schnitzler, E

2016-01-01

One of the causes of preventable adverse drug events (ADES) in older patients constitutes inappropriate prescription of drugs (PIM). The PIM is where risks exceed the clinical benefit. Several instruments can be use to measure this problem, the most used are: a) Beers criteria; b) Screening tool to Older People Potentially inappropriate Prescription (STOPP); c) Screening tool to Alert Doctors to Right Appropriate indicated Treatments (START); d) The Medication Appropriateness Index (MAI). This study aims to assess the prevalence of PIM, in a population of older adults in three clinical scopes of university hospital. cross sectional study of 300 cases from a random sample of fields: hospitalization (n=100), ambulatory (n=100) and emergency (n=100), all patients over 65 years old or more who where treated at our hospital. 1355 prescription drugs were analized, finding patients hospitalized (PIM) of 57.7%, 55%, 26%, and 80% according to Beers, in ambulatory 36%, 36.5%, 5% and 52% with the same tools and in emergency 35%, 35%, 6% y 52% with the same tools. Was found significant association the PIM with polipharmacy with Beers, STOPP and MAI. results can be compare to world literature (26-80% vs 11-73.1%). The STOPP-START used in an integrated manner would be best estimating the problem of PIM. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Inappropriate emergency laboratory test ordering: defensive or peer evidence shared based medicine?

Directory of Open Access Journals (Sweden)

C. Descovich

2013-05-01

Full Text Available BACKGROUND The laboratory overuse is widely prevalent in hospital practice, mostly in the emergency care. Reasons for excessive and inappropriate test-ordering include defensive behaviour and fear or uncertainty, lack of experience, the misuse of protocols and guidelines, “routine” and local attitudes, inadequate educational feedback and clinician’s unawareness about the cost of examinations and their related implications. AIM OF THE STUDY AND METHODS The primary target of our working group was to reduce inappropriate ordering on a urgent basis test, implementing further examinations not yet previewed in the hospital panel of the available urgencies, according to the evidence based diagnosis concept. The secondary goal was to indicate strategies of re-engineering of the processes, improving turnaround time in the laboratory management of emergencies. After evaluating, as first intervention, the more reliable sources for practice guidelines, systematic reviews and RCTs, the committee further discussed main topics with in-hospital stakeholders, selected from Emergency, Internal Medicine and Surgery Depts. The working group, in many subsequent audits, tried to obtain a systematic feed back with all involved professionals. RESULTS After reviewing literature’s evidence, the board constrained testing options by defining the basic emergency laboratory panel tests (blood type, hemogram, blood urea nitrogen, plasma creatinine, glucose, sodium, potassium, chloride, osmolarity, CRP, bicarbonate, CPK, creatine phosphokinase-MB, myoglobin, troponin, BNP and NT-proBNP, PT-INR, PTT, D-dimer, beta- HCG, biochemical urinalysis etc.. As final result, the proposed tests reduced the overall number of inappropriate investigations and increased, with newer and updated tests, the available panel for critical patients. DISCUSSION A collegiate review of data reporting, in-hospital deepening of problems and the inter- professional discussion of the evidences

Effect of aquifer storage and recovery (ASR) on recovered stormwater quality variability.

Science.gov (United States)

Page, D W; Peeters, L; Vanderzalm, J; Barry, K; Gonzalez, D

2017-06-15

Aquifer Storage and Recovery (ASR) is increasingly being considered as a means of reusing urban stormwater to supplement available urban water resources. Storage of stormwater in an aquifer has been shown to affect water quality but it has also been claimed that storage will also decrease the stormwater quality variability making for improved predictability and management. This study is the first to document the changes in stormwater quality variability as a result of subsurface storage at four full scale ASR sites using advanced statistical techniques. New methods to examine water quality are required as data is often highly left censored and so traditional measures of variability such as the coefficient of variation are inappropriate. It was observed that for some water quality parameters (most notably E. coli) there was a marked improvement of water quality and a significant decrease in variability at all sites. This means that aquifer storage prior to engineered treatment systems may be advantageous in terms of system design to avoid over engineering. For other parameters such as metal(loids)s and nutrients the trend was less clear due to the numerous processes occurring during storage leading to an increase in variability, especially for geogenic metals and metalloids such as iron and arsenic. Depending upon the specific water quality parameters and end use, use of ASR may not have a dampening effect on stormwater quality variability. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

A qualitative examination of inappropriate hospital admissions and lengths of stay

Directory of Open Access Journals (Sweden)

Hammond Christina L

2009-03-01

Full Text Available Abstract Background Research has shown that a number of patients, with a variety of diagnoses, are admitted to hospital when it is not essential and can remain in hospital unnecessarily. To date, research in this area has been primarily quantitative. The purpose of this study was to explore the perceived causes of inappropriate or prolonged lengths of stay and focuses on a specific population (i.e., patients with long term neurological conditions. We also wanted to identify interventions which might avoid admission or expedite discharge as periods of hospitalisation pose particular risks for this group. Methods Two focus groups were conducted with a convenience sample of eight primary and secondary care clinicians working in the Derbyshire area. Data were analysed using a thematic content approach. Results The participants identified a number of key causes of inappropriate admissions and lengths of stay, including: the limited capacity of health and social care resources; poor communication between primary and secondary care clinicians and the cautiousness of clinicians who manage patients in community settings. The participants also suggested a number of strategies that may prevent inappropriate admissions or reduce length of stay (LoS, including: the introduction of new sub-acute care facilities; the introduction of auxiliary nurses to support specialist nursing staff and patient held summaries of specialist consultations. Conclusion Clinicians in both the secondary and primary care sectors acknowledged that some admissions were unnecessary and some patients remain in hospital for a prolonged period. These events were attributed to problems with the current capacity or structuring of services. It was noted, for example, that there is a shortage of appropriate therapeutic services and that the distribution of beds between community and sub-acute care should be reviewed.

Proximal femoral osteosarcoma: Diagnostic challenges translate into delayed and inappropriate management.

Science.gov (United States)

Dahan, M; Anract, P; Babinet, A; Larousserie, F; Biau, D

2017-11-01

The proximal femuris is an uncommon site of osteosarcoma. The unusual manifestations at this site may lead to diagnostic and therapeutic mistakes. We therefore performed a retrospective study to estimate the proportions of patients with imaging study findings and/or clinical manifestations typical for osteosarcoma and/or inappropriate treatment decisions. Proximal femoral osteosarcoma often produces atypical clinical and radiological presentations. Consecutive patients who underwent surgery at our center to treat proximal femoral osteosarcoma were included. For each patient, we collected the epidemiological characteristics, clinical symptoms, imaging study findings, treatment, and tumor outcome. Proportions were computed with their confidence intervals. Twelve patients had surgery for proximal femoral osteosarcoma between 1986 and 2015. Imaging findings were typical in 1 (8%) patient; they consisted of ill-defined osteolysis in 11/12 (92%) patients, a periosteal reaction in 1/12 (8%) patient, soft tissue involvement in 7/12 (58%) patients, and immature osteoid matrix in 11/12 (92%) patients. No patient had the typical combination of pain with a soft tissue swelling. Management was inappropriate in 2/12 (17%) patients, who did not undergo all the recommended imaging studies before surgery and were treated in another center before the correct diagnosis was established. At last follow-up, 4 patients had died (after a mean of 7 years) and 8 were alive (after a mean of 4 years). Proximal femoral osteosarcoma is uncommon and rarely produces the typical clinical and imaging study findings. The atypical presentation often results in diagnostic errors and inappropriate treatments. Ill-defined osteolysis on standard radiographs should prompt computed tomography or magnetic resonance imaging of the proximal femur. Treatment in a specialized center is imperative. IV, retrospective study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Women born preterm or with inappropriate weight for gestational age are at risk of subsequent gestational diabetes and pre-eclampsia

DEFF Research Database (Denmark)

á Rogvi, Rasmus; Forman, Julie Lyng; Damm, Peter

2012-01-01

Low birthweight, which can be caused by inappropriate intrauterine growth or prematurity, is associated with development of gestational diabetes mellitus (GDM) as well as pre-eclampsia later in life, but the relative effects of prematurity and inappropriate intrauterine growth remain uncertain....

Program definition and assessment overview. [for thermal energy storage project management

Science.gov (United States)

Gordon, L. H.

1980-01-01

The implementation of a program level assessment of thermal energy storage technology thrusts for the near and far term to assure overall coherent energy storage program is considered. The identification and definition of potential thermal energy storage applications, definition of technology requirements, and appropriate market sectors are discussed along with the necessary coordination, planning, and preparation associated with program reviews, workshops, multi-year plans and annual operating plans for the major laboratory tasks.

Patient and Sample Identification. Out of the Maze?

Directory of Open Access Journals (Sweden)

Lippi Giuseppe

2017-04-01

Full Text Available Background: Patient and sample misidentification may cause significant harm or discomfort to the patients, especially when incorrect data is used for performing specific healthcare activities. It is hence obvious that efficient and quality care can only start from accurate patient identification. There are many opportunities for misidentification in healthcare and laboratory medicine, including homonymy, incorrect patient registration, reliance on wrong patient data, mistakes in order entry, collection of biological specimens from wrong patients, inappropriate sample labeling and inaccurate entry or erroneous transmission of test results through the laboratory information system. Many ongoing efforts are made to prevent this important healthcare problem, entailing streamlined strategies for identifying patients throughout the healthcare industry by means of traditional and innovative identifiers, as well as using technologic tools that may enhance both the quality and efficiency of blood tubes labeling. The aim of this article is to provide an overview about the liability of identification errors in healthcare, thus providing a pragmatic approach for diverging the so-called patient identification crisis.

Comparison of rates of potentially inappropriate medication use according to the Zhan criteria for VA versus private sector medicare HMOs.

Science.gov (United States)

Barnett, Mitchell J; Perry, Paul J; Langstaff, Jodi D; Kaboli, Peter J

2006-06-01

Inappropriate prescribing in the elderly is common, but rates across different health care systems and the impact of formulary restrictions are not well described. To determine if rates of inappropriate medication use in the elderly differ between the Veterans Affairs (VA) health care system and the private sector Medicare health maintenance organization (HMO) patients. A cross-sectional study design compared administrative pharmacy claims from 10 distinct geographic regions in the United States in the VA health care system and 10 analogous regions for patients enrolled in Medicare HMOs. The cohorts included 123,633 VA and 157,517 Medicare HMO patients aged 65 years and older. Inappropriate medication use was identified using the Zhan modification of the Beers criteria, which categorizes 33 potentially inappropriate drugs into 3 major classifications: "always avoid," "rarely appropriate," and "some indications." Comparisons between the VA health care system and the private sector Medicare HMO were performed for overall differences and stratified by gender and age. The drug formulary status of the Zhan-criteria drugs was known for the VA health system but not for the Medicare HMO patients. Compared with private sector patients, VA patients were less likely to receive any inappropriate medication (21% vs. 29%, P private sector for males (21% vs. 24%, P private sector Medicare HMOs, elderly VA patients were less likely to receive medications defined by the Zhan criteria as potentially inappropriate. A restrictive formulary that excludes 12 of the 33 Zhan criteria drugs may be a factor in the reduction of undesired prescribing patterns in elderly populations.

Tariffs, Quotas, and the Corrupt Purchasing of Inappropriate Technology

OpenAIRE

Neil Campbell

2005-01-01

This paper develops a simple model where a manager of a firm in a Less-Developed Country (LDC) has the choice of whether or not to purchase an inappropriate technology in return for a bribe (kick-back) from the supplier of the technology. Provided that the manager achieves some minimum level of profit, the manager has a positive probability of not getting caught taking the bribe. The actual size of the bribe is determined by Nash axiomatic bargaining between the manager and the supplier. An i...

The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries.

Science.gov (United States)

Renom-Guiteras, Anna; Meyer, Gabriele; Thürmann, Petra A

2015-07-01

The aim of the study was to develop a European list of potentially inappropriate medications (PIM) for older people, which can be used for the analysis and comparison of prescribing patterns across European countries and for clinical practice. A preliminary PIM list was developed, based on the German PRISCUS list of potentially inappropriate medications and other PIM lists from the USA, Canada and France. Thirty experts on geriatric prescribing from Estonia, Finland, France, the Netherlands, Spain and Sweden participated; eight experts performed a structured expansion of the list, suggesting further medications; twenty-seven experts participated in a two-round Delphi survey assessing the appropriateness of drugs and suggesting dose adjustments and therapeutic alternatives. Finally, twelve experts completed a brief final survey to decide upon issues requiring further consensus. Experts reached a consensus that 282 chemical substances or drug classes from 34 therapeutic groups are PIM for older people; some PIM are restricted to a certain dose or duration of use. The PIM list contains suggestions for dose adjustments and therapeutic alternatives. The European Union (EU)(7)-PIM list is a screening tool, developed with participation of experts from seven European countries, that allows identification and comparison of PIM prescribing patterns for older people across European countries. It can also be used as a guide in clinical practice, although it does not substitute the decision-making process of individualised prescribing for older people. Further research is needed to investigate the feasibility and applicability and, finally, the clinical benefits of the newly developed list.

HiRITER - An evaluation tool to reduce the adverse effect of inappropriate human actions in nuclear power plants

International Nuclear Information System (INIS)

Park, J.; Jung, W.; Kim, J.; Kim, S.; Heo, G.

2012-01-01

From end-users to regulatory bodies, it is widely recognized that human-induced events including inappropriate human actions are one of the most crucial sources degrading the overall safety of nuclear power plants (NPPs). This means that a systematic framework through which inappropriate human actions can be effectively identified is necessary to enhance the safety of NPPs. For this reason, HiRITER (High Risk Inducible Task Evaluator) has been developed, which is able to evaluate the effect of inappropriate human actions on risk as well as performance. To this end, HiRITER integrates three modules that have distinctive roles: human error prediction module that is able to determine the types of failure modes resulting from inappropriate human actions with the associated daily task, performance evaluation module that computes the loss of electric power due to the change of component configurations caused by human error and risk evaluation module that clarifies whether or not the propagation of human error can trigger an unexpected shutdown of NPPs. In addition, a couple of real events that had occurred in domestic NPPs are simulated in order to validate the feasibility of HiRITER. As a result, it is observed that the results of HiRITER are largely congruent with those of real events. Therefore, although a huge amount of additional effort is indispensable to enhance the overall accuracy of estimated results, it is expected that HiRITER could be a good starting point to reduce the adverse effect of inappropriate human actions in NPPs

Detention storage volume for combined sewer overflow into a river.

Science.gov (United States)

Temprano, J; Tejero, I

2002-06-01

This article discusses the storage volume needed in a combined sewer system tank in order to preserve the water quality. There are a lot of design criteria which do not take into account the conditions of the receiving water, and as a result are inappropriate. A model was used to simulate the performance of a theoretical combined sewer system where a tank was located downstream. Results were obtained from the overflows produced by the rain recorded in Santander (Spain) for 11 years, with several combinations of storage volume and treatment capacity in the wastewater treatment plant. Quality criteria were also proposed for faecal coliforms, BOD, and total nitrogen to evaluate the effects from the overflows in the river water quality. Equations have been obtained which relate the number of overflows, the storage volume and the treatment plant capacity. The bacteriological pollution, quantified by means of faecal coliforms, was the analytical parameter which produced the most adverse effects in the river, so that more storage volume is needed (45 to 180 m3 ha(-1) net) than with other simulated pollutants (5 to 50 m3 ha(-1) net for BOD, and less than 4 m3 ha(-1) net for the total nitrogen). The increase in the treatment plant's capacity, from two to three times the flow in dry weather, reduces the impact on the river water in a more effective way, allowing a reduction of up to 65% in the number of overflows rather than increasing the storage volume.

Evaluation of electrical aversion therapy for inappropriate sexual behaviour after traumatic brain injury: a single case experimental design study

Science.gov (United States)

ter Mors, Bert Jan; van Heugten, Caroline M; van Harten, Peter N

2012-01-01

Inappropriate sexual behaviour after acquired brain injury is a severe complication. Evidence for effective treatment is not available. Electrical aversion therapy (EAT) is a behavioural therapeutic option used in persons with intellectual disabilities, which might be suitable for brain-injured individuals for whom other therapies are not effective. The effect of EAT in brain injury has not been investigated previously. A single case experimental design was used. In an ABBA (baseline-treatment-treatment-withdrawal) design the frequency of the target behaviour (ie, inappropriate sexual behaviour) in a 40-year-old man was measured daily. A total of 551 measurements were recorded. A significant reduction of the target behaviour was seen after the first treatment phase (baseline 12.18 (2.59) vs 3.15 (3.19) mean target behaviours daily); this reduction remained stable over time. We conclude that EAT was effective in this patient with inappropriate sexual behaviour due to severe brain injury. EAT can therefore be considered in therapy resistant inappropriate sexual behaviour in brain-injured patients. PMID:22922913

Rates of inappropriate antiretroviral prescription among injection drug users

Directory of Open Access Journals (Sweden)

Bonner Simon

2007-01-01

Full Text Available Abstract Background Although the survival benefits of antiretroviral therapy (ART for the treatment of HIV infection are well established, the clinical management of HIV disease continues to present major challenges. There are particular concerns regarding access to appropriate HIV treatment among HIV-infected injection drug users (IDU. Methods In a prospective cohort study of HIV-infected IDU in Vancouver, Canada, we examined initial ART regimens vis-à-vis the provincial government's therapeutic guidelines at the time ART was initiated. Briefly, there have been four sets of guidelines: Era 1 (1992 to November 1995; double-drug (dual NRTIs ART for patients with a CD4 cell count of 350 or less; Era 2 (December 1995 to May 1996; double-drug therapy for patients with a CD4+ cell count of 500 or less; Era 3 (June 1996 to June 1997; triple-drug therapy (dual NRTIs with a PI or NNRTI for patients who had a plasma viral load of > 100,000 HIV-1 RNA copies/mL; dual therapy with two NRTIs for those with a plasma viral load of 5,000 to 100,000 HIV-1 RNA copies/mL; Era 4 (since July 1997; universal use of triple drug therapy as first-line treatment. Results Between May 1996 and May 2003, 431 HIV-infected individuals were enrolled into the cohort. By May 31, 2003, 291 (67.5% individuals had initiated ART. We noted instances of inappropriate antiretroviral prescription in each guideline era, with 9 (53% in Era 1, 3 (12% in Era 2, 22 (28% in Era 3, and 23 (15% in Era 4. Of the 57 subjects who received an inappropriate ART regimen initially, 14 never received the appropriate therapy; among the remaining 43, the median time to the initiation of a guideline-appropriate ART regimen was 12 months (inter-quartile range 5 – 20. Conclusion The present study identified measurable rates of guideline-inappropriate ART prescription for patients who were injection drug users. Rates were highest in the era of dual therapy, although high rates persisted into the triple

Global Patterns of Legacy Nitrate Storage in the Vadose Zone

Science.gov (United States)

Ascott, M.; Gooddy, D.; Wang, L.; Stuart, M.; Lewis, M.; Ward, R.; Binley, A. M.

2017-12-01

Global-scale nitrogen (N) budgets have been developed to quantify the impact of man's influence on the nitrogen cycle. However, these budgets often do not consider legacy effects such as accumulation of nitrate in the deep vadose zone. In this presentation we show that the vadose zone is an important store of nitrate which should be considered in future nitrogen budgets for effective policymaking. Using estimates of depth to groundwater and nitrate leaching for 1900-2000, we quantify for the first time the peak global storage of nitrate in the vadose zone, estimated as 605 - 1814 Teragrams (Tg). Estimates of nitrate storage are validated using previous national and basin scale estimates of N storage and observed groundwater nitrate data for North America and Europe. Nitrate accumulation per unit area is greatest in North America, China and Central and Eastern Europe where thick vadose zones are present and there is an extensive history of agriculture. In these areas the long solute travel time in the vadose zone means that the anticipated impact of changes in agricultural practices on groundwater quality may be substantially delayed. We argue that in these areas use of conventional nitrogen budget approaches is inappropriate and their continued use will lead to significant errors.

Inappropriate prescribing in outpatient healthcare: an evaluation of respiratory infection visits among veterans in teaching versus non-teaching primary care clinics

Directory of Open Access Journals (Sweden)

Diane M. Parente

2017-03-01

Full Text Available Abstract A recent study led by the Centers for Disease Control and Prevention (CDC revealed at least 30% of antibiotic prescriptions in the outpatient setting were inappropriate. In this study of all ages, among adult patients, results were similar to the overall population, with the majority of inappropriate prescribing relating to respiratory infections. We applied the same methodology to investigate rates of antibiotic prescribing for respiratory tract infections in outpatient primary care clinics at the Providence Veterans Affairs Medical Center. The results of our evaluation reflected comparable rates of inappropriate prescribing, but when stratified by teaching versus non-teaching primary care clinics, inappropriate prescribing was significantly higher in non-teaching clinics (17.6% vs 44.0%, p < .0001. Respiratory infection visits in non-teaching outpatient clinics may be a pragmatic target for antimicrobial stewardship programs.

Inappropriate prescribing and prescribing omissions among drug-related problems using STOPP-START criteria

NARCIS (Netherlands)

Verdoorn, M.A.; Kwint, H.-F.; Faber, A.; L. Bouvy, M.

2013-01-01

Background and objectives: Medication review has been suggested as a way to prevent drug related problems (DRPs). Screening tools have been formulated to identify potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs) respectively called Screening Tool of Older

Identification of the Rice Wines with Different Marked Ages by Electronic Nose Coupled with Smartphone and Cloud Storage Platform.

Science.gov (United States)

Wei, Zhebo; Xiao, Xize; Wang, Jun; Wang, Hui

2017-10-31

In this study, a portable electronic nose (E-nose) was self-developed to identify rice wines with different marked ages-all the operations of the E-nose were controlled by a special Smartphone Application. The sensor array of the E-nose was comprised of 12 MOS sensors and the obtained response values were transmitted to the Smartphone thorough a wireless communication module. Then, Aliyun worked as a cloud storage platform for the storage of responses and identification models. The measurement of the E-nose was composed of the taste information obtained phase (TIOP) and the aftertaste information obtained phase (AIOP). The area feature data obtained from the TIOP and the feature data obtained from the TIOP-AIOP were applied to identify rice wines by using pattern recognition methods. Principal component analysis (PCA), locally linear embedding (LLE) and linear discriminant analysis (LDA) were applied for the classification of those wine samples. LDA based on the area feature data obtained from the TIOP-AIOP proved a powerful tool and showed the best classification results. Partial least-squares regression (PLSR) and support vector machine (SVM) were applied for the predictions of marked ages and SVM (R² = 0.9942) worked much better than PLSR.

Identification of the Rice Wines with Different Marked Ages by Electronic Nose Coupled with Smartphone and Cloud Storage Platform

Directory of Open Access Journals (Sweden)

Zhebo Wei

2017-10-01

Full Text Available In this study, a portable electronic nose (E-nose was self-developed to identify rice wines with different marked ages—all the operations of the E-nose were controlled by a special Smartphone Application. The sensor array of the E-nose was comprised of 12 MOS sensors and the obtained response values were transmitted to the Smartphone thorough a wireless communication module. Then, Aliyun worked as a cloud storage platform for the storage of responses and identification models. The measurement of the E-nose was composed of the taste information obtained phase (TIOP and the aftertaste information obtained phase (AIOP. The area feature data obtained from the TIOP and the feature data obtained from the TIOP-AIOP were applied to identify rice wines by using pattern recognition methods. Principal component analysis (PCA, locally linear embedding (LLE and linear discriminant analysis (LDA were applied for the classification of those wine samples. LDA based on the area feature data obtained from the TIOP-AIOP proved a powerful tool and showed the best classification results. Partial least-squares regression (PLSR and support vector machine (SVM were applied for the predictions of marked ages and SVM (R2 = 0.9942 worked much better than PLSR.

Inappropriate colonoscopic surveillance of hyperplastic polyps.

LENUS (Irish Health Repository)

Keane, R A

2011-11-15

Colonoscopic surveillance of hyperplastic polyps alone is controversial and may be inappropriate. The colonoscopy surveillance register at a university teaching hospital was audited to determine the extent of such hyperplastic polyp surveillance. The surveillance endoscopy records were reviewed, those patients with hyperplastic polyps were identified, their clinical records were examined and contact was made with each patient. Of the 483 patients undergoing surveillance for colonic polyps 113 (23%) had hyperplastic polyps alone on last colonoscopy. 104 patients remained after exclusion of those under appropriate surveillance. 87 of the 104 patients (84%) were successfully contacted. 37 patients (8%) were under appropriate colonoscopic surveillance for a significant family history of colorectal carcinoma. 50 (10%) patients with hyperplastic polyps alone and no other clinical indication for colonoscopic surveillance were booked for follow up colonoscopy. This represents not only a budgetary but more importantly a clinical opportunity cost the removal of which could liberate valuable colonoscopy time for more appropriate indications.

[Inappropriate test methods in allergy].

Science.gov (United States)

Kleine-Tebbe, J; Herold, D A

2010-11-01

Inappropriate test methods are increasingly utilized to diagnose allergy. They fall into two categories: I. Tests with obscure theoretical basis, missing validity and lacking reproducibility, such as bioresonance, electroacupuncture, applied kinesiology and the ALCAT-test. These methods lack both the technical and clinical validation needed to justify their use. II. Tests with real data, but misleading interpretation: Detection of IgG or IgG4-antibodies or lymphocyte proliferation tests to foods do not allow to separate healthy from diseased subjects, neither in case of food intolerance, allergy or other diagnoses. The absence of diagnostic specificity induces many false positive findings in healthy subjects. As a result unjustified diets might limit quality of life and lead to malnutrition. Proliferation of lymphocytes in response to foods can show elevated rates in patients with allergies. These values do not allow individual diagnosis of hypersensitivity due to their broad variation. Successful internet marketing, infiltration of academic programs and superficial reporting by the media promote the popularity of unqualified diagnostic tests; also in allergy. Therefore, critical observation and quick analysis of and clear comments to unqualified methods by the scientific medical societies are more important than ever.

Improving Inappropriate Social Behavior of Autistic Students Using the LISTEN Intervention Strategy

Science.gov (United States)

Al-Shammari, Zaid; Daniel, Cathy; Faulkner, Paula; Yawkey, Thomas D.

2010-01-01

A case study was conducted on the development of the LISTEN intervention strategy for use with autistic students to improve inappropriate social behaviors. The study was conducted in a special education classroom in an autism school in Kuwait. Examination of LISTEN Intervention Strategy applications included: duration of targeted behavior; methods…

Lost in hospital: a qualitative interview study that explores the perceptions of NHS inpatients who spent time on clinically inappropriate hospital wards.

Science.gov (United States)

Goulding, Lucy; Adamson, Joy; Watt, Ian; Wright, John

2015-10-01

Prior research suggests that the placement of patients on clinically inappropriate hospital wards may increase the risk of experiencing patient safety issues. To explore patients' perspectives of the quality and safety of the care received during their inpatient stay on a clinically inappropriate hospital ward. Qualitative study using semi-structured interviews. Nineteen patients who had spent time on at least one clinically inappropriate ward during their hospital stay at a large NHS teaching hospital in England. Patients would prefer to be treated on the correct specialty ward, but it is generally accepted that this may not be possible. When patients are placed on inappropriate wards, they may lack a sense of belonging. Participants commented on potential failings in communication, medical staff availability, nurses' knowledge and the resources available, each of which may contribute to unsafe care. Patients generally acknowledge the need for placement on inappropriate wards due to demand for inpatient beds, but may report dissatisfaction in terms of preference and belonging. Importantly, patients recount issues resulting from this placement that may compromise their safety. Hospital managers should be encouraged to appreciate this insight and potential threat to safe practice and where possible avoid inappropriate ward transfers and admissions. Where such admissions are unavoidable, staff should take action to address the gaps in safety of care that have been identified. © 2013 John Wiley & Sons Ltd.

Rooting out institutional corruption to manage inappropriate off-label drug use.

Science.gov (United States)

Rodwin, Marc A

2013-01-01

Prescribing drugs for uses that the FDA has not approved - off-label drug use - can sometimes be justified but is typically not supported by substantial evidence of effectiveness. At the root of inappropriate off-label drug use lie perverse incentives for pharmaceutical firms and flawed oversight of prescribing physicians. Typical reform proposals such as increased sanctions for manufacturers might reduce the incidence of unjustified off-label use, but they do not remove the source of the problem. Public policy should address the cause and control the practice. To manage inappropriate off-label drug use, off-label prescriptions must be tracked in order to monitor the risks and benefits and the manufacturers' conduct. Even more important, reimbursement rules should be changed so that manufacturers cannot profit from off-label sales. When off-label sales pass a critical threshold, manufacturers should also be required to pay for independent testing of the safety and effectiveness of off-label drug uses and for the FDA to review the evidence. Manufacturers should also finance, under FDA supervision, programs designed to warn physicians and the public about the risks of off-label drug use. © 2013 American Society of Law, Medicine & Ethics, Inc.

The syndrome of inappropriate antidiuretic hormone: prevalence, causes and consequences.

LENUS (Irish Health Repository)

Hannon, M J

2010-06-01

Hyponatraemia is the commonest electrolyte abnormality found in hospital inpatients, and is associated with a greatly increased morbidity and mortality. The syndrome of inappropriate antidiuretic hormone (SIADH) is the most frequent cause of hyponatraemia in hospital inpatients. SIADH is the clinical and biochemical manifestation of a wide range of disease processes, and every case warrants investigation of the underlying cause. In this review, we will examine the prevalence, pathophysiology, clinical characteristics and clinical consequences of hyponatraemia due to SIADH.

Bibliography of the seasonal thermal energy storage library

Energy Technology Data Exchange (ETDEWEB)

Prater, L.S.; Casper, G.; Kawin, R.A.

1981-08-01

The Main Listing is arranged alphabetically by the last name of the first author. Each citation includes the author's name, title, publisher, publication date, and where applicable, the National Technical Information Service (NTIS) number or other document number. The number preceding each citation is the identification number for that document in the Seasonal Thermal Energy Storage (STES) Library. Occasionally, one or two alphabetic characters are added to the identification number. These alphabetic characters indicate that the document is contained in a collection of papers, such as the proceedings of a conference. An Author Index and an Identification Number Index are included. (WHK)

An Action Research Study of Intellectual Disabilities, Inappropriate Behaviors and Learned Helplessness

Science.gov (United States)

Luper, Elizabeth P. S.; Lockley, Jeannie

2008-01-01

This study focused on a population of 36 female patients, aged 25 to 65, who were diagnosed with intellectual disabilities, all of whom had long-standing patterns of inappropriate behaviors. In an attempt to increase more appropriate behaviors in these patients, a set of standardized contingency rules were established. These rules were implemented…

Continuous inventory in SNM storage facilities

International Nuclear Information System (INIS)

Chambers, W.H.

1975-01-01

Instrumentation and data processing techniques that provide inexpensive verification of material in storage were investigated. Transfers of special nuclear materials (SNM) into the storage area are accompanied by an automated verification of the container identity, weight, and the radiation signature of the contents. This information is computer-processed and stored for comparison at subsequent transfers and also provides the data base for record purposes. Physical movement of containers across the boundary of the storage area is presently accomplished by operating personnel in order to minimize expensive modifications to existing storage facilities. Personnel entering and leaving the storage area are uniquely identified and also through portal monitors capable of detecting small quantities of SNM. Once material is placed on the storage shelves, simple, low-cost container tagging and radiation sensors are activated. A portion of the prescribed gamma signature, obtained by duplicate shelf monitors during the transfer verification, is thus continuously checked against the stored identification data. Radiation detector design is severely constrained by the need to discriminate individual signatures in a high background area and the need for low unit costs. In operation any unauthorized change in signal is analyzed along with auxiliary data from surveillance sensors to activate the appropriate alarms. (auth))

Overview of the National Waste Terminal Storage Program

International Nuclear Information System (INIS)

Zerby, C.D.

1976-01-01

The following seven distinct steps necessary for developing a terminal storage facility are discussed: identification of formations of interest; reconnaissance surveys; in situ tests; area studies; detailed confirmation studies; pilot plant operations; and conversion of the pilot plant into a federal repository

The Use of WISC-R Subtest Scatter in the Identification of Intellectually Gifted Handicapped Children: An Inappropriate Task?

Science.gov (United States)

Brown, Scott W.

1984-01-01

The paper discusses issues involved in the identification of gifted handicapped children, reviewing several research studies that attempted to define a specific configuration of Wechsler Intelligence Scale for Children-Revised subtest scores indicative of handicapped children possessing intellectual gifts. The author concludes that profiles and…

Evaluation of storage/transportation options to support criteria development for the Phase I MRS [Monitored Retrievable Storage

International Nuclear Information System (INIS)

Sorenson, K.B.; Brown, N.N.; Bennett, P.C.; Lake, W.

1991-01-01

The Department of Energy's (DOE) Office of Civilian Waste Management (OCRWM) plans to develop an interim storage facility to enable acceptance of spent fuel in 1998. It is estimated that this interim storage facility would be needed for about two years. A Monitored Retrievable Storage (MRS) facility is anticipated in 2000 and a repository in 2010. Acceptance and transport of spent fuel by DOE/OCRWM in 1998 will require an operating transportation system. Because this interim storage facility is not yet defined, development of an optimally compatible transportation system is not a certainty. In order to assure a transport capability for 1998 acceptance of spent fuel, it was decided that the OCRWM transportation program had to identify likely options for an interim storage facility, including identification of the components needed for compatibility between likely interim storage facility options and transportation. Primary attention was given to existing hardware, although conceptual designs were also considered. A systems-based probabilistic decision model was suggested by Sandia National Laboratories and accepted by DOE/OCRWM's transportation program. Performance of the evaluation task involved several elements of the transportation program. This paper describes the decision model developed to accomplish this task, along with some of the results and conclusions. 1 ref., 4 figs

Evaluation of continued storage of samples at the 325 Laboratory

International Nuclear Information System (INIS)

McVey, C.B.

1996-01-01

This report provides identification of potential Program users for samples that are archived at Pacific Northwest National Laboratory (PNNL) facilities, establishes cost releated to packaging and transportation of these samples to 222-S, for continued storage at 325 facilities, disposal and transfer costs. The report provides a recommendation to dispose of 20 samples, transfer 99 samples to PNNL and to continue storage of the remaining samples at PNNL's 325 facility

Physical violence by an intimate partner and the inappropriate use of prenatal care services among women in Northeastern Brazil.

Science.gov (United States)

Carneiro, Jackelyne Faierstein; Valongueiro, Sandra; Ludermir, Ana Bernarda; Araújo, Thália Velho Barreto de

2016-01-01

To analyze the association between physical violence by an intimate partner (PVIP) and the inappropriate use of prenatal care services. A nested cross-sectional study was conducted with 1,026 women, based on data from a prospective cohort study designed to investigate intimate partner violence among pregnant women enrolled in the Family Health Program (PSF) in Recife, Northeastern Brazil. The use of prenatal care services was assessed with basis on the guidelines from the Program for Humanization of Prenatal Care and Childbirth (Brazilian Ministry of Health) and considered the time of the first prenatal care visit and the total number of visits during the pregnancy. Data were collected through two face-to-face interviews (one in the last pregnancy trimester and the other in the postpartum period), using standardized questionnaires and data on Pregnancy Card records. An unconditional logistic regression was performed to estimate the odds ratio (OR) and the 95% confidence intervals to measure the association between an PVIP and the inappropriate use of prenatal care services, using the stepwise method. The prevalence of the inappropriate use of prenatal care services was 44.1% and of an PVIP, 25.6%. In the logistic regression analysis, an intimatePVIP was associated with inappropriate prenatal care (OR = 1.37; 95%CI 1.01 - 1.85; p = 0.04) after adjustment by variables confirmed as confounders (parity, alcohol use in pregnancy, and education level). Women who are victims of an PVIP have more chance of receiving inappropriate prenatal care due to late onset of prenatal care, fewer prenatal care visits, or both.

Congenital short QT syndrome and implantable cardioverter defibrillator treatment: inherent risk for inappropriate shock delivery.

Science.gov (United States)

Schimpf, Rainer; Wolpert, Christian; Bianchi, Francesca; Giustetto, Carla; Gaita, Florenzo; Bauersfeld, Urs; Borggrefe, Martin

2003-12-01

A congenital short QT interval constitutes a new primary electrical abnormality associated with syncope and/or sudden cardiac death. We report on the initial use of implantable cardioverter defibrillator (ICD) therapy in patients with inherited short QT interval and discuss sensing abnormalities and detection issues. In five consecutive patients from two unrelated European families who had structurally normal hearts, excessively shortened QT intervals, and a strong positive family history of sudden cardiac death, ICDs were placed for primary and secondary prevention. Mean QT intervals were 252 +/- 13 ms (QTc 287 +/- 13 ms). Despite normal sensing behavior during intraoperative and postoperative device testing, 3 of 5 patients experienced inappropriate shock therapies for T wave oversensing 30 +/- 26 days after implantation. Programming lower sensitivities and decay delays prevented further inappropriate discharges. The congenital short QT syndrome constitutes a new clinical entity with an increased risk for sudden cardiac death. Currently, ICD treatment is the only therapeutic option. In patients with short QT interval and implanted ICD, increased risk for inappropriate therapy is inherent due to the detection of short-coupled and prominent T waves. Careful testing of ICD function and adaptation of sensing levels and decay delays without sacrificing correct arrhythmia detection are essential.

From passive storage to daily waste retrieval; changing the working culture at Sellafield's pile fuel storage pond

Energy Technology Data Exchange (ETDEWEB)

Carlisle, Derek [Sellafield Ltd, Seascale, Cumbria (United Kingdom)

2013-07-01

The Pile Fuel Storage Pond (PFSP) was built in 1948/50 to treat materials from the Windscale Piles. Multiple operational regimes over the intervening 60 years have resulted in a complex inventory of spent nuclear fuels, solid and liquid intermediate level wastes. A coordinated programme of work, designed to retrieve and safely dispose of the pond contents, has been implemented to enable the decommissioning of the facility. The long period of passive storage operations which preceded the implementation of the programme meant that the operator was faced with a dual challenge of providing new technical capability and changing a working culture that was inappropriate for the dynamic environment required to successfully deliver the programme. It was recognised that the nature of the programme meant that implementing a standard manufacturing approach to operations would not be appropriate. In order to create a dynamic retrievals focussed working culture, the operator has vigorously embraced change programmes aimed at improving a number of working practices including encouraging innovation, managing integrated but flexible production schedules, and encouraging work-face problem solving. The combined impact of beginning to resolve the technical challenges and focussing on the delivery culture has resulted in the facility making a step change towards becoming fully retrievals operations focussed. (authors)

From passive storage to daily waste retrieval; changing the working culture at Sellafield's pile fuel storage pond

International Nuclear Information System (INIS)

Carlisle, Derek

2013-01-01

The Pile Fuel Storage Pond (PFSP) was built in 1948/50 to treat materials from the Windscale Piles. Multiple operational regimes over the intervening 60 years have resulted in a complex inventory of spent nuclear fuels, solid and liquid intermediate level wastes. A coordinated programme of work, designed to retrieve and safely dispose of the pond contents, has been implemented to enable the decommissioning of the facility. The long period of passive storage operations which preceded the implementation of the programme meant that the operator was faced with a dual challenge of providing new technical capability and changing a working culture that was inappropriate for the dynamic environment required to successfully deliver the programme. It was recognised that the nature of the programme meant that implementing a standard manufacturing approach to operations would not be appropriate. In order to create a dynamic retrievals focussed working culture, the operator has vigorously embraced change programmes aimed at improving a number of working practices including encouraging innovation, managing integrated but flexible production schedules, and encouraging work-face problem solving. The combined impact of beginning to resolve the technical challenges and focussing on the delivery culture has resulted in the facility making a step change towards becoming fully retrievals operations focussed. (authors)

Documented Safety Analysis for the Waste Storage Facilities

Energy Technology Data Exchange (ETDEWEB)

Laycak, D

2008-06-16

This documented safety analysis (DSA) for the Waste Storage Facilities was developed in accordance with 10 CFR 830, Subpart B, 'Safety Basis Requirements', and utilizes the methodology outlined in DOE-STD-3009-94, Change Notice 3. The Waste Storage Facilities consist of Area 625 (A625) and the Decontamination and Waste Treatment Facility (DWTF) Storage Area portion of the DWTF complex. These two areas are combined into a single DSA, as their functions as storage for radioactive and hazardous waste are essentially identical. The B695 Segment of DWTF is addressed under a separate DSA. This DSA provides a description of the Waste Storage Facilities and the operations conducted therein; identification of hazards; analyses of the hazards, including inventories, bounding releases, consequences, and conclusions; and programmatic elements that describe the current capacity for safe operations. The mission of the Waste Storage Facilities is to safely handle, store, and treat hazardous waste, transuranic (TRU) waste, low-level waste (LLW), mixed waste, combined waste, nonhazardous industrial waste, and conditionally accepted waste generated at LLNL (as well as small amounts from other DOE facilities).

2012 American Geriatrics Society Beers criteria: enhanced applicability for detecting potentially inappropriate medications in European older adults? A comparison with the Screening Tool of Older Person's Potentially Inappropriate Prescriptions.

Science.gov (United States)

Blanco-Reina, Encarnación; Ariza-Zafra, Gabriel; Ocaña-Riola, Ricardo; León-Ortiz, Matilde

2014-07-01

To determine the prevalence of potentially inappropriate medications (PIMs) and related factors through a comparative analysis of the Screening Tool of Older Person's Potentially Inappropriate Prescriptions (STOPP), the 2003 Beers criteria, and the 2012 AGS update of the Beers criteria. Cross-sectional. Primary care. Community-dwelling persons aged 65 and older who live on the island of Lanzarote, Spain (N = 407). Sociodemographic characteristics; independence in activities of daily living; cognitive function; Geriatric Depression Scale; clinical diagnoses; and complete data on indication, dosage, and length of drug treatments. One thousand eight hundred seventh-two prescriptions were examined, and the rate of PIMs was assessed with the three criteria. The primary endpoint was the percentage of participants receiving at least one PIM. Multivariate logistic regression was used to examine the factors related to PIMs. Potentially inappropriate medications were present in 24.3%, 35.4%, and 44% of participants, according to the 2003 Beers criteria, STOPP, and 2012 Beers criteria, respectively. The profile of PIMs was also different (the most frequent being benzodiazepines in both Beers criteria lists and aspirin in the STOPP). The number of drugs was associated with risk of prescribing PIMs in all three models, as was the presence of a psychological disorder in the 2003 Beers criteria (odds ratio (OR) = 2.07, 95% confidence interval (CI) = 1.26-3.40) and the 2012 Beers criteria (OR = 2.91, 95% CI = 1.83-4.66). The kappa for degree of agreement between STOPP and the 2012 Beers criteria was 0.35 (95% CI = 0.25-0.44). The 2012 Beers criteria detected the highest number of PIMs, and given the scant overlapping with the STOPP criteria, the use of both tools may be seen as complementary. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Inappropriate mode switching clarified by using a chest radiograph

Directory of Open Access Journals (Sweden)

Brian Marino, DO

2015-08-01

Full Text Available An 80-year-old woman with a history of paroxysmal atrial fibrillation and atrioventricular node disease status post-dual chamber pacemaker placement was noted to have abnormal pacing episodes during a percutaneous coronary intervention. Pacemaker interrogation revealed a high number of short duration mode switching episodes. Representative electrograms demonstrated high frequency nonphysiologic recordings predominantly in the atrial lead. Intrinsic pacemaker malfunction was excluded. A chest radiograph showed excess atrial and ventricular lead slack in the right ventricular inflow. It was suspected that lead–lead interaction resulted in artifacts and oversensing, causing frequent short episodes of inappropriate mode switching.

The isolated Leptospira Spp. Identification by molecular biological techniques

Directory of Open Access Journals (Sweden)

Duangjai Suwancharoen

2017-01-01

Full Text Available Leptospirosis is a zoonotic disease caused by the bacteria of Leptospira spp. Identification of this bacterium relies on serotyping and genotyping. Data base for animal causative serovars in Thailand is limited. As the unknown serovars are found in the laboratory, they need to be sent overseas for referent identification. To reduce the cost, this research intended to develop a leptospiral identification method which is user–friendly and able to classify efficiently. Ten Leptospira isolations were cultured from urine samples. They were identified by three molecular biological techniques, including Pulsed-Field Gel Electrophoresis (PFGE, Variable Number Tandem Repeat (VNTR and Multilocus Sequence Typing (MLST. These methods were developed and compared to find the most suitable one for leptospiral identification. VNTR was found to be inappropriate since it could not identify the agents and it did not show the PCR product. PFGE and MLST gave the same results of the unknown 1 and 2 which were L.weilii sv Samin st Samin. Unknown 4 showed different results by each technique. Unknown 5 to 10 were likely to be L.meyeri sv Ranarum st ICF and Leptonema illini sv Illini st 3055 by PFGE but MLST could not identify the serovar. However, molecular biological technique for Leptospira identification should be done by several methods in order to confirm the result of each other.

Monitoring and inspection techniques for long term storage of higher activity waste packages

International Nuclear Information System (INIS)

Bolton, Gary

2013-01-01

In 2009, following recent changes in United Kingdom (UK) Government Policy, the Nuclear Decommissioning Authority (NDA) identified a knowledge gap in the area of long term interim storage of waste packages. A cross-industry Integrated Project Team (IPT) for Interim Storage was created with responsibility for delivering Industry Guidance on the storage of packaged Higher Activity Waste (HAW) for the current UK civil decommissioning and clean-up programmes. This included a remit to direct research and development projects via the NDA's Direct Research Portfolio (DRP) to fill the knowledge gap. The IPT for Interim Storage published Industry Guidance in 2012 which established a method to define generic package performance criteria and made recommendations on monitoring and inspection. The package performance method consists of the following steps; identification of the package safety function, identification of evolutionary processes that may affect safety function performance, determination of measurable indicators of these evolutionary processes and calibration of the indicators into package performance zones. This article provides an overview of three projects funded by the NDA's DRP that the UK National Nuclear Laboratory (NNL) have completed to address monitoring and inspection needs of waste packages in interim storage. (orig.)

The effect of ICD programming on inappropriate and appropriate ICD Therapies in ischemic and nonischemic cardiomyopathy: the MADIT-RIT trial.

Science.gov (United States)

Sedláček, Kamil; Ruwald, Anne-Christine; Kutyifa, Valentina; McNitt, Scott; Thomsen, Poul Erik Bloch; Klein, Helmut; Stockburger, Martin; Wichterle, Dan; Merkely, Bela; DE LA Concha, Joaquin Fernandez; Swissa, Moshe; Zareba, Wojciech; Moss, Arthur J; Kautzner, Josef; Ruwald, Martin H

2015-04-01

The MADIT-RIT trial demonstrated reduction of inappropriate and appropriate ICD therapies and mortality by high-rate cut-off and 60-second-delayed VT therapy ICD programming in patients with a primary prophylactic ICD indication. The aim of this analysis was to study effects of MADIT-RIT ICD programming in patients with ischemic and nonischemic cardiomyopathy. First and total occurrences of both inappropriate and appropriate ICD therapies were analyzed by multivariate Cox models in 791 (53%) patients with ischemic and 707 (47%) patients with nonischemic cardiomyopathy. Patients with ischemic and nonischemic cardiomyopathy had similar incidence of first inappropriate (9% and 11%, P = 0.21) and first appropriate ICD therapy (11.6% and 14.1%, P = 0.15). Patients with ischemic cardiomyopathy had higher mortality rate (6.1% vs. 3.3%, P = 0.01). MADIT-RIT high-rate cut-off (arm B) and delayed VT therapy ICD programming (arm C) compared with conventional (arm A) ICD programming were associated with a significant risk reduction of first inappropriate and appropriate ICD therapy in patients with ischemic and nonischemic cardiomyopathy (HR range 0.11-0.34, P programming and delayed VT therapy ICD programming in both ischemic and nonischemic cardiomyopathy patients. High-rate cut-off and delayed VT therapy ICD programming are associated with significant reduction in first and total inappropriate and appropriate ICD therapy in patients with ischemic and nonischemic cardiomyopathy. © 2014 Wiley Periodicals, Inc.

