WorldWideScience

Sample records for incident management ultimately

  1. Towards an Ultimate Battery Thermal Management System

    DEFF Research Database (Denmark)

    Khan, Mohammad Rezwan; Swierczynski, Maciej Jozef; Kær, Søren Knudsen

    2017-01-01

    The prevailing standards and scientific literature offer a wide range of options for the construction of a battery thermal management system (BTMS). The design of an innovative yet well-functioning BTMS requires strict supervision, quality audit and continuous improvement of the whole process. It...

  2. Waste management, ultimate waste disposal and the fuel cycle

    International Nuclear Information System (INIS)

    Rengeling, H.W.

    1991-01-01

    The four main steps of waste management are: interim storage of spent fuel elements, reprocessing of spent fuels and recycling of recovered nuclear materials, direct, ultimate disposal of waste that cannot or should not be reprocessed for technical or economic reasons, disposal of radioactive waste. The expert opinion focusses on ultimate disposal as the most problematic step, stating the legal problems arising from ultimate disposal being carried out by private, licensed contractors, or completely under civil law, discussing the two possibilities also from the point of view of constitutional law and legal policy. Other aspects examined are: distribution of responsibilities, harmonization and systematization of legal provisions; principles to be applied to an evidence to be produced for due waste management; the financing of ultimate disposal: special levies, licence fees, taxes, levies for pollution control. The expert opinion considers special levies as a control measure to be the right instrument in case of ultimate disposal being placed into private hands. (HSCH) [de

  3. Incident Information Management Tool

    CERN Document Server

    Pejovic, Vladimir

    2015-01-01

    Flaws of\tcurrent incident information management at CMS and CERN\tare discussed. A new data\tmodel for future incident database is\tproposed and briefly described. Recently developed draft version of GIS-­‐based tool for incident tracking is presented.

  4. Traffic incident management resource management.

    Science.gov (United States)

    2009-01-01

    The necessity of a multi-disciplinary approach involving law enforcement, fire and rescue, transportation, towing and recovery, and others has been well-recognized and integrated into incident management operations. This same multidisciplinar...

  5. Critical incident stress management.

    Science.gov (United States)

    Lim, J J; Childs, J; Gonsalves, K

    2000-10-01

    Recent studies have indicated implementation of the CISM Program has impacted and reduced the cost of workers' compensation claims for stress related conditions and the number of lost work days (Ott, 1997; Western Management Consultants, 1996). Occupational health professionals need to be ready to develop and implement a comprehensive critical incident stress management process in anticipation of a major event. The ability to organize, lead, or administer critical incident stress debriefings for affected employees is a key role for the occupational health professional. Familiarity with these concepts and the ability to identify a critical incident enhances value to the business by mitigating the stress and impact to the workplace. Critical Incident Stress Management Systems have the potential for decreasing stress and restoring employees to normal life function--a win/win situation for both the employees and the organization.

  6. Information Security Incident Management

    Directory of Open Access Journals (Sweden)

    D. I. Persanov

    2010-03-01

    Full Text Available The present report highlights the points of information security incident management in an enterprise. Some aspects of the incident and event classification are given. The author presents his view of the process scheme over the monitoring and processing information security events. Also, the report determines a few critical points of the listed process and gives the practical recommendations over its development and optimization.

  7. Management and ultimate storage of wastes from nuclear power generation

    International Nuclear Information System (INIS)

    1989-09-01

    The annotation on R and D prorgam 86 parts I-II have been brought together in the present report part I, together with some general viewpoints, and been classified according to subject. Part II of the present report comprises viewpoints of 'Research Program 1987-1992' and part III of 'Alternative methods of ultimate storage'. Swedish and French viewpoints are presented in Swedish, the remaining foreign material in English. The comments are grouped in subject catergories. (O.S.)

  8. Incident Management: Process into Practice

    Science.gov (United States)

    Isaac, Gayle; Moore, Brian

    2011-01-01

    Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…

  9. Improving freight crash incident management.

    Science.gov (United States)

    2015-06-01

    The objective of this study was to determine the most effective way to mitigate the effect of freight : crash incidents on Louisiana freeways. Candidate incident management strategies were reviewed from : practice in other states and from those publi...