Excess Baggage for Birds: Inappropriate Placement of Tags on Gannets Changes Flight Patterns

Science.gov (United States)

Vandenabeele, Sylvie P.; Grundy, Edward; Friswell, Michael I.; Grogan, Adam; Votier, Stephen C.; Wilson, Rory P.

2014-01-01

Devices attached to flying birds can hugely enhance our understanding of their behavioural ecology for periods when they cannot be observed directly. For this, scientists routinely attach units to either birds' backs or their tails. However, inappropriate payload distribution is critical in aircraft and, since birds and planes are subject to the same laws of physics during flight, we considered aircraft aerodynamic constraints to explain flight patterns displayed by northern gannets Sula bassana equipped with (small ca. 14 g) tail- and back-mounted accelerometers and (larger ca. 30 g) tail-mounted GPS units. Tail-mounted GPS-fitted birds showed significantly higher cumulative numbers of flap-glide cycles and a higher pitch angle of the tail than accelerometer-equipped birds, indicating problems with balancing inappropriately placed weights with knock-on consequences relating to energy expenditure. These problems can be addressed by carefully choosing where to place tags on birds according to the mass of the tags and the lifestyle of the subject species. PMID:24671007

Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities

DEFF Research Database (Denmark)

Niwata, Satoko; Yamada, Yukari; Ikegami, Naoki

2006-01-01

dependent on the disease or condition was found in patients with chronic constipation. Multiple logistic regression analysis revealed psychotropic drug use (OR = 1.511), medication cost of per day (OR = 1.173), number of medications (OR = 1.140), and age (OR = 0.981) as factors related to inappropriate...

Inappropriate and Excessive Guilt: Instrument Validation and Developmental Differences in Relation to Depression

Science.gov (United States)

Tilghman-Osborne, Carlos; Cole, David A.; Felton, Julia W.

2012-01-01

Inappropriate or excessive guilt is listed as a symptom of depression by the American Psychiatric Association ("1994"). Although many measures of guilt have been developed, definitional and operational problems exist, especially in the application of such measures in childhood and adolescence. To address these problems, the current study…

[Severe nutritional deficiencies in young infants with inappropriate plant milk consumption].

Science.gov (United States)

Le Louer, B; Lemale, J; Garcette, K; Orzechowski, C; Chalvon, A; Girardet, J-P; Tounian, P

2014-05-01

Over the past few years, we have observed increasing consumption of inappropriate plant milks as an alternative to infant milk formula. Some families believe that foods labeled as natural are the most healthy and an appropriate nutritional choice. However, their composition does not respect European recommendations. They are always hypocaloric and protein, vitamin, and mineral concentrations are inadequate. The aim of this study was to report severe nutritional complications after inappropriate plant milk consumption. Between 2008 and 2011, we studied severe nutritional deficiencies caused by consumption of plant milks bought in health food stores or online shops. Infants were identified in our centers and examined through medical history, physical examination, and laboratory testing. Nine cases of infants aged from 4 to 14 months were observed. In all cases, these milks were used as an alternative to milk formulas for supposed cow's milk allergy. At diagnosis, four patients were aged 6 months or less. They had received plant milk exclusively for 1-3 months. The beverages consumed were rice, soya, almond and sweet chestnut milks. In three cases, infants presented severe protein-calorie malnutrition with substantial hypoalbuminemia (slow down the progress of this social trend. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Inappropriate complementary feeding practice increases risk of stunting in children aged 12-24 months

Directory of Open Access Journals (Sweden)

Hijra Hijra

2016-12-01

Inappropriate complementary feeding practice increased the risk of stunting in 12-24 months old children by 8.26. This study confirms the need to scale up interventions during the first 2 years of life, including appropriate infant feeding practices.

Effect of the Tool to Reduce Inappropriate Medications on Medication Communication and Deprescribing.

Science.gov (United States)

Fried, Terri R; Niehoff, Kristina M; Street, Richard L; Charpentier, Peter A; Rajeevan, Nallakkandi; Miller, Perry L; Goldstein, Mary K; O'Leary, John R; Fenton, Brenda T

2017-10-01

To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. Randomized clinical trial. Primary care clinics at a Veterans Affairs Medical Center. Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128). TRIM extracts information on medications and chronic conditions from the EHR and contains data entry screens for information obtained from brief chart review and telephonic patient assessment. These data serve as input for automated algorithms identifying medication reconciliation discrepancies, potentially inappropriate medications (PIMs), and potentially inappropriate regimens. Clinician feedback reports summarize discrepancies and provide recommendations for deprescribing. Patient feedback reports summarize discrepancies and self-reported medication problems. Primary: subscales of the Patient Assessment of Care for Chronic Conditions (PACIC) related to shared decision-making; clinician and patient communication. Secondary: changes in medications. 29.7% of TRIM participants and 15.6% of control participants provided the highest PACIC ratings; this difference was not significant. Adjusting for covariates and clustering of patients within clinicians, TRIM was associated with significantly more-active patient communication and facilitative clinician communication and with more medication-related communication among patients and clinicians. TRIM was significantly associated with correction of medication discrepancies but had no effect on number of medications or reduction in PIMs. TRIM improved communication about medications and accuracy of documentation. Although there was no association with prescribing, the small sample size provided limited power to examine medication-related outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The

Inappropriate shock delivery by implantable cardioverter defibrillator due to electrical interference with washing machine.

Science.gov (United States)

Chongtham, Dhanaraj Singh; Bahl, Ajay; Kumar, Rohit Manoj; Talwar, K K

2007-05-31

We report a patient with hypertrophic cardiomyopathy who received an inappropriate implantable cardioverter defibrillator shock due to electrical interference from a washing machine. This electrical interference was detected as an episode of ventricular fibrillation with delivery of shock without warning symptoms.

Statin therapy reduces inappropriate shock in non-ischemic patients with mild heart failure

DEFF Research Database (Denmark)

Ruwald, Anne-Christine H.; Zareba, Wojciech; Jons, Christian

2013-01-01

tachycardia zone of 170 to 199 bpm (arm A), high-rate cutoff with a ventricular tachycardia zone ≥200 bpm (arm B), or 60-second-delayed therapy (arm C). The end points of inappropriate therapy, appropriate therapy, and death were assessed among 485 patients with and 998 without diabetes mellitus. Innovative...

The syndrome of inappropriate antidiuretic hormone secretion after giant leaf frog (Phyllomedusa bicolor) venom exposure.

Science.gov (United States)

Leban, Vid; Kozelj, Gordana; Brvar, Miran

2016-09-15

In Europe body purification and natural balance restoring rituals are becoming increasingly popular, but an introduction of Amazonian shamanic rituals in urban Europe can result in unexpected adverse events. A 44-year-old woman attended a Kambô or Sapo ritual in Slovenia where dried skin secretion from a giant leaf frog (Phyllomedusa bicolor) was applied to five freshly burned wounds at her shoulder. Afterwards, she drank 6 litres of water and gradually developed nausea and vomiting, confusion, lethargy, muscle weakness, spasms and cramps, seizure, decreased consciousness level and short-term memory loss. The initial laboratory tests showed profound plasma hypoosmolality (251 mOsm/kg) proportional to hyponatremia (116 mmol/L) combined with inappropriately elevated urine osmolality (523 mOsm/kg) and high urine sodium concentration (87 mmol/L) indicating a syndrome of inappropriate antidiuretic hormone secretion. The patient was treated with 0.9% sodium chloride and a restriction of water intake. Plasma osmolality and hyponatremia improved one day after venom exposure, but the symptoms disappeared as late as the third day. In patients presenting with neurological symptoms and a line of small body burns Phyllomedusa bicolor venom exposure should be suspected. Acute symptomatic hyponatremia after Phyllomedusa bicolor venom exposure is the result of inappropriate antidiuretic hormone secretion that can be exacerbated by excessive water intake. Copyright © 2016 Elsevier Ltd. All rights reserved.

Is modification of the VVI backup mode in implantable cardioverter-defibrillators from St Jude medical required due to increased risk of inappropriate shocks?

DEFF Research Database (Denmark)

Philbert, Berit Thornvig; Tfelt-Hansen, Jacob; Jacobsen, Peter K

2017-01-01

Inappropriate implantable cardioverter-defibrillator (ICD) shock therapy is painful, stressful, and typically occurs unexpected in conscious patients and may be related to a less favourable prognosis. In our institution, we have observed four cases of multiple inappropriate ICD shocks during reset...... a ventricular fibrillation (VF) zone starting at 146 b.p.m., with shock therapy only and changes in sensitivity settings making the ICD more sensitive. In all cases, the reason for the multiple inappropriate shocks was that the VF zone was reached due to exercise-induced sinus tachycardia or due to oversensing...... during sinus rhythm. The VVI backup mode has to balance between protection from failure of ICD therapy during life-threatening ventricular arrhythmias and from inappropriate shocks. It seems the non-programmable parameters in VVI backup mode of St Jude Medical ICDs carry an unacceptable high risk...

Medical chilling device designed for hypothermic hydration graft storage system: Design, thermohydrodynamic modeling, and preliminary testing

Energy Technology Data Exchange (ETDEWEB)

Seo, Jung Hwan [Hongik University, Seoul (Korea, Republic of)

2015-02-15

Hypothermic hydration graft storage is essential to reduce the metabolic demand of cells in vitro. The alleviated metabolic demands reduce the emergence rate of anaerobic metabolism generating adenosine triphosphate (ATP) energy that creates free radicals. The cessive free radicals can damage cells and tissues due to their highly oxidative power with molecules. Current cooling systems such as a conventional air cooling system and an ice pack system are inappropriate for chilling cell tissues in vitro because of inconvenience in use and inconsistent temperature sustainability caused by large size and progressive melting, respectively. Here, we develop a medical chilling device (MCD) for hypothermic hydration graft storage based on thermo-hydrodynamic modeling and thermal electric cooling technology. Our analysis of obtained hydrodynamic thermal behavior of the MCD revealed that the hypothermic condition of 4 .deg. C was continuously maintained, which increased the survival rates of cells in vitro test by reduced free radicals. The validated performance of the MCD promises future development of an optimal hypothermic hydration graft storage system designed for clinical use.

Diagnosis of the syndrome of inappropriate secretion of antidiuretic hormone

DEFF Research Database (Denmark)

Holm, Ellen Astrid; Bie, Peter; Ottesen, Michael

2009-01-01

BACKGROUND: Hyponatremia is a frequent condition in elderly patients. In diagnostic workup, a 24-hour urine sample is used to measure urinary osmolality and urinary sodium concentration necessary to confirm the diagnosis of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH...... natriuretic peptides, renin, and aldosterone were measured in the supine and upright positions of patients and compared with nine healthy age-matched control patients. RESULTS: The patients had low plasma osmolality (median 266 mOsm/kg) and measurable levels of arginine vasopressin (median 1.8 pg/mL). Values...

Using an Electronic Highlighter to Eliminate the Negative Effects of Pre-Existing, Inappropriate Highlighting

Science.gov (United States)

Gier, Vicki; Kreiner, David; Hudnell, Jason; Montoya, Jodi; Herring, Daniel

2011-01-01

The purpose of the present experiment was to determine whether using an active learning technique, electronic highlighting, can eliminate the negative effects of pre-existing, poor highlighting on reading comprehension. Participants read passages containing no highlighting, appropriate highlighting, or inappropriate highlighting. We hypothesized…

Identification of irradiated pepper with comet assay

International Nuclear Information System (INIS)

Prieto Miranda, Enrique Fco.; Moreno Alvarez, Damaris L.; Carro Palacio, Sandra; Iglesia Enriquez, Isora

2007-01-01

The treatment of foods with ionizing radiations is a technological process utilized in order to increase the hygienic quality and the storage time of the foods. Several methods of detection of irradiated foods have been recommended. The comet assay of DNA is one fast and economical technique for the qualitative identification of irradiated foods. The objective of the present paper was to identify with the comet assay technique the modifications of the DNA molecule of irradiated pepper storage at environment and refrigeration temperatures and different post-irradiation times for different absorbed dose values, (0.1, 0.3 and 0.5 kGy). It was demonstrated that for the high absorbed dose values was observed a greater break into fragments of the DNA molecule, which shows the application of this technique for the identification of irradiated foods. (author)

Unique identification code for medical fundus images using blood vessel pattern for tele-ophthalmology applications.

Science.gov (United States)

Singh, Anushikha; Dutta, Malay Kishore; Sharma, Dilip Kumar

2016-10-01

Identification of fundus images during transmission and storage in database for tele-ophthalmology applications is an important issue in modern era. The proposed work presents a novel accurate method for generation of unique identification code for identification of fundus images for tele-ophthalmology applications and storage in databases. Unlike existing methods of steganography and watermarking, this method does not tamper the medical image as nothing is embedded in this approach and there is no loss of medical information. Strategic combination of unique blood vessel pattern and patient ID is considered for generation of unique identification code for the digital fundus images. Segmented blood vessel pattern near the optic disc is strategically combined with patient ID for generation of a unique identification code for the image. The proposed method of medical image identification is tested on the publically available DRIVE and MESSIDOR database of fundus image and results are encouraging. Experimental results indicate the uniqueness of identification code and lossless recovery of patient identity from unique identification code for integrity verification of fundus images. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effect of rational and irrational statements on intensity and 'inappropriateness' of emotional distress and irrational beliefs in psychotherapy patients.

Science.gov (United States)

Cramer, D; Kupshik, G

1993-09-01

Ellis's rational-emotive theory postulates that since irrational statements augment emotional distress, replacing irrational with rational statements should lessen distress. This hypothesis was tested in the initial stages of psychotherapy by having 13 and 14 clinical out-patients respectively repeat for one minute either rational or irrational statements about their major presenting psychological problem. The distinction by Ellis & Harper (1975) that 'inappropriate' emotions differ qualitatively from 'appropriate' emotions was also examined. Although the experimental intervention had no effect on a post-test measure of irrational beliefs, patients repeating rational statements had significantly lower appropriate and inappropriate negative emotions at post-test, suggesting that inappropriate emotions do not differ qualitatively from appropriate emotions and that making rational statements may lower emotional distress in patients. Patients reiterating irrational statements showed no change in emotions, implying that these kinds of irrational cognitions may have already been present.

Radiolysis of Salts and Long-Term Storage Issues for Both Pure and Impure PuO{sub 2} Materials in Plutonium Storage Containers

Energy Technology Data Exchange (ETDEWEB)

Lav Tandon

2000-05-01

The Material Identification and Surveillance (MIS) project sponsored a literature search on the effects of radiation on salts, with focus on alkali chlorides. The goal of the survey was to provide a basis for estimating the magnitude of {alpha} radiation effects on alkali chlorides that can accompany plutonium oxide (PuO{sub 2}) into storage. Chloride radiolysis can yield potentially corrosive gases in plutonium storage containers that can adversely affect long-term stability. This literature search was primarily done to provide a tutorial on this topic, especially for personnel with nonradiation chemistry backgrounds.

A case of appropriate inappropriate device therapy: Hyperkalemia-induced ventricular oversensing

OpenAIRE

Oudit, Gavin Y; Cameron, Doug; Harris, Louise

2008-01-01

The present case describes a patient who received inappropriate, but potentially life-saving, therapy from her implantable cardioverter defibrillator (ICD) in the setting of acute hyperkalemia (plasma potassium concentration = 8 mM). Hyperkalemia was associated with the development of a slow sinusoidal ventricular tachycardia, at a rate of 100 beats/min to 125 beats/min (610 ms to 480 ms) in a patient who is pacemaker-dependent. There was associated fractionation of the ICD electrogram and T ...

Identification of Hazardous Road Locations on the basis of jerks

DEFF Research Database (Denmark)

Agerholm, Niels; Jensen, Robin; Andersen, Camilla Sloth

The dark figures for the Danish traffic safety have increased for decades and are now around 91%. As the Hazardous Road Location (HRL) identification, a cornerstone in the traffic safety work, is based on the registered accidents, the identification is increasingly more random and uncertain...... on data from three months of driving by 380 cars, which is equivalent to a distance of 1.9 million km. This indicates that concentrations of decelerations are located where there are high traffic volumes, but not that the design and furniture of the road on the location can explain an HRL. This also...... indicates that concentrations of jerks can be found where the road has safety problems or is inappropriately designed. This is supported by literature dealing with this topic. On the other hand, jerks are very sensitive to unevenness in the road surface, and data from these locations must be removed...

Performance Costs when Emotion Tunes Inappropriate Cognitive Abilities: Implications for Mental Resources and Behavior

Science.gov (United States)

Storbeck, Justin

2012-01-01

Emotion tunes cognition, such that approach-motivated positive states promote verbal cognition, whereas withdrawal-motivated negative states promote spatial cognition (Gray, 2001). The current research examined whether self-control resources become depleted and influence subsequent behavior when emotion tunes an inappropriate cognitive tendency.…

Hybrid Swarm Intelligence Optimization Approach for Optimal Data Storage Position Identification in Wireless Sensor Networks

Science.gov (United States)

Mohanasundaram, Ranganathan; Periasamy, Pappampalayam Sanmugam

2015-01-01

The current high profile debate with regard to data storage and its growth have become strategic task in the world of networking. It mainly depends on the sensor nodes called producers, base stations, and also the consumers (users and sensor nodes) to retrieve and use the data. The main concern dealt here is to find an optimal data storage position in wireless sensor networks. The works that have been carried out earlier did not utilize swarm intelligence based optimization approaches to find the optimal data storage positions. To achieve this goal, an efficient swam intelligence approach is used to choose suitable positions for a storage node. Thus, hybrid particle swarm optimization algorithm has been used to find the suitable positions for storage nodes while the total energy cost of data transmission is minimized. Clustering-based distributed data storage is utilized to solve clustering problem using fuzzy-C-means algorithm. This research work also considers the data rates and locations of multiple producers and consumers to find optimal data storage positions. The algorithm is implemented in a network simulator and the experimental results show that the proposed clustering and swarm intelligence based ODS strategy is more effective than the earlier approaches. PMID:25734182

High-level waste storage tank farms/242-A evaporator standards/requirements identification document (S/RID), Vol. 4

Energy Technology Data Exchange (ETDEWEB)

1994-04-01

Radiation protection of personnel and the public is accomplished by establishing a well defined Radiation Protection Organization to ensure that appropriate controls on radioactive materials and radiation sources are implemented and documented. This Requirements Identification Document (RID) applies to the activities, personnel, structures, systems, components, and programs involved in executing the mission of the Tank Farms. The physical boundaries within which the requirements of this RID apply are the Single Shell Tank Farms, Double Shell Tank Farms, 242-A Evaporator-Crystallizer, 242-S, T Evaporators, Liquid Effluent Retention Facility (LERF), Purgewater Storage Facility (PWSF), and all interconnecting piping, valves, instrumentation, and controls. Also included is all piping, valves, instrumentation, and controls up to and including the most remote valve under Tank Farms control at any other Hanford Facility having an interconnection with Tank Farms. The boundary of the structures, systems, components, and programs to which this RID applies, is defined by those that are dedicated to and/or under the control of the Tank Farms Operations Department and are specifically implemented at the Tank Farms.

High-level waste storage tank farms/242-A evaporator standards/requirements identification document (S/RID), Vol. 4

International Nuclear Information System (INIS)

1994-04-01

Radiation protection of personnel and the public is accomplished by establishing a well defined Radiation Protection Organization to ensure that appropriate controls on radioactive materials and radiation sources are implemented and documented. This Requirements Identification Document (RID) applies to the activities, personnel, structures, systems, components, and programs involved in executing the mission of the Tank Farms. The physical boundaries within which the requirements of this RID apply are the Single Shell Tank Farms, Double Shell Tank Farms, 242-A Evaporator-Crystallizer, 242-S, T Evaporators, Liquid Effluent Retention Facility (LERF), Purgewater Storage Facility (PWSF), and all interconnecting piping, valves, instrumentation, and controls. Also included is all piping, valves, instrumentation, and controls up to and including the most remote valve under Tank Farms control at any other Hanford Facility having an interconnection with Tank Farms. The boundary of the structures, systems, components, and programs to which this RID applies, is defined by those that are dedicated to and/or under the control of the Tank Farms Operations Department and are specifically implemented at the Tank Farms

Teaching Women with Intellectual Disabilities to Identify and Report Inappropriate Staff-to-Resident Interactions

Science.gov (United States)

Bollman, Jessica R.; Davis, Paula K.

2009-01-01

This study examined the effectiveness of behavioral skills training in teaching 2 adult women with mild intellectual disabilities to report inappropriate staff-to-resident interactions. The reporting skill included making a self-advocacy response, walking away, and reporting the interaction. Participants' performance was measured during baseline,…

Modified Reporting of Positive Urine Cultures to Reduce Inappropriate Treatment of Asymptomatic Bacteriuria Among Nonpregnant, Noncatheterized Inpatients: A Randomized Controlled Trial.

Science.gov (United States)

Daley, Peter; Garcia, David; Inayatullah, Raheel; Penney, Carla; Boyd, Sarah

2018-05-28

DESIGNWe conducted a randomized, parallel, unblinded, superiority trial of a laboratory reporting intervention designed to reduce antibiotic treatment of asymptomatic bacteriuria (ASB).METHODSResults of positive urine cultures from 110 consecutive inpatients at 2 urban acute-care hospitals were randomized to standard report (control) or modified report (intervention). The standard report included bacterial count, bacterial identification, and antibiotic susceptibility information including drug dosage and cost. The modified report stated: "This POSITIVE urine culture may represent asymptomatic bacteriuria or urinary tract infection. If urinary tract infection is suspected clinically, please call the microbiology laboratory … for identification and susceptibility results." We used the following exclusion criteria: age pregnancy, presence of an indwelling urinary catheter, samples from patients already on antibiotics, neutropenia, or admission to an intensive care unit. The primary efficacy outcome was the proportion of appropriate antibiotic therapy prescribed.RESULTSAccording to our intention-to-treat (ITT) analysis, the proportion of appropriate treatment (urinary tract infection treated plus ASB not treated) was higher in the modified arm than in the standard arm: 44 of 55 (80.0%) versus 29 of 55 (52.7%), respectively (absolute difference, -27.3%; RR, 0.42; P = .002; number needed to report for benefit, 3.7).CONCLUSIONSModified reporting resulted in a significant reduction in inappropriate antibiotic treatment without an increase in adverse events. Safety should be further assessed in a large effectiveness trial before implementationTRIAL REGISTRATION. clinicaltrials.gov#NCT02797613Infect Control Hosp Epidemiol 2018;1-6.

The dynamics of female self-identification conceptions: from modernism to postmodernist feminism

Directory of Open Access Journals (Sweden)

Е Е Agafonova

2009-09-01

Full Text Available A number of new contradictions between the personality and society, including the accentuation of the problem of human being's identity and self-identification have been engendered by globalization. Whereas formerly the individual enjoyed a stable set of norms, values, and motivations determining his identity structure, nowadays social institutions bearing responsibility for the stable identity development are experiencing transformations and fail to accomplish their functions to the full extent or are actually in complete collapse. The social, economic and political status of woman has undergone the most drastic transformations resulting in pivotal changes of her identity structure and identification processes. Under the contemporary circumstances the old-fashioned modernist views and ideas about the role, status, and position of women, the traditional patterns of behaviour and value judgments turn out to be inappropriate. One can state that the classical ideas of women's self-identification are old and tired version and now it is time for a new apprehension of this significant process. The problem of identity and self-identification has been handled in a particular way both in the framework of postmodernist theories and in terms of contemporary feminist conceptions. The theorists of postmodernist feminism have put forward a sufficiently interesting and important project reconsidering female/gender identity structure as well as female identification/self-identification processes.

Morvan syndrome: a rare cause of syndrome of inappropriate antidiuretic hormone secretion

OpenAIRE

DEMIRBAS, SEREF; AYKAN, MUSA BARIS; ZENGIN, HAYDAR; MAZMAN, SEMIR; SAGLAM, KENAN

2017-01-01

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) accounts for an important part of hyponatremia cases. The causes of SIADH can be detected almost always. As a rare disorder, Morvan Syndrome can be defined by the sum of peripheral nerve hyperexcitability, autonomic instability and neuropsychiatric features. Antibodies to voltage-gated potassium channels (Anti ? VGKC-Ab) including contactin associated protein-like 2 antibodies (CASPR2-Ab) and leucine-rich glioma inactivated ...

Different patterns of inappropriate antimicrobial use in surgical and medical units at a tertiary care hospital in Switzerland: a prevalence survey.

Directory of Open Access Journals (Sweden)

Alexia Cusini

Full Text Available BACKGROUND: Unnecessary or inappropriate use of antimicrobials is associated with the emergence of antimicrobial resistance, drug toxicity, increased morbidity and health care costs. Antimicrobial use has been reported to be incorrect or not indicated in 9-64% of inpatients. We studied the quality of antimicrobial therapy and prophylaxis in hospitalized patients at a tertiary care hospital to plan interventions to improve the quality of antimicrobial prescription. METHODOLOGY/PRINCIPAL FINDINGS: Experienced infectious diseases (ID fellows performed audits of antimicrobial use at regular intervals among all patients--with or without antimicrobials--hospitalized in predefined surgical, medical, haemato-oncological, or intensive care units. Data were collected from medical and nursing patient charts with a standardized questionnaire. Appropriateness of antimicrobial use was evaluated using a modified algorithm developed by Gyssens et al.; the assessment was double-checked by a senior ID specialist. We evaluated 1577 patients of whom 700 (44.4% had antimicrobials, receiving a total of 1270 prescriptions. 958 (75.4% prescriptions were for therapy and 312 (24.6% for prophylaxis. 37.0% of therapeutic and 16.6% of prophylactic prescriptions were found to be inappropriate. Most frequent characteristics of inappropriate treatments included: No indication (17.5%; incorrect choice of antimicrobials (7.6%; incorrect application of drugs (9.3%; and divergence from institutional guidelines (8%. Characteristics of inappropriate prophylaxes were: No indication (9%; incorrect choice of antimicrobials (1%; duration too long or other inappropriate use (6.7%. Patterns of inappropriate antimicrobial varied widely in the different hospital units; empirical prescriptions were more frequently incorrect than prescriptions based on available microbiological results. CONCLUSIONS/SIGNIFICANCE: Audits of individual patient care provide important data to identify local

Can patient safety be improved by reducing the volume of “inappropriate prescribing tasks” handed over to out-of-hours junior doctors?

Directory of Open Access Journals (Sweden)

Amis SM

2018-03-01

Full Text Available Samuel Martin Amis, Tobin Henry Edgar Osicki Department of Acute Internal Medicine, South Warwickshire Foundation Trust, Warwick, UK Background: First-year doctors found that during out-of-hours shifts they were being delayed and distracted from reviewing potentially sick/deteriorating patients by a high volume of prescribing tasks. This predominately consisted of oral anticoagulation prescribing and rewrites of drug charts. We hoped that if we could reduce this burden of “inappropriate prescribing tasks”, we could not only improve junior doctors’ job satisfaction and opportunities for training but also give them more time for patient reviews. Methods: Three weekends were initially audited to quantify the number of “inappropriate prescribing tasks” using data from the hospital’s computerized task assigning system. On three subsequent weekends, a checklist was handed out to the ward teams on Friday mornings. This checklist was designed to encourage the day teams to check that drug charts would not need oral anticoagulation or rewriting over the weekend. Results: An overall reduction in “inappropriate prescribing tasks” of 46% with a specific reduction in inappropriate oral anticoagulation prescribing of 65% was observed. Inappropriate drug chart rewrites were reduced by 30%. The reduction in the mean number of pre-intervention inappropriate prescribing tasks (as a percentage of total prescribing tasks and the post-intervention mean was 6.94% (95% confidence interval −0.54 to 14.42, p-value=0.062. Conclusion: Improved job satisfaction and a perceived reduced workload were noted from post-intervention qualitative surveys. While improved patient safety directly resulting from this intervention is more difficult to establish, and the observed reduction in inappropriate prescribing was only approaching statistical significance, our colleagues commented in post-intervention feedback that they felt they had more time, and felt less

19 CFR 191.14 - Identification of merchandise or articles by accounting method.

Science.gov (United States)

2010-04-01

... applies to identification of merchandise or articles in inventory or storage, as well as identification of... identified as being received into and withdrawn from the same inventory. Even if merchandise or articles are... or articles under this section, subject to the conditions of this section. If any such inventory...

The Primary Solid Waste Storage Gaps Experienced By Nairobi ...

African Journals Online (AJOL)

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Key Words: Household Storage, Solid Waste Management; Garbage Bins. Introduction .... depends on people's identification with the SWM system. The character of SWM ..... end up in the right place, and health and safety of those handling the full ... Afullo A (2004) Environmental and occupational health aspects of waste ...

Can Physicians Identify Inappropriate Nuclear Stress Tests? An Examination of Inter-rater Reliability for the 2009 Appropriate Use Criteria for Radionuclide Imaging

Science.gov (United States)

Ye, Siqin; Rabbani, LeRoy E.; Kelly, Christopher R.; Kelly, Maureen R.; Lewis, Matthew; Paz, Yehuda; Peck, Clara L.; Rao, Shaline; Bokhari, Sabahat; Weiner, Shepard D.; Einstein, Andrew J.

2014-01-01

Background We sought to determine inter-rater reliability of the 2009 Appropriate Use Criteria (AUC) for radionuclide imaging (RNI) and whether physicians at various levels of training can effectively identify nuclear stress tests with inappropriate indications. Methods and Results Four hundred patients were randomly selected from a consecutive cohort of patients undergoing nuclear stress testing at an academic medical center. Raters with different levels of training (including cardiology attending physicians, cardiology fellows, internal medicine hospitalists, and internal medicine interns) classified individual nuclear stress tests using the 2009 AUC. Consensus classification by two cardiologists was considered the operational gold standard, and sensitivity and specificity of individual raters for identifying inappropriate tests was calculated. Inter-rater reliability of the AUC was assessed using Cohen’s kappa statistics for pairs of different raters. The mean age of patients was 61.5 years; 214 (54%) were female. The cardiologists rated 256 (64%) of 400 NSTs as appropriate, 68 (18%) as uncertain, 55 (14%) as inappropriate; 21 (5%) tests were unable to be classified. Inter-rater reliability for non-cardiologist raters was modest (unweighted Cohen’s kappa, 0.51, 95% confidence interval, 0.45 to 0.55). Sensitivity of individual raters for identifying inappropriate tests ranged from 47% to 82%, while specificity ranged from 85% to 97%. Conclusions Inter-rater reliability for the 2009 AUC for RNI is modest, and there is considerable variation in the ability of raters at different levels of training to identify inappropriate tests. PMID:25563660

Do physician outcome judgments and judgment biases contribute to inappropriate use of treatments? Study protocol

Directory of Open Access Journals (Sweden)

Lott Alison

2007-06-01

Full Text Available Abstract Background There are many examples of physicians using treatments inappropriately, despite clear evidence about the circumstances under which the benefits of such treatments outweigh their harms. When such over- or under- use of treatments occurs for common diseases, the burden to the healthcare system and risks to patients can be substantial. We propose that a major contributor to inappropriate treatment may be how clinicians judge the likelihood of important treatment outcomes, and how these judgments influence their treatment decisions. The current study will examine the role of judged outcome probabilities and other cognitive factors in the context of two clinical treatment decisions: 1 prescription of antibiotics for sore throat, where we hypothesize overestimation of benefit and underestimation of harm leads to over-prescription of antibiotics; and 2 initiation of anticoagulation for patients with atrial fibrillation (AF, where we hypothesize that underestimation of benefit and overestimation of harm leads to under-prescription of warfarin. Methods For each of the two conditions, we will administer surveys of two types (Type 1 and Type 2 to different samples of Canadian physicians. The primary goal of the Type 1 survey is to assess physicians' perceived outcome probabilities (both good and bad outcomes for the target treatment. Type 1 surveys will assess judged outcome probabilities in the context of a representative patient, and include questions about how physicians currently treat such cases, the recollection of rare or vivid outcomes, as well as practice and demographic details. The primary goal of the Type 2 surveys is to measure the specific factors that drive individual clinical judgments and treatment decisions, using a 'clinical judgment analysis' or 'lens modeling' approach. This survey will manipulate eight clinical variables across a series of sixteen realistic case vignettes. Based on the survey responses, we will be

Inappropriate implantable cardioverter-defibrillator shocks in Brugada syndrome: Pattern in primary and secondary prevention

Directory of Open Access Journals (Sweden)

Aimé Bonny

2017-01-01

Conclusion: Inappropriate shock is common in Brugada syndrome during the early periods after an ICD implantation, and seems to be more likely in asymptomatic patients. This finding may warrant a review of the indications for ICD implantation, especially in the young and apparently healthy population of patients with Brugada syndrome.

Household storage of medicines and self-medication practices in south-east Islamic Republic of Iran.

Science.gov (United States)

Foroutan, B; Foroutan, R

2014-10-12

Self-medication and inappropriate storage of medicines at home are potential health risks. This crosssectional study in south-east Islamic Republic of Iran in 2010 aimed to determine where householders kept their medicines and to assess the frequency and determinants of self-medication. Householders from different parts of Birjand city (n = 500) were visited and completed a semi-structured questionnaire. Analgesics were the most common medicines stored at home, followed by adult cold remedies and antibiotics. The refrigerator was the most common place for storing medicines (50.6%). Most householders did not consult the package inserts. Many householders (53.6%) reported that they practised self-medication, and the frequency of reuse of physicianprescribed antibiotics was high. There was a significant association between self-medication and educational level but not with age, sex, martial status, occupation and type of insurance. Better public knowledge and information about storage and risks of reuse of prescription medications is needed.

Documented Safety Analysis for the Waste Storage Facilities March 2010

Energy Technology Data Exchange (ETDEWEB)

Laycak, D T

2010-03-05

This Documented Safety Analysis (DSA) for the Waste Storage Facilities was developed in accordance with 10 CFR 830, Subpart B, 'Safety Basis Requirements,' and utilizes the methodology outlined in DOE-STD-3009-94, Change Notice 3. The Waste Storage Facilities consist of Area 625 (A625) and the Decontamination and Waste Treatment Facility (DWTF) Storage Area portion of the DWTF complex. These two areas are combined into a single DSA, as their functions as storage for radioactive and hazardous waste are essentially identical. The B695 Segment of DWTF is addressed under a separate DSA. This DSA provides a description of the Waste Storage Facilities and the operations conducted therein; identification of hazards; analyses of the hazards, including inventories, bounding releases, consequences, and conclusions; and programmatic elements that describe the current capacity for safe operations. The mission of the Waste Storage Facilities is to safely handle, store, and treat hazardous waste, transuranic (TRU) waste, low-level waste (LLW), mixed waste, combined waste, nonhazardous industrial waste, and conditionally accepted waste generated at LLNL (as well as small amounts from other DOE facilities).

Site safety progress review of spent fuel central interim storage facility. Final report

International Nuclear Information System (INIS)

Gurpinar, A.; Serva, L.; Giuliani

1995-01-01

Following the request of the Czech Power Board (CEZ) and within the scope of the Technical Cooperation Project CZR/9/003, a progress review of the site safety of the Spent Fuel Central Interim Storage Facility (SFCISF) was performed. The review involved the first two stages of the works comprising the regional survey and identification of candidate sites for the underground and surface storage options. Five sites have been identified as a result of the previous works. The following two stages will involved the identification of the preferred candidate sites for the two options and the final site qualification. The present review had the purpose of assessing the work already performed and making recommendations for the next two stages of works

Crystallization study of a glass used for fission product storage

International Nuclear Information System (INIS)

Morlevat, J.-P.; Uny, Gisele; Jacquet-Francillon, Noel.

1981-06-01

The vitreous matrix used in France is a borosilicate glass of low melting point allowing introduction of volatil fission products and of good chemical stability. However, like any glass, if storage temperature is higher than transformation temperature a partial crystallization can occur. Before final storage, it is important to determine of leaching by water eventually occuring on the choosen site is modified by crystalline phases. The aim of this study is the determination of the leaching rate and the identification of crystalline phases formed during thermal treatment and evaluation of its volumic fraction [fr

Alternatives to reduce corrosion of carbon steel storage drums

International Nuclear Information System (INIS)

Zirker, L.R.; Beitel, G.A.

1995-11-01

The major tasks of this research were (a) pollution prevention opportunity assessments on the overpacking operations for failed or corroded drums, (b) research on existing container corrosion data, (c) investigation of the storage environment of the new Resource Conservation and Recovery Act Type II storage modules, (d) identification of waste streams that demonstrate deleterious corrosion affects on drum storage life, and (e) corrosion test cell program development. Twenty-one waste streams from five US Department of Energy (DOE) sites within the DOE Complex were identified to demonstrate a deleterious effect to steel storage drums. The major components of these waste streams include acids, salts, and solvent liquids, sludges, and still bottoms. The solvent-based waste streams typically had the shortest time to failure: 0.5 to 2 years. The results of this research support the position that pollution prevention evaluations at the front end of a project or process will reduce pollution on the back end

Performance costs when emotion tunes inappropriate cognitive abilities: implications for mental resources and behavior.

Science.gov (United States)

Storbeck, Justin

2012-08-01

Emotion tunes cognition, such that approach-motivated positive states promote verbal cognition, whereas withdrawal-motivated negative states promote spatial cognition (Gray, 2001). The current research examined whether self-control resources become depleted and influence subsequent behavior when emotion tunes an inappropriate cognitive tendency. In 2 experiments, either an approach-motivated positive state or a withdrawal-motivated negative state was induced, and then participants completed a verbal or a spatial working memory task creating conditions of emotion-cognition alignment (e.g., approach/verbal) or misalignment (e.g., approach/spatial). A control condition was also included. To examine behavioral costs due to depleted self-control resources, participants completed either a Stroop task (Stroop, 1935; Experiment 1) or a Black/White implicit association test (IAT; Greenwald, McGhee, & Schwartz, 1998; Experiment 2). Participants in the misalignment conditions performed worse on the Stroop task, and they were worse at controlling their implicit attitude biases on the IAT. Thus, when emotion tunes inappropriate cognitive tendencies for one's current environment, self-control resources become depleted, impairing behavioral control. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Collecting duct renal cell carcinoma with the syndrome of inappropriate antidiuresis: An autopsy case report

Directory of Open Access Journals (Sweden)

Emi Yasuda

2013-01-01

Full Text Available A 57-year-old Japanese man visited our hospital with a moist cough. Chest radiographic imaging showed a left hilar shadow. Adenocarcinoma cells were found on cytologic screening of fresh sputum. Although multiple metastases including brain were detected, no tumor was observed in the kidneys. The patient underwent whole-brain irradiation and chemotherapy for advanced-stage lung cancer. One month before his death, carcinomatous meningitis was detected. Hyponatremia, hypo-osmolality, and hypertonic urine suggested the syndrome of inappropriate antidiuresis. Restricting water intake improved the hyponatremia; however, he developed fever and hematuria. Despite systemic administration of an antibacterial drug, he died. Primary tumor in the lung was absent, but adenocarcinoma of the right kidney was evident on autopsy. Lectin histochemical analysis of the carcinoma revealed its distal nephron origin, confirming collecting duct carcinoma. Severe carcinomatous meningitis, which is possibly caused the syndrome of inappropriate antidiuresis, was observed, with no cancer involvement of the pituitary gland and hypothalamus.

Introduction of inappropriate complementary feeding in the first year of life and associated factors in children with low socioeconomic status.

Science.gov (United States)

Dallazen, Camila; Silva, Sara Araújo da; Gonçalves, Vivian Siqueira Santos; Nilson, Eduardo Augusto Fernandes; Crispim, Sandra Patricia; Lang, Regina Maria Ferreira; Moreira, Júlia Dubois; Tietzmann, Daniela Cardoso; Vítolo, Márcia Regina

2018-02-19

The study aimed to identify factors associated with the introduction of inappropriate complementary feeding in the first year of life in children living in municipalities (counties) with low socioeconomic statusl. This was a cross-sectional multicenter study in 1,567 children 12 to 59 months of age in 48 municipalities participating in the Brazil Without Poverty plan in the South of Brazil. A structured questionnaire was applied to the children's parents to obtain socio-demographic information and the age at which inappropriate complementary foods were introduced for the first time in complementary feeding. Prevalence of introduction of sugar before four months of age was 35.5% (n = 497; 95%CI: 33.1-38.0). The prevalence rates for the introduction of cookies/crackers, creamy yogurt, and jelly before six months of age were 20.4% (n = 287; 95%CI: 18.3-22.3), 24.8% (n = 349; 95%CI: 22.4-27.1), and 13.8% (n = 192; 95%CI: 12.0-15.7), respectively. Associations were identified between low maternal schooling (PR = 1.25; 95%CI: 1.03-1.51) and low monthly family income (PR = 1.22; CI95%: 1.01-1.48) and the introduction of inappropriate complementary feeding. The study identified the introduction of inappropriate complementary feeding in the first year of life among children in municipalities with high socioeconomic vulnerability in the South of Brazil, associated with low maternal schooling and low monthly family income.

Potentially inappropriate prescribing and cost outcomes for older people: a national population study.

LENUS (Irish Health Repository)

Cahir, Caitriona

2010-05-01

Optimization of drug prescribing in older populations is a priority due to the significant clinical and economic costs of drug-related illness. This study aimed to: (i) estimate the prevalence of potentially inappropriate prescribing (PIP) in a national Irish older population using European specific explicit prescribing criteria; (ii) investigate the association between PIP, number of drug classes, gender and age and; (iii) establish the total cost of PIP.

Identification of the Area for Proper Integration of Three Current Storage Objects into One Complex Logistics Point

Directory of Open Access Journals (Sweden)

Li Chenguang

2017-05-01

Full Text Available The paper presents an option to identify the suitable area for locating the specific storage object in order to integrate three current storage objects into one complex logistics point. Initial chapters of the paper are focused on overview of theoretical terms related to the storage objects, their activities, services, parameters as well as their location and allocation. Other parts of this paper outline specific methods regarding the issue of storage objects location. Its main part describes individual steps for identifying the suitable storage object location in the certain area using the specific method.

Level, pattern, and determinants of polypharmacy and inappropriate use of medications by village doctors in a rural area of Bangladesh

Directory of Open Access Journals (Sweden)

Rasu RS

2014-12-01

Full Text Available Rafia S Rasu,1 Mohammad Iqbal,2 SMA Hanifi,2 Ariful Moula2 Shahidul Hoque,2 Sabrina Rasheed,2 Abbas Bhuiya2 1School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA; 2Centre for Equity and Health System, International Centre for Diarrhoeal Disease Research (ICDDR,B, Dhaka, Bangladesh Objective: Village doctors, informal health care providers practicing modern medicine, are dominant health care providers in rural Bangladesh. Given their role, it is important to examine their prescription pattern and inappropriate use of medication. Methods: These cross-sectional study data were collected through surveys of patients seen by village doctors during 2008 and 2010 at Chakaria, a typical rural area of Bangladesh. Categorization of appropriate, inappropriate, and harmful prescriptions by disease conditions was based on guidelines defined by the World Health Organization (WHO, the United Nations Children’s Fund (UNICEF, and the Government of Bangladesh. Analytical categorization of polypharmacy was defined when five or more medications were prescribed for a patient at a single visit. Findings: A total of 2,587 prescriptions were written by village doctors during the survey periods. Among the prescriptions were appropriate (10%, inappropriate (8%, combination of appropriate and inappropriate (63%, and harmful medications (19%. Village doctors with more than high school education were 53% less likely (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.26–0.86 to give polypharmacy prescriptions than those with less than high school education. While exploring determinants of prescribing inappropriate and harmful medications, this study found that polypharmacy prescriptions were six times more likely [OR: 6.00, 95% CI: 3.88–9.29] to have harmful medications than prescriptions with <5 medications. Conclusion: Village doctors’ training and supervision may improve the quality of services and establish accountability for the

Virtual model of an automated system for the storage of collected waste

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Enciu George

2017-01-01

Full Text Available One of the problems identified in waste collection integrated systems is the storage space. The design process of an automated system for the storage of collected waste includes finding solutions for the optimal exploitation of the limited storage space, seen that the equipment for the loading, identification, transport and transfer of the waste covers most of the available space inside the integrated collection system. In the present paper a three-dimensional model of an automated storage system designed by the authors for a business partner is presented. The storage system can be used for the following types of waste: plastic and glass recipients, aluminium cans, paper, cardboard and WEEE (waste electrical and electronic equipment. Special attention has been given to the transfer subsystem, specific for the storage system, which should be able to transfer different types and shapes of waste. The described virtual model of the automated system for the storage of collected waste will be part of the virtual model of the entire integrated waste collection system as requested by the beneficiary.

The amino acid's backup bone - storage solutions for proteomics facilities.

Science.gov (United States)

Meckel, Hagen; Stephan, Christian; Bunse, Christian; Krafzik, Michael; Reher, Christopher; Kohl, Michael; Meyer, Helmut Erich; Eisenacher, Martin

2014-01-01

Proteomics methods, especially high-throughput mass spectrometry analysis have been continually developed and improved over the years. The analysis of complex biological samples produces large volumes of raw data. Data storage and recovery management pose substantial challenges to biomedical or proteomic facilities regarding backup and archiving concepts as well as hardware requirements. In this article we describe differences between the terms backup and archive with regard to manual and automatic approaches. We also introduce different storage concepts and technologies from transportable media to professional solutions such as redundant array of independent disks (RAID) systems, network attached storages (NAS) and storage area network (SAN). Moreover, we present a software solution, which we developed for the purpose of long-term preservation of large mass spectrometry raw data files on an object storage device (OSD) archiving system. Finally, advantages, disadvantages, and experiences from routine operations of the presented concepts and technologies are evaluated and discussed. This article is part of a Special Issue entitled: Computational Proteomics in the Post-Identification Era. Guest Editors: Martin Eisenacher and Christian Stephan. Copyright © 2013. Published by Elsevier B.V.

Assessment of safety and health of storage workers - a psychosocial approach

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Joanna Sadłowska-Wrzesińska

2016-03-01

Full Text Available Background: Although there is still a lot to do as far as prevention and elimination of traditional health and work safety hazards is concerned, the problem of psychosocial risk prevention is extremely important nowadays. It is crucial to take into consideration the health of workers and promotion of health in the workplace, as the occupational stress epidemics is getting more and more widespread. Methods: The article is based on the statistic analysis of accidents at work as well as the analysis of health problems resulting from the job itself. The latest work safety reports have been reviewed and special attention has been paid to psychosocial risk analysis. The author has tried to explicate the terms of new and emerging risks as regards storage work. Results: Various threat aspects of storage work have been evaluated. Deficits in psychosocial hazard identification have been indicated. What is more, no correlation between occupational tasks of storage workers and their knowledge about psychosocial risks has been emphasized.  An exemplified approach to warehouse psychosocial threat identification has been presented. The approach is based on the diagnosis of the current situation.  Conclusions: The psychosocial risk of storage work may lead to health deterioration, greater accident risk and worse performance at work. Such consequences mean that the psychosocial risks affect both an individual and the organization. Therefore, we should expect more intense efforts to increase psychosocial risk awareness of both employers and employees.

Lean Methodology Reduces Inappropriate Use of Antipsychotics for Agitation at a Psychiatric Hospital.

Science.gov (United States)

Goga, Joshana K; Depaolo, Antonio; Khushalani, Sunil; Walters, J Ken; Roca, Robert; Zisselman, Marc; Borleis, Christopher

2017-01-01

To Evaluate the Effects of Applying Lean Methodology-Improving Quality Increasing Efficiency by Eliminating Waste and Reducing Costs-An Approach To Decrease the Prescribing Frequency of Antipsychotics for The Indication of Agitation. Historically Controlled Study. Bheppard Pratt Health System is the Largest Private Provider of Psychiatric Care in Maryland With a Total Bed Capacity of 300. There Were 4 337 Patient Days From November 1 2012 to October 31 2013 on the Dementia Unit. All Patients Admitted on the Dementia Unit Were 65 Years of Age and Older with a Primary Diagnosis of Dementia. our Multidisciplinary Team Used Lean Methodology to Identify the Root Causes and Interventions Necessary to Reduce Inappropriate Antipsychotic Use. The Primary Outcome Was Rate of Inappropriately Indicating Agitation as the Rationale When Prescribing Antipsychotic Medications. There Was a 90% (P Agitation. The Lean Methodology Interventions Led To A 90% (P Agitation and a 10% Rate Reduction in Overall Antipsychotic Prescribing. Key Words: Agitation Alzheimer's Antipsychotics Behavioral and Psychological Symptoms of Dementia Centers For Medicare & Medicaid Services Dementia Root-cause Analysis. BPSD = Behavioral and Psychological Symptoms of Dementia CATIE-AD = Clinical Antipsychotic Trials of Intervention Effectiveness in Alzheimer's Disease EMR = Electronic Medical Records GAO = Government Accountability Office GNCIS = Geriatric Neuropsychiatric Clinical Indicator Scale.

The inappropriate use of lumbar magnetic resonance imaging in a health service area; Utilizacion inapropiada de la resonancia magnetica lumbar en un area de salud

Energy Technology Data Exchange (ETDEWEB)

Rodriguez Recio, F. J.; Sanz, J. C.; Vera, S. [Hospital General de Soria (Spain); Peiro, S. [Fundacion de Investigacion en Servicios de Salud Valencia (Spain)

1999-07-01

To identify the percentage of inappropriate lumbar spine magnetic resonance imaging in the Soria Health Service, to quantify the costs and the possible association between inadequate use, the characteristics of the patient and the services requested. A descriptive study of the inappropriate use of MRI of the lumbar spine, taken from the retrospective examination, carried out by a radiologist, of the 233 MRI's requested between 1995 and 1998. For the valuation, the criteria of the American College of Radiology (ACR) and the Basque Agency for the Evaluation of Technologies (OSTEBA) were used. All the MRI's were carried out at an approved centre, the costs were calculated taken form the expenses paid by the Insalud, including the transport costs, calculated at prices applicable for the year in question. 11.7% of the studies were values as inappropriate, 2.1% debatable and the remainder adequate according to the ACR criteria, concentrating the inadequacy on studies for lumbago, that reached 80% of the inappropriate requests. The ACR and OSTEBA criteria coincided to a high degree (kappa statistics: 0.87). The expense related to the unnecessary studies was a litter higher than a million pesetas. No differences were found in the proportion of inappropriate studies according to the characteristics of the patient or the service requested, except the one already mentioned for the supposition diagnosis. Although the results of the study cannot be generalised to other environments, they suggest the possibility of a significant proportion of inappropriate use of lumbar spine MRI that could have an important repercussion on health care expenses. (Author) 11 refs.

Low temperature storage test phase 2 : identification of problem species

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-12-15

The use of renewable fuels such as biodiesel, in motor vehicle fuels is expected to grow rapidly in North America as a result of governmental mandates. Biodiesel is a fuel component made from plant and animal feedstocks via a transesterification process. The fatty acid methyl esters (FAME) of biodiesel have cloud points that range from 5 degrees C to -15 degrees C. The poor low temperature performance of blends containing FAME must be understood in order to avoid operability issues. This paper presented the results of several testing programs conducted by researchers to investigate filter plugging in biodiesel fuels caused by high levels of saturated monoglycerides. The low temperature storage stability of 57 biodiesel fuels comprised of B5 and B20 made with canola methyl ester (CME), soybean methyl ester (SME), tallow methyl ester (TME) and palm methyl ester (PME) was investigated. Filter blocking tests were conducted to assess storage stability. Deposits from the blends were analyzed using gas chromatography and mass spectrometry (GC-MS) in order to identify the problem species. Results of the study confirmed the deleterious impact of saturated mono-glycerides in FAME on the low temperature operability of filters in fuel handling systems. 11 refs., 7 tabs., 5 figs. 9 appendices.

Optimization of Experimental Model Parameter Identification for Energy Storage Systems

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Rosario Morello

2013-09-01

Full Text Available The smart grid approach is envisioned to take advantage of all available modern technologies in transforming the current power system to provide benefits to all stakeholders in the fields of efficient energy utilisation and of wide integration of renewable sources. Energy storage systems could help to solve some issues that stem from renewable energy usage in terms of stabilizing the intermittent energy production, power quality and power peak mitigation. With the integration of energy storage systems into the smart grids, their accurate modeling becomes a necessity, in order to gain robust real-time control on the network, in terms of stability and energy supply forecasting. In this framework, this paper proposes a procedure to identify the values of the battery model parameters in order to best fit experimental data and integrate it, along with models of energy sources and electrical loads, in a complete framework which represents a real time smart grid management system. The proposed method is based on a hybrid optimisation technique, which makes combined use of a stochastic and a deterministic algorithm, with low computational burden and can therefore be repeated over time in order to account for parameter variations due to the battery’s age and usage.

Using RFID to Enhance Security in Off-Site Data Storage

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Enrique de la Hoz

2010-08-01

Full Text Available Off-site data storage is one of the most widely used strategies in enterprises of all sizes to improve business continuity. In medium-to-large size enterprises, the off-site data storage processes are usually outsourced to specialized providers. However, outsourcing the storage of critical business information assets raises serious security considerations, some of which are usually either disregarded or incorrectly addressed by service providers. This article reviews these security considerations and presents a radio frequency identification (RFID-based, off-site, data storage management system specifically designed to address security issues. The system relies on a set of security mechanisms or controls that are arranged in security layers or tiers to balance security requirements with usability and costs. The system has been successfully implemented, deployed and put into production. In addition, an experimental comparison with classical bar-code-based systems is provided, demonstrating the system’s benefits in terms of efficiency and failure prevention.

Using RFID to Enhance Security in Off-Site Data Storage

Science.gov (United States)

Lopez-Carmona, Miguel A.; Marsa-Maestre, Ivan; de la Hoz, Enrique; Velasco, Juan R.

2010-01-01

Off-site data storage is one of the most widely used strategies in enterprises of all sizes to improve business continuity. In medium-to-large size enterprises, the off-site data storage processes are usually outsourced to specialized providers. However, outsourcing the storage of critical business information assets raises serious security considerations, some of which are usually either disregarded or incorrectly addressed by service providers. This article reviews these security considerations and presents a radio frequency identification (RFID)-based, off-site, data storage management system specifically designed to address security issues. The system relies on a set of security mechanisms or controls that are arranged in security layers or tiers to balance security requirements with usability and costs. The system has been successfully implemented, deployed and put into production. In addition, an experimental comparison with classical bar-code-based systems is provided, demonstrating the system’s benefits in terms of efficiency and failure prevention. PMID:22163638

Using RFID to enhance security in off-site data storage.

Science.gov (United States)

Lopez-Carmona, Miguel A; Marsa-Maestre, Ivan; de la Hoz, Enrique; Velasco, Juan R

2010-01-01

Off-site data storage is one of the most widely used strategies in enterprises of all sizes to improve business continuity. In medium-to-large size enterprises, the off-site data storage processes are usually outsourced to specialized providers. However, outsourcing the storage of critical business information assets raises serious security considerations, some of which are usually either disregarded or incorrectly addressed by service providers. This article reviews these security considerations and presents a radio frequency identification (RFID)-based, off-site, data storage management system specifically designed to address security issues. The system relies on a set of security mechanisms or controls that are arranged in security layers or tiers to balance security requirements with usability and costs. The system has been successfully implemented, deployed and put into production. In addition, an experimental comparison with classical bar-code-based systems is provided, demonstrating the system's benefits in terms of efficiency and failure prevention.

Implementation of two-party protocols in the noisy-storage model

International Nuclear Information System (INIS)

Wehner, Stephanie; Curty, Marcos; Schaffner, Christian; Lo, Hoi-Kwong

2010-01-01

The noisy-storage model allows the implementation of secure two-party protocols under the sole assumption that no large-scale reliable quantum storage is available to the cheating party. No quantum storage is thereby required for the honest parties. Examples of such protocols include bit commitment, oblivious transfer, and secure identification. Here, we provide a guideline for the practical implementation of such protocols. In particular, we analyze security in a practical setting where the honest parties themselves are unable to perform perfect operations and need to deal with practical problems such as errors during transmission and detector inefficiencies. We provide explicit security parameters for two different experimental setups using weak coherent, and parametric down-conversion sources. In addition, we analyze a modification of the protocols based on decoy states.

Diffused holographic information storage and retrieval using photorefractive optical materials

Science.gov (United States)

McMillen, Deanna Kay

Holography offers a tremendous opportunity for dense information storage, theoretically one bit per cubic wavelength of material volume, with rapid retrieval, of up to thousands of pages of information simultaneously. However, many factors prevent the theoretical storage limit from being reached, including dynamic range problems and imperfections in recording materials. This research explores new ways of moving closer to practical holographic information storage and retrieval by altering the recording materials, in this case, photorefractive crystals, and by increasing the current storage capacity while improving the information retrieved. As an experimental example of the techniques developed, the information retrieved is the correlation peak from an optical recognition architecture, but the materials and methods developed are applicable to many other holographic information storage systems. Optical correlators can potentially solve any signal or image recognition problem. Military surveillance, fingerprint identification for law enforcement or employee identification, and video games are but a few examples of applications. A major obstacle keeping optical correlators from being universally accepted is the lack of a high quality, thick (high capacity) holographic recording material that operates with red or infrared wavelengths which are available from inexpensive diode lasers. This research addresses the problems from two positions: find a better material for use with diode lasers, and reduce the requirements placed on the material while maintaining an efficient and effective system. This research found that the solutions are new dopants introduced into photorefractive lithium niobate to improve wavelength sensitivities and the use of a novel inexpensive diffuser that reduces the dynamic range and optical element quality requirements (which reduces the cost) while improving performance. A uniquely doped set of 12 lithium niobate crystals was specified and

Extent and cost of inappropriate use of tumour markers in patients with pulmonary disease: a multicentre retrospective study in Shanghai, China.

Science.gov (United States)

Zhang, Haichen; Song, Yunxiao; Zhang, Xiong; Hu, Jun; Yuan, Suwei; Ma, Jin

2018-02-28

The currently implemented healthcare reform in China requires substantial capital investment. Although overtreatment results in serious waste, inappropriate laboratory use is widespread, and overuse of tumour markers (TMs) has attracted increasing attention. Retrospective study. The respiratory, thoracic surgery and oncology departments of three hospitals in Shanghai from 2014 to 2015. Patients with chronic obstructive pulmonary disease (COPD) and primary bronchogenic lung cancer (PLC). Based on clinical guidelines and physician experience, the criteria of suitability of TM examinations were determined, and the number, cost and proportion of inappropriate TM requests were analysed. The area under the receiver operating characteristic curve for carcinoembryonic antigen+cytokeratin fragment 21-1+squamous cell carcinoma antigen+neuron-specific enolase in patients with COPD and PLC was 0.813, in accordance with the cost-effectiveness principle, indicating good clinical and health economics values. In the 2706 patients, 12 496-16 956 (58.27%-79.06%) of TM requests were inappropriate. Furthermore, the involved expense was 650 200-1 014 156 yuan, accounting for 7.69%-12.00% of examination expenses and 1.35%-2.11% of hospitalisation costs. We found that the inappropriate use of TMs was widespread for patients with pulmonary disease. Clinicians should use TMs strictly according to the guidelines to effectively manage laboratory resources and control costs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Genotypic variability and mutant identification in cicer arietinum L. by seed storage protein profiling

International Nuclear Information System (INIS)

Hameed, A.; Iqbal, N.; Shah, T.M.

2012-01-01

A collection of thirty-four chickpea genotypes, including five kabuli and twenty-nine desi, were analyzed by SDS-PAGE for seed storage protein profiling. Total soluble seed proteins were resolved on 12% gels. A low level of variability was observed in desi as compared to kabuli genotypes. Dendrogram based on electrophoretic data clustered the thirty-four genotypes in four major groups. As large number of desi genotypes illustrated identical profiles, therefore could not be differentiated on the basis of seed storage protein profiles. One kabuli genotype ILC-195 found to be the most divergent showing 86% similarity with all other genotypes. ILC-195 can be distinguished from its mutant i.e., CM-2000 and other kabuli genotypes on the basis of three peptides i.e. SSP-66, SSP-43 and SSP-39. Some proteins peptides were found to be genotype specific like SSP-26 for ICCV-92311. Uniprot and NCBI protein databases were searched for already reported and characterized seed storage proteins in chickpea. Among 33 observed peptides, only six seed storages proteins from chickpea source were available in databases. On the basis of molecular weight similarity, identified peptides were SSP-64 as Serine/Threonine dehydratase, SSP-56 as Alpha-amylase inhibitor, SSP-50 as Provicillin, SSP-39 as seed imbibition protein, SSP-35 as Isoflavane reductase and SSP-19 as lipid transport protein. Highest variability was observed in vicillin subunits and beta subunits of legumins and its polymorphic forms. In conclusion, seed storage profiling can be economically used to asses the genetic variation, phylogenetic relationship and as markers to differentiate mutants from their parents. (author)

Potentially inappropriate medication use in a city of Southeast Brazil

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Mauro Cunha Xavier Pinto

2012-03-01

Full Text Available Potentially inappropriate medication use by the Diamantina (Minas Gerais State population was investigated by analyzing medicine consumption, self-medication, polypharmacy and drug interactions of medicines prescribed among those interviewed. Level of knowledge about rational drug use and its relationship to socio-economic variables was also evaluated using a semi-structured questionnaire. This survey was based on stratified sampling of 423 individuals selected randomly. The prevalence of prescription drug consumption was 42.32% (n=179 and cardiovascular drugs were the most prescribed. Drug interactions were found in 45.81% (n=82 of prescriptions and 92.68% (n=76 of these interactions were moderate, with co-administration of cardiovascular drugs occurring in more than half of the cases. The inappropriate use of medication, according to Beers criteria, occurred in 44.73% of prescriptions to the elderly. The prevalence of self-medication was 63.34% (n=268 while 21.99% (n=91 of individuals administered medications to their children without formal prescriptions, where this practice was associated to analgesic/antipyretic consumption. The population showed a high prevalence of inappropriate use of drugs across all strata of society, representing an issue requiring effective actions to promote rational use of medicines.O consumo inapropriado de medicamentos pela população de Diamantina-MG foi investigado através da análise do consumo de medicamentos, automedicação, polifarmácia e interações medicamentosas prescritas aos entrevistados. Também foi avaliado o nível de conhecimento sobre uso racional de medicamentos e sua relação com variáveis sócio-econômicas através de um questionário semi-estruturado. Este estudo transversal foi baseado em amostragem estratificada e contou com a participação de 423 indivíduos selecionados aleatoriamente. A prevalência do consumo de medicamentos prescritos foi de 42,32% (n=179, sendo os

Response to hypothetical social scenarios in individuals with traumatic brain injury who present inappropriate social behavior: a preliminary report.

Science.gov (United States)

Gagnon, Jean; Henry, Anne; Decoste, François-Pierre; Ouellette, Michel; McDuff, Pierre; Daelman, Sacha

2013-03-01

Very little research thus far has examined the decision making that underlies inappropriate social behavior (ISB) post-TBI (traumatic brain injury). To verify the usefulness of a new instrument, the Social Responding Task, for investigating whether, in social decision making, individuals with TBI, who present inappropriate social behavior (ISB), have difficulty anticipating their own feelings of embarrassment and others' angry reactions following an ISB. Seven subjects with TBI presenting with inappropriate social behavior (TBI-ISB), 10 presenting with appropriate social behavior (TBI-ASB), and 15 healthy controls were given 12 hypothetical scenarios three times, each time ending with a different behavioral response. Subjects were asked to gauge the likelihood of their displaying the behavior in that situation (part A) and of it being followed by an angry reaction from the other or by feelings of embarrassment in themselves (part B). TBI-ISB subjects scored higher than TBI-ASB and healthy controls on a scale of likelihood of displaying an ISB. RESULTS regarding expectations of angry reactions from others and feelings of embarrassment after an ISB were similar among groups. Negative correlations between endorsement of an inappropriate behavior and anticipation of negative emotional consequences were significant for both TBI-ASB and control subjects, but not for TBI-ISB subjects. RESULTS suggest that the TBI-ISB participants were likely to endorse an ISB despite being able to anticipate a negative emotional response in themselves or others, suggesting that there were other explanations for their poor behavior. A self-reported likely response to hypothetical social scenarios can be a useful approach for studying the neurocognitive processes behind the poor choices of individuals with TBI-ISB, but the task needs further validation studies. A comprehensive discussion follows on the underlying mechanisms affecting social behaviors after a TBI.

Response to Hypothetical Social Scenarios in Individuals with Traumatic Brain Injury Who Present Inappropriate Social Behavior: A Preliminary Report

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Michel Ouellette

2013-01-01

Full Text Available Background: Very little research thus far has examined the decision making that underlies inappropriate social behavior (ISB post-TBI (traumatic brain injury. Objectives: To verify the usefulness of a new instrument, the Social Responding Task, for investigating whether, in social decision making, individuals with TBI, who present inappropriate social behavior (ISB, have difficulty anticipating their own feelings of embarrassment and others’ angry reactions following an ISB. Methods: Seven subjects with TBI presenting with inappropriate social behavior (TBI-ISB, 10 presenting with appropriate social behavior (TBI-ASB, and 15 healthy controls were given 12 hypothetical scenarios three times, each time ending with a different behavioral response. Subjects were asked to gauge the likelihood of their displaying the behavior in that situation (part A and of it being followed by an angry reaction from the other or by feelings of embarrassment in themselves (part B. Results: TBI-ISB subjects scored higher than TBI-ASB and healthy controls on a scale of likelihood of displaying an ISB. Results regarding expectations of angry reactions from others and feelings of embarrassment after an ISB were similar among groups. Negative correlations between endorsement of an inappropriate behavior and anticipation of negative emotional consequences were significant for both TBI-ASB and control subjects, but not for TBI-ISB subjects. Conclusions: Results suggest that the TBI-ISB participants were likely to endorse an ISB despite being able to anticipate a negative emotional response in themselves or others, suggesting that there were other explanations for their poor behavior. A self-reported likely response to hypothetical social scenarios can be a useful approach for studying the neurocognitive processes behind the poor choices of individuals with TBI-ISB, but the task needs further validation studies. A comprehensive discussion follows on the underlying

Plutonium waste container identification

International Nuclear Information System (INIS)

Schmierer, T.J.

1979-01-01

The purpose of this paper is to define the parameters of a method for identifying plutonium waste containers. This information will form the basis for a permanent committee to develop a complete identification program for use throughout the world. Although a large portion of the information will be on handwritten notebooks and may not be as extensive as is desired, it will all be helpful. The final information will be programmed into computer language and be available to all interested parties as well as a central control committee which will have the expertise to provide each government with advice on the packaging, storage, and measurement of the waste for which it is responsible. As time progresses, this central control committee should develop permanent storage sites and establish a system of records which will last for hundreds of years

Model calibration and beam control systems for storage rings

International Nuclear Information System (INIS)

Corbett, W.J.; Lee, M.J.; Ziemann, V.

1993-04-01

Electron beam storage rings and linear accelerators are rapidly gaining worldwide popularity as scientific devices for the production of high-brightness synchrotron radiation. Today, everybody agrees that there is a premium on calibrating the storage ring model and determining errors in the machine as soon as possible after the beam is injected. In addition, the accurate optics model enables machine operators to predictably adjust key performance parameters, and allows reliable identification of new errors that occur during operation of the machine. Since the need for model calibration and beam control systems is common to all storage rings, software packages should be made that are portable between different machines. In this paper, we report on work directed toward achieving in-situ calibration of the optics model, detection of alignment errors, and orbit control techniques, with an emphasis on developing a portable system incorporating these tools

Identification of irradiated pepper by ESR measurement

International Nuclear Information System (INIS)

Morishita, Norio; Kume, Tamikazu; Kawakami, Waichiro; Ishigaki, Isao

1988-01-01

The possibility of using electron spin resonance (ESR) for identification of irradiated black and white pepper was examined. The ESR spectra induced by irradiation with 10 kGy are clearly distinguishable from that of unirradiated samples. The intensity of signal induced by irradiation was markedly reduced during 2 weeks storage but it was slowly reduced on further storage. The difference of intensity between the irradiated and unirradiated samples can be distinguished after 13 weeks storage. In this experiment, ground black pepper, ground white pepper and whole white pepper can be identified after 13 weeks. On the other hand, whole black pepper cannot be identified after 8 weeks because of the variation of values. It suggests that the suitable method for sample preparation such as separation of pellicle of whole black pepper is required before ESR measurement. (author)

Effect of a multi-faceted quality improvement intervention on inappropriate antibiotic use in children with non-bloody diarrhoea admitted to district hospitals in Kenya

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Opondo Charles

2011-11-01

Full Text Available Abstract Background There are few reports of interventions to reduce the common but irrational use of antibiotics for acute non-bloody diarrhoea amongst hospitalised children in low-income settings. We undertook a secondary analysis of data from an intervention comprising training of health workers, facilitation, supervision and face-to-face feedback, to assess whether it reduced inappropriate use of antibiotics in children with non-bloody diarrhoea and no co-morbidities requiring antibiotics, compared to a partial intervention comprising didactic training and written feedback only. This outcome was not a pre-specified end-point of the main trial. Methods Repeated cross-sectional survey data from a cluster-randomised controlled trial of an intervention to improve management of common childhood illnesses in Kenya were used to describe the prevalence of inappropriate antibiotic use in a 7-day period in children aged 2-59 months with acute non-bloody diarrhoea. Logistic regression models with random effects for hospital were then used to identify patient and clinician level factors associated with inappropriate antibiotic use and to assess the effect of the intervention. Results 9, 459 admission records of children were reviewed for this outcome. Of these, 4, 232 (44.7% were diagnosed with diarrhoea, with 130 of these being bloody (dysentery therefore requiring antibiotics. 1, 160 children had non-bloody diarrhoea and no co-morbidities requiring antibiotics-these were the focus of the analysis. 750 (64.7% of them received antibiotics inappropriately, 313 of these being in the intervention hospitals vs. 437 in the controls. The adjusted logistic regression model showed the baseline-adjusted odds of inappropriate antibiotic prescription to children admitted to the intervention hospitals was 0.30 times that in the control hospitals (95%CI 0.09-1.02. Conclusion We found some evidence that the multi-faceted, sustained intervention described in this

Identification and characterisation of factors affecting losses in the large-scale, non-ventilated bulk storage of wood chips and development of best storage practices

Energy Technology Data Exchange (ETDEWEB)

Garstang, J.; Weekes, A.; Poulter, R.; Bartlett, D.

2002-07-01

The report describes the findings of a study to determine the factors affecting the commercial storage of wood chips for biomass power generation in the UK. The UK's first such plant in North Yorkshire uses a mixture of forestry residues and short rotation coppice (SRC) willow, where problems with the stored fuel highlighted the need to determine best storage practices. Two wood chip piles were built (one with willow chip and the other with wood chips from board leaf forestry residues) and monitored (moisture, temperature, chemical composition, spore numbers and species, heat and air flows, bulk density, etc). Local weather data was also obtained. Recommendations for future storage practices are made.

[Discontinuation of potentially inappropriate medications at the end of life: perspectives from patients, their relatives, and physicians

NARCIS (Netherlands)

Geijteman, E.C.; Tempelman, M.M.; Dees, M.K.; Huisman, B.A.H.; Perez, R.S.; Zuylen, L. van; Heide, A. van der

2017-01-01

OBJECTIVE: To obtain insight into the perspectives of patients, relatives and physicians towards potentially inappropriate medications (PIMs) at the end of life. DESIGN: Qualitative interview study. METHOD: An analysis of in-depth interviews with 17 patients who were diagnosed as having a life

AN APPROACH TO REDUCE THE STORAGE REQUIREMENT FOR BIOMETRIC DATA IN AADHAR PROJECT

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T. Sivakumar

2013-02-01

Full Text Available AADHAR is an Indian Government Project to provide unique identification to each Citizen of India. The objective of the project is to collect all the personal details and the biometric traits from each individual. Biometric traits such as iris, face and fingerprint are being collected for authentication. All the information will be stored in a centralized data repository. Considering about the storage requirement for the biometric data of the entire population of India, approximately 20,218 TB of storage space will be required. Since 10 fingerprint data are stored, fingerprint details will take most of the space. In this paper, the storage requirement for the biometric data in the AADHAR project is analyzed and a method is proposed to reduce the storage by cropping the original biometric image before storing. This method can reduce the storage space of the biometric data drastically. All the measurements given in this paper are approximate only.

Preliminary study of acoustic emission (ae) noise signal identification for crude oil storage tank

International Nuclear Information System (INIS)

Nurul Ain Ahmad Latif; Shukri Mohd

2008-08-01

This preliminary work was carried out to simulate the Acoustic Emission (AE) signal contributed by pitting corrosion, and noise signal from environment during crude oil storage tanks monitoring. The purpose of this study is to prove that acoustic emission (AE) could be used to detect the formation of pitting corrosion in the crude oil storage tank and differentiated it from other sources of noise signal. In this study, the pitting corrosion was simulated by inducing low voltage and low amperage current onto the crude oil storage tank material (ASTM 516 G 70). Water drop, air blow and surface rubbing were applied onto the specimen surface. To simulate the noise signal produce by rain fall, wind blow and other sources of noise during AE crude oil storage tanks monitoring. AE sensor was attached onto the other surface of specimen to acquire all of these AE signals which then has send to AE DiSP 24 data acquisition system for signal conditioning. AE win software has been used to analyse this entire signal. It is found that, simulated pitting corrosion could be detected by AE system and differentiated from other sources of noise by using amplitude analysis. From the amplitude analysis is shown that 20-30 dB is the range amplitude for the blow test, 50-60 dB for surface rubbing test and over than 60 dB for water drop test. (Author)

Morvan syndrome: a rare cause of syndrome of inappropriate antidiuretic hormone secretion.

Science.gov (United States)

Demirbas, Seref; Aykan, Musa Baris; Zengin, Haydar; Mazman, Semir; Saglam, Kenan

2017-01-01

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) accounts for an important part of hyponatremia cases. The causes of SIADH can be detected almost always. As a rare disorder, Morvan Syndrome can be defined by the sum of peripheral nerve hyperexcitability, autonomic instability and neuropsychiatric features. Antibodies to voltage-gated potassium channels (Anti - VGKC-Ab) including contactin associated protein-like 2 antibodies (CASPR2-Ab) and leucine-rich glioma inactivated protein 1 antibodies (LGI1-Ab) were previously known for the potential association with this condition. We present a Morvan Syndrome in a patient who presented with various neuropsychiatric symptoms and SIADH.

Energy Conversion and Storage Program

Energy Technology Data Exchange (ETDEWEB)

Cairns, E.J.

1992-03-01

The Energy Conversion and Storage Program applies chemistry and materials science principles to solve problems in (1) production of new synthetic fuels, (2) development of high-performance rechargeable batteries and fuel cells, (3) development of advanced thermochemical processes for energy conversion, (4) characterization of complex chemical processes, and (5) application of novel materials for energy conversion and transmission. Projects focus on transport-process principles, chemical kinetics, thermodynamics, separation processes, organic and physical chemistry, novel materials, and advanced methods of analysis. Electrochemistry research aims to develop advanced power systems for electric vehicle and stationary energy storage applications. Topics include identification of new electrochemical couples for advanced rechargeable batteries, improvements in battery and fuel-cell materials, and the establishment of engineering principles applicable to electrochemical energy storage and conversion. Chemical Applications research includes topics such as separations, catalysis, fuels, and chemical analyses. Included in this program area are projects to develop improved, energy-efficient methods for processing waste streams from synfuel plants and coal gasifiers. Other research projects seek to identify and characterize the constituents of liquid fuel-system streams and to devise energy-efficient means for their separation. Materials Applications research includes the evaluation of the properties of advanced materials, as well as the development of novel preparation techniques. For example, the use of advanced techniques, such as sputtering and laser ablation, are being used to produce high-temperature superconducting films.

The syndrome of inappropriate antidiuretic hormone: current and future management options.

LENUS (Irish Health Repository)

Sherlock, Mark

2010-06-01

Hyponatraemia is the commonest electrolyte abnormality, and syndrome of inappropriate antidiuretic hormone (SIADH) is the most frequent underlying pathophysiology. Hyponatraemia is associated with significant morbidity and mortality, and as such appropriate treatment is essential. Treatment options for SIADH include fluid restriction, demeclocycline, urea, frusemide and saline infusion, all of which have their limitations. The introduction of the vasopressin-2 receptor antagonists has allowed clinicians to specifically target the underlying pathophysiology of SIADH. Initial studies have shown good efficacy and safety profiles in the treatment of mild to moderate hyponatraemia. However, studies assessing the efficacy and safety of these agents in acute severe symptomatic hyponatraemia are awaited. Furthermore, the cost of these agents at present may limit their use.

Identification and characterization of radioactive wastes

International Nuclear Information System (INIS)

RANDRIAMORA, T.H.

2007-01-01

As the goal of the radioactive waste management is to protect human health and the environment, without imposing excessive constraints to the future generations, this work consists with of the identification of the radioactive waste existing in Madagascar, theirs characterizations for their later conditioning and their final storage. In this work, we used a dosimeter GRAETZ X5 C and a portable spectrometer EXPLORANIUM GR 135. These apparatuses have a great advantage at the user level because of their capacity to measure the equivalent dose rate, to identify, search and locate radiocative elements. The establishment of national center for radioactive waste management for the conditioning and the storage of spent sealed sources is the best solution for radioactive waste management in Madagascar. [fr

Independent Spent Fuel Storage Installations (ISFSI). Annual report, FY 1978

International Nuclear Information System (INIS)

Zima, G.E.

1979-03-01

The prime objective of the subject program is the identification of technical aspects of the design, operation and maintenance of independent spent fuel storage installations which could contribute to technical bases for Regulations and Regulatory Guides issued by NRC for these facilities. Activities on the various tasks of the program for the FY 1978 period are discussed in this report

An inappropriate tool: criminal law and HIV in Asia.

Science.gov (United States)

Csete, Joanne; Dube, Siddharth

2010-09-01

Asian countries have applied criminal sanctions widely in areas directly relevant to national HIV programmes and policies, including criminalization of HIV transmission, sex work, homosexuality and drug injection. This criminalization may impede universal access to HIV prevention and treatment services in Asia and undermine vulnerable people's ability to be part of the HIV response. To review the status of application of criminal law in key HIV-related areas in Asia and analyze its impact. Review of literature and application of human rights norms to analysis of criminal law measures. Criminal laws in the areas considered here and their enforcement, while intended to reduce HIV transmission, are inappropriate and counterproductive with respect to health and human rights. Governments should remove punitive laws that impede the HIV response and should ensure meaningful participation of people living with HIV, people who use illicit drugs, sex workers and men who have sex with men in combating stigma and discrimination and developing rights-centered approaches to HIV.

Analysis of Inappropriate Admissions of Residents of Medicalized Nursing Homes to Emergency Departments: A Prospective Multicenter Study in Burgundy.

Science.gov (United States)

Manckoundia, Patrick; Menu, Didier; Turcu, Alin; Honnart, Didier; Rossignol, Sylvie; Alixant, Jean-Christophe; Sylvestre, Franck-Henry; Bailly, Vanessa; Dion, Michèle; Putot, Alain

2016-07-01

To determine the rate of inappropriate admissions to emergency departments (EDs) and to identify determinants of these admissions. Prospective multicenter study. Burgundy (France), EDs and medical nursing homes (MNHs). 1000 Burgundy MNH residents admitted to EDs, from April 17 to June 20, 2013. For each subject, a questionnaire was completed. Data included age, gender, type of health professional who referred the resident to the ED (THP), whether or not a medical dispatcher organized the transfer to the ED, transport mode, reason for admission to the ED, level of independence according to the Groupes Iso-Ressource score (GIRS), and diagnosis made in the ED. The French version of the Appropriateness Evaluation Protocol grid was applied to each admission to the ED, and in some situations, the expert committee ruled on the appropriateness of the admission to the ED. MNH characteristics were also recorded. Two groups were constituted according to the appropriateness or not of admission to the ED. Mean age of the 1000 residents was 87. There were 706 women. Two-thirds were referred to the EDs by a physician, mainly a general practitioner. In 91.7%, the transfer to the ED was organized by a medical dispatcher, and 8.8% were transported by medicalized transport. More than 95% had a GIRS ≤4. Among the admissions to EDs, 18.1% were inappropriate. Female gender (P = .017), nonmedicalized transport (P = .002), public MNH (P = .044), and nonaccess to a geriatric opinion in an emergency (P = .043) were determinants of inappropriate admission to EDs. In this first study on admissions to EDs of MNH residents using French data, we found a lower rate of admissions to the ED than that reported in the literature. Female gender, nonmedicalized transport, public MNH, and nonaccess to a geriatric opinion in an emergency were associated with inappropriate admission to EDs. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier

Hypertrophic Pachymeningitis and the Syndrome of Inappropriate Antidiuretic Hormone Secretion: Coincidence or Cause?

Science.gov (United States)

Harsch, Igor Alexander; Schiffer, Anne; Konturek, Peter C

2017-01-01

To investigate a potential cause of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). A 70-year-old female patient had nausea and collapsed. Although euvolemic, pathological laboratory findings showed hyponatremia and hypoosmolality, and cerebral magnetic resonance imaging showed hypertrophic pachymeningitis. Secondary hypertrophic pachymeningitis was excluded. Other nonneurological reasons for SIADH were also excluded. Moderate fluid restriction restored an almost normal serum osmolality and sodium. This case of SIADH was conservatively treated with moderate fluid restriction that almost restored normal serum osmolality and sodium levels. © 2017 S. Karger AG, Basel.

Second Generation CO2 FEP Analysis: CASSIF - Carbon Storage Scenario Identification Framework

NARCIS (Netherlands)

Yavuz, F.; Tilburg, T. van; David, P.; Spruijt, M.; Wildenborg, T.

2009-01-01

Carbon dioxide Capture and Storage (CCS) is a promising contribution to reduce further increase of atmospheric CO2 emissions from fossil fuels. The CCS concept anticipates that large amounts of CO2 are going to be stored in the subsurface for the long term. Since CCS is a rather new technology,

A combinatorial characterization scheme for high-throughput investigations of hydrogen storage materials

International Nuclear Information System (INIS)

Hattrick-Simpers, Jason R; Chiu, Chun; Bendersky, Leonid A; Tan Zhuopeng; Oguchi, Hiroyuki; Heilweil, Edwin J; Maslar, James E

2011-01-01

In order to increase measurement throughput, a characterization scheme has been developed that accurately measures the hydrogen storage properties of materials in quantities ranging from 10 ng to 1 g. Initial identification of promising materials is realized by rapidly screening thin-film composition spread and thickness wedge samples using normalized IR emissivity imaging. The hydrogen storage properties of promising samples are confirmed through measurements on single-composition films with high-sensitivity (resolution <0.3 μg) Sievert's-type apparatus. For selected samples, larger quantities of up to ∼100 mg may be prepared and their (de)hydrogenation and micro-structural properties probed via parallel in situ Raman spectroscopy. Final confirmation of the hydrogen storage properties is obtained on ∼1 g powder samples using a combined Raman spectroscopy/Sievert's apparatus.

Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals.

LENUS (Irish Health Repository)

Gallagher, Paul

2011-11-01

Potentially inappropriate prescribing is common in older people presenting to hospital with acute illness in Ireland. The aim of this study was to determine if this phenomenon is unique to Ireland or whether it is a more widespread problem in hospitals across Europe.

Between two beds: inappropriately delayed discharges from hospitals.

Science.gov (United States)

Holmås, Tor Helge; Islam, Mohammad Kamrul; Kjerstad, Egil

2013-12-01

Acknowledging the necessity of a division of labour between hospitals and social care services regarding treatment and care of patients with chronic and complex conditions, is to acknowledge the potential conflict of interests between health care providers. A potentially important conflict is that hospitals prefer comparatively short length of stay (LOS) at hospital, while social care services prefer longer LOS all else equal. Furthermore, inappropriately delayed discharges from hospital, i.e. bed blocking, is costly for society. Our aim is to discuss which factors that may influence bed blocking and to quantify bed blocking costs using individual Norwegian patient data, merged with social care and hospital data. The data allow us to divide hospital LOS into length of appropriate stay (LAS) and length of delay (LOD), the bed blocking period. We find that additional resources allocated to social care services contribute to shorten LOD indicating that social care services may exploit hospital resources as a buffer for insufficient capacity. LAS increases as medical complexity increases indicating hospitals incentives to reduce LOS are softened by considerations related to patients’ medical needs. Bed blocking costs constitute a relatively large share of the total costs of inpatient care.

Energy storage

International Nuclear Information System (INIS)

Anon.

1992-01-01

This chapter discusses the role that energy storage may have on the energy future of the US. The topics discussed in the chapter include historical aspects of energy storage, thermal energy storage including sensible heat storage, latent heat storage, thermochemical heat storage, and seasonal heat storage, electricity storage including batteries, pumped hydroelectric storage, compressed air energy storage, and superconducting magnetic energy storage, and production and combustion of hydrogen as an energy storage option

Syndrome of inappropriate antidiuretic hormone secretion: Revisiting a classical endocrine disorder

Directory of Open Access Journals (Sweden)

Binu P Pillai

2011-01-01

Full Text Available Hyponatremia occurs in about 30% of hospitalized patients and syndrome of inappropriate antidiuretic hormone secretion (SIADH is a common cause of hyponatremia. SIADH should be differentiated from other causes of hyponatremia like diuretic therapy, hypothyroidism and hypocortisolism. Where possible, all attempts should be made to identify and rectify the cause of SIADH. The main problem in SIADH is fluid excess, and hyponatremia is dilutional in nature. Fluid restriction is the main stay in the treatment of SIADH; however, cerebral salt wasting should be excluded in the clinical setting of brain surgeries, subarachnoid hemorrhage, etc. Fluid restriction in cerebral salt wasting can be hazardous. Sodium correction in chronic hyponatremia (onset >48 hours should be done slowly to avoid deleterious effects in brain.

The Blunt Tool: Inappropriateness of the Concept of Transition for the Analyses of Democratic Consolidation

Directory of Open Access Journals (Sweden)

Dražen Lalić

2010-01-01

Full Text Available The article is analyzing the inappropriateness of the “classical” theories of transition for the analyses of democratic consolidation in the contemporary post-communist societies, including the Croatian one. The authors are claiming that the aforementioned theories are insufficient for a subtle explanation of the recent ongoing major political and social changes in the post-communist societies. The article is stressing the most characteristic examples of the “bluntness”, i.e. of the inappropriateness of the transition theory basic concepts for the analyses of democratic consolidation, as well as of the socio-cultural and socio-structural assumptions and other important concepts related to the post-communist transition phenomenon. Furthermore, the article is exposing the problems connected with various interpretations of the phases of the transition period in relation to the cleavage between the institutional constitution of the democratic system and the democratic deficit characteristic of the post-communist states. Finally, the article is bolding the necessity of re-conceptualization of the basic concepts of the theory of transition; however, not towards the construction of a new theory, but rather towards the adaptation of the existing theory to the recent social and political processes in the contemporaneous post-communist societies.

International Symposium on Site Characterization for CO2Geological Storage

Energy Technology Data Exchange (ETDEWEB)

Tsang, Chin-Fu

2006-02-23

Several technological options have been proposed to stabilize atmospheric concentrations of CO{sub 2}. One proposed remedy is to separate and capture CO{sub 2} from fossil-fuel power plants and other stationary industrial sources and to inject the CO{sub 2} into deep subsurface formations for long-term storage and sequestration. Characterization of geologic formations for sequestration of large quantities of CO{sub 2} needs to be carefully considered to ensure that sites are suitable for long-term storage and that there will be no adverse impacts to human health or the environment. The Intergovernmental Panel on Climate Change (IPCC) Special Report on Carbon Dioxide Capture and Storage (Final Draft, October 2005) states that ''Site characterization, selection and performance prediction are crucial for successful geological storage. Before selecting a site, the geological setting must be characterized to determine if the overlying cap rock will provide an effective seal, if there is a sufficiently voluminous and permeable storage formation, and whether any abandoned or active wells will compromise the integrity of the seal. Moreover, the availability of good site characterization data is critical for the reliability of models''. This International Symposium on Site Characterization for CO{sub 2} Geological Storage (CO2SC) addresses the particular issue of site characterization and site selection related to the geologic storage of carbon dioxide. Presentations and discussions cover the various aspects associated with characterization and selection of potential CO{sub 2} storage sites, with emphasis on advances in process understanding, development of measurement methods, identification of key site features and parameters, site characterization strategies, and case studies.

Geologic Water Storage in Pre-Columbian Peru

Energy Technology Data Exchange (ETDEWEB)

Fairley Jr., Jerry P.

1997-07-14

Agriculture in the arid and semi-arid regions that comprise much of present-day Peru, Bolivia, and Northern Chile is heavily dependent on irrigation; however, obtaining a dependable water supply in these areas is often difficult. The precolumbian peoples of Andean South America adapted to this situation by devising many strategies for transporting, storing, and retrieving water to insure consistent supply. I propose that the ''elaborated springs'' found at several Inka sites near Cuzco, Peru, are the visible expression of a simple and effective system of groundwater control and storage. I call this system ''geologic water storage'' because the water is stored in the pore spaces of sands, soils, and other near-surface geologic materials. I present two examples of sites in the Cuzco area that use this technology (Tambomachay and Tipon) and discuss the potential for identification of similar systems developed by other ancient Latin American cultures.

Test Plan for Cask Identification Detector

Energy Technology Data Exchange (ETDEWEB)

Rauch, Eric Benton [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-09-29

This document serves to outline the testing of a Used Fuel Cask Identification Detector (CID) currently being designed under the DOE-NE MPACT Campaign. A bench-scale prototype detector will be constructed and tested using surrogate neutron sources. The testing will serve to inform the design of the full detector that is to be used as a way of fingerprinting used fuel storage casks based on the neutron signature produced by the used fuel inside the cask.

National waste terminal storage program: configuration management plan. Volume I. Management summary

International Nuclear Information System (INIS)

1977-05-01

Objective of the Configuration Management Plan is to describe the Office of Waste Isolation's approach for the systematic identification, change control, status accounting, and auditing of: documents defining the NWTS Program and the plans for attaining the defined objectives; physical and functional characteristics of each storage site, facility, systems and equipment; and associated costs and schedules

The Association Between Potentially Inappropriate Prescribing and Medication-Related Hospital Admissions in Older Patients : A Nested Case Control Study

NARCIS (Netherlands)

van der Stelt, C. A K; Vermeulen Windsant-van den Tweel, A. M A; Egberts, A. C G; van den Bemt, P. M L A; Leendertse, A. J.; Hermens, W. A J J; van Marum, R. J.; Derijks, H. J.

2016-01-01

Introduction: Medication-related problems can cause serious adverse drug events (ADEs) that may lead to hospitalization of the patient. There are multiple screening methods to detect and reduce potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). Whether this will

The Association Between Potentially Inappropriate Prescribing and Medication-Related Hospital Admissions in Older Patients: A Nested Case Control Study

NARCIS (Netherlands)

van der Stelt, C.A.K.; Vermeulen Windsant-van den Tweel, A.M.A.; Egberts, A.C.G.|info:eu-repo/dai/nl/162850050; van den Bemt, P.M.L.A.|info:eu-repo/dai/nl/151330689; Leendertse, A.J.; Hermens, W.A.J.J.; van Marum, R.J.; Derijks, Jeroen|info:eu-repo/dai/nl/304840505

2016-01-01

Introduction: Medication-related problems can cause serious adverse drug events (ADEs) that may lead to hospitalization of the patient. There are multiple screening methods to detect and reduce potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). Whether this will

Inappropriate eating behavior: a longitudinal study with female adolescents

Directory of Open Access Journals (Sweden)

Leonardo de Sousa Fortes

2014-03-01

Full Text Available Objective: To evaluate the inappropriate eating behaviors (IEB of female adolescents over a one-year period. Methods: 290 adolescents aged between 11 and 14 years old participated in the three research stages (T1: first four months, T2: second four months and T3: third four months. The Eating Attitudes Test (EAT-26 was applied to assess the IEB. Weight and height were measured to calculate body mass index (BMI in the three study periods. Analysis of variance for repeated measures was used to analyze the data, adjusted for the scores of the Body Shape Questionnaire and the Brazil Economic Classification Criteria. Results: Girls at T1 showed a higher frequency of IEB compared to T2 (p=0.001 and T3 (p=0.001. The findings also indicated higher values for BMI in T3 in relation to T1 (p=0.04. The other comparisons did not show statistically significant differences. Conclusions: IEB scores of female adolescents declined over one year.

Energy Storage.

Science.gov (United States)

Eaton, William W.

Described are technological considerations affecting storage of energy, particularly electrical energy. The background and present status of energy storage by batteries, water storage, compressed air storage, flywheels, magnetic storage, hydrogen storage, and thermal storage are discussed followed by a review of development trends. Included are…

Automatic Priming Effects for New Associations in Lexical Decision and Perceptual Identification

NARCIS (Netherlands)

D. Pecher (Diane); J.G.W. Raaijmakers (Jeroen)

1999-01-01

textabstractInformation storage in semantic memory was investigated by looking at automatic priming effects for new associations in two experiments. In the study phase word pairs were presented in a paired-associate learning task. Lexical decision and perceptual identification were used to examine

Underground Storage Tanks - Storage Tank Locations

Data.gov (United States)

NSGIC Education | GIS Inventory — A Storage Tank Location is a DEP primary facility type, and its sole sub-facility is the storage tank itself. Storage tanks are aboveground or underground, and are...

Cold-storage defects in butter and their relation to the autoxidation of unsaturated fatty acids

NARCIS (Netherlands)

Badings, H.T.

1970-01-01

In this thesis investigations are described of the identification of aroma compounds which are formed as a result of oxidative deterioration of butter during cold storage, producing a typical trainy (fishy) off-flavour. As these flavour defects are caused chiefly by autoxidative breakdown of

Symptomatic Hypoglycemia Related to Inappropriately High IGF-II Serum Levels in a Patient with Desmoplastic Small Round Cell Tumor

Directory of Open Access Journals (Sweden)

Williams Fernandes Barra

2010-01-01

Full Text Available A 45-year old man was diagnosed with desmoplastic small round cell tumor (DSRCT with involvement of the peritoneum and pelvis. Disease progression was observed despite systemic chemotherapy. Six months after diagnosis, he developed severe hypoglycemia presented with seizures. He received intravenous glucose infusion and hydrocortisone with poor glycemic control, but with seizures resolution. The investigation excluded insulinoma, adrenal, liver and GH deficiencies. Laboratory showed slight rise of IGF-II and significant increase of the ratio IGF-II : IGF-I, which is pathognomonic of non-islet cell tumor hypoglycemia (NICTH. He received the diagnoses of NICTH related to IGF-II inappropriate production by DSRCT. Despite the attempt to control tumor mass and hypoglycemia, the patient died 9 months after diagnosis. NICTH related to inappropriate IGF-II secretion should be investigated in all cancer patients with refractory hypoglycemia whom insulinoma and other metabolic abnormalities were excluded from.