  10. Towards an Ultimate Battery Thermal Management System: A Review

    Directory of Open Access Journals (Sweden)

    Mohammad Rezwan Khan

    2017-03-01

    Full Text Available The prevailing standards and scientific literature offer a wide range of options for the construction of a battery thermal management system (BTMS. The design of an innovative yet well-functioning BTMS requires strict supervision, quality audit and continuous improvement of the whole process. It must address all the current quality and safety (Q&S standards. In this review article, an effective battery thermal management is sought considering the existing battery Q&S standards and scientific literature. The article contains a broad overview of the current existing standards and literature on a generic compliant BTMS. The aim is to assist in the design of a novel compatible BTMS. Additionally, the article delivers a set of recommendations to make an effective BTMS.

  11. The ultimate in-core fuel management code for pressurized water reactors

    International Nuclear Information System (INIS)

    Levine, S.H.; Bai, D.; Zhian, L.

    1994-01-01

    The ultimate in-core fuel management code for pressurized water reactors is defined and a code presented which aims toward the ultimate code. The code environment which is written in C-language with all of the neutronic codes written in Fortran. The main goal is to minimize fuel costs while meeting all constraint. The code presented is a combination of two fuel management codes now in operation, plus some modifications and additions which bring it closer to the ultimate code. (authors). 13 refs. 1 fig

  12. Information sharing for traffic incident management.

    Science.gov (United States)

    2009-01-01

    Traffic incident management focuses on developing procedures, implementing policies, and deploying technologies to more quickly identify incidents, improve response times, and more effectively and efficiently manage the incident scene. Because so man...

  13. Ultimate biochemical oxygen demand in semi-intensively managed shrimp pond waters

    Science.gov (United States)

    Three independent studies were conducted to quantified ultimate biochemical oxygen demand (UBOD) and the corresponding decomposition rate constant for production pond (average 21.5 ha each) waters and effluents on six semi-intensively managed marine shrimp (Litopenaeus vannamei) farms in Honduras. S...

  14. Information Security Incident Management Practical Aspects

    Directory of Open Access Journals (Sweden)

    A. B. Kostina

    2010-03-01

    Full Text Available The information security incident management process model (ISIMP is developed; the role of this process in the information security management system is established. Input and output data of the process are determined. Key practical aspects of incident management are determined.

  15. Bronchoaspiration: incidence, consequences and management.

    Science.gov (United States)

    Beck-Schimmer, Beatrice; Bonvini, John M

    2011-02-01

    Aspiration is defined as the inhalation of oropharyngeal or gastric contents into the lower respiratory tract. Upon injury, epithelial cells and alveolar macrophages secrete chemical mediators, attracting and activating neutrophils, which in turn release proteases and reactive oxygen species, degrading the alveolocapillary unit. Aspiration can lead to a range of diseases such as infectious pneumonia, chemical pneumonitis or respiratory distress syndrome with significant morbidity and mortality. It occurs in approximately 3-10 per 10 000 operations with an increased incidence in obstetric and paediatric anaesthesia. Patients are most at risk during induction of anaesthesia and extubation, in particular in emergency situations. The likelihood of significant aspiration can be reduced by fasting, pharmacological intervention and correct anaesthetic management using a rapid sequence induction. Treatment of acid aspiration is by suctioning after witnessed aspiration; antibiotics are indicated in patients with aspiration pneumonia only. Steroids are not proven to improve outcome or reduce mortality. Patients with acute lung injury requiring mechanical ventilation should be ventilated using lung protective strategies with low tidal volumes and low plateau pressure values, attempting to limit peak lung distension and end-expiratory collapse.

  16. 49 CFR 1542.307 - Incident management.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Incident management. 1542.307 Section 1542.307 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION... Incident management. (a) Each airport operator must establish procedures to evaluate bomb threats, threats...

  17. Kentucky's highway incident management strategic plan.

    Science.gov (United States)

    2005-06-01

    Kentucky s Highway Incident Management Strategic Plan consists of a mission statement, 4 goals, 16 objectives, and 49 action strategies. The action strategies are arranged by priority and recommended time frame for implementation. When implemented...

  18. Integrating incident investigation into the management system

    International Nuclear Information System (INIS)

    Peterson, E.E.