The Prevalence of Inappropriate Image Duplication in Biomedical Research Publications

Science.gov (United States)

Casadevall, Arturo; Fang, Ferric C.

2016-01-01

ABSTRACT Inaccurate data in scientific papers can result from honest error or intentional falsification. This study attempted to determine the percentage of published papers that contain inappropriate image duplication, a specific type of inaccurate data. The images from a total of 20,621 papers published in 40 scientific journals from 1995 to 2014 were visually screened. Overall, 3.8% of published papers contained problematic figures, with at least half exhibiting features suggestive of deliberate manipulation. The prevalence of papers with problematic images has risen markedly during the past decade. Additional papers written by authors of papers with problematic images had an increased likelihood of containing problematic images as well. As this analysis focused only on one type of data, it is likely that the actual prevalence of inaccurate data in the published literature is higher. The marked variation in the frequency of problematic images among journals suggests that journal practices, such as prepublication image screening, influence the quality of the scientific literature. PMID:27273827

Short notes and reviews Simplifying hydrozoan classification: inappropriateness of the group Hydroidomedusae in a phylogenetic context

OpenAIRE

Marques, Antonio C.

2001-01-01

The systematics of Hydrozoa is considered from the viewpoint of logical consistency between phylogeny and classification. The validity of the nominal taxon Hydroidomedusae (including all groups of Hydrozoa except the Siphonophorae) is discussed with regard to its distinctness and inclusive relationships. In general, phylogenetic systematic evidence suggest that the use of the term Hydroidomedusae is inappropriate given our current level of understanding. It is concluded that no new, or resurr...

Electronic palatal rugae impression: a potentially relevant technology in personal identification

Directory of Open Access Journals (Sweden)

Fabrizio Guerra

2016-06-01

Full Text Available Forensic medicine is now able to identify people through lots of different systems. Actually, fingerprints identification is the mostused identification method. To avoid identifying, many people alter or erase their fingerprints through chemical and / or abrasivesystems. The study of palatal rugae (palatoscopy is an identification technique today accepted by the international scientificcommunity as an alternative, safe and effective identification system, because of their characteristic feature of immutability andindividuality. Currently, the most used procedure is dental impression through plaster casts or photographs. The difficulties in therecording and cast’s storage limited the use of this identification system in comparison with others techniques. In order to improvethe palatal rugae analysis system, we designed a software, connected to a camera device that allows to acquire the palatal impression,to easily identify the salient palatal features and to store them in a database. This would permit a fast, simple and economicrecognition method that could be used without the need of specific staff training and that could easily be integrated with the existingfingerprint identification systems.

Resource Conservation and Recovery Act (RCRA) Part B permit application for tank storage units at the Oak Ridge Y-12 Plant

International Nuclear Information System (INIS)

1994-05-01

In compliance with the Resource Conservation and Recovery Act (RCRA), this report discusses information relating to permit applications for three tank storage units at Y-12. The storage units are: Building 9811-1 RCRA Tank Storage Unit (OD-7); Waste Oil/Solvent Storage Unit (OD-9); and Liquid Organic Solvent Storage Unit (OD-10). Numerous sections discuss the following: Facility description; waste characteristics; process information; groundwater monitoring; procedures to prevent hazards; contingency plan; personnel training; closure plan, post closure plan, and financial requirements; record keeping; other federal laws; organic air emissions; solid waste management units; and certification. Sixteen appendices contain such items as maps, waste analyses and forms, inspection logs, equipment identification, etc

Durability of spent nuclear fuels and facility components in wet storage

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-04-01

Wet storage continues to be the dominant option for the management of irradiated fuel elements and assemblies (fuel units). Fuel types addressed in this study include those used in: power reactors, research and test reactors, and defence reactors. Important decisions must be made regarding acceptable storage modes for a broad variety of fuel types, involving numerous combinations of fuel and cladding materials. A broadly based materials database has the following important functions: to facilitate solutions to immediate and pressing materials problems; to facilitate decisions on the most effective long term interim storage methods for numerous fuel types; to maintain and update a basis on which to extend the licenses of storage facilities as regulatory periods expire; to facilitate cost-effective transfer of numerous fuel types to final disposal. Because examinations of radioactive materials are expensive, access to materials data and experience that provide an informed basis to analyse and extrapolate materials behaviour in wet storage environments can facilitate identification of cost-effective approaches to develop and maintain a valuable materials database. Fuel storage options include: leaving the fuel in wet storage, placing the fuel in canisters with cover gases, stored underwater, or transferring the fuel to one of several dry storage modes, involving a range of conditioning options. It is also important to anticipate the condition of the various materials as periods of wet storage are extended or as decisions to transfer to dry storage are implemented. A sound basis for extrapolation is needed to assess fuel and facility component integrity over the expected period of wet storage. A materials database also facilitates assessment of the current condition of specific fuel and facility materials, with minimal investments in direct examinations. This report provides quantitative and semi-quantitative data on materials behaviour or references sources of data to

Durability of spent nuclear fuels and facility components in wet storage

International Nuclear Information System (INIS)

1998-04-01

Wet storage continues to be the dominant option for the management of irradiated fuel elements and assemblies (fuel units). Fuel types addressed in this study include those used in: power reactors, research and test reactors, and defence reactors. Important decisions must be made regarding acceptable storage modes for a broad variety of fuel types, involving numerous combinations of fuel and cladding materials. A broadly based materials database has the following important functions: to facilitate solutions to immediate and pressing materials problems; to facilitate decisions on the most effective long term interim storage methods for numerous fuel types; to maintain and update a basis on which to extend the licenses of storage facilities as regulatory periods expire; to facilitate cost-effective transfer of numerous fuel types to final disposal. Because examinations of radioactive materials are expensive, access to materials data and experience that provide an informed basis to analyse and extrapolate materials behaviour in wet storage environments can facilitate identification of cost-effective approaches to develop and maintain a valuable materials database. Fuel storage options include: leaving the fuel in wet storage, placing the fuel in canisters with cover gases, stored underwater, or transferring the fuel to one of several dry storage modes, involving a range of conditioning options. It is also important to anticipate the condition of the various materials as periods of wet storage are extended or as decisions to transfer to dry storage are implemented. A sound basis for extrapolation is needed to assess fuel and facility component integrity over the expected period of wet storage. A materials database also facilitates assessment of the current condition of specific fuel and facility materials, with minimal investments in direct examinations. This report provides quantitative and semi-quantitative data on materials behaviour or references sources of data to

Encephalitis associated with inappropriate antidiuretic hormone secretion due to chikungunya infection in Recife, State of Pernambuco, Brazil

Directory of Open Access Journals (Sweden)

Norma Lucena-Silva

Full Text Available Abstract The symptoms of chikungunya virus (CHIKV infection include fever, headache, muscle aches, skin rash, and polyarthralgia, characterized by intense pain, edema, and temporary functional impairment. This is the first report of encephalitis caused by CHIKV infection associated with an atypical presentation of syndrome of inappropriate antidiuretic hormone secretion, evolving to cognitive impairment and apraxia of speech.

Neutrino Signals in Electron-Capture Storage-Ring Experiments

Directory of Open Access Journals (Sweden)

Avraham Gal

2016-06-01

Full Text Available Neutrino signals in electron-capture decays of hydrogen-like parent ions P in storage-ring experiments at GSI are reconsidered, with special emphasis placed on the storage-ring quasi-circular motion of the daughter ions D in two-body decays P → D + ν e . It is argued that, to the extent that daughter ions are detected, these detection rates might exhibit modulations with periods of order seconds, similar to those reported in the GSI storage-ring experiments for two-body decay rates. New dedicated experiments in storage rings, or using traps, could explore these modulations.

Gas storage materials, including hydrogen storage materials

Science.gov (United States)

Mohtadi, Rana F; Wicks, George G; Heung, Leung K; Nakamura, Kenji

2013-02-19

A material for the storage and release of gases comprises a plurality of hollow elements, each hollow element comprising a porous wall enclosing an interior cavity, the interior cavity including structures of a solid-state storage material. In particular examples, the storage material is a hydrogen storage material such as a solid state hydride. An improved method for forming such materials includes the solution diffusion of a storage material solution through a porous wall of a hollow element into an interior cavity.

Potentially inappropriate medications in elderly Japanese patients: effects of pharmacists' assessment and intervention based on Screening Tool of Older Persons' Potentially Inappropriate Prescriptions criteria ver.2.

Science.gov (United States)

Kimura, T; Ogura, F; Yamamoto, K; Uda, A; Nishioka, T; Kume, M; Makimoto, H; Yano, I; Hirai, M

2017-04-01

The Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (stopp) criteria were updated in 2014 (stopp criteria ver.2), but few studies have evaluated the usefulness of stopp criteria in elderly patients. This prospective observational study evaluated the prevalence of potentially inappropriate medications (PIMs), and the efficacy of hospital pharmacists' assessment and intervention based on stopp criteria ver.2. The study was conducted at three medical units of Kobe University Hospital between April 2015 and March 2016. Pharmacists assessed and detected PIMs based on stopp criteria ver.2 and considered the patient's intention to change the prescription at the time of admission of each patient. If the pharmacists judged that benefits outweighed risks of prescription change and the patients consented to change the medications, they recommended the doctor to change the prescription. If there was a risk of exacerbation of disease by the change of medications and the pharmacists judged it to be difficult to adjust medications during hospitalization or the patients did not consent to change the medications, they did not recommend to change it. The pharmacists and the doctors discussed and finally decided whether to change the PIMs or not. The number of patients prescribed PIMs, the number and contents of PIMs, and the number of medications changed after pharmacists' intervention were calculated. Totally, 822 new inpatients aged ≥65 years prescribed ≥1 daily medicine were included. Their median (interquartile range) age was 75·0 (71·0-80·0) years, and 54·9% were male. According to the criteria, 346 patients (42·1%) were prescribed ≥1 PIMs. Patients prescribed PIMs took significantly more medications than others: 10·0 (7·0-13·0) vs. 6·0 (4·0-9·0), P older people (benzodiazepines) (30/67) and (iii) drugs that predictably increase the risk of falls in older people (hypnotic Z-drugs) (15/31). Over 40% elderly patients were prescribed PIMs

A case of appropriate inappropriate device therapy: Hyperkalemia-induced ventricular oversensing

Science.gov (United States)

Oudit, Gavin Y; Cameron, Doug; Harris, Louise

2008-01-01

The present case describes a patient who received inappropriate, but potentially life-saving, therapy from her implantable cardioverter defibrillator (ICD) in the setting of acute hyperkalemia (plasma potassium concentration = 8 mM). Hyperkalemia was associated with the development of a slow sinusoidal ventricular tachycardia, at a rate of 100 beats/min to 125 beats/min (610 ms to 480 ms) in a patient who is pacemaker-dependent. There was associated fractionation of the ICD electrogram and T wave oversensing, leading to ventricular oversensing with resultant detection in the ventricular fibrillation rate zone. This was followed by shock therapy, even though the ventricular tachycardia rate was below the programmed detection rate of the ICD. The subsequent emergency treatment of the hyperkalemia normalized the electrogram, corrected the ventricular oversensing and arrhythmia, and restored rate-adaptive single-chamber ventricular pacing. PMID:18340383

Frontotemporal dementia caused by CHMP2B mutation is characterised by neuronal lysosomal storage pathology

DEFF Research Database (Denmark)

Clayton, Emma L.; Mizielinska, Sarah; Edgar, James R.

2015-01-01

Mutations in the charged multivesicular body protein 2B (CHMP2B) cause frontotemporal dementia (FTD). We report that mice which express FTD-causative mutant CHMP2B at physiological levels develop a novel lysosomal storage pathology characterised by large neuronal autofluorescent aggregates...... in human CHMP2B mutation brain than in neurodegenerative disease or age-matched control brains. These data suggest that lysosomal storage pathology is the major neuronal pathology in FTD caused by CHMP2B mutation. Recent evidence suggests that two other genes associated with FTD, GRN and TMEM106B...... are important for lysosomal function. Our identification of lysosomal storage pathology in FTD caused by CHMP2B mutation now provides evidence that endolysosomal dysfunction is a major degenerative pathway in FTD....

Identification of QTLs for seed germination capability after various storage periods using two RIL populations in rice.

Science.gov (United States)

Jiang, Wenzhu; Lee, Joohyun; Jin, Yong-Mei; Qiao, Yongli; Piao, Rihua; Jang, Sun Mi; Woo, Mi-Ok; Kwon, Soon-Wook; Liu, Xianhu; Pan, Hong-Yu; Du, Xinglin; Koh, Hee-Jong

2011-04-01

Seed germination capability of rice is one of the important traits in the production and storage of seeds. Quantitative trait loci (QTL) associated with seed germination capability in various storage periods was identified using two sets of recombinant inbred lines (RILs) which derived from crosses between Milyang 23 and Tong 88-7 (MT-RILs) and between Dasanbyeo and TR22183 (DT-RILs). A total of five and three main additive effects (QTLs) associated with seed germination capability were identified in MT-RILs and DT-RILs, respectively. Among them, six QTLs were identified repeatedly in various seed storage periods designated as qMT-SGC5.1, qMT-SGC7.2, and qMT-SGC9.1 on chromosomes 5, 7, and 9 in MT-RILs, and qDT-SGC2.1, qDT-SGC3.1, and qDT-SGC9.1 on chromosomes 2, 3, and 9 in DT-RILs, respectively. The QTL on chromosome 9 was identified in both RIL populations under all three storage periods, explaining up to 40% of the phenotypic variation. Eight and eighteen pairs additive × additive epistatic effect (epistatic QTL) were identified in MT-RILs and DT-RILs, respectively. In addition, several near isogenic lines (NILs) were developed to confirm six repeatable QTL effects using controlled deterioration test (CDT). The identified QTLs will be further studied to elucidate the mechanisms controlling seed germination capability, which have important implications for long-term seed storage.

A novel mutation in PNPLA2 leading to neutral lipid storage disease with myopathy.

Science.gov (United States)

Ash, Daniel B; Papadimitriou, Dimitra; Hays, Arthur P; Dimauro, Salvatore; Hirano, Michio

2012-09-01

Mutations in PNPLA2, a gene encoding adipose triglyceride lipase, lead to neutral lipid storage disease with myopathy. To report the clinical and molecular features of a case of neutral lipid storage disease with myopathy resulting from a novel mutation in PNPLA2. Case report. University hospital. A 65-year-old man with progressive muscle weakness and high serum creatine kinase levels. Direct sequencing of the PNPLA2 gene. Identification of a novel homozygous mutation in the patient's PNPLA2 gene confirmed the suspected diagnosis of neutral lipid storage disease with myopathy. Screening of the PNPLA2 gene should be considered for patients presenting with high levels of creatine kinase, progressive muscle weakness, and systemic lipid accumulation. The presence of Jordans anomaly can be a strong diagnostic clue.

PC-Cluster based Storage System Architecture for Cloud Storage

OpenAIRE

Yee, Tin Tin; Naing, Thinn Thu

2011-01-01

Design and architecture of cloud storage system plays a vital role in cloud computing infrastructure in order to improve the storage capacity as well as cost effectiveness. Usually cloud storage system provides users to efficient storage space with elasticity feature. One of the challenges of cloud storage system is difficult to balance the providing huge elastic capacity of storage and investment of expensive cost for it. In order to solve this issue in the cloud storage infrastructure, low ...

Assessing materials handling and storage capacities in port terminals

Science.gov (United States)

Dinu, O.; Roşca, E.; Popa, M.; Roşca, M. A.; Rusca, A.

2017-08-01

Terminals constitute the factual interface between different modes and, as a result, buffer stocks are unavoidable whenever transport flows with different discontinuities meet. This is the reason why assessing materials handling and storage capacities is an important issue in the course of attempting to increase operative planning of logistic processes in terminals. Proposed paper starts with a brief review of the compatibilities between different sorts of materials and corresponding transport modes and after, a literature overview of the studies related to ports terminals and their specialization is made. As a methodology, discrete event simulation stands as a feasible technique for assessing handling and storage capacities at the terminal, taking into consideration the multi-flows interaction and the non-uniform arrivals of vessels and inland vehicles. In this context, a simulation model, that integrates the activities of an inland water terminal and describes the essential interactions between the subsystems which influence the terminal capacity, is developed. Different scenarios are simulated for diverse sorts of materials, leading to bottlenecks identification, performance indicators such as average storage occupancy rate, average dwell or transit times estimations, and their evolution is analysed in order to improve the transfer operations in the logistic process

Microbiological method for radiation sterilization (I). General knowledge and handling technique for bacterial identification

International Nuclear Information System (INIS)

Koshikawa, Tomihiko

2004-01-01

The part I in this title series describes the basic knowledge and technique for identification of bacteria in the radiation sterilization of medical devices, where the radiation dose can be decided from the number and radio-resistance of the bioburden (bacteria on the device). Four essential, actual technologies for identification are described: isolation and storage of bacteria; decision of bacterial natures, involving 3 Gram staining methods, morphology by microscopy and/or phase-contrast microscopy, spore-forming bacteria, and size measurement by micrometry; Other test items for identification of genus, involving motility, oxygen demand, catalase, oxidase, acid production from glucose, and OF (oxidation or fermentation for glucose degradation) test; and colony observation. Media, identification kits and record forms for these are presented. (N.I.)

SOLID-STATE STORAGE DEVICE WITH PROGRAMMABLE PHYSICAL STORAGE ACCESS

DEFF Research Database (Denmark)

2017-01-01

a storage device action request, and the storage device evaluating a first rule of the one or more rules by determining if the received request fulfills request conditions comprised in the first rule, and in the affirmative the storage device performing request actions comprised in the first rule......Embodiments of the present invention includes a method of operating a solid-state storage device, comprising a storage device controller in the storage device receiving a set of one or more rules, each rule comprising (i) one or more request conditions to be evaluated for a storage device action...... request received from a host computer, and (ii) one or more request actions to be performed on a physical address space of a non-volatile storage unit in the solid-state storage device in case the one or more request conditions are fulfilled; the method further comprises: the storage device receiving...

Identification of Shewanella baltica as the most important H2S-producing species during iced storage of Danish marine fish.

Science.gov (United States)

Fonnesbech Vogel, Birte; Venkateswaran, Kasthuri; Satomi, Masataka; Gram, Lone

2005-11-01

Shewanella putrefaciens has been considered the main spoilage bacteria of low-temperature stored marine seafood. However, psychrotropic Shewanella have been reclassified during recent years, and the purpose of the present study was to determine whether any of the new Shewanella species are important in fish spoilage. More than 500 H2S-producing strains were isolated from iced stored marine fish (cod, plaice, and flounder) caught in the Baltic Sea during winter or summer time. All strains were identified as Shewanella species by phenotypic tests. Different Shewanella species were present on newly caught fish. During the warm summer months the mesophilic human pathogenic S. algae dominated the H2S-producing bacterial population. After iced storage, a shift in the Shewanella species was found, and most of the H2S-producing strains were identified as S. baltica. The 16S rRNA gene sequence analysis confirmed the identification of these two major groups. Several isolates could only be identified to the genus Shewanella level and were separated into two subgroups with low (44%) and high (47%) G+C mol%. The low G+C% group was isolated during winter months, whereas the high G+C% group was isolated on fish caught during summer and only during the first few days of iced storage. Phenotypically, these strains were different from the type strains of S. putrefaciens, S. oneidensis, S. colwelliana, and S. affinis, but the high G+C% group clustered close to S. colwelliana by 16S rRNA gene sequence comparison. The low G+C% group may constitute a new species. S. baltica, and the low G+C% group of Shewanella spp. strains grew well in cod juice at 0 degrees C, but three high G+C Shewanella spp. were unable to grow at 0 degrees C. In conclusion, the spoilage reactions of iced Danish marine fish remain unchanged (i.e., trimethylamine-N-oxide reduction and H2S production); however, the main H2S-producing organism was identified as S. baltica.

Developing new transportable storage casks for interim dry storage

International Nuclear Information System (INIS)

Hayashi, K.; Iwasa, K.; Araki, K.; Asano, R.

2004-01-01

Transportable storage metal casks are to be consistently used during transport and storage for AFR interim dry storage facilities planning in Japan. The casks are required to comply with the technical standards of regulations for both transport (hereinafter called ''transport regulation'') and storage (hereafter called ''storage regulation'') to maintain safety functions (heat transfer, containment, shielding and sub-critical control). In addition to these requirements, it is not planned in normal state to change the seal materials during storage at the storage facility, therefore it is requested to use same seal materials when the casks are transported after storage period. The dry transportable storage metal casks that satisfy the requirements have been developed to meet the needs of the dry storage facilities. The basic policy of this development is to utilize proven technology achieved from our design and fabrication experience, to carry out necessary verification for new designs and to realize a safe and rational design with higher capacity and efficient fabrication

How to predict a high rate of inappropriateness for upper endoscopy in an endoscopic centre?

Science.gov (United States)

Buri, L; Bersani, G; Hassan, C; Anti, M; Bianco, M A; Cipolletta, L; Di Giulio, E; Di Matteo, G; Familiari, L; Ficano, L; Loriga, P; Morini, S; Pietropaolo, V; Zambelli, A; Grossi, E; Intraligi, M; Tessari, F; Buscema, M

2010-09-01

Inappropriateness of upper endoscopy (EGD) indication causes decreased diagnostic yield. Our aim of was to identify predictors of appropriateness rate for EGD among endoscopic centres. A post-hoc analysis of two multicentre cross-sectional studies, including 6270 and 8252 patients consecutively referred to EGD in 44 (group A) and 55 (group B) endoscopic Italian centres in 2003 and 2007, respectively, was performed. A multiple forward stepwise regression was applied to group A, and independently validated in group B. A <70% threshold was adopted to define inadequate appropriateness rate clustered by centre. discrete variability of clustered appropriateness rates among the 44 group A centres was observed (median: 77%; range: 41-97%), and a <70% appropriateness rate was detected in 11 (25%). Independent predictors of centre appropriateness rate were: percentage of patients referred by general practitioners (GP), rate of urgent examinations, prevalence of relevant diseases, and academic status. For group B, sensitivity, specificity and area under receiver operating characteristic curve of the model in detecting centres with a <70% appropriateness rate were 54%, 93% and 0.72, respectively. A simple predictive rule, based on rate of patients referred by GPs, rate of urgent examinations, prevalence of relevant diseases and academic status, identified a small subset of centres characterised by a high rate of inappropriateness. These centres may be presumed to obtain the largest benefit from targeted educational programs. Copyright (c) 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Identification of Error of Commissions in the LOCA Using the CESA Method

Energy Technology Data Exchange (ETDEWEB)

Tukhbyet-olla, Myeruyert; Kang, Sunkoo; Kim, Jonghyun [KEPCO international nuclear graduate school, Ulsan (Korea, Republic of)

2015-10-15

An Errors of commission (EOCs) can be defined as the performance of any inappropriate action that aggravates the situation. The primary focus in current PSA is placed on those sequences of hardware failures and/or EOOs that lead to unsafe system states. Although EOCs can be treated when identified, a systematic and comprehensive treatment of EOC opportunities remains outside the scope of PSAs. However, some past experiences in the nuclear industry show that EOCs have contributed to severe accidents. Some recent and emerging human reliability analysis (HRA) methods suggest approaches to identify and quantify EOCs, such as ATHEANA, MERMOS, GRS, MDTA, and CESA. The CESA method, developed by the Risk and Human Reliability Group at the Paul Scherrer Institute, is to identify potentially risk-significant EOCs, given an existing PSA. The main idea underlying the method is to catalog the key actions that are required in the procedural response to plant events and to identify specific scenarios in which these candidate actions could erroneously appear to be required. This paper aims at identifying EOCs in the LOCA by using the CESA method. This study is focused on the identification of EOCs, while the quantification of EOCs is out of scope. Then, this paper applies the CESA method to the emergency operating procedure (EOP) of LOCA for APR1400. Finally, this study presents potential EOCs that may lead to the aggravation in the mitigation of LOCA. This study has identified the EOC events for APR1400 in the LOCA using CESA method. The result identified three candidate EOCs event using operator action catalog and RAW cutset of LOCA. These candidate EOC events are inappropriate terminations of safety injection system, safety injection tank and containment spray system. Then after reviewing top 100 accident sequences of PSA, this study finally identified one EOC scenario and EOC path, that is, inappropriate termination of safety injection system.

Implementation of a Computerized Order Entry Tool to Reduce the Inappropriate and Unnecessary Use of Cardiac Stress Tests With Imaging in Hospitalized Patients.

Science.gov (United States)

Gertz, Zachary M; O'Donnell, William; Raina, Amresh; Balderston, Jessica R; Litwack, Andrew J; Goldberg, Lee R

2016-10-15

The rising use of imaging cardiac stress tests has led to potentially unnecessary testing. Interventions designed to reduce inappropriate stress testing have focused on the ambulatory setting. We developed a computerized order entry tool intended to reduce the use of imaging cardiac stress tests and improve appropriate use in hospitalized patients. The tool was evaluated using preimplementation and postimplementation cohorts at a single urban academic teaching hospital. All hospitalized patients referred for testing were included. The co-primary outcomes were the use of imaging stress tests as a percentage of all stress tests and the percentage of inappropriate tests, compared between the 2 cohorts. There were 478 patients in the precohort and 463 in the postcohort. The indication was chest pain in 66% and preoperative in 18% and was not significantly different between groups. The use of nonimaging stress tests increased from 4% in the pregroup to 15% in the postgroup (p nonimaging stress tests increased from 7% to 25% (p nonimaging cardiac stress tests and reduced the use of imaging tests yet was not able to reduce inappropriate use. Our study highlights the differences in cardiac stress testing between hospitalized and ambulatory patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Inappropriate pharmacological treatment in older adults affected by cardiovascular disease and other chronic comorbidities: a systematic literature review to identify potentially inappropriate prescription indicators

Directory of Open Access Journals (Sweden)

Lucenteforte E

2017-10-01

Full Text Available Ersilia Lucenteforte,1 Niccolò Lombardi,1,* Davide Liborio Vetrano,2,* Domenico La Carpia,2,* Zuzana Mitrova,3 Ursula Kirchmayer,3 Giovanni Corrao,4 Francesco Lapi,5 Alessandro Mugelli,1 Alfredo Vannacci1 On behalf of the Italian Group for Appropriate Drug prescription in the Elderly (I-GrADE 1Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA, University of Florence, Florence, Italy; 2Department of Geriatrics Catholic University, Rome, Italy; 3Department of Epidemiology, ASL 1 Rome, Italy; 4Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy; 5Epidemiology Unit, ARS Toscana, Florence, Italy *These authors contributed equally to this work Abstract: Avoiding medications in which the risks outweigh the benefits in the elderly patient is a challenge for physicians, and different criteria to identify inappropriate prescription (IP exist to aid prescribers. Definition of IP indicators in the Italian geriatric population affected by cardiovascular disease and chronic comorbidities could be extremely useful for prescribers and could offer advantages from a public health perspective. The purpose of the present study was to identify IP indicators by means of a systematic literature review coupled with consensus criteria. A systematic search of PubMed, EMBASE, and CENTRAL databases was conducted, with the search structured around four themes and combining each with the Boolean operator “and”. The first regarded “prescriptions”, the second “adverse events”, the third “cardiovascular conditions”, and the last was planned to identify studies on “older people”. Two investigators independently reviewed titles, abstracts, full texts, and selected articles addressing IP in the elderly affected by cardiovascular condition using the following inclusion criteria: studies on people aged ≥65 years; studies on patients with no restriction on age but with data on subjects

Effects of Transport and Storage Conditions on Gene Expression in Blood Samples.

Science.gov (United States)

Malentacchi, Francesca; Pizzamiglio, Sara; Wyrich, Ralf; Verderio, Paolo; Ciniselli, Chiara; Pazzagli, Mario; Gelmini, Stefania

2016-04-01

Inappropriate handling of blood samples might induce or repress gene expression and/or lead to RNA degradation affecting downstream analysis. In particular, sample transport is a critical step for biobanking or multicenter studies because of uncontrolled variables (i.e., unstable temperature). We report the results of a pilot study implemented within the EC funded SPIDIA project, aimed to investigate the role of transport and storage of blood samples containing and not containing an RNA stabilizer. Blood was collected from a single donor both in EDTA and in PAXgene Blood RNA tubes. Half of the samples were sent to a second laboratory both at room temperature and at 4°C, whereas the remaining samples were stored at room temperature and at 4°C. Gene expression of selected genes (c-FOS, IL-1β, IL-8, and GAPDH) known to be induced or repressed by ex vivo blood handling and of blood-mRNA quality biomarkers identified and validated within the SPIDIA project, which allow for monitoring changes in unstabilized blood samples after collection and during transport and storage, were analyzed by RT-qPCR. If the shipment of blood in tubes not containing RNA stabilizer is not performed under a stable condition, gene profile studies can be affected by the effects of transport. Moreover, also controlled temperature shipment (4°C) can influence the expression of specific genes if blood is collected in tubes not containing a stabilizer. The use of dedicated biomarkers or time course experiments should be performed in order to verify potential bias on gene expression analysis due to sample shipment and storage conditions. Alternatively, the use of RNA stabilizer containing tubes can represent a reliable option to avoid ex vivo RNA changes.

Evaluation of storage/transportation options to support criteria development for the Phase I MRS

International Nuclear Information System (INIS)

Sorenson, K.B.; Brown, N.N.; Bennett, P.C.; Lake, W.

1991-01-01

The DOE's Office of Civilian Waste Management (OCRWM) plans to develop an interim storage facility to enable acceptance of spent fuel in 1998. It is estimated that this interim storage facility would be needed for about two years. A Monitored Retrievable Storage (MRS) facility is anticipated in 2000 and a repository in 2010. Acceptance and transport of spent fuel by DOE/OCRWM in 1998 will require an operating transportation system. Because this interim storage facility is not yet defined, development of an optimally compatible transportation system is not a certainty. In order to assure a transport capability for 1998 acceptance of spent fuel, it was decided that the OCRWM transportation program had to identify likely options for an interim storage facility, including identification of the components needed for compatibility between likely interim storage facility options and transportation. Primary attention was given to existing hardware, although conceptual designs were also considered. A systems-based probabilistic decision model was suggested by Sandia National Labs. and accepted by DOE/OCRWM's transportation program. Performance of the evaluation task involved several elements of the transportation program. This paper describes the decision model developed to accomplish this task, along with some of the results and conclusions

Vancomycin intoxication in a patient with inappropriate antidiuretic hormone syndrome and diarrhea

Directory of Open Access Journals (Sweden)

Patricia Hidalgo-Collazos

2015-07-01

Full Text Available Vancomycin is an antibiotic used for infections by gram-positive bacteria with a two-compartment pharmacokinetic model. Its monitoring has an established therapeutic range (10-20 mg/L to prevent nephrotoxicity and ototoxicity due to supratherapeutic levels, and inefficiency and development of resistance by subtherapeutic levels. Nephrotoxicity for vancomycin monotherapy at standard doses according to pathogen and typical regimens (usual dose: 15-20 mg/kg/12 h is rare and usually reversible. Moreover, monitoring plasma concentrations allows to achieve concentrations within therapeutic range to allow safe and effective drug use. The renal hypoperfusion can cause pre-renal damage, resulting in elevated levels of serum creatinine, resulting in decreased antibiotic elimination and nephrotoxicity. We report a case of unexpected vancomycin nephrotoxicity in a patient with syndrome Inappropriate antidiuretic hormone secretion associated paraneoplastic

Southern Adriatic sea as a potential area for CO2 geological storage

International Nuclear Information System (INIS)

Volpi, V.; Forlin, F.; Donda, F.; Civile, D.; Facchin, L.; Sauli, L.; Merson, B.; Sinza-Mendieta, K.; Shams, A.

2015-01-01

The Southern Adriatic Sea is one of the five prospective areas for CO 2 storage being evaluated under the three year (FP7) European SiteChar project dedicated to the characterization of European CO 2 storage sites. The potential reservoir for CO 2 storage is represented by a carbonate formation, the wackstones and packstones of the Scaglia Formation (Upper Cretaceous-Paleogene). In this paper, we present the geological characterization and the 3D modeling that led to the identification of three sites, named Grazia, Rovesti and Grifone, where the Scaglia Formation, with an average thickness of 50 m, reveals good petrophysical characteristics and is overlain by an up to 1 200 thick cap-rock. The vicinity of the selected sites to the Enel - Federico II power plant (one of the major Italian CO 2 emitter) where a pilot plant for CO 2 capture has been already started in April 2010, represents a good opportunity to launch the first Carbon Capture and Storage (CCS) pilot project in Italy and to apply this technology at industrial level, strongly contributing at the same time at reducing the national CO 2 emissions. (authors)

Electron spin resonance identification of irradiated fruits

International Nuclear Information System (INIS)

Raffi, J.J.; Agnel, J.-P.L.

1989-01-01

The electron spin resonance spectrum of achenes, pips, stalks and stones from irradiated fruits (stawberry, raspberry, red currant, bilberry, apple, pear, fig, french prune, kiwi, water-melon and cherry) always displays, just after γ-treatment, a weak triplet (a H ∼30 G) due to a cellulose radical; its left line (lower field) can be used as an identification test of irradiation, at least for strawberries, raspberries, red currants or bilberries irradiated in order to improve their storage time. (author)

Developing new transportable storage casks for interim dry storage

Energy Technology Data Exchange (ETDEWEB)

Hayashi, K.; Iwasa, K.; Araki, K.; Asano, R. [Hitachi Zosen Diesel and Engineering Co., Ltd., Tokyo (Japan)

2004-07-01

Transportable storage metal casks are to be consistently used during transport and storage for AFR interim dry storage facilities planning in Japan. The casks are required to comply with the technical standards of regulations for both transport (hereinafter called ''transport regulation'') and storage (hereafter called ''storage regulation'') to maintain safety functions (heat transfer, containment, shielding and sub-critical control). In addition to these requirements, it is not planned in normal state to change the seal materials during storage at the storage facility, therefore it is requested to use same seal materials when the casks are transported after storage period. The dry transportable storage metal casks that satisfy the requirements have been developed to meet the needs of the dry storage facilities. The basic policy of this development is to utilize proven technology achieved from our design and fabrication experience, to carry out necessary verification for new designs and to realize a safe and rational design with higher capacity and efficient fabrication.

Criteria for recladding of spent light water reactor fuel before long term pool storage

International Nuclear Information System (INIS)

Pettersson, K.; Jansson, L.

1979-01-01

The question of the need for any special treatment of failed fuel elements prior to long term pool storage has been studied. It is concluded that the main problem appears to be hydride embrittlement of failed fuel rods, which may lead to increased damage during handling and transport of the failed fuel. Some mechanisms for the degradation of failed fuel rods have been identified. They can all be considered as relatively improbable, but further experimental evidence is needed before it can be concluded that these degradation mechanisms are insignificant during pool storage. The report also contains a review of methods for identification of leaking fuel bundles and fuel rods. (Auth.)

Criteria for recladding of spent light water reactor fuel before long term pool storage

International Nuclear Information System (INIS)

Pettersson, K.; Jansson, L.

1979-06-01

The question of the need for any special treatment of failed fuel elements prior to long term pool storage has been studied. It is concluded that the main problem appears to be hydride embrittlement of failed fuel rods, which may lead to increased damage during handling and transport of the failed fuel. Some mechanisms for the degradation of failed fuel rods have been identified. They can all be considered as relatively improbable, but further experimental evidence is needed before it can be concluded that thede degradation mechanisms are insignificant during pool storage. The report also contains a review of methods for identification of leaking fuel bundles and fuel rods.(author)

Unexplained abdominal pain as a driver for inappropriate therapeutics: an audit on the use of intravenous proton pump inhibitors.

Science.gov (United States)

Lai, Pauline Siew Mei; Wong, Yin Yen; Low, Yong Chia; Lau, Hui Ling; Chin, Kin-Fah; Mahadeva, Sanjiv

2014-01-01

Background. Proton pump inhibitors (PPIs) are currently the most effective agents for acid-related disorders. However, studies show that 25-75% of patients receiving intravenous PPIs had no appropriate justification, indicating high rates of inappropriate prescribing. Objective. To examine the appropriate use of intravenous PPIs in accordance with guidelines and the efficacy of a prescribing awareness intervention at an Asian teaching institution. Setting. Prospective audit in a tertiary hospital in Malaysia. Method. Every 4th intravenous PPI prescription received in the pharmacy was screened against hospital guidelines. Interventions for incorrect indication/dose/duration were performed. Patients' demographic data, medical history and the use of intravenous PPI were collected. Included were all adult inpatients prescribed intravenous PPI. Main Outcome Measure. Proportion of appropriate IV PPI prescriptions. Results. Data for 106 patients were collected. Most patients were male [65(61.3%)], Chinese [50(47.2%)], with mean age ± SD = 60.3 ± 18.0 years. Most intravenous PPI prescriptions were initiated by junior doctors from the surgical [47(44.3%)] and medical [42(39.6%)] departments. Only 50/106(47.2%) patients had upper gastrointestinal endoscopy/surgery performed to verify the source of bleeding. Unexplained abdominal pain [81(76.4%)] was the main driver for prescribing intravenous PPIs empirically, out of which 73(68.9%) were for suspected upper gastrointestinal bleed. Overall, intravenous PPI was found to be inappropriately prescribed in 56(52.8%) patients for indication, dose or duration. Interventions on the use of intravenous PPI were most effective when performed by senior doctors (100%), followed by clinical pharmacists (50%), and inpatient pharmacists (37.5%, p = 0.027). Conclusion. Inappropriate intravenous PPI usage is still prevalent despite the enforcement of hospital guidelines. The promotion of prescribing awareness and evidence-based prescribing

De-implementation strategy to Reduce the Inappropriate use of urinary and intravenous CATheters: study protocol for the RICAT-study.

Science.gov (United States)

Laan, Bart J; Spijkerman, Ingrid J B; Godfried, Mieke H; Pasmooij, Berend C; Maaskant, Jolanda M; Borgert, Marjon J; Opmeer, Brent C; Vos, Margreet C; Geerlings, Suzanne E

2017-01-10

Urinary and (peripheral and central) intravenous catheters are widely used in hospitalized patients. However, up to 56% of the catheters do not have an appropriate indication and some serious complications with the use of these catheters can occur. The main objective of our quality improvement project is to reduce the use of catheters without an appropriate indication by 25-50%, and to evaluate the affecting factors of our de-implementation strategy. In a multicenter, prospective interrupted time series analysis, several interventions to avoid inappropriate use of catheters will be conducted in seven hospitals in the Netherlands. Firstly, we will define a list of appropriate indications for urinary and (peripheral and central) intravenous catheters, which will restrict the use of catheters and urge catheter removal when the indication is no longer appropriate. Secondly, after the baseline measurements, the intervention will take place, which consists of a kick-off meeting, including a competitive feedback report of the baseline measurements, and education of healthcare workers and patients. Additional strategies based on the baseline data and local conditions are optional. The primary endpoint is the percentage of catheters with an inappropriate indication on the day of data collection before and after the de-implementation strategy. Secondary endpoints are catheter-related infections or other complications, catheter re-insertion rate, length of hospital (and ICU) stay and mortality. In addition, the cost-effectiveness of the de-implementation strategy will be calculated. This study aims to reduce the use of urinary and intravenous catheters with an inappropriate indication, and as a result reduce the catheter-related complications. If (cost-) effective it provides a tool for a nationwide approach to reduce catheter-related infections and other complications. Dutch trial registry: NTR6015 . Registered 9 August 2016.

Can attribution theory explain carers' propensity to help men with intellectual disabilities who display inappropriate sexual behaviour?

Science.gov (United States)

Willner, P; Smith, M

2008-01-01

This study examined the responses of care managers and direct care staff to vignettes of inappropriate sexual behaviour by a man with an intellectual disability. The aim was to test the theory that helping behaviour is determined by emotional responses (positive and negative emotional reactions, and optimism), which in turn are determined by causal attributions (respectively: controllability and stability of the incident depicted in the vignette). The vignettes varied in response topography and the age of the victim. Regression analysis was used to examine the relationships between causal attributions, emotional responses, and willingness to invest extra time and effort in the service user's care. No support was found for the pathway: low controllability --> increased sympathy and/or decreased negative emotions --> increased helping. However, strong support was found for the pathway: low stability --> high optimism --> increased helping, particularly in direct care staff. High levels of sympathy were also associated with increased helping, the effect again being mediated by feelings of optimism. The data provide support for one (but not the other) strand of attribution theory as applied to inappropriate sexual behaviour. The discussion considers the discrepancy between the present data and the far less encouraging literature on attribution theory as applied to challenging behaviour.

Safety in transport and storage of radioactive materials

International Nuclear Information System (INIS)

Mezrahi, A.; Xavier, A.M.

1987-01-01

The increasing utilization of radioisotopes in Industrial, Medical and Research Facilities as well as the processing of Nuclear Materials involve transport activities in a routine basis. The present work has the following main objectives: I) the identification of the safety aspects related to handling, transport and storage of radioactive materials; II) the orientation of the personnel responsible for the radiological safety of Radioactive Installations viewing the elaboration and implementation of procedures to minimize accidents; III) the report of case-examples of accidents that have occured in Brazil due to non-compliance with Transport Regulations. (author) [pt

Energy storage

Science.gov (United States)

Kaier, U.

1981-04-01

Developments in the area of energy storage are characterized, with respect to theory and laboratory, by an emergence of novel concepts and technologies for storing electric energy and heat. However, there are no new commercial devices on the market. New storage batteries as basis for a wider introduction of electric cars, and latent heat storage devices, as an aid for solar technology applications, with satisfactory performance standards are not yet commercially available. Devices for the intermediate storage of electric energy for solar electric-energy systems, and for satisfying peak-load current demands in the case of public utility companies are considered. In spite of many promising novel developments, there is yet no practical alternative to the lead-acid storage battery. Attention is given to central heat storage for systems transporting heat energy, small-scale heat storage installations, and large-scale technical energy-storage systems.

Technical and economic assessment of fluidized bed augmented compressed air energy storage system. Volume III. Preconceptual design

Energy Technology Data Exchange (ETDEWEB)

Giramonti, A.J.; Lessard, R.D.; Merrick, D.; Hobson, M.J.

1981-09-01

A technical and economic assessment of fluidized bed combustion augmented compressed air energy storage systems is presented. The results of this assessment effort are presented in three volumes. Volume III - Preconceptual Design contains the system analysis which led to the identification of a preferred component configuration for a fluidized bed combustion augmented compressed air energy storage system, the results of the effort which transformed the preferred configuration into preconceptual power plant design, and an introductory evaluation of the performance of the power plant system during part-load operation and while load following.

Impact of legislation and a prescription monitoring program on the prevalence of potentially inappropriate prescriptions for monitored drugs in Ontario: a time series analysis

Science.gov (United States)

Juurlink, David; Yao, Zhan; Camacho, Ximena; Paterson, J. Michael; Singh, Samantha; Dhalla, Irfan; Sproule, Beth; Mamdani, Muhammad

2014-01-01

Background The increased use of opioid analgesics, sedative hypnotics and stimulants, coupled with the associated risks of overdose have raised concerns around the inappropriate prescribing of these monitored drugs. We assessed the impact of new legislation, the Narcotics Safety and Awareness Act, and a centralized Narcotics Monitoring System (implemented November 2011 and May 2012, respectively), on the dispensing of prescriptions suggestive of misuse. Methods We conducted a time series analysis of publicly funded prescriptions for opioids, benzodiazepines and stimulants dispensed monthly in Ontario from January 2007 to May 2013, based on information in the Ontario Public Drug Benefit Database. In the primary analysis, a prescription was deemed potentially inappropriate if it was dispensed within 7 days of an earlier prescription and was for at least 30 tablets of a drug in the same class as the earlier prescription, but originated from a different physician and a different pharmacy. Results After enactment of the new legislation, the prevalence of potentially inappropriate opioid prescriptions decreased by 12.5% in 6 months (from 1.6% in October 2011 to 1.4% in April 2012; p = 0.01). No further significant change was observed after the introduction of the narcotic monitoring system (p = 0.8). By May 2013, the prevalence had dropped to 1.0%. Inappropriate benzodiazepine prescribing was significantly influenced by both the legislation (p significantly influenced by the introduction of the monitoring system in May 2012, falling from 0.7% in April 2012 to 0.3% in May 2013 (p = 0.02). Interpretation For a select group of drugs prone to misuse and diversion, legislation and a prescription monitoring program reduced the prevalence of prescriptions suggestive of misuse. This suggests that regulatory interventions can promote appropriate prescribing which could potentially be applied to other jurisdictions and drugs of concern. PMID:25485251

Identification of Components or Fractions Associated with Adverse Changes in Freeze Dried Chicken and Pork during Storage

Science.gov (United States)

1978-06-01

objective of which was to further define and correlate the majur physical, chemical. and sensory changes which occur during the storage deterioration of pr...changes in freeze-dried chicken and pork during high temper-ao -r ature, oxygen-free storage. This effort was undertaken as part of the U.S. Air Force ...for 20 minutes, drained for five minutes, and weighed. Water was expressed from the rehydrated samples by a 500-kg Instron activated force acting

Dynamic Prediction of Power Storage and Delivery by Data-Based Fractional Differential Models of a Lithium Iron Phosphate Battery

Directory of Open Access Journals (Sweden)

Yunfeng Jiang

2016-07-01

Full Text Available A fractional derivative system identification approach for modeling battery dynamics is presented in this paper, where fractional derivatives are applied to approximate non-linear dynamic behavior of a battery system. The least squares-based state-variable filter (LSSVF method commonly used in the identification of continuous-time models is extended to allow the estimation of fractional derivative coefficents and parameters of the battery models by monitoring a charge/discharge demand signal and a power storage/delivery signal. In particular, the model is combined by individual fractional differential models (FDMs, where the parameters can be estimated by a least-squares algorithm. Based on experimental data, it is illustrated how the fractional derivative model can be utilized to predict the dynamics of the energy storage and delivery of a lithium iron phosphate battery (LiFePO 4 in real-time. The results indicate that a FDM can accurately capture the dynamics of the energy storage and delivery of the battery over a large operating range of the battery. It is also shown that the fractional derivative model exhibits improvements on prediction performance compared to standard integer derivative model, which in beneficial for a battery management system.

A new method, with application, for analysis of the impacts on flood risk of widely distributed enhanced hillslope storage

Directory of Open Access Journals (Sweden)

P. Metcalfe

2018-04-01

Full Text Available Enhanced hillslope storage is utilised in natural flood management in order to retain overland storm run-off and to reduce connectivity between fast surface flow pathways and the channel. Examples include excavated ponds, deepened or bunded accumulation areas, and gullies and ephemeral channels blocked with wooden barriers or debris dams. The performance of large, distributed networks of such measures is poorly understood. Extensive schemes can potentially retain large quantities of run-off, but there are indications that much of their effectiveness can be attributed to desynchronisation of sub-catchment flood waves. Inappropriately sited measures may therefore increase, rather than mitigate, flood risk. Fully distributed hydrodynamic models have been applied in limited studies but introduce significant computational complexity. The longer run times of such models also restrict their use for uncertainty estimation or evaluation of the many potential configurations and storm sequences that may influence the timings and magnitudes of flood waves.Here a simplified overland flow-routing module and semi-distributed representation of enhanced hillslope storage is developed. It is applied to the headwaters of a large rural catchment in Cumbria, UK, where the use of an extensive network of storage features is proposed as a flood mitigation strategy. The models were run within a Monte Carlo framework against data for a 2-month period of extreme flood events that caused significant damage in areas downstream. Acceptable realisations and likelihood weightings were identified using the GLUE uncertainty estimation framework. Behavioural realisations were rerun against the catchment model modified with the addition of the hillslope storage. Three different drainage rate parameters were applied across the network of hillslope storage. The study demonstrates that schemes comprising widely distributed hillslope storage can be modelled effectively within such a

A new method, with application, for analysis of the impacts on flood risk of widely distributed enhanced hillslope storage

Science.gov (United States)

Metcalfe, Peter; Beven, Keith; Hankin, Barry; Lamb, Rob

2018-04-01

Enhanced hillslope storage is utilised in natural flood management in order to retain overland storm run-off and to reduce connectivity between fast surface flow pathways and the channel. Examples include excavated ponds, deepened or bunded accumulation areas, and gullies and ephemeral channels blocked with wooden barriers or debris dams. The performance of large, distributed networks of such measures is poorly understood. Extensive schemes can potentially retain large quantities of run-off, but there are indications that much of their effectiveness can be attributed to desynchronisation of sub-catchment flood waves. Inappropriately sited measures may therefore increase, rather than mitigate, flood risk. Fully distributed hydrodynamic models have been applied in limited studies but introduce significant computational complexity. The longer run times of such models also restrict their use for uncertainty estimation or evaluation of the many potential configurations and storm sequences that may influence the timings and magnitudes of flood waves. Here a simplified overland flow-routing module and semi-distributed representation of enhanced hillslope storage is developed. It is applied to the headwaters of a large rural catchment in Cumbria, UK, where the use of an extensive network of storage features is proposed as a flood mitigation strategy. The models were run within a Monte Carlo framework against data for a 2-month period of extreme flood events that caused significant damage in areas downstream. Acceptable realisations and likelihood weightings were identified using the GLUE uncertainty estimation framework. Behavioural realisations were rerun against the catchment model modified with the addition of the hillslope storage. Three different drainage rate parameters were applied across the network of hillslope storage. The study demonstrates that schemes comprising widely distributed hillslope storage can be modelled effectively within such a reduced complexity

Potentially inappropriate liver transplantation in the era of the "sickest first" policy - A search for the upper limits.

Science.gov (United States)

Linecker, Michael; Krones, Tanja; Berg, Thomas; Niemann, Claus U; Steadman, Randolph H; Dutkowski, Philipp; Clavien, Pierre-Alain; Busuttil, Ronald W; Truog, Robert D; Petrowsky, Henrik

2017-11-11

Liver transplantation has emerged as a highly efficient treatment for a variety of acute and chronic liver diseases. However, organ shortage is becoming an increasing problem globally, limiting the applicability of liver transplantation. In addition, potential recipients are becoming sicker, thereby increasing the risk of losing the graft during transplantation or in the initial postoperative period after liver transplantation (three months). This trend is challenging the model for end-stage liver disease allocation system, where the sickest candidates are prioritised and no delisting criteria are given. The weighting of the deontological demand for "equity", trying to save every patient, regardless of the overall utility; and "efficiency", rooted in utilitarianism, trying to save as many patients as possible and increase the overall quality of life of patients facing the same problem, has to be reconsidered. In this article we are aiming to overcome the widespread concept of futility in liver transplantation, providing a definition of potentially inappropriate liver transplantation and giving guidance on situations where it is best not to proceed with liver transplantation, to decrease the mortality rate in the first three months after transplantation. We propose "absolute" and "relative" conditions, where early post-transplant mortality is highly probable, which are not usually captured in risk scores predicting post-transplant survival. Withholding liver transplantation for listed patients in cases where liver transplant is not deemed clearly futile, but is potentially inappropriate, is a far-reaching decision. Until now, this decision had to be discussed extensively on an individual basis, applying explicit communication and conflict resolution processes, since the model for end-stage liver disease score and most international allocation systems do not include explicit delisting criteria to support a fair delisting process. More work is needed to better

Subtle pulmonary nodules: detection and identification with storage phosphor radiographs and conventional chest films

International Nuclear Information System (INIS)

Scheck, R.J.; Schaetzl, M.; Kandziora, C.; Panzer, M.; Rienmueller, R.

1994-01-01

To determine the value of digital storagephosphor radiography (SR) on the detection and identification of subtle lung nodules, postero-anterior (PA) and lateral (LAT) film-screen (FR) chest radiographs were compared with isodose SR images of 45 patients with metastatic malignancies. The SR postprocessing was done with a particular mode previously optimized for routine chest radiography. Pulmonary metastases were found in 34 patients and were proved or excluded by CT (n=28) or longterm follow-up FR (n=17). Chest images were divided into four regions for evaluation of image quality, number of lung nodules per region and marked pulmonary structures by receiver-operating characteristics (ROC) analysis (45 patients; 125 nodules; 2810 observations; five readers). Of the nodules selected for an ROC study 82% were 0.5-1.0 cm in diameter. Overall image quality was rated better for FR concerning lung fields (PA) and mediastinum/hilum (LAT). More lung-field nodules were detected on FR than on SR chest images. Use of FR was superior to SR in the general identification of nodules (PA chest), especially concerning intermediate and subtle abnormalities, whereas there was no significant difference for LAT chest images. Our results show, that currently FR still has advantages over SR in the detection and identification of subtle lung nodules in routine clinical radiography. (orig.)

Potentially inappropriate prescribing in two populations with differing socio-economic profiles: a cross-sectional database study using the PROMPT criteria.

LENUS (Irish Health Repository)

Cooper, Janine A

2016-01-28

The purpose of this study is to establish the prevalence of potentially inappropriate prescribing (PIP) in middle-aged adults (45-64 years) in two populations with differing socio-economic profiles, and to investigate factors associated with PIP, using the PROMPT (PRescribing Optimally in Middle-aged People\\'s Treatments) criteria.

Identifying and acting on potentially inappropriate care? Inadequacy of current hospital coding for this task.

Science.gov (United States)

Cooper, P David; Smart, David R

2017-06-01

Recent Australian attempts to facilitate disinvestment in healthcare, by identifying instances of 'inappropriate' care from large Government datasets, are subject to significant methodological flaws. Amongst other criticisms has been the fact that the Government datasets utilized for this purpose correlate poorly with datasets collected by relevant professional bodies. Government data derive from official hospital coding, collected retrospectively by clerical personnel, whilst professional body data derive from unit-specific databases, collected contemporaneously with care by clinical personnel. Assessment of accuracy of official hospital coding data for hyperbaric services in a tertiary referral hospital. All official hyperbaric-relevant coding data submitted to the relevant Australian Government agencies by the Royal Hobart Hospital, Tasmania, Australia for financial year 2010-2011 were reviewed and compared against actual hyperbaric unit activity as determined by reference to original source documents. Hospital coding data contained one or more errors in diagnoses and/or procedures in 70% of patients treated with hyperbaric oxygen that year. Multiple discrete error types were identified, including (but not limited to): missing patients; missing treatments; 'additional' treatments; 'additional' patients; incorrect procedure codes and incorrect diagnostic codes. Incidental observations of errors in surgical, anaesthetic and intensive care coding within this cohort suggest that the problems are not restricted to the specialty of hyperbaric medicine alone. Publications from other centres indicate that these problems are not unique to this institution or State. Current Government datasets are irretrievably compromised and not fit for purpose. Attempting to inform the healthcare policy debate by reference to these datasets is inappropriate. Urgent clinical engagement with hospital coding departments is warranted.

A concept of an electricity storage system with 50 MWh storage capacity

Directory of Open Access Journals (Sweden)

Józef Paska

2012-06-01

Full Text Available Electricity storage devices can be divided into indirect storage technology devices (involving electricity conversion into another form of energy, and direct storage (in an electric or magnetic fi eld. Electricity storage technologies include: pumped-storage power plants, BES Battery Energy Storage, CAES Compressed Air Energy Storage, Supercapacitors, FES Flywheel Energy Storage, SMES Superconducting Magnetic Energy Storage, FC Fuel Cells reverse or operated in systems with electrolysers and hydrogen storage. These technologies have diff erent technical characteristics and economic parameters that determine their usability. This paper presents two concepts of an electricity storage tank with a storage capacity of at least 50 MWh, using the BES battery energy storage and CAES compressed air energy storage technologies.

Energy Conversion and Storage Program. 1990 annual report

Energy Technology Data Exchange (ETDEWEB)

Cairns, E.J.

1992-03-01

The Energy Conversion and Storage Program applies chemistry and materials science principles to solve problems in (1) production of new synthetic fuels, (2) development of high-performance rechargeable batteries and fuel cells, (3) development of advanced thermochemical processes for energy conversion, (4) characterization of complex chemical processes, and (5) application of novel materials for energy conversion and transmission. Projects focus on transport-process principles, chemical kinetics, thermodynamics, separation processes, organic and physical chemistry, novel materials, and advanced methods of analysis. Electrochemistry research aims to develop advanced power systems for electric vehicle and stationary energy storage applications. Topics include identification of new electrochemical couples for advanced rechargeable batteries, improvements in battery and fuel-cell materials, and the establishment of engineering principles applicable to electrochemical energy storage and conversion. Chemical Applications research includes topics such as separations, catalysis, fuels, and chemical analyses. Included in this program area are projects to develop improved, energy-efficient methods for processing waste streams from synfuel plants and coal gasifiers. Other research projects seek to identify and characterize the constituents of liquid fuel-system streams and to devise energy-efficient means for their separation. Materials Applications research includes the evaluation of the properties of advanced materials, as well as the development of novel preparation techniques. For example, the use of advanced techniques, such as sputtering and laser ablation, are being used to produce high-temperature superconducting films.

High level waste storage tanks 242-A evaporator standards/requirement identification document

International Nuclear Information System (INIS)

Biebesheimer, E.

1996-01-01

This document, the Standards/Requirements Identification Document (S/RIDS) for the subject facility, represents the necessary and sufficient requirements to provide an adequate level of protection of the worker, public health and safety, and the environment. It lists those source documents from which requirements were extracted, and those requirements documents considered, but from which no requirements where taken. Documents considered as source documents included State and Federal Regulations, DOE Orders, and DOE Standards

Tritium storage

International Nuclear Information System (INIS)

Hircq, B.

1990-01-01

This document represents a synthesis relative to tritium storage. After indicating the main storage particularities as regards tritium, storages under gaseous and solid form are after examined before establishing choices as a function of the main criteria. Finally, tritium storage is discussed regarding tritium devices associated to Fusion Reactors and regarding smaller devices [fr

Energy storage

International Nuclear Information System (INIS)

2012-01-01

After having outlined the importance of energy storage in the present context, this document outlines that it is an answer to economic, environmental and technological issues. It proposes a brief overview of the various techniques of energy storage: under the form of chemical energy (hydrocarbons, biomass, hydrogen production), thermal energy (sensitive or latent heat storage), mechanical energy (potential energy by hydraulic or compressed air storage, kinetic energy with flywheels), electrochemical energy (in batteries), electric energy (super-capacitors, superconductor magnetic energy storage). Perspectives are briefly evoked

Forbearance, Regulation, and Market Power in Natural Gas Storage: The Case of Ontario

Energy Technology Data Exchange (ETDEWEB)

Brown, D.; Ware, R.; Wetston, H.

2007-07-01

In late 2006 the Ontario Energy Board rendered a landmark decision to forbear from the price regulation of natural gas storage services. This paper examines the key issues and provides some economic analysis of the evidence. The decision followed a proceeding during which evidence was given on whether the market for storage is competitive or is subject to significant market power possessed by dominant and incumbent utility firms in the province. Intervenors in the proceeding were in broad agreement on the use of standard concepts from North American antitrust analysis of merger reviews: identification of the relevant product and geographic markets, analysis of market structure within the relevant market, and assessment of barriers to entry. A critical issue at the hearing was the extent of the geographic market; a broad market encompassing U.S. storage facilities in neighbouring states supports a finding of competition, whereas a narrower geographic market restricted to Ontario makes market power more likely. Since gas storage is only as functional as the pipelines connected to it, evidence was directed at assessing the availability of pipeline capacity in both primary and secondary markets. (auth)

Dry Cask Storage Inspection and Monitoring. Interim Report.

Energy Technology Data Exchange (ETDEWEB)

Bakhtiari, Susan [Argonne National Lab. (ANL), Argonne, IL (United States); Elmer, Thomas W. [Argonne National Lab. (ANL), Argonne, IL (United States); Koehl, Eugene R. [Argonne National Lab. (ANL), Argonne, IL (United States); Wang, Ke [Argonne National Lab. (ANL), Argonne, IL (United States); Raptis, Apostolos C. [Argonne National Lab. (ANL), Argonne, IL (United States); Kunerth, Dennis C. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Birk, Sandra M. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2014-03-04

Recently, the U.S. Nuclear Regulatory Commission (NRC) issued the guidance on the aging management of dry storage facilities that indicates the necessity to monitor the conditions of dry cask storage systems (DCSSs) over extended periods of time.1 Part of the justification of the aging management plans is the requirement for inspection and monitoring to verify whether continued monitoring, inspection or mitigation are necessary. To meet this challenge Argonne National Laboratory (ANL) in collaboration with Idaho National Laboratory (INL) is conducting scoping studies on current and emerging nondestructive evaluation/examination (NDE) and online monitoring (OLM) technologies for DCSS integrity assessments. The scope of work plan includes identification and verification of technologies for long-term online monitoring of DCSSs’ crucial physical parameters such as temperature, pressure, leakage and structural integrity in general. Modifications have been made to the current technologies to accommodate field inspections and monitoring. A summary of the scoping studies and experimental efforts conducted to date as well as plans for future activities is provided below.

Trends and interaction of polypharmacy and potentially inappropriate prescribing in primary care over 15 years in Ireland: a repeated cross-sectional study.

LENUS (Irish Health Repository)

Moriarty, Frank

2015-03-01

To examine: (1) changes in polypharmacy in 1997, 2002, 2007 and 2012 and; (2) changes in potentially inappropriate prescribing (PIP) prevalence and the relationship between PIP and polypharmacy in individuals aged ≥65 years over this period in Ireland.

Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review.

Science.gov (United States)

Tommelein, Eline; Mehuys, Els; Petrovic, Mirko; Somers, Annemie; Colin, Pieter; Boussery, Koen

2015-12-01

Potentially inappropriate prescribing (PIP) is one of the main risk factors for adverse drug events (ADEs) in older people. This systematic literature review aims to determine prevalence and type of PIP in community-dwelling older people across Europe, as well as identifying risk factors for PIP. The PubMed and Web of Science database were searched systematically for relevant manuscripts (January 1, 2000-December 31, 2014). Manuscripts were included if the study design was observational, the study participants were community-dwelling older patients in Europe, and if a published screening method for PIP was used. Studies that focused on specific pathologies or that focused on merely one inappropriate prescribing issue were excluded. Data analysis was performed using R statistics. Fifty-two manuscripts were included, describing 82 different sample screenings with an estimated overall PIP prevalence of 22.6 % (CI 19.2-26.7 %; range 0.0-98.0 %). Ten of the sample screenings were based on the Beers 1997 criteria, 19 on the Beers 2003 criteria, 14 on STOPP criteria (2008 version), 8 on START-criteria (2008 version), and 7 on the PRISCUS list. The 24 remaining sample screenings were carried out using compilations of screening methods or used country-specific lists such as the Laroche criteria. It appears that only PIP prevalence calculated from insurance data significantly differs from the other data collection method categories. Furthermore, risk factors most often positively associated with PIP prevalence were polypharmacy, poor functional status, and depression. Drug groups most often involved in PIP were anxiolytics (ATC-code: N05B), antidepressants (N06A), and nonsteroidal anti-inflammatory and anti-rheumatic products (M01A). PIP prevalence in European community-dwelling older adults is high and depends partially on the data collection method used. Polypharmacy, poor functional status, and depression were identified as the most common risk factors for PIP.

Review of thermal energy storage technologies based on PCM application in buildings

DEFF Research Database (Denmark)

Pomianowski, Michal Zbigniew; Heiselberg, Per; Zhang, Yinping

2013-01-01

Thermal energy storage systems (TES), using phase change material (PCM) in buildings, are widely investigated technologies and a fast developing research area. Therefore, there is a need for regular and consistent reviews of the published studies. This review is focused on PCM technologies...... is paid to discussion and identification of proper methods to correctly determine the thermal properties of PCM materials and their composites and as well procedures to determine their energy storage and saving potential. The purpose of the paper is to highlight promising technologies for PCM application...... developed to serve the building industry. Various PCM technologies tailored for building applications are studied with respect to technological potential to improve indoor environment, increase thermal inertia and decrease energy use for building operation. What is more, in this review special attention...

Advances in rapid identification and susceptibility testing of bacteria in the clinical microbiology laboratory: implications for patient care and antimicrobial stewardship programs

Directory of Open Access Journals (Sweden)

Florian P. Maurer

2017-03-01

Full Text Available Early availability of information on bacterial pathogens and their antimicrobial susceptibility is of key importance for the management of infectious diseases patients. Currently, using traditional approaches, it usually takes at least 48 hours for identification and susceptibility testing of bacterial pathogens. Therefore, the slowness of diagnostic procedures drives prolongation of empiric, potentially inappropriate, antibacterial therapies. Over the last couple of years, the improvement of available techniques (e.g. for susceptibility testing, DNA amplification assays, and introduction of novel technologies (e.g. MALDI-TOF has fundamentally changed approaches towards pathogen identification and characterization. Importantly, these techniques offer increased diagnostic resolution while at the same time shorten the time-to-result, and are thus of obvious importance for antimicrobial stewardship. In this review, we will discuss recent advances in medical microbiology with special emphasis on the impact of novel techniques on antimicrobial stewardship programs.

Interim Storage of Spent Nuclear Fuel before Final Disposal in Germany - Regulator's view

International Nuclear Information System (INIS)

Arens, G.; Goetz, Ch.; Geupel, Sandra; Gmal, B.; Mester, W.

2014-01-01

For spent nuclear fuel management in Germany the concept of dry interim storage in dual purpose casks before direct disposal is applied. The Federal Office for Radiation Protection (BfS) is the competent authority for licensing of interim storage facilities. The competent authority for surveillance of operation is the responsible authority of the respective federal state (Land). Currently operation licenses for storage facilities have been granted for a storage time of 40 years and are based on safety demonstrations for all safety issues as safe enclosure, shielding, sub-criticality and decay heat removal under consideration of operation conditions. In addition, transportability of the casks for the whole storage period has to be provided. Due to current delay in site selection and exploration of a disposal site, an extension of the storage time beyond 40 years could be needed. This will cause appropriate actions by the licensee and the competent authorities as well. A brief description of the regulatory base of licensing and surveillance of interim storage is given from the regulators view. Furthermore the current planning for final disposal of spent nuclear fuel and high level waste and its interconnections between storage and disposal concepts are shortly explained. Finally the relevant aspects for licensing of extended storage time beyond 40 years will be discussed. Current activities on this issue, which have been initiated by the Federal Government, will be addressed. On the regulatory side a review and amendment of the safety guideline for interim storage of spent fuel has been performed and the procedure of periodic safety review is being implemented. A guideline for implementing an ageing management programme is available in a draft version. Regarding safety of long term storage a study focussing on the identification and evaluation of long term effects as well as gaps of knowledge has been finished in 2010. A continuation and update is currently underway

FIELD-DEPLOYABLE SAMPLING TOOLS FOR SPENT NUCLEAR FUEL INTERROGATION IN LIQUID STORAGE

Energy Technology Data Exchange (ETDEWEB)

Berry, T.; Milliken, C.; Martinez-Rodriguez, M.; Hathcock, D.; Heitkamp, M.

2012-09-12

Methodology and field deployable tools (test kits) to analyze the chemical and microbiological condition of aqueous spent fuel storage basins and determine the oxide thickness on the spent fuel basin materials were developed to assess the corrosion potential of a basin. this assessment can then be used to determine the amount of time fuel has spent in a storage basin to ascertain if the operation of the reactor and storage basin is consistent with safeguard declarations or expectations and assist in evaluating general storage basin operations. The test kit was developed based on the identification of key physical, chemical and microbiological parameters identified using a review of the scientific and basin operations literature. The parameters were used to design bench scale test cells for additional corrosion analyses, and then tools were purchased to analyze the key parameters. The tools were used to characterize an active spent fuel basin, the Savannah River Site (SRS) L-Area basin. The sampling kit consisted of a total organic carbon analyzer, an YSI multiprobe, and a thickness probe. The tools were field tested to determine their ease of use, reliability, and determine the quality of data that each tool could provide. Characterization confirmed that the L Area basin is a well operated facility with low corrosion potential.

Laser innovation: wallet-sized exposure history, training record, and identification

International Nuclear Information System (INIS)

Stroupe, E.P.

1985-01-01

The science of lasers as used in video disks and audio compact disks has made possible very high capacity data storage. A wallet-sized card has been developed, which has a storage capacity of 1 megabyte - approx.800 typewritten pages of information. The data stored can be either machine readable or eye-readable information including photos, signatures, text, graphs, or x-rays. This technology coupled with user-friendly software, an IBM or compatible personal computer, and an optical read/write unit has made it possible to have a credit card size personal file that can be updated instantly. It is possible to have an identification card, an up-to-date complete radiation exposure history, and a training record combined into a single card

Storage and disposal of medicines by academics from health area from a public university of Paraná

Directory of Open Access Journals (Sweden)

Lenita Nunes Piveta

2015-11-01

Full Text Available Medicines are indispensable tools for the health establishment and care is required in their storage and disposal. This study aimed to verify the form of storage and disposal of medicines by students from the Health SciencesDepartment of a public university in Paraná. A cross-sectional study was conducted with students of Nursing, Pharmacy and Medicine courses from UniversidadeEstadual de Londrina, Paraná, Brazil, through the application of a self-report study. The data collection was performed in the University’s classrooms during the months of May to June of 2014, resulting in 564 students surveyed. It was considered proper disposal when the student referred to disposing the expired or inappropriate for use products in locations that make the collection of these products. The students interviewed had a mean age of 21.0 years (Standart Deviation: 3.3; 74.1% of the total were female. The bedroom was the main location quoted for storage of medicines (47.8% most of them keep the medicines out of reach of children (82.6%. Regarding the verification of the expiration date 60.1% of the students do this practice. Most of (64.5% keeps the remains of treatments for future use, and household waste (63.0% was the main mentioned location for the disposal of those who are expired. Only 20.7% discarded the medicines correctly. The study population stores the products correctly, however, most are largely unaware of the disposal locations. Therefore, it is necessary to promote awareness and guidance for the future professionals.

Inappropriate use of the title 'chiropractor' and term 'chiropractic manipulation' in the peer-reviewed biomedical literature

Directory of Open Access Journals (Sweden)

Wenban Adrian B

2006-08-01

contact with the principal researcher revealed that the care provider was not a chiropractor, as defined by the World Federation of Chiropractic. The authors of the other two case reports did not respond to my communications. In the case series, which involved twenty relevant cases, the principal researcher conceded that the term chiropractor had been inappropriately used and that his case series did not relate to chiropractors who had undergone appropriate formal training. The author of the secondary report, a British Medical Journal editor, conceded that he had misused the title chiropractor. Letters to editors were accepted and published by all four journals to which they were sent. To date one of the four journals has published a correction. Conclusion The results of this year-long prospective review suggests that the words 'chiropractor' and 'chiropractic manipulation' are often used inappropriately by European biomedical researchers when reporting apparent associations between cervical spine manipulation and symptoms suggestive of traumatic injury. Furthermore, in those cases reported here, the spurious use of terminology seems to have passed through the peer-review process without correction. Additionally, these findings provide further preliminary evidence, beyond that already provided by Terrett, that the inappropriate use of the title 'chiropractor' and term 'chiropractic manipulation' may be a significant source of over-reporting of the link between the care provided by chiropractors and injury. Finally, editors of peer-reviewed journals were amenable to publishing 'letters to editors', and to a lesser extent 'corrections', when authors had inappropriately used the title 'chiropractor' and/or term 'chiropractic manipulation'.

Favourable Formations for CO{sub 2} Storage in the Almazan Basin; Formaciones Favorables para el Almacenamiento de CO{sub 2} en la Cuenca de Almazan

Energy Technology Data Exchange (ETDEWEB)

Ruiz Rivas, C.; Lomba Falcon, L.

2008-04-10

Geological storage of carbon dioxide is one of the technological options that have been considered nowadays for global climate change mitigation. Underground CO{sub 2} storage requires the selection and identification of deep geological formations which must meet criteria for health and environmental safety in the middle-term of one thousand years. Deep permeable formations, depleted oil and gas fields, unminable coal seams and saline rocks are possible geological formations for CO{sub 2} storage. Some areas in our country have been selected to search potential CO{sub 2} reservoirs. Among these areas, sedimentary basins are highlighted because of their thick stratigraphic sequences and the availability of extensive geological data which are coming from fossil fuel exploration. In this report, the identification and selection of favourable geological formations in the Almazan basin is presented. A 3D simplified subsurface basin geological model that was based on a Geographic Information System is included as well. The report also includes suitable CO{sub 2} injection areas in the surface for the selected geological formations. Finally, a preliminary CO{sub 2} storage capacity estimation of a potential structural trap has been calculated, considering only physical CO{sub 2} trapping. This work has been undertaken in the framework of the Geological CO{sub 2} Storage Project which is within the Singular Strategic Project of the Ministry of Education and Science Generation, Capture and Storage advanced technologies of CO{sub 2}. (Author) 84 refs.

Thermochemical Heat Storage: from Reaction Storage Density to System Storage Density

NARCIS (Netherlands)

Jong, A.J. de; Vliet, L.D. van; Hoegaerts, C.L.G.; Roelands, C.P.M.; Cuypers, R.

2016-01-01

Long-term and compact storage of solar energy is crucial for the eventual transition to a 100% renewable energy economy. For this, thermochemical materials provide a promising solution. The compactness of a long-term storage system is determined by the thermochemical reaction, operating conditions,

Polypharmacy and potentially inappropriate medication use as the precipitating factor in readmissions to the hospital

Directory of Open Access Journals (Sweden)

Vishal Sehgal

2013-01-01

Full Text Available Background and Aim: Readmission to the hospital within 30 days of discharge from the hospital is a common occurrence. Congestive heart failure is the most common cause of readmissions in the hospital. We hypothesized that irrespective of the admission diagnosis polypharmacy and potentially inappropriate use of medications (PIM leads to readmissions within 30 days of discharge from the hospital. Materials and Methods: A retrospective study was carried out by reviewing the hospital records of 414 patients who were readmitted to the hospital within 30 days of discharge from the hospital between January 2008 and December 2009. The data was stratified to see which patients were on polypharmacy and/or on PIM. Polypharmacy was defined as use of more than 5 medications. PIM was defined as per the modified Beers criteria. Day 0 was defined as the day of discharge and day1 was defined as the day-after Admission to the hospital. Statistical analysis was carried out using a two-way analysis of variance (ANOVA on the data to see if polypharmacy and/or PIM was related to readmission within 30 days of discharge irrespective of admission diagnosis. Results: Polypharmacy was related to hospital readmission at day 1 and day 0, however inappropriate drug use was found to be not related at any day. Polypharmacy and PIM combined had a positive correlation to readmission only on days 1 and 0 and it was statistically significant. The use of minimal and appropriate use of drugs was statistically significant compared to polypharmacy and PIM use. Conclusions: Polypharmacy and PIM are under recognized cause of readmissions to the hospital.

New application of (ΔE-E) technique for particle identification and dosimetry

International Nuclear Information System (INIS)

Mineev, Yu.V.

1998-01-01

The modified method of charged particle identification is described. It is based on the simultaneous measurement of the energy E and the specific losses ΔE with the application of semiconductor detectors as well as programmed semiconductor memory devices for the storage of the preset calculated dependence ΔE(E) for each particle kinds. The comparison of expected and measured values ΔE at the measured energy value E defines completely the particle kind. New possibilities of the method for identification as well as separate and simultaneous detection of different particles (electrons, protons, alpha-particles, nuclei with Z ≤ 12 and gamma-radiation) are analyzed

Les perceptions de justice et de discrimination des candidats face à des questions inappropriées au recrutement

OpenAIRE

Ocana , Tania

2017-01-01

Applicants’ reaction research has mostly focused on fairness perceptions, but several researchers encourage the study of perceived job discrimination during the selection process, as well as specific consequences of that discrimination. In order to create a situation in which discrimination was possible, we studied the effects of inappropriate job interview questions related to a stigma on fairness and discrimination perceptions as well their impact on the recruiters’ and the organization’s i...

Unexplained abdominal pain as a driver for inappropriate therapeutics: an audit on the use of intravenous proton pump inhibitors

Directory of Open Access Journals (Sweden)

Pauline Siew Mei Lai

2014-06-01

Full Text Available Background. Proton pump inhibitors (PPIs are currently the most effective agents for acid-related disorders. However, studies show that 25–75% of patients receiving intravenous PPIs had no appropriate justification, indicating high rates of inappropriate prescribing.Objective. To examine the appropriate use of intravenous PPIs in accordance with guidelines and the efficacy of a prescribing awareness intervention at an Asian teaching institution.Setting. Prospective audit in a tertiary hospital in Malaysia.Method. Every 4th intravenous PPI prescription received in the pharmacy was screened against hospital guidelines. Interventions for incorrect indication/dose/duration were performed. Patients’ demographic data, medical history and the use of intravenous PPI were collected. Included were all adult inpatients prescribed intravenous PPI.Main Outcome Measure. Proportion of appropriate IV PPI prescriptions.Results. Data for 106 patients were collected. Most patients were male [65(61.3%], Chinese [50(47.2%], with mean age ± SD = 60.3 ± 18.0 years. Most intravenous PPI prescriptions were initiated by junior doctors from the surgical [47(44.3%] and medical [42(39.6%] departments. Only 50/106(47.2% patients had upper gastrointestinal endoscopy/surgery performed to verify the source of bleeding. Unexplained abdominal pain [81(76.4%] was the main driver for prescribing intravenous PPIs empirically, out of which 73(68.9% were for suspected upper gastrointestinal bleed. Overall, intravenous PPI was found to be inappropriately prescribed in 56(52.8% patients for indication, dose or duration. Interventions on the use of intravenous PPI were most effective when performed by senior doctors (100%, followed by clinical pharmacists (50%, and inpatient pharmacists (37.5%, p = 0.027.Conclusion. Inappropriate intravenous PPI usage is still prevalent despite the enforcement of hospital guidelines. The promotion of prescribing awareness and evidence

Prevalence and Risk of Inappropriate Sexual Behavior of Patients Toward Physical Therapist Clinicians and Students in the United States.

Science.gov (United States)

Boissonnault, Jill S; Cambier, Ziádee; Hetzel, Scott J; Plack, Margaret M

2017-11-01

For health care providers in the United States, the risk for nonfatal violence in the workplace is 16 times greater than that for other workers. Inappropriate patient sexual behavior (IPSB) is directed at clinicians, staff, or other patients and may include leering, sexual remarks, deliberate touching, indecent exposure, and sexual assault. Inappropriate patient sexual behavior may adversely affect clinicians, the organization, or patients themselves. Few IPSB risk factors for physical therapists have been confirmed. The US prevalence was last assessed in the 1990s. The objectives of this study were to determine career and 12-month exposure to IPSB among US physical therapists, physical therapist assistants, physical therapist students, and physical therapist assistant students and to identify IPSB risk factors. This was a retrospective and observational study. An electronic survey was developed; content validity and test-retest reliability were established. Participants were recruited through physical therapist and physical therapist assistant academic programs and sections of the American Physical Therapy Association. Inappropriate patient sexual behavior risk models were constructed individually for any, mild, moderate, and severe IPSB events reported over the past 12 months. Open-ended comments were analyzed using qualitative methods. Eight hundred ninety-two physical therapist professionals and students completed the survey. The career prevalence among respondents was 84%, and the 12-month prevalence was 47%. Statistical risk modeling for any IPSB over the past 12 months indicated the following risks: having fewer years of direct patient care, routinely working with patients with cognitive impairments, being a female practitioner, and treating male patients. Qualitative analysis of 187 open-ended comments revealed patient-related characteristics, provider-related characteristics, and abusive actions. Self-report, clinician memory, and convenience sampling are

Alternatives for water basin spent fuel storage using pin storage

International Nuclear Information System (INIS)

Viebrock, J.M.; Carlson, R.W.

1979-09-01

The densest tolerable form for storing spent nuclear fuel is storage of only the fuel rods. This eliminates the space between the fuel rods and frees the hardware to be treated as non-fuel waste. The storage density can be as much as 1.07 MTU/ft 2 when racks are used that just satisfy the criticality and thermal limitations. One of the major advantages of pin storage is that it is compatible with existing racks; however, this reduces the storage density to 0.69 MTU/ft 2 . Even this is a substantial increase over the 0.39 MTU/ft 2 that is achievable with current high capacity stainless steel racks which have been selected as the bases for comparison. Disassembly requires extensive operation on the fuel assembly to remove the upper end fitting and to extract the fuel rods from the assembly skeleton. These operations will be performed with the aid of an elevator to raise the assembly where each fuel rod is grappled. Lowering the elevator will free the fuel rod for transfer to the storage canister. A storage savings of $1510 per MTU can be realized if the pin storage concept is incorporated at a new away-from-reactor facility. The storage cost ranges from $3340 to $7820 per MTU of fuel stored with the lower cost applying to storage at an existing away-from-reactor storage facility and the higher cost applying to at-reactor storage

Dual paraneoplastic syndromes: small cell lung carcinoma-related oncogenic osteomalacia, and syndrome of inappropriate antidiuretic hormone secretion: report of a case and review of the literature.

Science.gov (United States)

Tantisattamo, Ekamol; Ng, Roland C K

2011-07-01

Acquired isolated renal phosphate wasting associated with a tumor, known as oncogenic osteomalacia or tumor-induced osteomalacia, is a rare paraneoplastic syndrome caused by overproduction of fibroblast growth factor 23. Oncogenic osteomalacia is usually associated with benign mesenchymal tumors. Syndrome of inappropriate antidiuretic hormone secretion (SIADH), on the other hand, is a common paraneoplastic syndrome caused by small cell carcinoma (SCC). Concomitant oncogenic osteomalacia and SIADH associated with SCC is very rare with only 4 other cases reported in the literature. The authors report a case of small cell lung cancer (SCLC)-related renal wasting hypophosphatemia and concurrent SIADH, and review the literature reporting 9 other cases of SCC associated with oncogenic osteomalacia. Almost half of reported cases of renal phosphate wasting associated with SCC concomitantly presented with SIADH. These cases had initial serum phosphorus level lower and survival periods shorter than those without SIADH. This rare combination of a dual paraneoplastic syndrome and low serum phosphorus may be a poor prognostic sign. In addition, both renal phosphate wasting and SIADH usually occur in a short period of time before identification of SCC. Therefore, renal wasting hypophosphatemia with concomitant SIADH/hyponatremia should prompt a search for SCC rather than a benign mesenchymal tumor.

Hydrogen Storage Engineering Center of Excellence Metal Hydride Final Report

Energy Technology Data Exchange (ETDEWEB)

Motyka, T. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2014-05-31

The Hydrogen Storage Engineering Center of Excellence (HSECoE) was established in 2009 by the U.S. Department of Energy (DOE) to advance the development of materials-based hydrogen storage systems for hydrogen-fueled light-duty vehicles. The overall objective of the HSECoE is to develop complete, integrated system concepts that utilize reversible metal hydrides, adsorbents, and chemical hydrogen storage materials through the use of advanced engineering concepts and designs that can simultaneously meet or exceed all the DOE targets. This report describes the activities and accomplishments during Phase 1 of the reversible metal hydride portion of the HSECoE, which lasted 30 months from February 2009 to August 2011. A complete list of all the HSECoE partners can be found later in this report but for the reversible metal hydride portion of the HSECoE work the major contributing organizations to this effort were the United Technology Research Center (UTRC), General Motors (GM), Pacific Northwest National Laboratory (PNNL), the National Renewable Energy Laboratory (NREL) and the Savannah River National Laboratory (SRNL). Specific individuals from these and other institutions that supported this effort and the writing of this report are included in the list of contributors and in the acknowledgement sections of this report. The efforts of the HSECoE are organized into three phases each approximately 2 years in duration. In Phase I, comprehensive system engineering analyses and assessments were made of the three classes of storage media that included development of system level transport and thermal models of alternative conceptual storage configurations to permit detailed comparisons against the DOE performance targets for light-duty vehicles. Phase 1 tasks also included identification and technical justifications for candidate storage media and configurations that should be capable of reaching or exceeding the DOE targets. Phase 2 involved bench-level testing and

Management model of movement and storage: design of a framework for improvement in management; Modelo de gestao da transferencia e estocagem: concepcao de uma estrutura conceitual para avanco na gestao

Energy Technology Data Exchange (ETDEWEB)

Spiegel, Thais; Perrotta, Carolina; Proenca, Adriano [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Escola Politecnica. Grupo de Producao Integrada; Lima, Mario Jorge; Paschoal, Luiz Claudio [PETROBRAS, Rio de Janeiro, RJ (Brazil)

2008-07-01

This paper presents the construction of the Movement and Storage Management Model (MG-TE). This model tries to represent, in a generic way, the work of the management staff of the Movement and Storage (TE) sector of PETROBRAS' refineries. The 'MG-TE' was developed as a representation of the management work based in the identification of Management Practices organized by Thematic Categories, what makes their identification and recognition easier. The 'MG-TE' is a cognitive structure (framework) that allows the development of a series of management projects. As a main result, this article presents the establishment of a Management Practice that orchestrates the improvement of the management in many Movement and Storage sectors. The Management Practice of TE improvement refers to the contribution of the model as a common structural reference, materialized in the MG-TE, in its the ability to support collective discussions and allow the construction of an expert management model of the Movement and Storage sector. This practice handles, therefore, the coordination of a change in MG-TE, from its descriptive character of reality to a model of Best Management Practices for the Movement and Storage sector (author)

Containment and storage of uranium hexafluoride at US Department of Energy uranium enrichment plants

International Nuclear Information System (INIS)

Barlow, C.R.; Alderson, J.H.; Blue, S.C.; Boelens, R.A.; Conkel, M.E.; Dorning, R.E.; Ecklund, C.D.; Halicks, W.G.; Henson, H.M.; Newman, V.S.; Philpot, H.E.; Taylor, M.S.; Vournazos, J.P.; Pryor, W.A.; Ziehlke, K.T.

1992-07-01

Isotopically depleted UF 6 (uranium hexafluoride) accumulates at a rate five to ten times greater than the enriched product and is stored in steel vessels at the enrichment plant sites. There are approximately 55,000 large cylinders now in storage at Paducah, Kentucky; Portsmouth, Ohio; and Oak Ridge, Tennessee. Most of them contain a nominal 14 tons of depleted UF 6 . Some of these cylinders have been in the unprotected outdoor storage environment for periods approaching 40 years. Storage experience, supplemented by limited corrosion data, suggests a service life of about 70 years under optimum conditions for the 48-in. diameter, 5/16-in.-wall pressure vessels (100 psi working pressure), using a conservative industry-established 1/4-in.-wall thickness as the service limit. In the past few years, however, factors other than atmospheric corrosion have become apparent that adversely affect the serviceability of small numbers of the storage containers and that indicate the need for a managed program to ensure maintenance ofcontainment integrity for all the cylinders in storage. The program includes periodic visual inspections of cylinders and storage yards with documentation for comparison with other inspections, a group of corrosion test programs to permit cylinder life forecasts, and identification of (and scheduling for remedial action) situations in which defects, due to handling damage or accelerated corrosion, can seriously shorten the storage life or compromise the containment integrity of individual cylinders. The program also includes rupture testing to assess the effects of certain classes of damage on overall cylinder strength, aswell as ongoing reviews of specifications, procedures, practices, and inspection results to effect improvements in handling safety, containment integrity, and storage life

Review of advances in human reliability analysis of errors of commission, Part 1: EOC identification

International Nuclear Information System (INIS)

Reer, Bernhard

2008-01-01

In close connection with examples relevant to contemporary probabilistic safety assessment (PSA), a review of advances in human reliability analysis (HRA) of post-initiator errors of commission (EOCs), i.e. inappropriate actions under abnormal operating conditions, has been carried out. The review comprises both EOC identification (part 1) and quantification (part 2); part 1 is presented in this article. Emerging HRA methods addressing the problem of EOC identification are: A Technique for Human Event Analysis (ATHEANA), the EOC HRA method developed by Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS), the Misdiagnosis Tree Analysis (MDTA) method, and the Commission Errors Search and Assessment (CESA) method. Most of the EOCs referred to in predictive studies comprise the stop of running or the inhibition of anticipated functions; a few comprise the start of a function. The CESA search scheme-which proceeds from possible operator actions to the affected systems to scenarios and uses procedures and importance measures as key sources of input information-provides a formalized way for identifying relatively important scenarios with EOC opportunities. In the implementation however, attention should be paid regarding EOCs associated with familiar but non-procedural actions and EOCs leading to failures of manually initiated safety functions

Retrievable surface storage: interim storage of solidified high-level waste

International Nuclear Information System (INIS)

LaRiviere, J.R.; Nelson, D.C.

1976-01-01

Studies have been conducted on retrievable-surface-storage concepts for the interim storage of solidified high-level wastes. These studies have been reviewed by the Panel on Engineered Storage, convened by the Committee on Radioactive Waste Management of the National Research Council-National Academy of Sciences. The Panel has concluded that ''retrievable surface storage is an acceptable interim stage in a comprehensive system for managing high-level radioactive wastes.'' The scaled storage cask concept, which was recommended by the Panel on Engineered Storage, consists of placing a canister of waste inside a carbon-steel cask, which in turn is placed inside a thick concrete cylinder. The waste is cooled by natural convection air flow through an annulus between the cask and the inner wall of the concrete cylinder. The complete assembly is placed above ground in an outdoor storage area

Optimal design and application of a compound cold storage system combining seasonal ice storage and chilled water storage

NARCIS (Netherlands)

Yan, C.; Shi, W.; Li, X.; Zhao, Y.

2016-01-01

Seasonal cold storage using natural cold sources for cooling is a sustainable cooling technique. However, this technique suffers from limitations such as large storage space and poor reliability. Combining seasonal storage with short-term storage might be a promising solution while it is not

Identification of sixteen peptides reflecting heat and/or storage induced processes by profiling of commercial milk samples.

Science.gov (United States)

Ebner, Jennifer; Baum, Florian; Pischetsrieder, Monika

2016-09-16

Peptide profiles of different drinking milk samples were examined to study how the peptide fingerprint of milk reflects processing conditions. The combination of a simple and fast method for peptide extraction using stage tips and MALDI-TOF-MS enabled the fast and easy generation and relative quantification of peptide fingerprints for high-temperature short-time (HTST), extended shelf life (ESL) and ultra-high temperature (UHT) milk of the same dairies. The relative quantity of 16 peptides changed as a function of increasing heat load. Additional heating experiments showed that among those, the intensity of peptide β-casein 196-209 (m/z 1460.9Da) was most heavily influenced by heat treatment indicating a putative marker peptide for milk processing conditions. Storage experiments with HTST- and UHT milk revealed that the differences between different types of milk samples were not only caused by the heating process. Relevant was also the proteolytic activity of enzymes during storage, which were differently influenced by the heat treatment. These results indicate that the peptide profile may be suitable to monitor processing as well as storage conditions of milk. In the present study, peptide profiling of different types of milk was carried out by MALDI-TOF-MS after stage-tip extraction and relative quantification using an internal reference peptide. Although MALDI-TOF-MS covers only part of the peptidome, the method is easy and quick and is, therefore, suited for routine analysis to address several aspects of food authenticity. Using this method, 16 native peptides were detected in milk that could be modulated by different industrial processes. Subsequent heating and storage experiments with pasteurized and UHT milk confirmed that these peptides are indeed related to the production or storage conditions of the respective products. Furthermore, the heating experiments revealed one peptide, namely the β-casein-derived sequence β-casein 196-209, which underwent

Decreasing Inappropriate Use of Mobile Devices in Urban High School Classrooms: Comparing an Antecedent Intervention With and Without the Good Behavior Game.

Science.gov (United States)

Hernan, Colleen J; Collins, Tai A; Morrison, Julie Q; Kroeger, Stephen D

2018-03-01

As the capabilities of portable technology continue to advance and become more accessible, educators express concern about the impact of the inappropriate use of mobile devices on academic engagement and learning. An alternating treatments design was used to compare the effectiveness of an antecedent (Clear Box) intervention and an interdependent group contingency (Clear Box + Good Behavior Game [GBG]) intervention to typical classroom management techniques (Control) in increasing the academic engagement and decreasing mobile device use of high school students during instruction. The results indicate an increase in academic engagement and a decrease in the inappropriate presence of mobile devices in both classrooms with the implementation of the Clear Box + GBG, as compared with the Clear Box and Control conditions. In addition, teacher and student social validity data suggested that teachers and students viewed the Clear Box + GBG intervention favorably. Discussion focuses on contributions to the current literature, implications for practice, and suggestions for future areas of research.

The use of application-specific performance targets and engineering considerations to guide hydrogen storage materials development

Energy Technology Data Exchange (ETDEWEB)

Stetson, Ned T., E-mail: ned.stetson@ee.doe.gov [U.S. Department of Energy, 1000 Independence Ave., SW, EE-2H, Washington, DC 20585 (United States); Ordaz, Grace; Adams, Jesse; Randolph, Katie [U.S. Department of Energy, 1000 Independence Ave., SW, EE-2H, Washington, DC 20585 (United States); McWhorter, Scott [Savannah River National Laboratory, Aiken, SC 29808 (United States)

2013-12-15

Highlights: •Portable power and material handling equipment as early market technology pathways. •Engineering based system-level storage-materials requirements. •Application based targets. -- Abstract: The Hydrogen and Fuel Cells Technologies Office, carried out through the DOE Office of Energy Efficiency and Renewable Energy, maintains a broad portfolio of activities to enable the commercialization of fuel cells across a range of near, mid and long-term applications. Improved, advanced hydrogen storage technologies are seen as a critical need for successful implementation of hydrogen fuel cells in many of these applications. To guide and focus materials development efforts, the DOE develops system performance targets for the specific applications of interest, and carries out system engineering analyses to determine the system-level performance delivered when the materials are incorporated into a complete system. To meet the needs of applications, it is important to consider the system-level performance, not just the material-level properties. An overview of the DOE’s hydrogen storage efforts in developing application-specific performance targets and systems engineering to guide hydrogen storage materials identification and development is herein provided.

The use of application-specific performance targets and engineering considerations to guide hydrogen storage materials development

International Nuclear Information System (INIS)

Stetson, Ned T.; Ordaz, Grace; Adams, Jesse; Randolph, Katie; McWhorter, Scott

2013-01-01

Highlights: •Portable power and material handling equipment as early market technology pathways. •Engineering based system-level storage-materials requirements. •Application based targets. -- Abstract: The Hydrogen and Fuel Cells Technologies Office, carried out through the DOE Office of Energy Efficiency and Renewable Energy, maintains a broad portfolio of activities to enable the commercialization of fuel cells across a range of near, mid and long-term applications. Improved, advanced hydrogen storage technologies are seen as a critical need for successful implementation of hydrogen fuel cells in many of these applications. To guide and focus materials development efforts, the DOE develops system performance targets for the specific applications of interest, and carries out system engineering analyses to determine the system-level performance delivered when the materials are incorporated into a complete system. To meet the needs of applications, it is important to consider the system-level performance, not just the material-level properties. An overview of the DOE’s hydrogen storage efforts in developing application-specific performance targets and systems engineering to guide hydrogen storage materials identification and development is herein provided

Method of storing the fuel storage pot in a fuel storage tank for away-from-reactor-storage

International Nuclear Information System (INIS)

Ishiguro, Jun-ichi.