    1992-01-01

    In the last 10 yr, the size and frequency of incidents affecting the communities and environment surrounding chemical processing facilities has increased. The chemical process industry, which has always concerned itself with the safety of its facilities, has responded by committing to stricter standards of operation and management. A critical element of these management practices is the use of a structured incident investigation program. Many facilities have implemented and disciplined themselves to perform good investigation of incidents. However, most of these facilities maintain incident investigation as part of their safety management programs. This allows the process to be disconnected from the management system that deals with the day-to-day business of the facility. The first step of integration is understanding the objectives and functions of the management system into which the integration is to occur. To begin, a common definition of management is needed. Management, for the purposes of this discussion, is defined as the system of activities used to control, coordinate, and improve the flow of work within a facility or organization. This definition refers to several concepts that need further development in order to understand how incident investigation can be integrated into a management system, including (a) flow of work, (b) control, and (c) improvement. Application can be made to the nuclear industry

  19. Incident Management Organization succession planning stakeholder feedback

    Science.gov (United States)

    Anne E. Black

    2013-01-01

    This report presents complete results of a 2011 stakeholder feedback effort conducted for the National Wildfire Coordination Group (NWCG) Executive Board concerning how best to organize and manage national wildland fire Incident Management Teams in the future to meet the needs of the public, agencies, fire service and Team members. Feedback was collected from 858...

  20. IT Security Vulnerability and Incident Response Management

    NARCIS (Netherlands)

    Hafkamp, W.H.M.; Paulus, S.; Pohlman, N.; Reimer, H.

    2006-01-01

    This paper summarises the results of a Dutch PhD research project on IT security vulnerability and incident response management, which is supervised by the University of Twente in the Netherlands and which is currently in its final stage. Vulnerabilities are ‘failures or weaknesses in computer

  1. Evaluating and improving incident management using historical incident data : case studies at Texas transportation management centers.

    Science.gov (United States)

    2009-08-01

    The companion guidebook (0-5485-P2) developed as part of this study provides the procedures and : methodologies for effective use of historical incident data at Texas Transportation Management Centers : (TMCs). This research report documents the resu...

  2. Computer incident response and forensics team management conducting a successful incident response

    CERN Document Server

    Johnson, Leighton

    2013-01-01

    Computer Incident Response and Forensics Team Management provides security professionals with a complete handbook of computer incident response from the perspective of forensics team management. This unique approach teaches readers the concepts and principles they need to conduct a successful incident response investigation, ensuring that proven policies and procedures are established and followed by all team members. Leighton R. Johnson III describes the processes within an incident response event and shows the crucial importance of skillful forensics team management, including when and where the transition to forensics investigation should occur during an incident response event. The book also provides discussions of key incident response components. Provides readers with a complete handbook on computer incident response from the perspective of forensics team management Identify the key steps to completing a successful computer incident response investigation Defines the qualities necessary to become a succ...

  3. New York integrated incident management system evaluation project final report

    Science.gov (United States)

    2007-03-23

    The Integrated Incident Management System (IIMS) enables incident response personnel to transmit data about an incident to other responders and dispatchers on a real-time basis. When an incident is entered into IIMS, the system uses GPS to identify t...

  4. Incident Management in Academic Information System using ITIL Framework

    Science.gov (United States)

    Palilingan, V. R.; Batmetan, J. R.

    2018-02-01

    Incident management is very important in order to ensure the continuity of a system. Information systems require incident management to ensure information systems can provide maximum service according to the service provided. Many of the problems that arise in academic information systems come from incidents that are not properly handled. The objective of this study aims to find the appropriate way of incident management. The incident can be managed so it will not be a big problem. This research uses the ITIL framework to solve incident problems. The technique used in this study is a technique adopted and developed from the service operations section of the ITIL framework. The results of this research found that 84.5% of incidents appearing in academic information systems can be handled quickly and appropriately. 15.5% incidents can be escalated so as to not cause any new problems. The model of incident management applied to make academic information system can run quickly in providing academic service in a good and efficient. The incident management model implemented in this research is able to manage resources appropriately so as to quickly and easily manage incidents.

  5. Development of Kentucky's highway incident management strategic plan.

    Science.gov (United States)

    2005-05-01

    ven though Kentucky has undertaken many initiatives to improve specific aspects of incident management, there has never been a plan that establishes an overall framework for a systematic, statewide, multi-agency effort to improve the management of hi...

  6. Melanoma in Organ Transplant Recipients: Incidence, Outcomes and Management Considerations

    Directory of Open Access Journals (Sweden)

    Faisal R. Ali

    2012-01-01

    Full Text Available The incidence of melanoma continues to increase year on year. With better surgical techniques and medical management, greater numbers of organ transplants are being performed annually with much longer graft survival. The authors review our current understanding of the incidence of melanoma amongst organ transplant recipients, outcomes compared to the immunocompetent population, and management strategies in this burgeoning group.