1980-01-01

Purpose: To prevent the contact of sodium in the away-from-reactor-storage fuel storage tank with sodium in a fuel storage pool having radioactivity ana always retain clean state therein. Method: Sodium is filled in a container body of the away-from-reactor-storage fuel storage tank, and a conduit, a cycling pump, and cooling means are disposed to form a sodium coolant cycling loop. The fuel storage pool is so stored in the container body that the heat of the pool is projected from the liquid surface of the sodium in the container. Therefore, the sodium in the container is isolated from the sodium in the pool containing strong radioactivity to prevent contact of the former sodium from the latter sodium. (Sekiya, K.)

Unexplained abdominal pain as a driver for inappropriate therapeutics: an audit on the use of intravenous proton pump inhibitors

OpenAIRE

Pauline Siew Mei Lai; Yin Yen Wong; Yong Chia Low; Hui Ling Lau; Kin-Fah Chin; Sanjiv Mahadeva

2014-01-01

Background. Proton pump inhibitors (PPIs) are currently the most effective agents for acid-related disorders. However, studies show that 25–75% of patients receiving intravenous PPIs had no appropriate justification, indicating high rates of inappropriate prescribing. Objective. To examine the appropriate use of intravenous PPIs in accordance with guidelines and the efficacy of a prescribing awareness intervention at an Asian teaching institution. Setting. Prospective audit in a tertiary hosp...

Spent fuel storage - dry storage options and issues

International Nuclear Information System (INIS)

Akins, M.J.

2007-01-01

The increase in the number of nuclear energy power generation facilities will require the ability to store the spent nuclear fuel for a long period until the host countries develop reprocessing or disposal options. Plants have storage pools which are closely associated with the operating units. These are excellent for short term storage, but require active maintenance and operations support which are not desirable for the long term. Over the past 25 years, dry storage options have been developed and implemented throughout the world. In recent years, protection against terrorist attack has become an increasing source of design objectives for these facilities, as well as the main nuclear plant. This paper explores the current design options of dry storage cask systems and examines some of the current design issues for above ground , in-ground, or below-ground storage of spent fuel in dry casks. (author)

Astrochemistry in TSR and CSR Ion Storage Rings

Science.gov (United States)

Novotny, Oldrich

2017-04-01

Dissociative recombination (DR) of molecular ions plays a key role in controlling the charge density and composition of the cold interstellar medium (ISM). Experimental data on DR are required in order to understand the chemical network in the ISM and related processes such as star formation from molecular clouds. Needed data include not only total reaction cross sections, but also the chemical composition and excitation states of the neutral products. Utilizing the TSR storage ring in Heidelberg, Germany, we have carried out DR measurements for astrophysically important molecular ions. We use a merged electron-ion beams technique combined with event-by-event fragment counting and fragment imaging. The count rate of detected neutral DR products yields the absolute DR rate coefficient. Imaging the distribution of fragment distances provides information on the kinetic energy released including the states of both the initial molecule and the final products. Additional kinetic energy sensitivity of the employed detector allows for identification of fragmentation channels by fragment-mass combination within each dissociation event. Such combined information is essential for studies on DR of polyatomic ions with multi-channel breakup. The recently commissioned Cryogenic Storage Ring (CSR) in Heidelberg, Germany, extends the experimental capabilities of TSR by operation at cryogenic temperatures down to 6 K. At these conditions residual gas densities down to 100 cm-3 can be reached resulting in beam storage times of several hours. Long storage in the cold environment allows the ions to relax down to their rotational ground state, thus mimicking well the conditions in the cold ISM. A variety of astrophysically relevant reactions will be investigated at these conditions, such as DR, electron impact excitation, ion-neutral collisions, etc. We report our TSR results on DR of HCl+ and D2Cl+. We also present first results from the CSR commissioning experiments.

Potentially inappropriate medicines in elderly hospitalised patients according to the EU(7)-PIM list, STOPP version 2 criteria and comprehensive protocol.

Science.gov (United States)

Mucalo, Iva; Hadžiabdić, Maja Ortner; Brajković, Andrea; Lukić, Sonja; Marić, Patricia; Marinović, Ivana; Bačić-Vrca, Vesna

2017-08-01

The aim of this study was to measure the prevalence of potentially inappropriate medications (PIMs) by using the EU(7)-PIM list, STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions) version 2 criteria and the new comprehensive protocol. This prospective study involved a sample of 276 consecutive elderly patients discharged from the university teaching hospital. Age, gender, diagnoses, medication history and medicines at discharge were recorded. The main outcome measure was the prevalence of PIMs according to each set of criteria: EU(7)-PIM list, STOPP version 2 criteria and comprehensive protocol. The median patient age (range) was 74 (65-92) years. The median number of prescribed medications was 7 (1-17). STOPP identified 393 PIMs affecting 190 patients (69%), EU(7)-PIM list identified 330 PIMs in 184 patients (66.7%) whilst the comprehensive protocol identified 134 PIMs in 102 patients (37%). STOPP version 2 criteria identified significantly more PIMs per patient than the other two protocols (p comprehensive protocol and was found as a more sensitive tool for PIM detection.

Winter electricity supply and seasonal storage deficit in the Swiss Alps

Science.gov (United States)

Manso, Pedro; Monay, Blaise; Dujardin, Jérôme; Schaefli, Bettina; Schleiss, Anton

2017-04-01

Switzerland electricity production depends at 60% on hydropower, most of the remainder coming from nuclear power plants. The ongoing energy transition foresees an increase in renewable electricity production of solar photovoltaic, wind and geothermal origin to replace part of nuclear production; hydropower, in its several forms, will continue to provide the backbone and the guarantee of the instantaneous and permanent stability of the electric system. One of the key elements of any future portfolio of electricity mix with higher shares of intermittent energy sources like wind and solar are fast energy storage and energy deployment solutions. Hydropower schemes with pumping capabilities are eligible for storage at different time scales, whereas high-head storage hydropower schemes have already a cornerstone role in today's grid operation. These hydropower storage schemes have also been doing what can be labelled as "seasonal energy storage" in different extents, storing abundant flows in the wet season (summer) to produce electricity in the dry (winter) alpine season. Some of the existing reservoirs are however under sized with regards to the available water inflows and either spill over or operate as "run-of-the-river" which is economically suboptimal. Their role in seasonal energy transfer could increase through storage capacity increase (by dam heightening, by new storage dams in the same catchment). Inversely, other reservoirs that already store most of the wet season inflow might not fill up in the future in case inflows decrease due to climate changes; these reservoirs might then have extra storage capacity available to store energy from sources like solar and wind, if water pumping capacity is added or increased. The present work presents a comprehensive methodology for the identification of the seasonal storage deficit per catchment considering todays and future hydrological conditions with climate change, applied to several landmark case studies in

Extremely secure identification documents

International Nuclear Information System (INIS)

Tolk, K.M.; Bell, M.

1997-09-01

The technology developed in this project uses biometric information printed on the document and public key cryptography to ensure that an adversary cannot issue identification documents to unauthorized individuals or alter existing documents to allow their use by unauthorized individuals. This process can be used to produce many types of identification documents with much higher security than any currently in use. The system is demonstrated using a security badge as an example. This project focused on the technologies requiring development in order to make the approach viable with existing badge printing and laminating technologies. By far the most difficult was the image processing required to verify that the picture on the badge had not been altered. Another area that required considerable work was the high density printed data storage required to get sufficient data on the badge for verification of the picture. The image processing process was successfully tested, and recommendations are included to refine the badge system to ensure high reliability. A two dimensional data array suitable for printing the required data on the badge was proposed, but testing of the readability of the array had to be abandoned due to reallocation of the budgeted funds by the LDRD office

Locally Minimum Storage Regenerating Codes in Distributed Cloud Storage Systems

Institute of Scientific and Technical Information of China (English)

Jing Wang; Wei Luo; Wei Liang; Xiangyang Liu; Xiaodai Dong

2017-01-01

In distributed cloud storage sys-tems, inevitably there exist multiple node fail-ures at the same time. The existing methods of regenerating codes, including minimum storage regenerating (MSR) codes and mini-mum bandwidth regenerating (MBR) codes, are mainly to repair one single or several failed nodes, unable to meet the repair need of distributed cloud storage systems. In this paper, we present locally minimum storage re-generating (LMSR) codes to recover multiple failed nodes at the same time. Specifically, the nodes in distributed cloud storage systems are divided into multiple local groups, and in each local group (4, 2) or (5, 3) MSR codes are constructed. Moreover, the grouping method of storage nodes and the repairing process of failed nodes in local groups are studied. The-oretical analysis shows that LMSR codes can achieve the same storage overhead as MSR codes. Furthermore, we verify by means of simulation that, compared with MSR codes, LMSR codes can reduce the repair bandwidth and disk I/O overhead effectively.

Assessing storage adequacy

International Nuclear Information System (INIS)

Amirault, P.

2004-01-01

Government policy encourages the use of natural gas. It is expected that liquefied natural gas (LNG) and Arctic gas will make up 20 to 25 per cent of supply. This presentation provided an outlook of storage value based on a technical analysis by the National Petroleum Counsel (NPC) report. A moderately robust growth is expected in the residential and commercial load which may be partially offset by robust growth in electricity. The net result is an increase in storage requirements. It was concluded that there is a strong case for growth in storage demand but a lack of good sites for additional capacity. This will lead to higher storage values. The NPC sees the need for 1 Tcf more storage use by 2025, of which 700 Bcf will need to come from new storage. In particular, current storage levels may not be sufficient to meet a colder than normal winter, and deliverability is affected by field inventory. Most storage capacity was built before 1985, mostly by regulated entities. It is expected that only 250 to 400 Bcf will be added over the next 25 years in North America. If storage becomes scarce, prices will move to the marginal cost of new additions, and the upper limit on price will be determined by salt cavern storage. An increase of $1.00 in the price of leasing storage would add about $0.11 to the average price of consumed gas. tabs., figs

Status of the spent fuel dry storage programme for Cernavoda NPP

International Nuclear Information System (INIS)

Radu, M.

1999-01-01

The Cernavoda NPP Unit 1 (600 MWe Standard type) is in operation since December 1996. Within the framework of the R and D Radioactive Waste and Spent Fuel Management Programme, investigations, studies and research are carried out on site identification and conceptual designs for both a Spent Fuel Interim Storage Facility and a Spent Fuel Disposal Facility. The status of the work performed in the framework of this programme as well as the situation of the spent fuel resulting from the Research Institutes will be presented in the paper. (author)

The socio-technical transition of distributed electricity storage into future networks—System value and stakeholder views

International Nuclear Information System (INIS)

Grünewald, Philipp H.; Cockerill, Timothy T.; Contestabile, Marcello; Pearson, Peter J.G.

2012-01-01

Whole system models for the GB electricity system suggest that distributed electricity storage has the potential to significantly reduce the system integration cost for future system scenarios. From a policy perspective, this poses the question why this value should not be realised within existing market structures. Opinion among stakeholders is divided. Some believe that storage deployment constitutes a ‘special case’ in need of policy support. Others insist that markets can provide the necessary platform to negotiate contracts, which reward storage operators for the range of services they could provide. This paper seeks to inform this debate with a process of stakeholder engagement using a perspective informed by socio-technical transition literatures. This approach allows the identification of tensions among actors in the electricity system and of possibilities for co-evolution in the deployment of storage technologies during a transition towards a low carbon electricity system. It also draws attention to policy-related challenges of technology lock-in and path dependency resulting from poor alignment of incumbent regimes with the requirements for distributed electricity storage. - Highlights: ► Electricity storage is poorly aligned with existing regimes in the electricity system. ► Stakeholders perceive electricity storage as “somebody else's problem”. ► Combining stakeholder views and transition theory provides new insight. ► Transition from network to operational benefits poses regulatory challenge. ► Value aggregation made difficult due to institutional barriers.

Inappropriately low aldosterone concentrations in adults with AIDS-related diarrhoea in Zambia: a study of response to fluid challenge

Directory of Open Access Journals (Sweden)

Lumayi Ruth

2008-04-01

Full Text Available Abstract Background Chronic diarrhoea is one of the most debilitating consequences of HIV infection in sub-Saharan Africa and it carries a high mortality rate. We report unexpectedly low concentrations of circulating aldosterone in 12 patients (6 men, 6 women in the University Teaching Hospital, Lusaka, who all had diarrhoea for over one month. Changes in serum electrolytes, blood pressure, Karnofsky score and serum aldosterone concentration were being monitored during a short study of responses to saline infusion (3 litres/24 h over 72 hours. Findings At baseline, 9/12 (75% of the patients were hyponatraemic, 10/11 (91% were hypokalaemic, and 6/12 (50% had undetectable aldosterone concentrations. Blood pressure and Karnofsky score rose and creatinine concentration fell in response to the infusion. Conclusion Circulating aldosterone concentrations were inappropriately low and complicate the profound electrolyte deficiencies resulting from chronic diarrhoea. Management of these deficiencies needs to be more aggressive than is currently practised and consideration should be given to a formal clinical trial of mineralocorticoid replacement in these severely ill patients. If the inappropriately low aldosterone reflects a general adrenal failure, it may explain a considerable proportion of the high mortality seen both before and after initiation of anti-retroviral therapy.

The NASA Redox Storage System Development project, 1980

Science.gov (United States)

1982-12-01

The technical accomplishments pertaining to the development of Redox systems and related technology are outlined in terms of the task elements: prototype systems development, application analyses, and supporting technology. Prototype systems development provides for a major procurement to develop an industrial capability to take the current NASA Lewis technology and go on to the design, development, and commercialization of iron-chromium Redox storage systems. Application analyses provides for the definition of application concepts and technology requirements, specific definition studies, and the identification of market sectors and their penetration potential. Supporting technology includes both in house and contractual efforts that encompass implementation of technology improvements in membranes, electrodes, reactant processing, and system design. The status of all elements is discussed.

Storage Policies and Optimal Shape of a Storage System

NARCIS (Netherlands)

Zaerpour, N.; De Koster, René; Yu, Yugang

2013-01-01

The response time of a storage system is mainly influenced by its shape (configuration), the storage assignment and retrieval policies, and the location of the input/output (I/O) points. In this paper, we show that the optimal shape of a storage system, which minimises the response time for single

MALDI-TOF MS Profiling-Advances in Species Identification of Pests, Parasites, and Vectors

Directory of Open Access Journals (Sweden)

Jayaseelan Murugaiyan

2017-05-01

Full Text Available Invertebrate pests and parasites of humans, animals, and plants continue to cause serious diseases and remain as a high treat to agricultural productivity and storage. The rapid and accurate species identification of the pests and parasites are needed for understanding epidemiology, monitoring outbreaks, and designing control measures. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS profiling has emerged as a rapid, cost effective, and high throughput technique of microbial species identification in modern diagnostic laboratories. The development of soft ionization techniques and the release of commercial pattern matching software platforms has resulted in the exponential growth of applications in higher organisms including parasitology. The present review discusses the proof-of-principle experiments and various methods of MALDI MS profiling in rapid species identification of both laboratory and field isolates of pests, parasites and vectors.

MALDI-TOF MS Profiling-Advances in Species Identification of Pests, Parasites, and Vectors.

Science.gov (United States)

Murugaiyan, Jayaseelan; Roesler, Uwe

2017-01-01

Invertebrate pests and parasites of humans, animals, and plants continue to cause serious diseases and remain as a high treat to agricultural productivity and storage. The rapid and accurate species identification of the pests and parasites are needed for understanding epidemiology, monitoring outbreaks, and designing control measures. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) profiling has emerged as a rapid, cost effective, and high throughput technique of microbial species identification in modern diagnostic laboratories. The development of soft ionization techniques and the release of commercial pattern matching software platforms has resulted in the exponential growth of applications in higher organisms including parasitology. The present review discusses the proof-of-principle experiments and various methods of MALDI MS profiling in rapid species identification of both laboratory and field isolates of pests, parasites and vectors.

MASCOT HTML and XML parser: an implementation of a novel object model for protein identification data.

Science.gov (United States)

Yang, Chunguang G; Granite, Stephen J; Van Eyk, Jennifer E; Winslow, Raimond L

2006-11-01

Protein identification using MS is an important technique in proteomics as well as a major generator of proteomics data. We have designed the protein identification data object model (PDOM) and developed a parser based on this model to facilitate the analysis and storage of these data. The parser works with HTML or XML files saved or exported from MASCOT MS/MS ions search in peptide summary report or MASCOT PMF search in protein summary report. The program creates PDOM objects, eliminates redundancy in the input file, and has the capability to output any PDOM object to a relational database. This program facilitates additional analysis of MASCOT search results and aids the storage of protein identification information. The implementation is extensible and can serve as a template to develop parsers for other search engines. The parser can be used as a stand-alone application or can be driven by other Java programs. It is currently being used as the front end for a system that loads HTML and XML result files of MASCOT searches into a relational database. The source code is freely available at http://www.ccbm.jhu.edu and the program uses only free and open-source Java libraries.

Prediction of battery storage ageing and solid electrolyte interphase property estimation using an electrochemical model

Science.gov (United States)

Ashwin, T. R.; Barai, A.; Uddin, K.; Somerville, L.; McGordon, A.; Marco, J.

2018-05-01

Ageing prediction is often complicated due to the interdependency of ageing mechanisms. Research has highlighted that storage ageing is not linear with time. Capacity loss due to storing the battery at constant temperature can shed more light on parametrising the properties of the Solid Electrolyte Interphase (SEI); the identification of which, using an electrochemical model, is systematically addressed in this work. A new methodology is proposed where any one of the available storage ageing datasets can be used to find the property of the SEI layer. A sensitivity study is performed with different molecular mass and densities which are key parameters in modelling the thickness of the SEI deposit. The conductivity is adjusted to fine tune the rate of capacity fade to match experimental results. A correlation is fitted for the side reaction variation to capture the storage ageing in the 0%-100% SoC range. The methodology presented in this paper can be used to predict the unknown properties of the SEI layer which is difficult to measure experimentally. The simulation and experimental results show that the storage ageing model shows good accuracy for the cases at 50% and 90% and an acceptable agreement at 20% SoC.

Storage potential in the deeper subsurface of Baden-Wuerttemberg; Speicherpotenziale im tieferen Untergrund Baden-Wuerttembergs

Energy Technology Data Exchange (ETDEWEB)

Fehn, Charlotte; Wirsing, Gunther [Regierungspraesidium Freiburg (Germany). Referat Landeshydrogeologie und -geothermie

2011-07-01

In the framework of the project ''Information system on geological storage formations in Germany - basis for a climate friendly geotechnical and energetic use of the deeper subsurface (Storage Catalogue of Germany)'' coordinated by the Federal Institute of Geosciences and Natural Resources (BGR), the geological surveys of the federal states of Germany have developed potential maps on reservoir rock units and barrier rock units, using nationwide uniform criteria. In Baden-Wuerttemberg, work concentrated on the Molasse Basin and the Upper Rhine Graben. Based on the depth (more than 800 m) and thickness (more than 10 m), in the Molasse Basin potential storage reservoirs become apparent in the so called Bausteinschichten (Untere Meeresmolasse, Tertiary), Eisensandstein-Formation (Middle Jurassic) and Stubensandstein-Formation (Upper Keuper). In the Upper Rhine Graben storage potential occurs mainly in the Tertiary (Niederroedern-Formation, Grau Mergel-Formation und Pechelbronn- and Lymnaeenmergel-Formation), in the Muschelkalk, the Buntsandstein and the Rotliegend/Upper Carboniferous. Mapping methodology and the available data base only allow a general view of distribution of storage potential and cap rock. The assessment is complicated by an inhomogeneous lithologic structure of stratigraphic units, the forecast of their regional continuity and the complexity of the investigated areas in terms of geology and tectonics. The latter applies especially to the Upper Rhine Graben restricting its suitability as storage site. More differentiated conclusions concerning the lithology, the extension and net thickness of storage reservoirs and cap rocks, their sealing capacity as well as the identification of trapping structures can only be achieved by further studies. (orig.)

Lyoluminescence technique as an identification method for irradiated food stuffs

International Nuclear Information System (INIS)

Chazhoor, J.S.

1988-01-01

The paper presents the studies made on the suitability of lyoluminescence technique as an analytical method for the identification of irradiated food stuffs. Powder milk, cinnamon, cardamom, clove, red chilly, cocoa, pepper, tea, coffee, turmeric and coriander showed lyoluminescence response when irradiated by a 10 kGy 60 Co and dissolved in luminol solution. Various dosimetric parameters such as effect of storage time, proportionality of the lyoluminescence response to dose etc were studied. (author). 1 tab., 3 figs

Behavior of Salmonella spp. and natural microbiota on fresh-cut dragon fruits at different storage temperatures.

Science.gov (United States)

Sim, Hui Li; Hong, Yoon-Ki; Yoon, Won Byong; Yuk, Hyun-Gyun

2013-01-01

The aim of this study was to determine survival or growth of unadapted, acid-adapted and cold-stressed Salmonella spp., and natural microbiota on fresh-cut dragon fruits at different storage temperatures. Dragon fruits were sliced and spot inoculated with five-strain cocktail of Salmonella spp. at two inoculum levels (2.5 or 5.5 log CFU/g). Inoculated fruits were stored at 28°C for 48h and at 4°C and 12°C for 96 h. Salmonella population significantly increased by 2.4 to 3.0 log CFU/g at low inoculum level, whereas the numbers increased by 0.4 to 0.7 log CFU/g at the high inoculum level on fruits held at 28°C for 48h. Only unadapted and acid-adapted cells grew with 0.7 to 0.9log increase at the low inoculum level at 12°C for 96h. No significant growth was observed at both inoculum levels during storage at 4°C. Overall, acid, starved and cold adaptation of Salmonella spp. did not show significant difference in survival or growth on fresh-cut dragon fruits during storage compared to unadapted control cells. For natural microbiota on the fruit, mesophilic bacterial counts reached to 5-log CFU/g at 28 and 12°C by 9.9 and 52.9h. Similar with Salmonella spp. there was no growth of natural microbiota at 4°C. These results showed that Salmonella spp. could grow on fresh-cut dragon fruits under inappropriate storage conditions, indicating that fresh-cut dragon fruits could be a potential vehicle for salmonellosis. Thus, this study suggests that fresh-cut dragon fruits should be stored at 4°C to ensure the safety as well as to extend the shelf life of fresh-cut dragon fruits. Copyright © 2012 Elsevier B.V. All rights reserved.

Effect of interventions to reduce potentially inappropriate use of drugs in nursing homes: a systematic review of randomised controlled trials

Directory of Open Access Journals (Sweden)

Gjerberg Elisabeth

2011-04-01

Full Text Available Abstract Background Studies have shown that residents in nursing homes often are exposed to inappropriate medication. Particular concern has been raised about the consumption of psychoactive drugs, which are commonly prescribed for nursing home residents suffering from dementia. This review is an update of a Norwegian systematic review commissioned by the Norwegian Directorate of Health. The purpose of the review was to identify and summarise the effect of interventions aimed at reducing potentially inappropriate use or prescribing of drugs in nursing homes. Methods We searched for systematic reviews and randomised controlled trials in the Cochrane Library, MEDLINE, EMBASE, ISI Web of Knowledge, DARE and HTA, with the last update in April 2010. Two of the authors independently screened titles and abstracts for inclusion or exclusion. Data on interventions, participants, comparison intervention, and outcomes were extracted from the included studies. Risk of bias and quality of evidence were assessed using the Cochrane Risk of Bias Table and GRADE, respectively. Outcomes assessed were use of or prescribing of drugs (primary and the health-related outcomes falls, physical limitation, hospitalisation and mortality (secondary. Results Due to heterogeneity in interventions and outcomes, we employed a narrative approach. Twenty randomised controlled trials were included from 1631 evaluated references. Ten studies tested different kinds of educational interventions while seven studies tested medication reviews by pharmacists. Only one study was found for each of the interventions geriatric care teams, early psychiatric intervening or activities for the residents combined with education of health care personnel. Several reviews were identified, but these either concerned elderly in general or did not satisfy all the requirements for systematic reviews. Conclusions Interventions using educational outreach, on-site education given alone or as part of an

Low-Cost alpha Alane for Hydrogen Storage

Energy Technology Data Exchange (ETDEWEB)

Fabian, Tibor [Ardica Technologies, San Francisco, CA (United States); Petrie, Mark [SRI International, Menlo Park, CA (United States); Crouch-Baker, Steven [SRI International, Menlo Park, CA (United States); Fong, Henry [SRI International, Menlo Park, CA (United States)

2017-10-10

This project was directed towards the further development of the Savannah River National Laboratory (SRNL) lab-scale electrochemical synthesis of the hydrogen storage material alpha-alane and Ardica Technologies-SRI International (SRI) chemical downstream processes that are necessary to meet DoE cost metrics and transition alpha-alane synthesis to an industrial scale. Ardica has demonstrated the use of alpha-alane in a fuel-cell system for the U.S. Army WFC20 20W soldier power system that has successfully passed initial field trials with individual soldiers. While alpha-alane has been clearly identified as a desirable hydrogen storage material, cost-effective means for its production and regeneration on a scale of use applicable to the industry have yet to be established. We focused on three, principal development areas: 1. The construction of a comprehensive engineering techno-economic model to establish the production costs of alpha-alane by both electrochemical and chemical routes at scale. 2. The identification of critical, cost-saving design elements of the electrochemical cell and the quantification of the product yields of the primary electrochemical process. A moving particle-bed reactor design was constructed and operated. 3. The experimental quantification of the product yields of candidate downstream chemical processes necessary to produce alpha-alane to complete the most cost-effective overall manufacturing process. Our techno-economic model shows that under key assumptions most 2015 and 2020 DOE hydrogen storage system cost targets for low and medium power can be achieved using the electrochemical alane synthesis process. To meet the most aggressive 2020 storage system cost target, $1/g, our model indicates that 420 metric tons per year (MT/y) production of alpha-alane is required. Laboratory-scale experimental work demonstrated that the yields of two of the three critical component steps within the overall “electrochemical process” were

Thermal energy storage devices, systems, and thermal energy storage device monitoring methods

Science.gov (United States)

Tugurlan, Maria; Tuffner, Francis K; Chassin, David P.

2016-09-13

Thermal energy storage devices, systems, and thermal energy storage device monitoring methods are described. According to one aspect, a thermal energy storage device includes a reservoir configured to hold a thermal energy storage medium, a temperature control system configured to adjust a temperature of the thermal energy storage medium, and a state observation system configured to provide information regarding an energy state of the thermal energy storage device at a plurality of different moments in time.

SECON - A tool for estimation of storage costs and storage project revenue

International Nuclear Information System (INIS)

Hall, O.

1997-01-01

The SECON model Storage ECONomics is useful for gas suppliers, storage operators, gas distributors and consumers when investigating new storage possibilities. SECON has been used within the Sydkraft group to compare cost for different types of storage and to identify the market niche for lined rock cavern (LRC) storage. In the model cost for the different storage types, salt caverns, LNG, and LRC can be compared. By using input according to market needs each storage type can be validated for a specific service e.g. peak shaving, seasonal storage or balancing. The project revenue can also be calculated. SECON includes three models for income calculation; US storage service, Trading and Avoided Supply Contract Costs. The income models calculates annual turnover, pay of time, net present value, internal rate of return and max. liquidity shortfall for the project. The SECON will facilitate sensitivity analysis both regarding cost for different services and different storage types and on the income side by using different scenarios. At the poster session SECON will be presented live and the delegates will have the opportunity to test the model. (au)

Concrete storage cask for interim storage of spent nuclear fuel

International Nuclear Information System (INIS)

Nabemoto, Toyonobu; Fujiwara, Hiroaki; Kobayashi, Shunji; Shionaga, Ryosuke

2004-01-01

Experiments and analytical evaluation of the fabrication, non-destructive inspection and structural integrity of reinforced concrete body for storage casks were carried out to demonstrate the concrete storage cask for spent fuel generated from nuclear power plants. Analytical survey on the type of concrete material and fabrication method of the storage cask was performed and the most suitable fabrication method for the concrete body was identified to reduce concrete cracking. The structural integrity of the concrete body of the storage cask under load conditions during storage was confirmed and the long term integrity of concrete body against degradation dependent on environmental factors was evaluated. (author)

Monitored Retrievable Storage conceptual system study: metal storage casks

International Nuclear Information System (INIS)

Unterzuber, R.; Cross, T.E.; Krasicki, B.R.

1983-08-01

A description of the metal cask storage facility concept is presented with the operations required to handle the spent fuel or high-level wastes and transuranic wastes. A generic Receiving and Handling Facility, provided by PNL, has been used for this study. Modifications to the storage delivery side of the handling facility, necessary to couple the Receiving and Handling Facility with the storage facility, are described. The equipment and support facilities needed for the storage facility are also described. Two separate storage facilities are presented herein: one for all spent fuel storage, and one for storage of high-level waste (HLW) and transuranic waste (TRU). Each facility is described for the capacities and rates defined by PNL in the Concept Technical Performance Criteria and Base Assumptions (see Table 1.3-1). Estimates of costs and time-distributions of expenditures have been developed to construct, operate, and decommission the conceptual MRS facilities in mid-1983 dollars, for the base cases given using the cost categories and percentages provided by PNL. Cost estimates and time-distributions of expenditures have also been developed to expand the facility throughput rate from 1800 MTU to 3000 MTU, and to expand the facility storage capacity from 15,000 MTU to 72,00 MTU. The life cycle cost of the facility for the bounding cases of all spent fuel and all HLW and TRU, using the time-distributions of costs developed above and assuming a two percent per year discount rate, are also presented. 3 references, 16 figures, 18 tables

Biomarker for Glycogen Storage Diseases

Science.gov (United States)

2017-07-03

Fructose Metabolism, Inborn Errors; Glycogen Storage Disease; Glycogen Storage Disease Type I; Glycogen Storage Disease Type II; Glycogen Storage Disease Type III; Glycogen Storage Disease Type IV; Glycogen Storage Disease Type V; Glycogen Storage Disease Type VI; Glycogen Storage Disease Type VII; Glycogen Storage Disease Type VIII

Identification of nitrate sources in groundwater and potential impact on drinking water reservoir (Goczałkowice reservoir, Poland)

Science.gov (United States)

Czekaj, Joanna; Jakóbczyk-Karpierz, Sabina; Rubin, Hanna; Sitek, Sławomir; Witkowski, Andrzej J.

2016-08-01

Goczałkowice dammed reservoir (area - 26 km2) is a strategic object for flood control in the Upper Vistula River catchment and one of the most important source of drinking water in the Upper Silesian Industrial Region (Southern Poland). Main aims of the investigation were identification of sources of nitrate and assessment of their significance in potential risk to groundwater quality. In the catchment area monitoring network of 22 piezometers, included 14 nested, have been installed. The significant spatial and seasonal differences in chemical composition between northern and southern part of the catchment were indicated based on the groundwater sampling conducted twice - in autumn 2011 and spring 2012. Maximum observed concentrations of nitrate were identified in northern part of the study area 255 mg/L as a results of inappropriate sewage management and agriculture activity. Results, based on the combines multi-scale hydrogeological and hydrochemical field studies, groundwater flow and transport modelling, dual stable isotope approach and geochemical modelling indicate mainly agriculture and inappropriate sewage water management as a sources of NO3- contamination of groundwater which moreover is affected by geochemical processes. In general, contaminated groundwater does not impact surface water quality. However, due to high concentration of nitrate in northern part a continues measurements of nitrogen compounds should be continued and used for reducing uncertainty of the predictive scenarios of the mass transport modelling in the study area.

Corrosion in systems for storage and transportation of petroleum products and biofuels identification, monitoring and solutions

CERN Document Server

Groysman, Alec

2014-01-01

This book treats corrosion as it occurs and affects processes in real-world situations, and thus points the way to practical solutions. Topics described include the conditions in which petroleum products are corrosive to metals; corrosion mechanisms of petroleum products; which parts of storage tanks containing crude oils and petroleum products undergo corrosion; dependence of corrosion in tanks on type of petroleum products; aggressiveness of petroleum products to polymeric material; how microorganisms take part in corrosion of tanks and pipes containing petroleum products; which corrosion monitoring methods are used in systems for storage and transportation of petroleum products; what corrosion control measures should be chosen; how to choose coatings for inner and outer surfaces of tanks containing petroleum products; and how different additives (oxygenates, aromatic solvents) to petroleum products and biofuels influence metallic and polymeric materials. The book is of interest to corrosion engineers, mat...

Performance of VITEK mass spectrometry V3.0 for rapid identification of clinical Aspergillus fumigatus in different culture conditions based on ribosomal proteins.

Science.gov (United States)

Zhou, Longrong; Chen, Yongquan; Xu, Yuanhong

2017-01-01

Fast and accurate discrimination of Aspergillus fumigatus is significant, since misidentification may lead to inappropriate clinical therapy. This study assessed VITEK mass spectrometry (MS) V3.0 for A. fumigatus identification using extracted fungal ribosomal proteins. A total of 52 isolates preliminarily identified as A. fumigatus by traditional morphological methods were inoculated in three different culture media and cultured at two different temperatures. The specific spectral fingerprints of different culture time points (48, 72, 96, and 120 h) were obtained. Of all strains, 88.5% (46/52) were discriminated as A. fumigatus , while the remaining 11.5% (6/52) produced results inconsistent with morphological analysis. Molecular sequencing, as a reference method for species identification, was used to validate the morphological analysis and matrix-assisted laser desorption/ionization time of flight MS. Chi-square tests ( χ 2 test, P =0.05) demonstrated that the culture medium and incubation temperature had no effects on identification accuracy; however, identification accuracy of the strains in the 48-h group was lower than that in other groups. In addition, we found that ribosomal proteins extracted from A. fumigatus can be stored in different environments for at least 1 week, with their profiles remaining stable and strain identification results showing no change. This is beneficial for medical institutions with no mass spectrometer at hand. Overall, this study showed the powerful ability of VITEK MS V 3.0 in identifying A. fumigatus .

Technology and Manufacturing Readiness of Early Market Motive and Non-Motive Hydrogen Storage Technologies for Fuel Cell Applications

Energy Technology Data Exchange (ETDEWEB)

Ronnebro, Ewa

2012-06-16

PNNL’s objective in this report is to provide DOE with a technology and manufacturing readiness assessment to identify hydrogen storage technologies’ maturity levels for early market motive and non-motive applications and to provide a path forward toward commercialization. PNNL’s Technology Readiness Assessment (TRA) is based on a combination of Technology Readiness Level (TRL) and Manufacturing Readiness Level (MRL) designations that enable evaluation of hydrogen storage technologies in varying levels of development. This approach provides a logical methodology and roadmap to enable the identification of hydrogen storage technologies, their advantages/disadvantages, gaps and R&D needs on an unbiased and transparent scale that is easily communicated to interagency partners. The TRA report documents the process used to conduct the TRA, reports the TRL and MRL for each assessed technology and provides recommendations based on the findings.

Wind turbine storage systems

International Nuclear Information System (INIS)

Ibrahim, H.; Ilinca, A.; Perron, J.

2005-01-01

Electric power is often produced in locations far from the point of utilization which creates a challenge in stabilizing power grids, particularly since electricity cannot be stored. The production of decentralized electricity by renewable energy sources offers a greater security of supply while protecting the environment. Wind power holds the greatest promise in terms of environmental protection, competitiveness and possible applications. It is known that wind energy production is not always in phase with power needs because of the uncertainty of wind. For that reason, energy storage is the key for the widespread integration of wind energy into the power grids. This paper proposed various energy storage methods that can be used in combination with decentralized wind energy production where an imbalance exists between electricity production and consumption. Energy storage can play an essential role in bringing value to wind energy, particularly if electricity is to be delivered during peak hours. Various types of energy storage are already in use or are being developed. This paper identified the main characteristics of various electricity storage techniques and their applications. They include stationary or embarked storage for long or short term applications. A comparison of characteristics made it possible to determine which types of electricity storage are best suited for wind energy. These include gravity energy; thermal energy; compressed air energy; coupled storage with natural gas; coupled storage with liquefied gas; hydrogen storage for fuel cells; chemical energy storage; storage in REDOX batteries; storage by superconductive inductance; storage in supercondensers; and, storage as kinetic energy. 21 refs., 21 figs

Neutron storage

International Nuclear Information System (INIS)

Strelkov, A.V.

2004-01-01

The report is devoted to neutron storage (NS) and describes the history of experiments on the NS development. Great attention is paid to ultracold neutron (UCN) storage. The experiments on the UCN generation, transport, spectroscopy, storage and detection are described. Experiments on searching the UCN electric-dipole moment and electric charge are continued. Possible using of UCN for studying the nanoparticles is discussed [ru

Tritium storage

International Nuclear Information System (INIS)

Hircq, B.

1989-01-01

A general synthesis about tritium storage is achieved in this paper and a particular attention is given to practical application in the Fusion Technology Program. Tritium, storage under gaseous form and solid form are discussed (characteristics, advantages, disadvantages and equipments). The way of tritium storage is then discussed and a choice established as a function of a logic which takes into account the main working parameters

Licensing of spent fuel dry storage and consolidated rod storage

International Nuclear Information System (INIS)

Bailey, W.J.

1990-02-01

The results of this study, performed by Pacific Northwest Laboratory (PNL) and sponsored by the US Department of Energy (DOE), respond to the nuclear industry's recommendation that a report be prepared that collects and describes the licensing issues (and their resolutions) that confront a new applicant requesting approval from the US Nuclear Regulatory Commission (NRC) for dry storage of spent fuel or for large-scale storage of consolidated spent fuel rods in pools. The issues are identified in comments, questions, and requests from the NRC during its review of applicants' submittals. Included in the report are discussions of (1) the 18 topical reports on cask and module designs for dry storage fuel that have been submitted to the NRC, (2) the three license applications for dry storage of spent fuel at independent spent fuel storage installations (ISFSIs) that have been submitted to the NRC, and (3) the three applications (one of which was later withdrawn) for large-scale storage of consolidated fuel rods in existing spent fuel storage pools at reactors that were submitted tot he NRC. For each of the applications submitted, examples of some of the issues (and suggestions for their resolutions) are described. The issues and their resolutions are also covered in detail in an example in each of the three subject areas: (1) the application for the CASTOR V/21 dry spent fuel storage cask, (2) the application for the ISFSI for dry storage of spent fuel at Surry, and (3) the application for full-scale wet storage of consolidated spent fuel at Millstone-2. The conclusions in the report include examples of major issues that applicants have encountered. Recommendations for future applicants to follow are listed. 401 refs., 26 tabs

Accurate Lithium-ion battery parameter estimation with continuous-time system identification methods

International Nuclear Information System (INIS)

Xia, Bing; Zhao, Xin; Callafon, Raymond de; Garnier, Hugues; Nguyen, Truong; Mi, Chris

2016-01-01

Highlights: • Continuous-time system identification is applied in Lithium-ion battery modeling. • Continuous-time and discrete-time identification methods are compared in detail. • The instrumental variable method is employed to further improve the estimation. • Simulations and experiments validate the advantages of continuous-time methods. - Abstract: The modeling of Lithium-ion batteries usually utilizes discrete-time system identification methods to estimate parameters of discrete models. However, in real applications, there is a fundamental limitation of the discrete-time methods in dealing with sensitivity when the system is stiff and the storage resolutions are limited. To overcome this problem, this paper adopts direct continuous-time system identification methods to estimate the parameters of equivalent circuit models for Lithium-ion batteries. Compared with discrete-time system identification methods, the continuous-time system identification methods provide more accurate estimates to both fast and slow dynamics in battery systems and are less sensitive to disturbances. A case of a 2"n"d-order equivalent circuit model is studied which shows that the continuous-time estimates are more robust to high sampling rates, measurement noises and rounding errors. In addition, the estimation by the conventional continuous-time least squares method is further improved in the case of noisy output measurement by introducing the instrumental variable method. Simulation and experiment results validate the analysis and demonstrate the advantages of the continuous-time system identification methods in battery applications.

Interaction between shock coils increased the incidence of inappropriate therapies and lead failure in implantable cardioverter defibrillator.

Science.gov (United States)

El Garhy, Mohammad; Ohlow, Marc-Alexander; Lauer, Bernward

Shock coil interaction in patients with multiple implantable cardioverter defibrillator (ICD) leads is occasionally observed. We aimed to evaluate the incidence of shock coil interaction and its clinical relevance. All ICD patients (646 patients) who came to follow up control in our ICD ambulance between January 1, 2011, and December 31, 2011 in the department of cardiology in Bad Berka hospital were retrospectively evaluated in this study. All baseline demographic, clinical, and procedural characteristics and postoperative chest x ray in postero-anterior and lateral view as well as clinical and ICD follow up data were evaluated. Among 646 patients 42 had multiple ICD leads (6.5%) of whom 36 patients (5.5% of total cohort patients and 85.7% of patients with multiple ICD leads) had shock coil interaction and presented the study group (Group I). The control group (Group II) consisted of 610 patients without coil-coil interaction including patients with single shock lead (604 patients) or patients with multiple leads but without interaction between shock coils (6 patients). Inappropriate anti-tachycardia therapies and RV lead revisions were more frequent in patients with interaction between shock coils (Group I vs Group II: 27.7% and 5.7%; p = 0.049 and 30.6% vs 6.4; p = 0.0001, respectively). Interaction between shock coils may be one of possible causes of lead failure and resulted in inappropriate therapies and subsequent lead revision. Copyright © 2018 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.

Reversible deep storage: reversibility options for storage in deep geological formations

International Nuclear Information System (INIS)

2009-01-01

This report describes the definition approach to reversibility conditions, presents the main characteristics of high-activity and intermediate-activity long-lived wastes, describes the storage in deep geological formations (safety functions, general description of the storage centre), discusses the design options for the different types of wastes (container, storage module, handling processes, phenomenological analysis, monitoring arrangements) and the decision process in support reversibility (steering of the storage process, progressive development and step-by-step closing), and reports and discusses the researches concerning the memory of the storage site

Recycling of underground storage tanks: a way-out to the risks; Reciclagem de tanques de combustiveis: solucoes para os riscos envolvidos

Energy Technology Data Exchange (ETDEWEB)

Duarte, Cristiano J.P.; Santos, Joao David [Companhia Brasileira de Petroleo Ipiranga, Porto Alegre, RS (Brazil)

2004-07-01

In petrol stations, the removal of an underground storage tank happens when it becomes unnecessary or inappropriate. Among the several reasons which motivate this removal, we can mention the environmental license process. According to the Resolution CONAMA 273/00, all the petrol stations are subjected to the previous, installation and operation licenses (including the ones in operation). This will cause the substitution of a large number of tanks all over Brazil along the following years. However, so that the license process can be successful, it is necessary that the environmental impacts caused by its implementation are properly managed, avoiding safety problems and providing that there won't be any damage to the environment. This work shows alternatives for the recycling of the tank, the destination of residue and the maintenance of safety all over the process. (author)

Simple DNA extraction of urine samples: Effects of storage temperature and storage time.

Science.gov (United States)

Ng, Huey Hian; Ang, Hwee Chen; Hoe, See Ying; Lim, Mae-Lynn; Tai, Hua Eng; Soh, Richard Choon Hock; Syn, Christopher Kiu-Choong

2018-06-01

Urine samples are commonly analysed in cases with suspected illicit drug consumption. In events of alleged sample mishandling, urine sample source identification may be necessary. A simple DNA extraction procedure suitable for STR typing of urine samples was established on the Promega Maxwell ® 16 paramagnetic silica bead platform. A small sample volume of 1.7mL was used. Samples were stored at room temperature, 4°C and -20°C for 100days to investigate the influence of storage temperature and time on extracted DNA quantity and success rate of STR typing. Samples stored at room temperature exhibited a faster decline in DNA yield with time and lower typing success rates as compared to those at 4°C and -20°C. This trend can likely be attributed to DNA degradation. In conclusion, this study presents a quick and effective DNA extraction protocol from a small urine volume stored for up to 100days at 4°C and -20°C. Copyright © 2018 Elsevier B.V. All rights reserved.

Inappropriate prescribing and adverse drug events in older people

Directory of Open Access Journals (Sweden)

Gallagher Paul F

2009-01-01

Full Text Available Abstract Inappropriate prescribing (IP in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs, morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.

Inappropriate prescribing and adverse drug events in older people.

LENUS (Irish Health Repository)

Hamilton, Hilary J

2009-01-01

Inappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.

Risk of iatrogenic human immunodeficiency virus infection through transfusion of blood tested by inappropriately stored or expired rapid antibody assays in a Zambian hospital

NARCIS (Netherlands)

Consten, E. C.; van der Meer, J. T.; de Wolf, F.; Heij, H. A.; Henny, P. C.; van Lanschot, J. J.

1997-01-01

BACKGROUND: The purpose of this study was to estimate the risk of human immunodeficiency virus (HIV) infection via the transfusion of blood tested by inappropriately stored or expired rapid antibody assays in Zambia. STUDY DESIGN AND METHODS: Surgical patients (n = 370) were tested with antibody

Adaptation of PyFlag to Efficient Analysis of Overtaken Computer Data Storage

Directory of Open Access Journals (Sweden)

Aleksander Byrski

2010-03-01

Full Text Available Based on existing software aimed at investigation support in the analysis of computer data storage overtaken during investigation (PyFlag, an extension is proposed involving the introduction of dedicated components for data identification and filtering. Hash codes for popular software contained in NIST/NSRL database are considered in order to avoid unwanted files while searching and to classify them into several categories. The extension allows for further analysis, e.g. using artificial intelligence methods. The considerations are illustrated by the overview of the system's design.

Optical storage networking

Science.gov (United States)

Mohr, Ulrich

2001-11-01

For efficient business continuance and backup of mission- critical data an inter-site storage network is required. Where traditional telecommunications costs are prohibitive for all but the largest organizations, there is an opportunity for regional carries to deliver an innovative storage service. This session reveals how a combination of optical networking and protocol-aware SAN gateways can provide an extended storage networking platform with the lowest cost of ownership and the highest possible degree of reliability, security and availability. Companies of every size, with mainframe and open-systems environments, can afford to use this integrated service. Three mayor applications are explained; channel extension, Network Attached Storage (NAS), Storage Area Networks (SAN) and how optical networks address the specific requirements. One advantage of DWDM is the ability for protocols such as ESCON, Fibre Channel, ATM and Gigabit Ethernet, to be transported natively and simultaneously across a single fiber pair, and the ability to multiplex many individual fiber pairs over a single pair, thereby reducing fiber cost and recovering fiber pairs already in use. An optical storage network enables a new class of service providers, Storage Service Providers (SSP) aiming to deliver value to the enterprise by managing storage, backup, replication and restoration as an outsourced service.

Storage Rings

International Nuclear Information System (INIS)

Fischer, W.