  7. Melanoma in Organ Transplant Recipients: Incidence, Outcomes and Management Considerations

    International Nuclear Information System (INIS)

    Ali, F. R.; Lear, J. T.

    2012-01-01

    The incidence of melanoma continues to increase year on year. With better surgical techniques and medical management, greater numbers of organ transplants are being performed annually with much longer graft survival. The authors review our current understanding of the incidence of melanoma amongst organ transplant recipients, outcomes compared to the immunocompetent population, and management strategies in this burgeoning group

  8. Pro-active Management of Traffic Incidents Using Novel Technologies

    NARCIS (Netherlands)

    Nitsche, P.; Olstam, J.; Taylor, N.; Reinthaler, M.; Ponweiser, W.; Bernhardsson, V.; Mocanu, I.; Uittenbogaard, J.; Dam, E. van

    2016-01-01

    This paper presents the results of the assessment phase of the project PRIMA (Pro-Active Incident Management), where the benefits, costs and risks of novel traffic incident management techniques are investigated. The project targets the enhancement of current state-of-the-art measures for handling

  9. Current approaches to managing aggressive incidents among in ...

    African Journals Online (AJOL)

    Background: Aggressive behavior and incidents in psychiatric wards are commonplace and management approaches should be evidencebased. This audit aims to review the management of violent incidents and aggressive behaviour in the acute wards of the Federal Neuropsychiatric Hospital Calabar against the NICE ...

  10. A New Model For Understanding Incident Management

    Science.gov (United States)

    2016-12-01

    emergency management agencies and practitioners. Additionally, NEMA seeks to improve and create “ strategic partnerships, innovative programs, and...formulated, and revised administrative responsibilities for emergency management .”33 Several scholarly journals , academic papers, and practitioner articles... management as a profession, David T. Crews states, “In their primary and ‘ strategic ’ roles, emergency managers must analyze the threat to economic

  11. Sports Related Injuries: Incidence, Management and Prevention

    OpenAIRE

    Stanger, Michael A.

    1982-01-01

    The incidence of injury related to various sports is reviewed according to sport, area of injury, number of participants and hours per week spent at the sport. Organized sports accounted for fewer injuries than unsupervised recreational activities like tree climbing, skateboarding and running. The knee is the most commonly injured site. Sensitivity to patients' commitment to their sport is necessary: sometimes instead of rest, they can substitute a less hazardous form of exercise. Principles ...

  12. Safer travel, improved economic productivity : incident management systems

    Science.gov (United States)

    1999-01-01

    This brochure gives an overview of how incident management technologies can be used to reduce incident-related congestion and increase road safety. It focuses on the need for interagency cooperation and the benefits that can be derived from the coope...

  13. Wildfire incidence and management in the forest transition zone of ...

    African Journals Online (AJOL)

    A survey was conducted in eight communities in the forest transition zone to assess the perceptions of farmers on farming-related wildfire incidences, specific activities in farming associated with incidence of wildfires and coping measures being used by farmers to manage wildfires. Farmers in the studied settlements hold ...

  14. Defining Incident Management Processes for CSIRTs: A Work in Progress

    National Research Council Canada - National Science Library

    Alberts, Chris; Dorofee, Audrey; Killcrece, Georgia; Ruefle, Robin; Zajicek, Mark

    2004-01-01

    .... Workflow diagrams and descriptions are provided for each of these processes. One advantage of the model is that it enables examination of incident management processes that cross organizational boundaries, both internally and externally...

  15. Air quality evaluation of Rhode Island's incident management program

    Science.gov (United States)

    1997-09-01

    The objective of this preliminary air quality analysis was to assess the potential air quality benefits associated with the implementation of Providence's Metropolitan portion of Rhode Island's Incident Management Program. Specifically, the air quali...

  16. Changing Incidence, Outcome and Management of Myelomeningocele

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-07-01

    Full Text Available Pediatric neurosurgeons at Children’s Memorial Hospital, Chicago, review their long-term experience and the evolution of the etiology, diagnosis and management of patients born with myelomeningocele (MM in 1975-1979 and followed for 25 years in a multi-disciplinary spina bifida clinic.

  17. Congenital clinical malaria: Incidence, management and outcome ...

    African Journals Online (AJOL)

    Objective: With paucity of documentation of congenital clinical malaria in the world literature, we therefore aimed to review its rates, presentation, management and out come of this problem in neonates at the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Methodology: This prospective study was carried out in ...