2010-01-01

Storage rings are circular machines that store particle beams at a constant energy. Beams are stored in rings without acceleration for a number of reasons (Tab. 1). Storage rings are used in high-energy, nuclear, atomic, and molecular physics, as well as for experiments in chemistry, material and life sciences. Parameters for storage rings such as particle species, energy, beam intensity, beam size, and store time vary widely depending on the application. The beam must be injected into a storage ring but may not be extracted (Fig. 1). Accelerator rings such as synchrotrons are used as storage rings before and after acceleration. Particles stored in rings include electrons and positrons; muons; protons and anti-protons; neutrons; light and heavy, positive and negative, atomic ions of various charge states; molecular and cluster ions, and neutral polar molecules. Spin polarized beams of electrons, positrons, and protons were stored. The kinetic energy of the stored particles ranges from 10 -6 eV to 3.5 x 10 12 eV (LHC, 7 x 10 12 eV planned), the number of stored particles from one (ESR) to 1015 (ISR). To store beam in rings requires bending (dipoles) and transverse focusing (quadrupoles). Higher order multipoles are used to correct chromatic aberrations, to suppress instabilities, and to compensate for nonlinear field errors of dipoles and quadrupoles. Magnetic multipole functions can be combined in magnets. Beams are stored bunched with radio frequency systems, and unbunched. The magnetic lattice and radio frequency system are designed to ensure the stability of transverse and longitudinal motion. New technologies allow for better storage rings. With strong focusing the beam pipe dimensions became much smaller than previously possible. For a given circumference superconducting magnets make higher energies possible, and superconducting radio frequency systems allow for efficient replenishment of synchrotron radiation losses of large current electron or positron beams

Inappropriate nutrients intake is associated with lower functional status and inferior quality of life in older adults with depression.

Science.gov (United States)

Guligowska, Agnieszka; Pigłowska, Małgorzata; Fife, Elizaveta; Kostka, Joanna; Sołtysik, Bartłomiej K; Kroc, Łukasz; Kostka, Tomasz

2016-01-01

The study is a case-control analysis of whether depression impairs physical and cognitive functioning and quality of life, and whether there is a relationship between nutrient deficiencies and these adverse changes. A total of 130 older subjects participated in the study: 65 with diagnosed depression (16 men and 49 women) and 65 age- and sex-matched controls without depression. All patients underwent comprehensive geriatric assessment. Nutritional state was assessed with the Mini Nutritional Assessment, cognitive performance was evaluated by the Mini-Mental State Examination and physical functioning by the Timed "Up & Go" test and handgrip strength. The pattern of consumption of various nutrients was analyzed in detail. The differences in cognitive functioning observed between the groups were related to specific nutrient intake, as was handgrip strength to some extent. The differences in nutritional status, several functional tests and muscle strength were related to both the presence of depression and inappropriate consumption of certain nutrients. The incidence of falls and poor quality of life may be partially associated with the presence of depression. The inappropriate intake of selected nutrients may impair the functioning and quality of life of older adults with depression, such as the excess consumption of sucrose and insufficient consumption of protein, fiber, eicosapentaenoic acid, niacin and vitamin B6. Particular nutrients should be translated into dietary patterns which allow the individual patient to address these nutrient deficiencies.

Coach Expectations About Off-Field Conduct and Bystander Intervention by U.S. College Football Players to Prevent Inappropriate Sexual Behavior.

Science.gov (United States)

Kroshus, Emily; Paskus, Tom; Bell, Lydia

2015-09-21

The objective of the present study was to assess whether there is a positive association between expectations about off-field conduct set by the team coach and the likelihood that college football players intend to engage as prosocial bystanders in the prevention of what they consider to be inappropriate sexual behavior. In a sample of U.S. collegiate football players (N = 3,281), a path analysis model tested the association between coach expectations, perceived likelihood of discipline for off-field transgressions, and likelihood of intending to intervene to prevent inappropriate sexual behavior. Mediation of these relationships by the athlete's sense of exploitative entitlement and their attitudes about intervening were also assessed. Findings supported the hypothesized relationships, with expectations and discipline associated with bystander intentions both directly and indirectly through the mediating pathways of entitlement and attitudes about intervening. These findings provide evidence about the important role that sports team coaches can play in encouraging bystander intervention by clarifying expectations and consequences for conduct off the field of play. Athletic departments can provide a framework within which coaches are informed about the importance of setting and enforcing standards for off-field behavior, and are appropriately incentivized to do so. © The Author(s) 2015.

STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers' criteria.

LENUS (Irish Health Repository)

Gallagher, Paul

2012-02-03

Introduction: STOPP (Screening Tool of Older Persons\\' potentially inappropriate Prescriptions) is a new, systems-defined medicine review tool. We compared the performance of STOPP to that of established Beers\\' criteria in detecting potentially inappropriate medicines (PIMs) and related adverse drug events (ADEs) in older patients presenting for hospital admission. METHODS: we prospectively studied 715 consecutive acute admissions to a university teaching hospital. Diagnoses, reason for admission and concurrent medications were recorded. STOPP and Beers\\' criteria were applied. PIMs with clear causal connection or contribution to the principal reason for admission were determined. RESULTS: median patient age (interquartile range) was 77 (72-82) years. Median number of prescription medicines was 6 (range 0-21). STOPP identified 336 PIMs affecting 247 patients (35%), of whom one-third (n = 82) presented with an associated ADE. Beers\\' criteria identified 226 PIMs affecting 177 patients (25%), of whom 43 presented with an associated ADE. STOPP-related PIMs contributed to 11.5% of all admissions. Beers\\' criteria-related PIMs contributed to significantly fewer admissions (6%). CONCLUSION: STOPP criteria identified a significantly higher proportion of patients requiring hospitalisation as a result of PIM-related adverse events than Beers\\' criteria. This finding has significant implications for hospital geriatric practice.

Inactivation of the infralimbic prefrontal cortex in rats reduces the influence of inappropriate habitual responding in a response-conflict task.

Science.gov (United States)

Haddon, J E; Killcross, S

2011-12-29

Previous research suggests the infralimbic cortex is important in situations when there is competition between goal-directed and habitual responding. Here we used a response conflict procedure to further explore the involvement of the infralimbic cortex in this relationship. Rats received training on two instrumental biconditional discriminations, one auditory and one visual, in two distinct contexts. One discrimination was "over-trained" relative to the other, "under-trained," discrimination in the ratio 3:1. At test, animals were presented with incongruent audiovisual stimulus compounds of the training stimuli in the under-trained context. The stimulus elements of these test compounds have previously dictated different lever press responses during training. Rats receiving control infusions into the infralimbic cortex showed a significant interference effect, producing more responses to the over-trained (habitual), but context-inappropriate, stimulus element of the incongruent compound. This interference effect was abolished by inactivation of the infralimbic cortex; animals showed a reduced tendency to produce the habitual but inappropriate response compared with animals receiving control infusions. This finding provides evidence that the infralimbic cortex is involved in attenuating the influence of goal-directed behavior, for example context-appropriate responding. Copyright © 2011 IBRO. Published by Elsevier Ltd. All rights reserved.

Fuel storage tank

International Nuclear Information System (INIS)

Peehs, M.; Stehle, H.; Weidinger, H.

1979-01-01

The stationary fuel storage tank is immersed below the water level in the spent fuel storage pool. In it there is placed a fuel assembly within a cage. Moreover, the storage tank has got a water filling and a gas buffer. The water in the storage tank is connected with the pool water by means of a filter, a surge tank and a water purification facility, temperature and pressure monitoring being performed. In the buffer compartment there are arranged catalysts a glow plugs for recombination of radiolysis products into water. The supply of water into the storage tank is performed through the gas buffer compartment. (DG) [de

Secure Storage Architectures

Energy Technology Data Exchange (ETDEWEB)

Aderholdt, Ferrol [Tennessee Technological University; Caldwell, Blake A [ORNL; Hicks, Susan Elaine [ORNL; Koch, Scott M [ORNL; Naughton, III, Thomas J [ORNL; Pogge, James R [Tennessee Technological University; Scott, Stephen L [Tennessee Technological University; Shipman, Galen M [ORNL; Sorrillo, Lawrence [ORNL

2015-01-01

The purpose of this report is to clarify the challenges associated with storage for secure enclaves. The major focus areas for the report are: - review of relevant parallel filesystem technologies to identify assets and gaps; - review of filesystem isolation/protection mechanisms, to include native filesystem capabilities and auxiliary/layered techniques; - definition of storage architectures that can be used for customizable compute enclaves (i.e., clarification of use-cases that must be supported for shared storage scenarios); - investigate vendor products related to secure storage. This study provides technical details on the storage and filesystem used for HPC with particular attention on elements that contribute to creating secure storage. We outline the pieces for a a shared storage architecture that balances protection and performance by leveraging the isolation capabilities available in filesystems and virtualization technologies to maintain the integrity of the data. Key Points: There are a few existing and in-progress protection features in Lustre related to secure storage, which are discussed in (Chapter 3.1). These include authentication capabilities like GSSAPI/Kerberos and the in-progress work for GSSAPI/Host-keys. The GPFS filesystem provides native support for encryption, which is not directly available in Lustre. Additionally, GPFS includes authentication/authorization mechanisms for inter-cluster sharing of filesystems (Chapter 3.2). The limitations of key importance for secure storage/filesystems are: (i) restricting sub-tree mounts for parallel filesystem (which is not directly supported in Lustre or GPFS), and (ii) segregation of hosts on the storage network and practical complications with dynamic additions to the storage network, e.g., LNET. A challenge for VM based use cases will be to provide efficient IO forwarding of the parallel filessytem from the host to the guest (VM). There are promising options like para-virtualized filesystems to

Spent-fuel-storage alternatives

International Nuclear Information System (INIS)

1980-01-01

The Spent Fuel Storage Alternatives meeting was a technical forum in which 37 experts from 12 states discussed storage alternatives that are available or are under development. The subject matter was divided into the following five areas: techniques for increasing fuel storage density; dry storage of spent fuel; fuel characterization and conditioning; fuel storage operating experience; and storage and transport economics. Nineteen of the 21 papers which were presented at this meeting are included in this Proceedings. These have been abstracted and indexed

Energy storage

International Nuclear Information System (INIS)

Odru, P.

2010-01-01

This book proposes a broad overview of the technologies developed in the domains of on-board electricity storage (batteries, super-capacitors, flywheels), stationary storage (hydraulic dams, compressed air, batteries and hydrogen), and heat storage (sensible, latent and sorption) together with their relative efficiency, their expected developments and what advantages they can offer. Eminent specialists of this domain have participated to the redaction of this book, all being members of the Tuck's Foundation 'IDees' think tank. (J.S.)

Spent-fuel-storage alternatives

Energy Technology Data Exchange (ETDEWEB)

1980-01-01

The Spent Fuel Storage Alternatives meeting was a technical forum in which 37 experts from 12 states discussed storage alternatives that are available or are under development. The subject matter was divided into the following five areas: techniques for increasing fuel storage density; dry storage of spent fuel; fuel characterization and conditioning; fuel storage operating experience; and storage and transport economics. Nineteen of the 21 papers which were presented at this meeting are included in this Proceedings. These have been abstracted and indexed. (ATT)

Identification of low amount of irradiated spices (red pepper, garlic, ginger powder) with luminescence analysis

International Nuclear Information System (INIS)

Kim, Byeong-Keun; Akram, Kashif; Kim, Cheong-Tae; Kang, Na-Roo; Lee, Jin-Won; Ryang, Jun-Hwan; Kwon, Joong-Ho

2012-01-01

For the identification of irradiated food, current analysis methods have limitations regarding presence and stability of radiation-induced markers. In this study, different spice blends with small quantity of different irradiated (0, 1 and 10 kGy) spice powders, such as red pepper, garlic or ginger, were investigated using PSL and TL techniques. In PSL-based screening analysis, the spice blends containing 10% of irradiated materials (1 or 10 kGy) were determined as intermediate or positive. In TL results, the blends containing 1% of 1 or 10 kGy-irradiated spices showed the typical TL glow curves that could be interpreted as positive. The blends with irradiated garlic powder provided more good results where identification was possible at 0.5% mixing of irradiated sample. However, the TL ratios of all spice blends were <0.1 and only TL glow curve shape and intensity may be used to discriminate the samples having irradiated component. - Highlights: ► Sample blends with small quantities of irradiated spices were evaluated. ► The PSL was inappropriate to detect irradiated ingredient in small quantity. ► TL glow curve shape and intensity could be used as conclusive evidence of irradiation. ► TL ratios of all irradiated and nonirradiated samples were <0.1.

A European perspective on alternatives to animal testing for environmental hazard identification and risk assessment.

Science.gov (United States)

Scholz, Stefan; Sela, Erika; Blaha, Ludek; Braunbeck, Thomas; Galay-Burgos, Malyka; García-Franco, Mauricio; Guinea, Joaquin; Klüver, Nils; Schirmer, Kristin; Tanneberger, Katrin; Tobor-Kapłon, Marysia; Witters, Hilda; Belanger, Scott; Benfenati, Emilio; Creton, Stuart; Cronin, Mark T D; Eggen, Rik I L; Embry, Michelle; Ekman, Drew; Gourmelon, Anne; Halder, Marlies; Hardy, Barry; Hartung, Thomas; Hubesch, Bruno; Jungmann, Dirk; Lampi, Mark A; Lee, Lucy; Léonard, Marc; Küster, Eberhard; Lillicrap, Adam; Luckenbach, Till; Murk, Albertinka J; Navas, José M; Peijnenburg, Willie; Repetto, Guillermo; Salinas, Edward; Schüürmann, Gerrit; Spielmann, Horst; Tollefsen, Knut Erik; Walter-Rohde, Susanne; Whale, Graham; Wheeler, James R; Winter, Matthew J

2013-12-01

Tests with vertebrates are an integral part of environmental hazard identification and risk assessment of chemicals, plant protection products, pharmaceuticals, biocides, feed additives and effluents. These tests raise ethical and economic concerns and are considered as inappropriate for assessing all of the substances and effluents that require regulatory testing. Hence, there is a strong demand for replacement, reduction and refinement strategies and methods. However, until now alternative approaches have only rarely been used in regulatory settings. This review provides an overview on current regulations of chemicals and the requirements for animal tests in environmental hazard and risk assessment. It aims to highlight the potential areas for alternative approaches in environmental hazard identification and risk assessment. Perspectives and limitations of alternative approaches to animal tests using vertebrates in environmental toxicology, i.e. mainly fish and amphibians, are discussed. Free access to existing (proprietary) animal test data, availability of validated alternative methods and a practical implementation of conceptual approaches such as the Adverse Outcome Pathways and Integrated Testing Strategies were identified as major requirements towards the successful development and implementation of alternative approaches. Although this article focusses on European regulations, its considerations and conclusions are of global relevance. Copyright © 2013 Elsevier Inc. All rights reserved.

Development of a rapid screening protocol for selection of strains resistant to spray drying and storage in dry powder.

Science.gov (United States)

Reimann, S; Grattepanche, F; Baggenstos, C; Rezzonico, E; Berger, B; Arigoni, F; Lacroix, C

2010-06-01

An efficient screening method for selection of Bifidobacterium longum strains resistant to spray drying and storage was developed based on randomly amplified polymorphic DNA (RAPD) for identification of the best survivors in mixed strains bacterial preparations. Three different primers were used to generate RAPD profiles of 22 B. longum strains. All strains were distinguished according to their RAPD profiles except for the strain NCC2705 and its H(2)O(2) resistant derivative variant. The 22 strains were grouped in 3 batches of 7, 7 and 8 strains and subjected to spray drying and storage at 30 and 37 °C under anaerobic conditions. Batch survival rates after spray drying reached 17.1±4.4%. Strains showing the highest prevalence and/or resistance to storage at 37 °C were selected from individual batches for subsequent spray drying and storage testing. After 67 days of storage, NCC572 was identified as the dominant strain in powder. The stability of strain NCC572 was confirmed by performing single spray drying and storage tests. Out of 22 B. longum strains, a robust strain was identified by combining RAPD with a simultaneous screening test for survival under spray drying and storage. The method allowed a fast screening of B. longum strains in mixture for resistance to spray drying and storage compared to traditional screening procedures carried out with individual strains, in the same conditions. This approach could be applied to other stress conditions.

Potential Teachers' Appropriate and Inappropriate Application of Pedagogical Resources in a Model-Based Physics Course: A "Knowledge in Pieces" Perspective on Teacher Learning

Science.gov (United States)

Harlow, Danielle B.; Bianchini, Julie A.; Swanson, Lauren H.; Dwyer, Hilary A.

2013-01-01

We used a "knowledge in pieces" perspective on teacher learning to document undergraduates' pedagogical resources in a model-based physics course for potential teachers. We defined pedagogical resources as small, discrete ideas about teaching science that are applied appropriately or inappropriately in specific contexts. Neither…

ERDA's Chemical Energy Storage Program

Science.gov (United States)

Swisher, J. H.; Kelley, J. H.

1977-01-01

The Chemical Energy Storage Program is described with emphasis on hydrogen storage. Storage techniques considered include pressurized hydrogen gas storage, cryogenic liquid hydrogen storage, storage in hydride compounds, and aromatic-alicyclic hydrogen storage. Some uses of energy storage are suggested. Information on hydrogen production and hydrogen use is also presented. Applications of hydrogen energy systems include storage of hydrogen for utilities load leveling, industrial marketing of hydrogen both as a chemical and as a fuel, natural gas supplementation, vehicular applications, and direct substitution for natural gas.

Thermal energy storage apparatus, controllers and thermal energy storage control methods

Science.gov (United States)

Hammerstrom, Donald J.

2016-05-03

Thermal energy storage apparatus, controllers and thermal energy storage control methods are described. According to one aspect, a thermal energy storage apparatus controller includes processing circuitry configured to access first information which is indicative of surpluses and deficiencies of electrical energy upon an electrical power system at a plurality of moments in time, access second information which is indicative of temperature of a thermal energy storage medium at a plurality of moments in time, and use the first and second information to control an amount of electrical energy which is utilized by a heating element to heat the thermal energy storage medium at a plurality of moments in time.

Assessing the processing quality of different potato cultivars during storage at various temperatures

International Nuclear Information System (INIS)

Amjad, A.; Randhawa, M.A.; Butt, M.S.; Asghar, M.

2016-01-01

Processing industry needs continuous supply of tubers for fries/chips preparation throughout the year. Storage is obligatory to meet the increasing demand of population. Objective of this study was to evaluate the processing and quality characteristics of different potato cultivars (Lady Rosetta, Sante, Hermes, Crozo, Kuroda and Asterix) during storage with 75-80 percent relative humidity for the period of 160 days at various temperatures (3 degree C, 7 degree C, 11 degree C). Quality parameters such as specific gravity, sprouting, weight loss, dry matter, starch content, ascorbic acid, sugar content and invertase enzyme activity were determined to estimate the processing potential of each cultivar. High Performance Liquid Chromatography (HPLC) equipped with amino (NH2) column and Refractive Index Detector (RID) was used for the identification and quantification of sugars. The findings of the present work showed that temperature significantly (p Hermes > Crozo > Sante > Asterix > Kuroda. (author)

Technology Base Research Project for electrochemical energy storage

Science.gov (United States)

Kinoshita, K.

1985-06-01

The DOE Electrochemical Energy Storage Program is divided into two projects: (1) the exploratory technology development and testing (ETD) project and (2) the technology base research (TBR) project. The role of the TBR Project is to perform supporting research for the advanced battery systems under development by the ETD Project, and to evaluate new systems with potentially superior performance, durability and/or cost characteristics. The specific goal of the TBR Project is to identify the most promising electrochemical technologies and transfer them to industry and/or the ETD Project for further development and scale-up. This report summarizes the research, financial, and management activities relevant to the TBR Project in CY 1984. General problem areas addressed by the project include identification of new electrochemical couples for advanced batteries, determination of technical feasibility of the new couples, improvements in battery components and materials, establishment of engineering principles applicable to electrochemical energy storage and conversion, and the assessment of fuel-cell technology for transportation applications. Major emphasis is given to applied research which will lead to superior performance and lower life-cycle costs. The TBR Project is divided into three major project elements: exploratory research, applied science research, and air systems research.

Energy storage

CERN Document Server

Brunet, Yves

2013-01-01

Energy storage examines different applications such as electric power generation, transmission and distribution systems, pulsed systems, transportation, buildings and mobile applications. For each of these applications, proper energy storage technologies are foreseen, with their advantages, disadvantages and limits. As electricity cannot be stored cheaply in large quantities, energy has to be stored in another form (chemical, thermal, electromagnetic, mechanical) and then converted back into electric power and/or energy using conversion systems. Most of the storage technologies are examined: b

Electricity Storage. Technology Brief

Energy Technology Data Exchange (ETDEWEB)

Simbolotti, G. [Italian National Agency for New Technologies, Energy and Sustainable Economic Development ENEA, Rome (Italy); Kempener, R. [International Renewable Energy Agency IRENA, Bonn (Germany)

2012-04-15

Electricity storage is a key technology for electricity systems with a high share of renewables as it allows electricity to be generated when renewable sources (i.e. wind, sunlight) are available and to be consumed on demand. It is expected that the increasing price of fossil fuels and peak-load electricity and the growing share of renewables will result in electricity storage to grow rapidly and become more cost effective. However, electricity storage is technically challenging because electricity can only be stored after conversion into other forms of energy, and this involves expensive equipment and energy losses. At present, the only commercial storage option is pumped hydro power where surplus electricity (e.g. electricity produced overnight by base-load coal or nuclear power) is used to pump water from a lower to an upper reservoir. The stored energy is then used to produce hydropower during daily high-demand periods. Pumped hydro plants are large-scale storage systems with a typical efficiency between 70% and 80%, which means that a quarter of the energy is lost in the process. Other storage technologies with different characteristics (i.e. storage process and capacity, conversion back to electricity and response to power demand, energy losses and costs) are currently in demonstration or pre-commercial stages and discussed in this brief report: Compressed air energy storage (CAES) systems, Flywheels; Electrical batteries; Supercapacitors; Superconducting magnetic storage; and Thermal energy storage. No single electricity storage technology scores high in all dimensions. The technology of choice often depends on the size of the system, the specific service, the electricity sources and the marginal cost of peak electricity. Pumped hydro currently accounts for 95% of the global storage capacity and still offers a considerable expansion potential but does not suit residential or small-size applications. CAES expansion is limited due to the lack of suitable

Storage in Europe

International Nuclear Information System (INIS)

Cabanes, J.M.; Rottenberg, J.; Abiad, A.; Caudron, S.; Girault, Ph.

2007-01-01

Storage represents one of the key elements among the different modulation tools. How the problem of storage is put forward in Europe in front of the increasing uncertainty of the gas demand and prices? What are the policies implemented by storage facility operators? To what extend storage can amortize gas prices volatility or allow the market actors to take the best profit of this volatility? These are the questions debated at this workshop by four specialists of this domain. (J.S.)

A methodology for the geological and numerical modelling of CO2 storage in deep saline formations

Science.gov (United States)

Guandalini, R.; Moia, F.; Ciampa, G.; Cangiano, C.

2009-04-01

Several technological options have been proposed to stabilize and reduce the atmospheric concentrations of CO2 among which the most promising are the CCS technologies. The remedy proposed for large stationary CO2 sources as thermoelectric power plants is to separate the flue gas, capturing CO2 and to store it into deep subsurface geological formations. In order to support the identification of potential CO2 storage reservoirs in Italy, the project "Identification of Italian CO2 geological storage sites", financed by the Ministry of Economic Development with the Research Fund for the Italian Electrical System under the Contract Agreement established with the Ministry Decree of march 23, 2006, has been completed in 2008. The project involves all the aspects related to the selection of potential storage sites, each carried out in a proper task. The first task has been devoted to the data collection of more than 6800 wells, and their organization into a geological data base supported by GIS, of which 1911 contain information about the nature and the thickness of geological formations, the presence of fresh, saline or brackish water, brine, gas and oil, the underground temperature, the seismic velocity and electric resistance of geological materials from different logs, the permeability, porosity and geochemical characteristics. The goal of the second task was the set up of a numerical modelling integrated tool, that is the in order to allow the analysis of a potential site in terms of the storage capacity, both from solubility and mineral trapping points of view, in terms of risk assessment and long-term storage of CO2. This tool includes a fluid dynamic module, a chemical module and a module linking a geomechanical simulator. Acquirement of geological data, definition of simulation parameter, run control and final result analysis can be performed by a properly developed graphic user interface, fully integrated and calculation platform independent. The project is then

The clandestine multiple graves in Malaysia: The first mass identification operation of human skeletal remains.

Science.gov (United States)

Mohd Noor, Mohd Suhani; Khoo, Lay See; Zamaliana Alias, Wan Zafirah; Hasmi, Ahmad Hafizam; Ibrahim, Mohamad Azaini; Mahmood, Mohd Shah

2017-09-01

The first ever mass identification operation of skeletal remains conducted for the clandestine graves in Malaysia consisted of 165 individuals unearthed from 28 human trafficking transit camps located in Wang Kelian, along the Thai-Malaysia border. A DVI response was triggered in which expert teams comprising of pathologists, anthropologists, odontologists, radiologists and DNA experts were gathered at the identified operation centre. The Department of Forensic Medicine, Hospital Sultanah Bahiyah, Alor Star, Kedah, located approximately 75km away from Wang Kelian, was temporarily converted into a victim identification centre (VIC) as it is the nearest available forensic facility to the mass grave site. The mortuary operation was conducted over a period of 3 months from June to September 2015, and was divided into two phases; phase 1 involving the postmortem examination of the remains of 116 suspected individuals and for phase 2 the remains of 49 suspected individuals. The fact that the graves were of unknown individuals afforded the mass identification operation a sufficient duration of 2 weeks as preparatory phase enabling procedurals and daily victim identification workflow to be established, and the setting up of a temporary body storage for the designated mortuary. The temporary body storage has proven to be a significant factor in enabling the successful conclusion of the VIC operation to the final phase of temporary controlled burials. Recognition from two international observers, Mr. Andréas Patiño Umaña, from the International Committee of Red Cross (ICRC) and Prof. Noel Woodford from Victoria Institute of Forensic Medicine (VIFM) had proven the mortuary operation was in compliance to the international quality and standards. The overall victim identification and mortuary operation identified a number of significant challenges, in particular the management of commingled human remains as well as the compilation of postmortem data in the absence of

Fractionated laser resurfacing corrects the inappropriate UVB response in geriatric skin.

Science.gov (United States)

Spandau, Dan F; Lewis, Davina A; Somani, Ally-Khan; Travers, Jeffrey B

2012-06-01

Non-melanoma skin cancer is a disease primarily afflicting geriatric patients as evidenced by the fact that 80% of all non-melanoma skin cancers are diagnosed in patients over the age of 60 years. As such, geriatric skin responds to cancer-inducing UVB irradiation in a manner that allows the establishment of tumor cells. Currently, the only effective treatment for non-melanoma skin cancer is the removal of the tumors after they appear, indicating the need for a more cost-effective prophylactic therapy. Geriatric volunteers were treated with fractionated laser resurfacing therapy on either sun-protected (upper buttocks) or chronically sun-exposed (dorsal forearm) skin. Fractionated laser resurfacing therapy was shown to decrease the occurrence of senescent fibroblasts in geriatric dermis, increase the dermal expression of IGF-1, and correct the inappropriate UVB response observed in untreated geriatric skin. These responses to fractionated laser resurfacing were equal to the effects seen previously using the more aggressive wounding following dermabrasion. Furthermore, fractionated laser resurfacing was equally effective in both sun-protected and sun-exposed skin. The ability of fractionated laser resurfacing treatment to protect against the occurrence of UVB-damaged proliferating keratinocytes indicates the potential of fractionated laser resurfacing to reduce or prevent aging-associated non-melanoma skin cancer.

Utilizing cloud storage architecture for long-pulse fusion experiment data storage

Energy Technology Data Exchange (ETDEWEB)

Zhang, Ming; Liu, Qiang [State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Wuhan, Hubei (China); School of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan, Hubei (China); Zheng, Wei, E-mail: zhenghaku@gmail.com [State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Wuhan, Hubei (China); School of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan, Hubei (China); Wan, Kuanhong; Hu, Feiran; Yu, Kexun [State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Wuhan, Hubei (China); School of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan, Hubei (China)

2016-11-15

Scientific data storage plays a significant role in research facility. The explosion of data in recent years was always going to make data access, acquiring and management more difficult especially in fusion research field. For future long-pulse experiment like ITER, the extremely large data will be generated continuously for a long time, putting much pressure on both the write performance and the scalability. And traditional database has some defects such as inconvenience of management, hard to scale architecture. Hence a new data storage system is very essential. J-TEXTDB is a data storage and management system based on an application cluster and a storage cluster. J-TEXTDB is designed for big data storage and access, aiming at improving read–write speed, optimizing data system structure. The application cluster of J-TEXTDB is used to provide data manage functions and handles data read and write operations from the users. The storage cluster is used to provide the storage services. Both clusters are composed with general servers. By simply adding server to the cluster can improve the read–write performance, the storage space and redundancy, making whole data system highly scalable and available. In this paper, we propose a data system architecture and data model to manage data more efficient. Benchmarks of J-TEXTDB performance including read and write operations are given.

Utilizing cloud storage architecture for long-pulse fusion experiment data storage

International Nuclear Information System (INIS)

Zhang, Ming; Liu, Qiang; Zheng, Wei; Wan, Kuanhong; Hu, Feiran; Yu, Kexun

2016-01-01

Scientific data storage plays a significant role in research facility. The explosion of data in recent years was always going to make data access, acquiring and management more difficult especially in fusion research field. For future long-pulse experiment like ITER, the extremely large data will be generated continuously for a long time, putting much pressure on both the write performance and the scalability. And traditional database has some defects such as inconvenience of management, hard to scale architecture. Hence a new data storage system is very essential. J-TEXTDB is a data storage and management system based on an application cluster and a storage cluster. J-TEXTDB is designed for big data storage and access, aiming at improving read–write speed, optimizing data system structure. The application cluster of J-TEXTDB is used to provide data manage functions and handles data read and write operations from the users. The storage cluster is used to provide the storage services. Both clusters are composed with general servers. By simply adding server to the cluster can improve the read–write performance, the storage space and redundancy, making whole data system highly scalable and available. In this paper, we propose a data system architecture and data model to manage data more efficient. Benchmarks of J-TEXTDB performance including read and write operations are given.

Design of the RFID for Storage of Biological Information

Directory of Open Access Journals (Sweden)

Sang-Hee Son

2009-02-01

Full Text Available Recent advances in RFID (radio frequency identification technology promises to create a wireless circuitry capable of interfacing with biological systems for acquisition, identification and processing of biological data based on radio frequency interaction. Thus, the RFID tag can be attached not only to consumer products and form part of the supply chain, but also to animals, plants and in particular human body. This paper describes the strategy for the design of a novel RFID tag, which stores vital biological information such as body temperature and blood pressure and heartbeat in accordance with the EPC global Class-1 standard. Biological data is obtained from a sensor technology that is based on resistance deviation-to-pulse width converter. The integrated chip consists of an analog front end, command interpreter, collision avoidance block, data storage, sensors, and interface circuitry. The system is capable of supporting heartbeats in the range of 40~200 beats per a minute and blood pressure 0~300mmHg. The proposed system employs collision free algorithm that supports access to single tag within a multiple tag environment. The approach facilitates intelligent management of patients in hospitals as part of an integrated healthcare management system.

Optimal routing in an automated storage/retrieval system with dedicated storage

NARCIS (Netherlands)

Berg, van den J.P.; Gademann, A.J.R.M.

1999-01-01

We address the sequencing of requests in an automated storage/retrieval system with dedicated storage. We consider the block sequencing approach, where a set of storage and retrieval requests is given beforehand and no new requests come in during operation. The objective for this static problem is

Establishing benchmarks and metrics for disruptive technologies, inappropriate and obsolete tests in the clinical laboratory.

Science.gov (United States)

Kiechle, Frederick L; Arcenas, Rodney C; Rogers, Linda C

2014-01-01

Benchmarks and metrics related to laboratory test utilization are based on evidence-based medical literature that may suffer from a positive publication bias. Guidelines are only as good as the data reviewed to create them. Disruptive technologies require time for appropriate use to be established before utilization review will be meaningful. Metrics include monitoring the use of obsolete tests and the inappropriate use of lab tests. Test utilization by clients in a hospital outreach program can be used to monitor the impact of new clients on lab workload. A multi-disciplinary laboratory utilization committee is the most effective tool for modifying bad habits, and reviewing and approving new tests for the lab formulary or by sending them out to a reference lab. Copyright © 2013 Elsevier B.V. All rights reserved.

Erroneous Magnet Positioning Leads to Failure of Inhibition of Inappropriate Shock during Fast Conducting Atrial Fibrillation Episodes.

Science.gov (United States)

Römers, Hans; VAN Dijk, Vincent; Balt, Jippe

2017-06-01

We present the case of a 75-year-old patient with a single-chamber St. Jude Medical internal cardioverter defibrillator (ICD; St. Jude Medical, St. Paul, MN, USA) for primary prevention, who was admitted with 39 inappropriate ICD shocks because of atrial fibrillation with rapid ventricular frequention, despite magnet placement. Review of the device manual and literature revealed that apart from different responses to magnet placement programmed for the various manufacturers, the type of magnet and the positioning can be of specific interest. In the case presented, the donut-shaped magnet should have been placed off-center instead of directly over the device. © 2017 Wiley Periodicals, Inc.

Water Storage: Quo Vadis?

Science.gov (United States)

Smakhtin, V.

2017-12-01

Humans stored water - in various forms - for ages, coping with water resources variability, and its extremes - floods and droughts. Storage per capita, and other storage-related indicators, have essentially become one way of reflecting the progress of economic development. Massive investments went into large surface water reservoirs that have become the characteristic feature of the earth's landscapes, bringing both benefits and controversy. As water variability progressively increases with changing climate, globally, on one hand, and the idea of sustainable development receives strong traction, on another - it may be worth the while to comprehensively examine current trends and future prospects for water storage development. The task is surely big, to say the least. The presentation will aim to initiate a structured discussion on this multi-facet issue and identify which aspects and trends of water storage development may be most important in the context of Sustainable Development Goals, Sendai Framework for Disaster Risk Reduction, Paris Agreement on Climate Change, and examine how, where and to what extent water storage planning can be improved. It will cover questions like i) aging of large water storage infrastructure, the current extent of this trend in various geographical regions, and possible impacts on water security and security of nations; ii) improved water storage development planning overall in the context of various water development alternatives and storage options themselves and well as their combinations iii) prospects for another "storage revolution" - speed increase in dam numbers, and where, if at all this is most likely iv) recent events in storage development, e.g. is dam decommissioning a trend that picks pace, or whether some developing economies in Asia can do without going through the period of water storage construction, with alternatives, or suggestions for alleviation of negative impacts v) the role of subsurface storage as an

A new storage-ring light source

Energy Technology Data Exchange (ETDEWEB)

Chao, Alex [SLAC National Accelerator Lab., Menlo Park, CA (United States)

2015-06-01

A recently proposed technique in storage ring accelerators is applied to provide potential high-power sources of photon radiation. The technique is based on the steady-state microbunching (SSMB) mechanism. As examples of this application, one may consider a high-power DUV photon source for research in atomic and molecular physics or a high-power EUV radiation source for industrial lithography. A less challenging proof-of-principle test to produce IR radiation using an existing storage ring is also considered.

Spent fuel storage requirements: the need for away-from-reactor storage

International Nuclear Information System (INIS)

1980-01-01

The analyses of on-site storage capabilities of domestic utilities and estimates of timing and magnitude of away-from-reactor (AFR) storage requirements were presented in the report DOE/ET-0075 entitled Spent Fuel Storage Requirements: The Need For Away-From-Reactor Storage published in February 1979 by the US Department of Energy. Since utility plans and requirements continue to change with time, a need exists to update the AFR requirements estimates as appropriate. This short report updates the results presented in DOE/ET-0075 to reflect recent data on reactor operations and spent fuel storage. In addition to the updates of cases representing the range of AFR requirements in DOE/ET-0075, new cases of interest reflecting utility and regulatory trends are presented

Signatures of Extended Storage of Used Nuclear Fuel in Casks

Energy Technology Data Exchange (ETDEWEB)

Rauch, Eric Benton [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-09-28

As the amount of used nuclear fuel continues to grow, more and more used nuclear fuel will be transferred to storage casks. A consolidated storage facility is currently in the planning stages for storing these casks, where at least 10,000 MTHM of fuel will be stored. This site will have potentially thousands of casks once it is operational. A facility this large presents new safeguards and nuclear material accounting concerns. A new signature based on the distribution of neutron sources and multiplication within casks was part of the Department of Energy Office of Nuclear Energy’s Material Protection, Account and Control Technologies (MPACT) campaign. Under this project we looked at fingerprinting each cask's neutron signature. Each cask has a unique set of fuel, with a unique spread of initial enrichment, burnup, cooling time, and power history. The unique set of fuel creates a unique signature of neutron intensity based on the arrangement of the assemblies. The unique arrangement of neutron sources and multiplication produces a reliable and unique identification of the cask that has been shown to be relatively constant over long time periods. The work presented here could be used to restore from a loss of continuity of knowledge at the storage site. This presentation will show the steps used to simulate and form this signature from the start of the effort through its conclusion in September 2016.

Lipid storage myopathies.

Science.gov (United States)

Bruno, Claudio; Dimauro, Salvatore

2008-10-01

The aim of this review is to provide an update on disorders of lipid metabolism affecting skeletal muscle exclusively or predominantly and to summarize recent clinical, genetic, and therapeutic studies in this field. Over the past 5 years, new clinical phenotypes and genetic loci have been described, unusual pathogenic mechanisms have been elucidated, and novel pharmacological approaches have been developed. At least one genetic defect responsible for the myopathic form of CoQ10 deficiency has been identified, causing a disorder that is allelic with the late-onset riboflavine-responsive form of multiple acyl-coenzyme A dehydrogenation deficiency. Novel mechanisms involved in the lipolytic breakdown of cellular lipid depots have been described and have led to the identification of genes and mutations responsible for multisystemic neutral lipid storage disorders, characterized by accumulation of triglyceride in multiple tissues, including muscle. Defects in lipid metabolism can affect either the mitochondrial transport and oxidation of exogenous fatty acid or the catabolism of endogenous triglycerides. These disorders impair energy production and almost invariably involve skeletal muscle, causing progressive myopathy with muscle weakness, or recurrent acute episodes of rhabdomyolysis triggered by exercise, fasting, or infections. Clinical and genetic characterization of these disorders has important implications both for accurate diagnostic approach and for development of therapeutic strategies.

Energy Storage Systems

Science.gov (United States)

Elliott, David

2017-07-01

As renewable energy use expands there will be a need to develop ways to balance its variability. Storage is one of the options. Presently the main emphasis is for systems storing electrical power in advanced batteries (many of them derivatives of parallel developments in the electric vehicle field), as well as via liquid air storage, compressed air storage, super-capacitors and flywheels, and, the leader so far, pumped hydro reservoirs. In addition, new systems are emerging for hydrogen generation and storage, feeding fuel cell power production. Heat (and cold) is also a storage medium and some systems exploit thermal effects as part of wider energy management activity. Some of the more exotic ones even try to use gravity on a large scale. This short book looks at all the options, their potentials and their limits. There are no clear winners, with some being suited to short-term balancing and others to longer-term storage. The eventual mix adopted will be shaped by the pattern of development of other balancing measures, including smart-grid demand management and super-grid imports and exports.

Extended storage of spent fuel

International Nuclear Information System (INIS)

1992-10-01

This document is the final report on the IAEA Co-ordinated Research Programme on the Behaviour of Spent Fuel and Storage Facility Components during Long Term Storage (BEFAST-II, 1986-1991). It contains the results on wet and dry spent fuel storage technologies obtained from 16 organizations representing 13 countries who participated in the co-ordinated research programme. Considerable quantities of spent fuel continue to arise and accumulate. Many countries are investigating the option of extended spent fuel storage prior to reprocessing or fuel disposal. Wet storage continues to predominate as an established technology with the construction of additional away-from-reactor storage pools. However, dry storage is increasingly used with most participants considering dry storage concepts for the longer term. Depending on the cladding type options of dry storage in air or inert gas are proposed. Dry storage is becoming widely used as a supplement to wet storage for zirconium alloy clad oxide fuels. Storage periods as long as under wet conditions appear to be feasible. Dry storage will also continue to be used for Al clad and Magnox type fuel. Enhancement of wet storage capacity will remain an important activity. Rod consolidation to increase wet storage capacity will continue in the UK and is being evaluated for LWR fuel in the USA, and may start in some other countries. High density storage racks have been successfully introduced in many existing pools and are planned for future facilities. For extremely long wet storage (≥50 years), there is a need to continue work on fuel integrity investigations and LWR fuel performance modelling. it might be that pool component performance in some cases could be more limiting than the FA storage performance. It is desirable to make concerted efforts in the field of corrosion monitoring and prediction of fuel cladding and poll component behaviour in order to maintain good experience of wet storage. Refs, figs and tabs

Storage of platelets: effects associated with high platelet content in platelet storage containers.

Science.gov (United States)

Gulliksson, Hans; Sandgren, Per; Sjödin, Agneta; Hultenby, Kjell

2012-04-01

A major problem associated with platelet storage containers is that some platelet units show a dramatic fall in pH, especially above certain platelet contents. The aim of this study was a detailed investigation of the different in vitro effects occurring when the maximum storage capacity of a platelet container is exceeded as compared to normal storage. Buffy coats were combined in large-volume containers to create primary pools to be split into two equal aliquots for the preparation of platelets (450-520×10(9) platelets/unit) in SSP+ for 7-day storage in two containers (test and reference) with different platelet storage capacity (n=8). Exceeding the maximum storage capacity of the test platelet storage container resulted in immediate negative effects on platelet metabolism and energy supply, but also delayed effects on platelet function, activation and disintegration. Our study gives a very clear indication of the effects in different phases associated with exceeding the maximum storage capacity of platelet containers but throw little additional light on the mechanism initiating those negative effects. The problem appears to be complex and further studies in different media using different storage containers will be needed to understand the mechanisms involved.

Probe Storage

NARCIS (Netherlands)

Gemelli, Marcellino; Abelmann, Leon; Engelen, Johannes Bernardus Charles; Khatib, M.G.; Koelmans, W.W.; Zaboronski, Olog; Campardo, Giovanni; Tiziani, Federico; Laculo, Massimo

2011-01-01

This chapter gives an overview of probe-based data storage research over the last three decades, encompassing all aspects of a probe recording system. Following the division found in all mechanically addressed storage systems, the different subsystems (media, read/write heads, positioning, data

High-level waste storage tank farms/242-A evaporator Standards/Requirements Identification Document (S/RID), Volume 2

International Nuclear Information System (INIS)

1994-04-01

The High-Level Waste Storage Tank Farms/242-A Evaporator Standards/Requirements Document (S/RID) is contained in multiple volumes. This document (Volume 2) presents the standards and requirements for the following sections: Quality Assurance, Training and Qualification, Emergency Planning and Preparedness, and Construction

Identification of a large intronic transposal insertion in SLC17A5 causing sialic acid storage disease

NARCIS (Netherlands)

Tarailo-Graovac, M. (Maja); Drögemöller, B.I. (Britt I.); Wasserman, W.W. (Wyeth W.); C.J. Ross; A.M.W. van den Ouweland (Ans); N. Darin (Niklas); Kollberg, G. (Gittan); Van Karnebeek, C.D.M. (Clara D. M.); Blomqvist, M. (Maria)

2017-01-01

textabstractBackground: Sialic acid storage diseases are neurodegenerative disorders characterized by accumulation of sialic acid in the lysosome. These disorders are caused by mutations in SLC17A5, the gene encoding sialin, a sialic acid transporter located in the lysosomal membrane. The most

High-level waste storage tank farms/242-A evaporator Standards/Requirements Identification Document (S/RID), Volume 2

Energy Technology Data Exchange (ETDEWEB)

1994-04-01

The High-Level Waste Storage Tank Farms/242-A Evaporator Standards/Requirements Document (S/RID) is contained in multiple volumes. This document (Volume 2) presents the standards and requirements for the following sections: Quality Assurance, Training and Qualification, Emergency Planning and Preparedness, and Construction.

Quantitative trait loci associated with longevity of lettuce seeds under conventional and controlled deterioration storage conditions.

Science.gov (United States)

Schwember, Andrés R; Bradford, Kent J

2010-10-01

Lettuce (Lactuca sativa L.) seeds have poor shelf life and exhibit thermoinhibition (fail to germinate) above ∼25°C. Seed priming (controlled hydration followed by drying) alleviates thermoinhibition by increasing the maximum germination temperature, but reduces lettuce seed longevity. Controlled deterioration (CD) or accelerated ageing storage conditions (i.e. elevated temperature and relative humidity) are used to study seed longevity and to predict potential seed lifetimes under conventional storage conditions. Seeds produced in 2002 and 2006 of a recombinant inbred line (RIL) population derived from a cross between L. sativa cv. Salinas×L. serriola accession UC96US23 were utilized to identify quantitative trait loci (QTLs) associated with seed longevity under CD and conventional storage conditions. Multiple longevity-associated QTLs were identified under both conventional and CD storage conditions for control (non-primed) and primed seeds. However, seed longevity was poorly correlated between the two storage conditions, suggesting that deterioration processes under CD conditions are not predictive of ageing in conventional storage conditions. Additionally, the same QTLs were not identified when RIL populations were grown in different years, indicating that lettuce seed longevity is strongly affected by production environment. Nonetheless, a major QTL on chromosome 4 [Seed longevity 4.1 (Slg4.1)] was responsible for almost 23% of the phenotypic variation in viability of the conventionally stored control seeds of the 2006 RIL population, with improved longevity conferred by the Salinas allele. QTL analyses may enable identification of mechanisms responsible for the sensitivity of primed seeds to CD conditions and breeding for improved seed longevity.

Common criteria among States for storage and use of dried blood spot specimens after newborn screening

Directory of Open Access Journals (Sweden)

Carlo Petrini

2012-06-01

Full Text Available Biological samples collected in biobanks are a resource with significant research potential. The Italian Joint Group cNB - cNBBSV (National committee of Bioethics - National committee for Biosecurity, Biotechnologies and Life Sciences published a document reporting recommendations on storage and use of dried blood spot (DBS and on the development of a National Network of Regional Newborn Screening Repositories for collection of residual DBS. Several ethical questions (about consent, possible use of genetic information, unanticipated possible usages for research purposes rise from residual newborn screening specimens collections. Moreover, legal and ethical controversies are accentuated by the conflicts between the interests of sample donors, biobank holders, researchers and the public. To overcome these difficulties the identification of a few criteria for storage and research usage of DBS is crucial.

Plutonium storage criteria

Energy Technology Data Exchange (ETDEWEB)

Chung, D. [Scientech, Inc., Germantown, MD (United States); Ascanio, X. [Dept. of Energy, Germantown, MD (United States)

1996-05-01

The Department of Energy has issued a technical standard for long-term (>50 years) storage and will soon issue a criteria document for interim (<20 years) storage of plutonium materials. The long-term technical standard, {open_quotes}Criteria for Safe Storage of Plutonium Metals and Oxides,{close_quotes} addresses the requirements for storing metals and oxides with greater than 50 wt % plutonium. It calls for a standardized package that meets both off-site transportation requirements, as well as remote handling requirements from future storage facilities. The interim criteria document, {open_quotes}Criteria for Interim Safe Storage of Plutonium-Bearing Solid Materials{close_quotes}, addresses requirements for storing materials with less than 50 wt% plutonium. The interim criteria document assumes the materials will be stored on existing sites, and existing facilities and equipment will be used for repackaging to improve the margin of safety.

Spent fuel storage rack

International Nuclear Information System (INIS)

Morikawa, Matsuo; Uchiyama, Yuichi.

1983-01-01

Purpose: To improve the safety and facilitate the design by limiting the relative displacement in a storage rack. Constitution: The outer wall of a storage rack disposed in water within a fuel pool, the pool wall opposing to the storage rack and the structure between the opposing storages racks are made as a space for confining the pool water or a structure formed with a slight gap, for example, a combination of a recessed structure and a protruded structure. In such a constitution, a space for confirming the pool water is established and the pool water thus confined forms a flow resistance when the storage rack vibrates upon earthquakes, serves as a damper and significantly reduces the responsivity. Furthermore, the relative displacement in the storage rack is limited to inhibit excess earthquake forces to exert on setting bolts and rack clamping bolts of the storage rack. (Sekiya, K.)

Aflatoxins & Safe Storage

Directory of Open Access Journals (Sweden)

Philippe eVillers

2014-04-01

Full Text Available The paper examines both field experience and research on the prevention of the exponential growth of aflatoxins during multi-month post harvest storage in hot, humid countries. The approach described is the application of modern safe storage methods using flexible, Ultra Hermetic™ structures that create an unbreatheable atmosphere through insect and microorganism respiration alone, without use of chemicals, fumigants, or pumps. Laboratory and field data are cited and specific examples are given describing the uses of Ultra Hermetic storage to prevent the growth of aflatoxins with their significant public health consequences. Also discussed is the presently limited quantitative information on the relative occurrence of excessive levels of aflatoxin (>20 ppb before versus after multi-month storage of such crops as maize, rice and peanuts when under high humidity, high temperature conditions and, consequently, the need for further research to determine the frequency at which excessive aflatoxin levels are reached in the field versus after months of post-harvest storage. The significant work being done to reduce aflatoxin levels in the field is mentioned, as well as its probable implications on post harvest storage. Also described is why, with some crops such as peanuts, using Ultra Hermetic storage may require injection of carbon dioxide or use of an oxygen absorber as an accelerant. The case of peanuts is discussed and experimental data is described.

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry for fast and accurate identification of clinically relevant Aspergillus species.

Science.gov (United States)

Alanio, A; Beretti, J-L; Dauphin, B; Mellado, E; Quesne, G; Lacroix, C; Amara, A; Berche, P; Nassif, X; Bougnoux, M-E

2011-05-01

New Aspergillus species have recently been described with the use of multilocus sequencing in refractory cases of invasive aspergillosis. The classical phenotypic identification methods routinely used in clinical laboratories failed to identify them adequately. Some of these Aspergillus species have specific patterns of susceptibility to antifungal agents, and misidentification may lead to inappropriate therapy. We developed a matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry (MS)-based strategy to adequately identify Aspergillus species to the species level. A database including the reference spectra of 28 clinically relevant species from seven Aspergillus sections (five common and 23 unusual species) was engineered. The profiles of young and mature colonies were analysed for each reference strain, and species-specific spectral fingerprints were identified. The performance of the database was then tested on 124 clinical and 16 environmental isolates previously characterized by partial sequencing of the β-tubulin and calmodulin genes. One hundred and thirty-eight isolates of 140 (98.6%) were correctly identified. Two atypical isolates could not be identified, but no isolate was misidentified (specificity: 100%). The database, including species-specific spectral fingerprints of young and mature colonies of the reference strains, allowed identification regardless of the maturity of the clinical isolate. These results indicate that MALDI-TOF MS is a powerful tool for rapid and accurate identification of both common and unusual species of Aspergillus. It can give better results than morphological identification in clinical laboratories. © 2010 The Authors. Clinical Microbiology and Infection © 2010 European Society of Clinical Microbiology and Infectious Diseases.

Geochemical modelling of CO2-water-rock interactions for carbon storage : data requirements and outputs

International Nuclear Information System (INIS)

Kirste, D.

2008-01-01

A geochemical model was used to predict the short-term and long-term behaviour of carbon dioxide (CO 2 ), formation water, and reservoir mineralogy at a carbon sequestration site. Data requirements for the geochemical model included detailed mineral petrography; formation water chemistry; thermodynamic and kinetic data for mineral phases; and rock and reservoir physical characteristics. The model was used to determine the types of outputs expected for potential CO 2 storage sites and natural analogues. Reaction path modelling was conducted to determine the total reactivity or CO 2 storage capability of the rock by applying static equilibrium and kinetic simulations. Potential product phases were identified using the modelling technique, which also enabled the identification of the chemical evolution of the system. Results of the modelling study demonstrated that changes in porosity and permeability over time should be considered during the site selection process.

Outlook of the process of storage of oncology drugs from the logistic operator in Colombia

Directory of Open Access Journals (Sweden)

Pedro Vicente Sánchez-Calvera

2014-05-01

Full Text Available This article mainly on the problem of  storage of oncology drugs, which is an important element in the supply chain, applied in the context of warehouse management of oncology drugs, in the logistics operator and providers of health services institutions (IPS for its acronym in Spanish of Bogotá DC and in the contex of a macro project "Methodological proposal for the definition of policies , rules of negotation and coordination in supply management of oncology drugs in Colombia," funded by Colciencias and the Universidad Nacional of Colombia. This article presents the current situation of oncology drugs, marking a characterization, diagnosis and identification and startegies evaluated under different scenarios. Finally, it is presented a proposal of improvement applied tranversely to storage processes including labels such as just in Time and the application of information and communication technologies (ICT.

Storage and distribution/Linear programming for storage operations

Energy Technology Data Exchange (ETDEWEB)

Coleman, D

1978-07-15

The techniques of linear programing to solve storage problems as applied in a tank farm tie-in with refinery throughput operation include: (1) the time-phased model which works on storage and refinery operations input parameters, e.g., production, distribution, cracking, etc., and is capable of representing product stockpiling in slack periods to meet future peak demands, and investigating alternative strategies such as exchange deals and purchase and leasing of additional storage, and (2) the Monte Carlo simulation method, which inputs parameters, e.g., arrival of crude products at refinery, tankage size, likely demand for products, etc., as probability distributions rather than single values, and is capable of showing the average utilization of facilities, potential bottlenecks, investment required to achieve an increase in utilization, and to enable the user to predict total investment, cash flow, and profit emanating from the original financing decision. The increasing use of computer techniques to solve refinery and storage problems is attributed to potential savings resulting from more effective planning, reduced computer costs, ease of access and more usable software. Diagrams.

Paliperidone Inducing Concomitantly Syndrome of Inappropriate Antidiuretic Hormone, Neuroleptic Malignant Syndrome, and Rhabdomyolysis

Directory of Open Access Journals (Sweden)

Jaspinder Kaur

2016-01-01

Full Text Available Paliperidone, an active metabolite of risperidone, is a new atypical antipsychotic agent. Syndrome of inappropriate antidiuretic hormone (SIADH, neuroleptic malignant syndrome (NMS, and rhabdomyolysis are the uncommon side effects of psychotropic drugs. We report a case of 35-year-old male with schizoaffective disorder who was admitted for acute-on-chronic exacerbation of his psychotic disorder for which intramuscular paliperidone 234 mg injection was given. Two days later, the patient developed hyponatremic seizures secondary to SIADH which was treated with hypertonic saline. On the third day, he developed high grade fever and severe muscle rigidity with raised creatine phosphokinase (CPK and liver enzymes levels. He was treated with dantrolene 100 mg, bromocriptine 2.5 mg, and lorazepam 2 mg. Our patient required management of the three rare conditions following treatment with paliperidone. This case highlights the need for health care providers to be aware of the rare, potentially life threatening but preventable hyponatremia, NMS, and rhabdomyolysis as a possible adverse effect of paliperidone.

Siting-selection study for the Soyland Power Cooperative, Inc. , compressed-air energy-storage system (CAES)

Energy Technology Data Exchange (ETDEWEB)

1982-01-01

A method used for siting a compressed air energy storage (CAES) system using geotechnical and environmental criteria is explained using the siting of a proposed 220 MW water-compensated CAES plant in Illinois as an example. Information is included on the identification and comparative ranking of 28 geotechnically and environmental sites in Illinois, the examination of fatal flaws, e.g., mitigation, intensive studies, costly studies, permit denials, at 7 sites; and the selection of 3 sites for further geological surveying. (LCL)

Release of radionuclides following severe accident in interim storage facility. Source term determination

International Nuclear Information System (INIS)

Morandi, S.; Mariani, M.; Giacobbo, F.; Covini, R.

2006-01-01

Among the severe accidents that can cause the release of radionuclides from an interim storage facility, with a consequent relevant radiological impact on the population, there is the impact of an aircraft on the facility. In this work, a safety assessment analysis for the case of an aircraft crash into an interim storage facility is tackled. To this aim a methodology, based upon DOE, IAEA and NUREG standard procedures and upon conservative yet realistic hypothesis, has been developed in order to evaluate the total radioactivity, source term, released to the biosphere in consequence of the impact, without recurring to the use of complicated numerical codes. The procedure consists in the identification of the accidental scenarios, in the evaluation of the consequent damage to the building structures and to the waste packages and in the determination of the total release of radionuclides through the building-atmosphere interface. The methodology here developed has been applied to the case of an aircraft crash into an interim storage facility currently under design. Results show that in case of perforation followed by a fire incident the total released activity would be greater of some orders of magnitude with respect to the case of mere perforation. (author)

CHEMICAL STORAGE: MYTHS VERSUS REALITY

International Nuclear Information System (INIS)

Simmons, F.

2007-01-01

A large number of resources explaining proper chemical storage are available. These resources include books, databases/tables, and articles that explain various aspects of chemical storage including compatible chemical storage, signage, and regulatory requirements. Another source is the chemical manufacturer or distributor who provides storage information in the form of icons or color coding schemes on container labels. Despite the availability of these resources, chemical accidents stemming from improper storage, according to recent reports (1) (2), make up almost 25% of all chemical accidents. This relatively high percentage of chemical storage accidents suggests that these publications and color coding schemes although helpful, still provide incomplete information that may not completely mitigate storage risks. This manuscript will explore some ways published storage information may be incomplete, examine the associated risks, and suggest methods to help further eliminate chemical storage risks

Appropriate prescribing in the elderly: an investigation of two screening tools, Beers criteria considering diagnosis and independent of diagnosis and improved prescribing in the elderly tool to identify inappropriate use of medicines in the elderly in primary care in Ireland.

LENUS (Irish Health Repository)

Ryan, C

2009-08-01

Elderly patients are particularly vulnerable to inappropriate prescribing, with increased risk of adverse drug reactions and consequently higher rates of morbidity and mortality. A large proportion of inappropriate prescribing is preventable by adherence to prescribing guidelines, suitable monitoring and regular medication review. As a result, screening tools have been developed to help clinicians improve their prescribing.

Overview of technical Issues Associated with the Long Term Storage of Light Water Reactor used Nuclear Fuel

International Nuclear Information System (INIS)

Sorenson, Ken B.

2014-01-01

The nuclear power technical community is developing the technical basis for demonstrating the safety of storing used nuclear fuel for extended periods of time. The combination of reactor operations that off-load spent fuel to interim storage, coupled with delays in repository construction, has resulted in the expectation that storage periods may be for longer periods of time than originally intended. As more fuel continues to be off-loaded from operating reactors, the need for expanded interim storage also increases. As repository programs are delayed, interim storage requirements will likely exceed licensing term limits. To address these operational realities, there has been a concerted international effort to identify and prioritize the technical issues that need to be addressed in order to demonstrate the safety of storing used nuclear fuel for extended periods of time. Since this is an international effort, different storage systems, regulations, and policies need to be considered. This results in differences in technical issues, as well as differences in priorities. However, this effort also identifies important commonalities in some technical areas that need to be addressed. A broad-based international evaluation of these technical issues provides a better understanding of technical concerns as they relate to individual storage systems and specific national regulatory frameworks. While there are several international activities underway that are focused on long term storage, this paper will discuss the activities of the Electric Power Research Institute (EPRI)/Extended Storage Collaboration Program (ESCP) International Subcommittee. A status report detailing the identification and prioritization of the technical issues was presented at the PSAM11 Conference in June 2012 (1). Since that conference, a final report has been completed by the EPRI/ESCP International Subcommittee (2). This paper will provide important results of the final report as well as

NV Energy Electricity Storage Valuation

Energy Technology Data Exchange (ETDEWEB)

Ellison, James F.; Bhatnagar, Dhruv; Samaan, Nader A.; Jin, Chunlian

2013-06-30

This study examines how grid-level electricity storage may benet the operations of NV Energy in 2020, and assesses whether those benets justify the cost of the storage system. In order to determine how grid-level storage might impact NV Energy, an hourly production cost model of the Nevada Balancing Authority (\\BA") as projected for 2020 was built and used for the study. Storage facilities were found to add value primarily by providing reserve. Value provided by the provision of time-of-day shifting was found to be limited. If regulating reserve from storage is valued the same as that from slower ramp rate resources, then it appears that a reciprocating engine generator could provide additional capacity at a lower cost than a pumped storage hydro plant or large storage capacity battery system. In addition, a 25-MW battery storage facility would need to cost $650/kW or less in order to produce a positive Net Present Value (NPV). However, if regulating reserve provided by storage is considered to be more useful to the grid than that from slower ramp rate resources, then a grid-level storage facility may have a positive NPV even at today's storage system capital costs. The value of having storage provide services beyond reserve and time-of-day shifting was not assessed in this study, and was therefore not included in storage cost-benefit calculations.

The SERI solar energy storage program

Science.gov (United States)

Copeland, R. J.; Wright, J. D.; Wyman, C. E.

1980-01-01

In support of the DOE thermal and chemical energy storage program, the solar energy storage program (SERI) provides research on advanced technologies, systems analyses, and assessments of thermal energy storage for solar applications in support of the Thermal and Chemical Energy Storage Program of the DOE Division of Energy Storage Systems. Currently, research is in progress on direct contact latent heat storage and thermochemical energy storage and transport. Systems analyses are being performed of thermal energy storage for solar thermal applications, and surveys and assessments are being prepared of thermal energy storage in solar applications. A ranking methodology for comparing thermal storage systems (performance and cost) is presented. Research in latent heat storage and thermochemical storage and transport is reported.

Diversity and carbon storage across the tropical forest biome

Science.gov (United States)

Sullivan, Martin J. P.; Talbot, Joey; Lewis, Simon L.; Phillips, Oliver L.; Qie, Lan; Begne, Serge K.; Chave, Jerôme; Cuni-Sanchez, Aida; Hubau, Wannes; Lopez-Gonzalez, Gabriela; Miles, Lera; Monteagudo-Mendoza, Abel; Sonké, Bonaventure; Sunderland, Terry; Ter Steege, Hans; White, Lee J. T.; Affum-Baffoe, Kofi; Aiba, Shin-Ichiro; de Almeida, Everton Cristo; de Oliveira, Edmar Almeida; Alvarez-Loayza, Patricia; Dávila, Esteban Álvarez; Andrade, Ana; Aragão, Luiz E. O. C.; Ashton, Peter; Aymard C., Gerardo A.; Baker, Timothy R.; Balinga, Michael; Banin, Lindsay F.; Baraloto, Christopher; Bastin, Jean-Francois; Berry, Nicholas; Bogaert, Jan; Bonal, Damien; Bongers, Frans; Brienen, Roel; Camargo, José Luís C.; Cerón, Carlos; Moscoso, Victor Chama; Chezeaux, Eric; Clark, Connie J.; Pacheco, Álvaro Cogollo; Comiskey, James A.; Valverde, Fernando Cornejo; Coronado, Eurídice N. Honorio; Dargie, Greta; Davies, Stuart J.; de Canniere, Charles; Djuikouo K., Marie Noel; Doucet, Jean-Louis; Erwin, Terry L.; Espejo, Javier Silva; Ewango, Corneille E. N.; Fauset, Sophie; Feldpausch, Ted R.; Herrera, Rafael; Gilpin, Martin; Gloor, Emanuel; Hall, Jefferson S.; Harris, David J.; Hart, Terese B.; Kartawinata, Kuswata; Kho, Lip Khoon; Kitayama, Kanehiro; Laurance, Susan G. W.; Laurance, William F.; Leal, Miguel E.; Lovejoy, Thomas; Lovett, Jon C.; Lukasu, Faustin Mpanya; Makana, Jean-Remy; Malhi, Yadvinder; Maracahipes, Leandro; Marimon, Beatriz S.; Junior, Ben Hur Marimon; Marshall, Andrew R.; Morandi, Paulo S.; Mukendi, John Tshibamba; Mukinzi, Jaques; Nilus, Reuben; Vargas, Percy Núñez; Camacho, Nadir C. Pallqui; Pardo, Guido; Peña-Claros, Marielos; Pétronelli, Pascal; Pickavance, Georgia C.; Poulsen, Axel Dalberg; Poulsen, John R.; Primack, Richard B.; Priyadi, Hari; Quesada, Carlos A.; Reitsma, Jan; Réjou-Méchain, Maxime; Restrepo, Zorayda; Rutishauser, Ervan; Salim, Kamariah Abu; Salomão, Rafael P.; Samsoedin, Ismayadi; Sheil, Douglas; Sierra, Rodrigo; Silveira, Marcos; Slik, J. W. Ferry; Steel, Lisa; Taedoumg, Hermann; Tan, Sylvester; Terborgh, John W.; Thomas, Sean C.; Toledo, Marisol; Umunay, Peter M.; Gamarra, Luis Valenzuela; Vieira, Ima Célia Guimarães; Vos, Vincent A.; Wang, Ophelia; Willcock, Simon; Zemagho, Lise

2017-01-01

Tropical forests are global centres of biodiversity and carbon storage. Many tropical countries aspire to protect forest to fulfil biodiversity and climate mitigation policy targets, but the conservation strategies needed to achieve these two functions depend critically on the tropical forest tree diversity-carbon storage relationship. Assessing this relationship is challenging due to the scarcity of inventories where carbon stocks in aboveground biomass and species identifications have been simultaneously and robustly quantified. Here, we compile a unique pan-tropical dataset of 360 plots located in structurally intact old-growth closed-canopy forest, surveyed using standardised methods, allowing a multi-scale evaluation of diversity-carbon relationships in tropical forests. Diversity-carbon relationships among all plots at 1 ha scale across the tropics are absent, and within continents are either weak (Asia) or absent (Amazonia, Africa). A weak positive relationship is detectable within 1 ha plots, indicating that diversity effects in tropical forests may be scale dependent. The absence of clear diversity-carbon relationships at scales relevant to conservation planning means that carbon-centred conservation strategies will inevitably miss many high diversity ecosystems. As tropical forests can have any combination of tree diversity and carbon stocks both require explicit consideration when optimising policies to manage tropical carbon and biodiversity.

Diversity and carbon storage across the tropical forest biome.

Science.gov (United States)

Sullivan, Martin J P; Talbot, Joey; Lewis, Simon L; Phillips, Oliver L; Qie, Lan; Begne, Serge K; Chave, Jerôme; Cuni-Sanchez, Aida; Hubau, Wannes; Lopez-Gonzalez, Gabriela; Miles, Lera; Monteagudo-Mendoza, Abel; Sonké, Bonaventure; Sunderland, Terry; Ter Steege, Hans; White, Lee J T; Affum-Baffoe, Kofi; Aiba, Shin-Ichiro; de Almeida, Everton Cristo; de Oliveira, Edmar Almeida; Alvarez-Loayza, Patricia; Dávila, Esteban Álvarez; Andrade, Ana; Aragão, Luiz E O C; Ashton, Peter; Aymard C, Gerardo A; Baker, Timothy R; Balinga, Michael; Banin, Lindsay F; Baraloto, Christopher; Bastin, Jean-Francois; Berry, Nicholas; Bogaert, Jan; Bonal, Damien; Bongers, Frans; Brienen, Roel; Camargo, José Luís C; Cerón, Carlos; Moscoso, Victor Chama; Chezeaux, Eric; Clark, Connie J; Pacheco, Álvaro Cogollo; Comiskey, James A; Valverde, Fernando Cornejo; Coronado, Eurídice N Honorio; Dargie, Greta; Davies, Stuart J; De Canniere, Charles; Djuikouo K, Marie Noel; Doucet, Jean-Louis; Erwin, Terry L; Espejo, Javier Silva; Ewango, Corneille E N; Fauset, Sophie; Feldpausch, Ted R; Herrera, Rafael; Gilpin, Martin; Gloor, Emanuel; Hall, Jefferson S; Harris, David J; Hart, Terese B; Kartawinata, Kuswata; Kho, Lip Khoon; Kitayama, Kanehiro; Laurance, Susan G W; Laurance, William F; Leal, Miguel E; Lovejoy, Thomas; Lovett, Jon C; Lukasu, Faustin Mpanya; Makana, Jean-Remy; Malhi, Yadvinder; Maracahipes, Leandro; Marimon, Beatriz S; Junior, Ben Hur Marimon; Marshall, Andrew R; Morandi, Paulo S; Mukendi, John Tshibamba; Mukinzi, Jaques; Nilus, Reuben; Vargas, Percy Núñez; Camacho, Nadir C Pallqui; Pardo, Guido; Peña-Claros, Marielos; Pétronelli, Pascal; Pickavance, Georgia C; Poulsen, Axel Dalberg; Poulsen, John R; Primack, Richard B; Priyadi, Hari; Quesada, Carlos A; Reitsma, Jan; Réjou-Méchain, Maxime; Restrepo, Zorayda; Rutishauser, Ervan; Salim, Kamariah Abu; Salomão, Rafael P; Samsoedin, Ismayadi; Sheil, Douglas; Sierra, Rodrigo; Silveira, Marcos; Slik, J W Ferry; Steel, Lisa; Taedoumg, Hermann; Tan, Sylvester; Terborgh, John W; Thomas, Sean C; Toledo, Marisol; Umunay, Peter M; Gamarra, Luis Valenzuela; Vieira, Ima Célia Guimarães; Vos, Vincent A; Wang, Ophelia; Willcock, Simon; Zemagho, Lise

2017-01-17

Tropical forests are global centres of biodiversity and carbon storage. Many tropical countries aspire to protect forest to fulfil biodiversity and climate mitigation policy targets, but the conservation strategies needed to achieve these two functions depend critically on the tropical forest tree diversity-carbon storage relationship. Assessing this relationship is challenging due to the scarcity of inventories where carbon stocks in aboveground biomass and species identifications have been simultaneously and robustly quantified. Here, we compile a unique pan-tropical dataset of 360 plots located in structurally intact old-growth closed-canopy forest, surveyed using standardised methods, allowing a multi-scale evaluation of diversity-carbon relationships in tropical forests. Diversity-carbon relationships among all plots at 1 ha scale across the tropics are absent, and within continents are either weak (Asia) or absent (Amazonia, Africa). A weak positive relationship is detectable within 1 ha plots, indicating that diversity effects in tropical forests may be scale dependent. The absence of clear diversity-carbon relationships at scales relevant to conservation planning means that carbon-centred conservation strategies will inevitably miss many high diversity ecosystems. As tropical forests can have any combination of tree diversity and carbon stocks both require explicit consideration when optimising policies to manage tropical carbon and biodiversity.

Maximizing the energy storage performance of phase change thermal storage systems

Energy Technology Data Exchange (ETDEWEB)

Amin, N.A.M.; Bruno, F.; Belusko, M. [South Australia Univ., Mawson Lakes, South Australia (Australia). Inst. for Sustainable Systems and Technologies

2009-07-01

The demand for electricity in South Australia is highly influenced by the need for refrigeration and air-conditioning. An extensive literature review has been conducted on the use of phase change materials (PCMs) in thermal storage systems. PCMs use latent heat at the solid-liquid phase transition point to store thermal energy. They are considered to be useful as a thermal energy storage (TES) material because they can provide much higher energy storage densities compared to conventional sensible thermal storage materials. This paper reviewed the main disadvantages of using PCMs for energy storage, such as low heat transfer, super cooling and system design issues. Other issues with PCMs include incongruence and corrosion of heat exchanger surfaces. The authors suggested that in order to address these problems, future research should focus on maximizing heat transfer by optimizing the configuration of the encapsulation through a parametric analysis using a PCM numerical model. The effective conductivity in encapsulated PCMs in a latent heat thermal energy storage (LHTES) system can also be increased by using conductors in the encapsulation that have high thermal conductivity. 47 refs., 1 tab., 1 fig.

Saline Cavern Adiabatic Compressed Air Energy Storage Using Sand as Heat Storage Material

Directory of Open Access Journals (Sweden)

Martin Haemmerle

2017-03-01

Full Text Available Adiabatic compressed air energy storage systems offer large energy storage capacities and power outputs beyond 100MWel. Salt production in Austria produces large caverns which are able to hold pressure up to 100 bar, thus providing low cost pressurized air storage reservoirs for adiabatic compressed air energy storage plants. In this paper the results of a feasibility study is presented, which was financed by the Austrian Research Promotion Agency, with the objective to determine the adiabatic compressed air energy storage potential of Austria’s salt caverns. The study contains designs of realisable plants with capacities between 10 and 50 MWel, applying a high temperature energy storage system currently developed at the Institute for Energy Systems and Thermodynamics in Vienna. It could be shown that the overall storage potential of Austria’s salt caverns exceeds a total of 4GWhel in the year 2030 and, assuming an adequate performance of the heat exchanger, that a 10MWel adiabatic compressed air energy storage plant in Upper Austria is currently feasible using state of the art thermal turbomachinery which is able to provide a compressor discharge temperature of 400 °C.

Modular vault dry storage system for interim storage of irradiated fuel

International Nuclear Information System (INIS)

Cundill, B.R.; Ealing, C.J.; Agarwal, B.K.

1988-01-01

The Foster Wheeler Energy Application (FWEA) Modular Vault Dry Store (MVDS) is a dry storage concept for the storage of all types of irradiated reactor fuel. For applications in the US, FWEA submitted an MVDS Topical Report to the US NRC during 1986. Following NRC approval of the MVDS Topical Report concept for unconsolidated LWR fuel, US utilities have available a new, compact, economic and flexible system for the storage of irradiated fuel at the reactor site for time periods of at least 20 years (the period of the first license). The MVDS concept jointly developed by FWEA and GEC in the U.K., has other applications for large central away from reactor storage facilities such as a Monitorable Retrievable Storage (MRS) installation. This paper describes the licensed MVDS design, aspects of performance are discussed and capital costs compared with alternative concepts. Alternative configurations of MVDS are outlined

Fuel assembly storage pool

International Nuclear Information System (INIS)

Hiranuma, Hiroshi.

1976-01-01

Object: To remove limitation of the number of storage of fuel assemblies to increase the number of storage thereof so as to relatively reduce the water depth required for shielding radioactive rays. Structure: Fuel assembly storage rack containers for receiving a plurality of spent fuel assembly racks are stacked in multi-layer fashion within a storage pool filled with water for shielding radioactive rays and removing heat. (Furukawa, Y.)

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) or hyponatraemia associated with valproic Acid : four case reports from the Netherlands and a case/non-case analysis of vigibase

NARCIS (Netherlands)

Beers, Erna; van Puijenbroek, Eugène P; Bartelink, Imke H; van der Linden, Carolien M J; Jansen, Paul A F

The Netherlands Pharmacovigilance Centre Lareb received four cases of severe symptomatic hyponatraemia or syndrome of inappropriate antidiuretic hormone secretion (SIADH) in association with valproic acid use, in which a causal relationship was suspected. This study describes these cases and gives

Electricity storage using a thermal storage scheme

Energy Technology Data Exchange (ETDEWEB)

White, Alexander, E-mail: ajw36@cam.ac.uk [Hopkinson Laboratory, Cambridge University Engineering Department, Trumpington Street, Cambridge. CB2 1PZ (United Kingdom)

2015-01-22

The increasing use of renewable energy technologies for electricity generation, many of which have an unpredictably intermittent nature, will inevitably lead to a greater demand for large-scale electricity storage schemes. For example, the expanding fraction of electricity produced by wind turbines will require either backup or storage capacity to cover extended periods of wind lull. This paper describes a recently proposed storage scheme, referred to here as Pumped Thermal Storage (PTS), and which is based on “sensible heat” storage in large thermal reservoirs. During the charging phase, the system effectively operates as a high temperature-ratio heat pump, extracting heat from a cold reservoir and delivering heat to a hot one. In the discharge phase the processes are reversed and it operates as a heat engine. The round-trip efficiency is limited only by process irreversibilities (as opposed to Second Law limitations on the coefficient of performance and the thermal efficiency of the heat pump and heat engine respectively). PTS is currently being developed in both France and England. In both cases, the schemes operate on the Joule-Brayton (gas turbine) cycle, using argon as the working fluid. However, the French scheme proposes the use of turbomachinery for compression and expansion, whereas for that being developed in England reciprocating devices are proposed. The current paper focuses on the impact of the various process irreversibilities on the thermodynamic round-trip efficiency of the scheme. Consideration is given to compression and expansion losses and pressure losses (in pipe-work, valves and thermal reservoirs); heat transfer related irreversibility in the thermal reservoirs is discussed but not included in the analysis. Results are presented demonstrating how the various loss parameters and operating conditions influence the overall performance.

Preliminary assessment of alternative dry storage methods for the storage of commercial spent nuclear fuel

International Nuclear Information System (INIS)

1981-11-01

This report presents the results of an assessment of the (1) state of technology, (2) licensability, (3) implementation schedule, and (4) costs of alternative dry methods for storage of spent fuel at a reactor location when used to supplement reactor pool storage facilities. The methods of storage that were considered included storage in casks, drywells, concrete silos and air-cooled vaults. The impact of disassembly of spent fuel and storage of consolidated fuel rods was also determined. The economic assessments were made based on the current projected storage requirements of Virginia Electric and Power Company's Surry Station for the period 1985 to 2009, which has two operating pressurized water reactors (824 MWe each). It was estimated that the unit cost for storage of spent fuel in casks would amount to $117/kgU and that such costs for storage in drywells would amount to $137/kgU. However, based on the overall assessment it was concluded both storage methods were equal in merit. Modular methods of storage were generally found to be more economic than those requiring all or most of the facilities to be constructed prior to commencement of storage operations

Apparatus for the storage of transport- and storage-containers containing radioactive fuel elements

International Nuclear Information System (INIS)

Vox, A.

1983-01-01

The invention concerns an apparatus for the storage of transport and storage containers containing radioactive fuel elements. For each transport or storage container there is a separate silo-type container of steel, concrete, prestressed concrete or suchlike breakproof and fireproof material, to be placed in the open, that can be opened for removal and placing of the transport or storage container respectively. (orig.) [de

Some wind-energy storage options

Energy Technology Data Exchange (ETDEWEB)

Eldridge, F R; Ljungstroem, O [ed.

1976-01-01

Systems capable of storing energy generated from the wind can be categorized in terms of electrochemical energy storage systems, thermal energy storage systems, kinetic energy systems, and potential energy systems. Recent surveys of energy storage systems have evaluated some of these available storage technologies in terms of the minimum economic sizes for utility applications, estimated capital costs of these units, expected life, dispersed storage capabilities, and estimated turn-around efficiencies of the units. These are summarized for various types of energy storage options.

Exploratory Technology Research Program for electrochemical energy storage. Annual report fr 1994

Energy Technology Data Exchange (ETDEWEB)

Kinoshita, K. [ed.

1995-09-01

The US Department of Energy`s Office of Propulsion Systems provides support for an Electrochemical Energy Storage Program, that includes research and development (R&D) on advanced rechargeable batteries and fuel cells. A major goal of this program is to develop electrochemical power sources suitable for application in electric vehicles (EVs). The program centers on advanced systems that offer the potential for high performance and low life-cycle costs, both of which are necessary to permit significant penetration into commercial markets. The DOE Electrochemical Energy Storage Program is divided into two projects: the Electric Vehicle Advanced Battery Systems (EVABS) Development Program and the Exploratory Technology Research (ETR) Program. The general R&D areas addressed by the program include identification of new electrochemical couples for advanced batteries, determination of technical feasibility of the new couples, improvements in battery components and materials, establishment of engineering principles applicable to electrochemical energy storage and conversion, and the development of air-system (fuel cell, metal/air) technology for transportation applications. Major emphasis is given to applied research which will lead to superior performance and lower life-cycle costs. The ETR Program is divided into three major program elements: Exploratory Research, Applied Science Research, and Air Systems Research. Highlights of each program element are summarized according to the appropriate battery system or electrochemical research area.

Hydrogen-based electrochemical energy storage

Science.gov (United States)

Simpson, Lin Jay

2013-08-06

An energy storage device (100) providing high storage densities via hydrogen storage. The device (100) includes a counter electrode (110), a storage electrode (130), and an ion conducting membrane (120) positioned between the counter electrode (110) and the storage electrode (130). The counter electrode (110) is formed of one or more materials with an affinity for hydrogen and includes an exchange matrix for elements/materials selected from the non-noble materials that have an affinity for hydrogen. The storage electrode (130) is loaded with hydrogen such as atomic or mono-hydrogen that is adsorbed by a hydrogen storage material such that the hydrogen (132, 134) may be stored with low chemical bonding. The hydrogen storage material is typically formed of a lightweight material such as carbon or boron with a network of passage-ways or intercalants for storing and conducting mono-hydrogen, protons, or the like. The hydrogen storage material may store at least ten percent by weight hydrogen (132, 134) at ambient temperature and pressure.

Management of functional Sprint Fidelis leads at cardiac resynchronization therapy-defibrillator generator replacement: a novel option for preventing inappropriate shocks from lead failure in fragile patients with high risk of sudden death.

Science.gov (United States)

Zhu, Dennis W X; Chu, Matthew M; House, Chad M

2017-12-01

In patients with a functional Sprint Fidelis lead at generator replacement, the manufacturer recommended to either continue to use the existing lead or replace it with a new lead. For those patients who continue to use a functional Fidelis lead, the risk of inappropriate shocks remains present if the lead fails in the future. We evaluated the feasibility of an alternative approach at the time of cardiac resynchronization therapy-defibrillator (CRT-D) generator replacement in patients with a functional bipolar left ventricular (LV) lead for prevention of inappropriate shocks from future Fidelis lead failure. During the procedure, the pace/sense IS-1 connection pin of the functional Fidelis lead was intentionally inserted into the LV port of the new CRT-D generator, while the existing bipolar LV lead IS-1 connection pin was inserted into the right ventricular (RV) pace/sense port. After such switching, the existing bipolar LV lead was used for functional LV pacing/sensing, while the Fidelis lead was used for functional RV pacing and high voltage shock only and could no longer be used for the purpose of sensing and detecting. This approach precluded oversensing and inappropriate shocks should the functional Fidelis lead fail in the future. Six fragile patients, who were not considered suitable candidates for lead replacement, underwent the alternative approach. During a follow-up of 35 ± 23 months, the CRT-D system functioned normally in five patients. The Fidelis lead fractured in one patient 7 months after generator replacement. The malfunction was detected promptly and the defected lead was replaced. No inappropriate detections or shock was triggered. In CRT-D patients with a functional Fidelis lead and a bipolar LV lead, switching of the Fidelis lead pace/sense IS-1 pin with the bipolar LV lead IS-1 pin at generator replacement did not affect normal system function. This novel approach may be valuable in fragile patients with high risk of sudden death for

Variety Is Not the Spice of Life for People with Autism Spectrum Disorders: Frequency Ratings of Central, Variable and Inappropriate Aspects of Common Real-Life Events

Science.gov (United States)

Loth, Eva; Happe, Francesca; Gomez, Juan Carlos

2010-01-01

This study used a novel rating task to investigate whether high-functioning individuals with autism spectrum disorder (ASD) have difficulties distinguishing essential from variable aspects of familiar events. Participants read stories about everyday events and judged how often central, variable, and inappropriate event-components normally occur in…

Performance of VITEK mass spectrometry V3.0 for rapid identification of clinical Aspergillus fumigatus in different culture conditions based on ribosomal proteins

Directory of Open Access Journals (Sweden)

Zhou L

2017-12-01

Full Text Available Longrong Zhou, Yongquan Chen, Yuanhong Xu Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Anhui, Hefei, People’s Republic of China Abstract: Fast and accurate discrimination of Aspergillus fumigatus is significant, since misidentification may lead to inappropriate clinical therapy. This study assessed VITEK mass spectrometry (MS V3.0 for A. fumigatus identification using extracted fungal ribosomal proteins. A total of 52 isolates preliminarily identified as A. fumigatus by traditional morphological methods were inoculated in three different culture media and cultured at two different temperatures. The specific spectral fingerprints of different culture time points (48, 72, 96, and 120 h were obtained. Of all strains, 88.5% (46/52 were discriminated as A. fumigatus, while the remaining 11.5% (6/52 produced results inconsistent with morphological analysis. Molecular sequencing, as a reference method for species identification, was used to validate the morphological analysis and matrix-assisted laser desorption/ionization time of flight MS. Chi-square tests (Χ2 test, P=0.05 demonstrated that the culture medium and incubation temperature had no effects on identification accuracy; however, identification accuracy of the strains in the 48-h group was lower than that in other groups. In addition, we found that ribosomal proteins extracted from A. fumigatus can be stored in different environments for at least 1 week, with their profiles remaining stable and strain identification results showing no change. This is beneficial for medical institutions with no mass spectrometer at hand. Overall, this study showed the powerful ability of VITEK MS V 3.0 in identifying A. fumigatus. Keywords: VITEK MS V 3.0, Aspergillus fumigatus, identification, ribosomal protein, spectral fingerprints, fungal, matrix assisted laser desorption ionization-time of flight mass spectrometry, MALDI-TOF MS

Radiological and clinical characterization of the lysosomal storage disorders: non-lipid disorders.

Science.gov (United States)

Parker, E I; Xing, M; Moreno-De-Luca, A; Harmouche, E; Terk, M R

2014-01-01

Lysosomal storage diseases (LSDs) are a large group of genetic metabolic disorders that result in the accumulation of abnormal material, such as mucopolysaccharides, glycoproteins, amino acids and lipids, within cells. Since many LSDs manifest during infancy or early childhood, with potentially devastating consequences if left untreated, timely identification is imperative to prevent irreversible damage and early death. In this review, the key imaging features of the non-lipid or extralipid LSDs are examined and correlated with salient clinical manifestations and genetic information. Disorders are stratified based on the type of excess material causing tissue or organ dysfunction, with descriptions of the mucopolysaccharidoses, mucolipidoses, alpha-mannosidosis, glycogen storage disorder II and cystinosis. In addition, similarities and differences in radiological findings between each of these LSDs are highlighted to facilitate further recognition. Given the rare and extensive nature of the LSDs, mastery of their multiple clinical and radiological traits may seem challenging. However, an understanding of the distinguishing imaging characteristics of LSDs and their clinical correlates may allow radiologists to play a key role in the early diagnosis of these progressive and potentially fatal disorders.

Relative judgment theory and the mediation of facial recognition: Implications for theories of eyewitness identification.

Science.gov (United States)

McAdoo, Ryan M; Gronlund, Scott D

2016-01-01

Many in the eyewitness identification community believe that sequential lineups are superior to simultaneous lineups because simultaneous lineups encourage inappropriate choosing due to promoting comparisons among choices (a relative judgment strategy), but sequential lineups reduce this propensity by inducing comparisons of lineup members directly to memory rather than to each other (an absolute judgment strategy). Different versions of the relative judgment theory have implicated both discrete-state and continuous mediation of eyewitness decisions. The theory has never been formally specified, but (Yonelinas, J Exp Psychol Learn Mem Cogn 20:1341-1354, 1994) dual-process models provide one possible specification, thereby allowing us to evaluate how eyewitness decisions are mediated. We utilized a ranking task (Kellen and Klauer, J Exp Psychol Learn Mem Cogn 40:1795-1804, 2014) and found evidence for continuous mediation when facial stimuli match from study to test (Experiment 1) and when they mismatch (Experiment 2). This evidence, which is contrary to a version of relative judgment theory that has gained a lot of traction in the legal community, compels reassessment of the role that guessing plays in eyewitness identification. Future research should continue to test formal explanations in order to advance theory, expedite the development of new procedures that can enhance the reliability of eyewitness evidence, and to facilitate the exploration of task factors and emergent strategies that might influence when recognition is continuously or discretely mediated.

Phenolic compounds participating in mulberry juice sediment formation during storage.

Science.gov (United States)

Zou, Bo; Xu, Yu-Juan; Wu, Ji-Jun; Yu, Yuan-Shan; Xiao, Geng-Sheng

The stability of clarified juice is of great importance in the beverage industry and to consumers. Phenolic compounds are considered to be one of the main factors responsible for sediment formation. The aim of this study is to investigate the changes in the phenolic content in clarified mulberry juice during storage. Hence, separation, identification, quantification, and analysis of the changes in the contents of phenolic compounds, both free and bound forms, in the supernatant and sediments of mulberry juice, were carried out using high performance liquid chromatographic system, equipped with a photo-diode array detector (HPLC-PDA) and HPLC coupled with quadrupole-time of flight mass spectrometric (HPLC-QTOF-MS/MS) techniques. There was an increase in the amount of sediment formed over the period of study. Total phenolic content of supernatant, as well as free phenolic content in the extracts of the precipitate decreased, whereas the bound phenolic content in the sediment increased. Quantitative estimation of individual phenolic compounds indicated high degradation of free anthocyanins in the supernatant and sediment from 938.60 to 2.30 mg/L and 235.60 to 1.74 mg/g, respectively. A decrease in flavonoids in the supernatant was also observed, whereas the contents of bound forms of gallic acid, protocatechuic acid, caffeic acid, and rutin in the sediment increased. Anthocyanins were the most abundant form of phenolics in the sediment, and accounted for 67.2% of total phenolics after 8 weeks of storage. These results revealed that phenolic compounds, particularly anthocyanins, were involved in the formation of sediments in mulberry juice during storage.

Identification of Chinese Herbal Medicines with Electronic Nose Technology: Applications and Challenges.

Science.gov (United States)

Zhou, Huaying; Luo, Dehan; GholamHosseini, Hamid; Li, Zhong; He, Jiafeng

2017-05-09

This paper provides a review of the most recent works in machine olfaction as applied to the identification of Chinese Herbal Medicines (CHMs). Due to the wide variety of CHMs, the complexity of growing sources and the diverse specifications of herb components, the quality control of CHMs is a challenging issue. Much research has demonstrated that an electronic nose (E-nose) as an advanced machine olfaction system, can overcome this challenge through identification of the complex odors of CHMs. E-nose technology, with better usability, high sensitivity, real-time detection and non-destructive features has shown better performance in comparison with other analytical techniques such as gas chromatography-mass spectrometry (GC-MS). Although there has been immense development of E-nose techniques in other applications, there are limited reports on the application of E-noses for the quality control of CHMs. The aim of current study is to review practical implementation and advantages of E-noses for robust and effective odor identification of CHMs. It covers the use of E-nose technology to study the effects of growing regions, identification methods, production procedures and storage time on CHMs. Moreover, the challenges and applications of E-nose for CHM identification are investigated. Based on the advancement in E-nose technology, odor may become a new quantitative index for quality control of CHMs and drug discovery. It was also found that more research could be done in the area of odor standardization and odor reproduction for remote sensing.

Energy storage

Energy Technology Data Exchange (ETDEWEB)

1962-07-01

The papers on energy storage problems, given to the United Nations Conference on New Sources of Energy, Rome, 1961, are reviewed. Many aspects of the subject are discussed: comparisons between the costs of storing energy in batteries and in fuel cells; the use, efficiency and expected improvement of fuel cells; the principles involved in the chemical conversion of solar energy to chemical energy; the use of metal hydride fuel cells; the chemical conversion and storage of concentrated solar energy for which the solar furnace is used for photochemical reactions. Finally, the general costs of storing energy in any form and delivering it are analyzed with particular reference to storage batteries and fuel cells.

Heat transport and storage

International Nuclear Information System (INIS)

Despois, J.

1977-01-01

Recalling the close connections existing between heat transport and storage, some general considerations on the problem of heat distribution and transport are presented 'in order to set out the problem' of storage in concrete form. This problem is considered in its overall plane, then studied under the angle of the different technical choices it involves. The two alternatives currently in consideration are described i.e.: storage in a mined cavity and underground storage as captive sheet [fr

Issues related to the transport of a transportable storage cask after storage

International Nuclear Information System (INIS)

McConnell, P.; Brimhall, J.L.; Creer, J.M.; Gilbert, E.R.; Sanders, T.L.; Jones, R.H.

1991-01-01

An evaluation was performed to assess whether the reliability of a transportable storage cask system and the risks associated with its use are comparable to those associated with existing transport cask systems and, if they are not, determine how the transportable storage cask system can be made as reliable as existing systems. Reliability and failure mode analyses of both transport-only casks and transportable storage casks and implementation options are compared. Current knowledge regarding the potential effects of a long-term dry storage environment on spent fuel and cask materials is reviewed. A summary assessment of the consideration for deploying a transportable storage cask (TSC) system with emphasis on preliminary design, validation and operational recommendations for TSC implementations is presented. The analyses conclude that a transportable storage cask can likely be shipped upopened by applying a combination of design considerations and operational constraints, including environmental monitoring and pretransport assessments of functional reliability of the cask. A proper mix of these constraints should yield risk parity with any existing transport cask

Hydrogen storage compositions

Science.gov (United States)

Li, Wen; Vajo, John J.; Cumberland, Robert W.; Liu, Ping

2011-04-19

Compositions for hydrogen storage and methods of making such compositions employ an alloy that exhibits reversible formation/deformation of BH.sub.4.sup.- anions. The composition includes a ternary alloy including magnesium, boron and a metal and a metal hydride. The ternary alloy and the metal hydride are present in an amount sufficient to render the composition capable of hydrogen storage. The molar ratio of the metal to magnesium and boron in the alloy is such that the alloy exhibits reversible formation/deformation of BH.sub.4.sup.- anions. The hydrogen storage composition is prepared by combining magnesium, boron and a metal to prepare a ternary alloy and combining the ternary alloy with a metal hydride to form the hydrogen storage composition.

Dry storage systems using casks for long term storage in an AFR and repository

International Nuclear Information System (INIS)

Einfeld, K.; Popp, F.W.

1986-01-01

In conclusion it can be stated that two basic routes with respect to spent fuel storage casks are feasible. One is the Multiple Transport Cask, which with certain modifications can be upgraded to meet the criteria for intermediate storage. Its status is characterized by the licensing of several types of Castor Casks for an intermediate storage period of 30 years in the AFR Storage Facility of DWK at Gorleben in the FRG. The other one is the Final Disposal (Repository) Cask, which can be made suitable for long term storage before a final decision with respect to a repository application is taken. The licensing procedure for a Pilot Conditioning Facility with the Pollux Cask System as reference case will be initiated by DWK in the near future. Under the assumption that in addition to the present Multiple Transport/Storage Casks a license for a Final disposal Cask with respect to long term storage is available, the relative merits of different cask storage systems would have to be evaluated

Advanced materials for energy storage.

Science.gov (United States)

Liu, Chang; Li, Feng; Ma, Lai-Peng; Cheng, Hui-Ming

2010-02-23

Popularization of portable electronics and electric vehicles worldwide stimulates the development of energy storage devices, such as batteries and supercapacitors, toward higher power density and energy density, which significantly depends upon the advancement of new materials used in these devices. Moreover, energy storage materials play a key role in efficient, clean, and versatile use of energy, and are crucial for the exploitation of renewable energy. Therefore, energy storage materials cover a wide range of materials and have been receiving intensive attention from research and development to industrialization. In this Review, firstly a general introduction is given to several typical energy storage systems, including thermal, mechanical, electromagnetic, hydrogen, and electrochemical energy storage. Then the current status of high-performance hydrogen storage materials for on-board applications and electrochemical energy storage materials for lithium-ion batteries and supercapacitors is introduced in detail. The strategies for developing these advanced energy storage materials, including nanostructuring, nano-/microcombination, hybridization, pore-structure control, configuration design, surface modification, and composition optimization, are discussed. Finally, the future trends and prospects in the development of advanced energy storage materials are highlighted.