  18. Management of adult spontaneous spondylodiscitis and its rising incidence.

    Science.gov (United States)

    Sur, A; Tsang, K; Brown, M; Tzerakis, N

    2015-09-01

    Spondylodiscitis refers to the infection of the intervertebral disc and osteomyelitis of the adjacent endplates, and it is uncommon in the developed world. Broad consensus indicates its incidence is on the rise. The aim of this retrospective study was twofold. First, we sought to give an up-to-date incidence estimate by comparing case presentation over two time periods (1995-1999 and 2008-2011). Data from the England and Wales census in 2001 and 2011 were used for incidence estimation. The second part of this study aimed to generate management guidance from data from medical and radiographic records of the 2008-2011 patient cohort. The incidence of adult spontaneous spondylodiscitis in the local region between 2008 and 2011 was 3.67/100,000 per year, representing a 150% increase from the incidence in 1995-1999. Our data demonstrate that methicillin sensitive Staphylococcus aureus remains the most common offending pathogen of spontaneous spondylodiscitis. The mean C-reactive protein (CRP) level remained at >30mg/l after a month of starting antibiotic treatment in both medically and surgically managed groups. Evidence suggests that the incidence of spondylodiscitis is on the rise. A review of our case series has demonstrated the effectiveness of intravenous antibiotic therapy. While no official guidance exists for when to switch from intravenous to oral antibiotics, our study shows that CRP at 1 month is >30mg/l and we recommend 6 weeks of intravenous therapy, followed by 6 further weeks of oral therapy.

  19. Early identification and management of critical incident stress.

    Science.gov (United States)

    Caine, Randy M; Ter-Bagdasarian, Levon

    2003-02-01

    Everyone experiences stress. That stress may be related to work (internal), community (external), or family; it may be cumulative or related to a particular critical incident. The cost related to treating acute stress is staggering, both to individuals and to organizations. Critical care nurses are well educated in the physiological responses to the stress of acute illness. Recognizing the emotional impact of stress and the techniques to manage it in themselves and in those with whom they work is equally as important. CISD is widely advocated as an intervention after critical incidents. Although debriefing in and of itself is effective, a single-session semistructured crisis intervention will not prevent posttraumatic stress; thus, the use of CISD as part of a comprehensive multifaceted approach to the management of acute stress related to a critical incident is recommended.

  20. Incidence and management of postoperative bile leaks: A ...

    African Journals Online (AJOL)

    Incidence and management of postoperative bile leaks: A prospective cohort analysis of 467 liver resections. A.J. Dell, J.E.J. Krige, E. Jonas, S.R. Thomson, S.J. Beningfield, U.K. Kotze, S.A. Tromp, S. Burmeister, M.M. Bernon, P.C. Bornman ...

  1. Safeguards concepts for an ultimate storage facility envisaged within the framework of alternative spent fuel management concepts

    International Nuclear Information System (INIS)

    Buttler, R.; Lauppe, W.D.; Pohlen, E.; Richter, B.; Stein, G.

    1984-12-01

    Safeguards concepts for the direct final storage of spent fuel in an unexploited salt dome are worked out and evaluated. The considerations are based on a PWR standard fuel element of the Biblis B type with a burn-up of 40.000 MWd/t SM, with an initial enrichment of 3.6%. Many problems are encountered which cannot be solved immediately with the currently available knowledge. Four approaches are explained. A comparison of the main non-proliferation aspects of direct final storage or reprocessing reveals advantages of waste management strategies including reprocessing. In the eight of the facts and results established the conclusion is to be drawn that the waste management strategy with direct final storage is somewhat problematic, from the safeguards point of view, because the technical realisation of a safeguards concept is questionable. For certain types of fuel elements for which reprocessing is not worthwhile, Article 35 of the Verification Agreement may offer a solution. For this case of the limited storage of spent fuel elements, an international central in accordance with this article could be agreed upon. (orig./HP) [de

  2. Flux scaling: Ultimate regime

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Flux scaling: Ultimate regime. With the Nusselt number and the mixing length scales, we get the Nusselt number and Reynolds number (w'd/ν) scalings: and or. and. scaling expected to occur at extremely high Ra Rayleigh-Benard convection. Get the ultimate regime ...

  3. Safety Incident Management Team Report for NIMLT Case 50796

    LENUS (Irish Health Repository)

    2017-01-17

    This is a report on the management of a patient safety incident involving BowelScreen and symptomatic colonoscopy services at Wexford General Hospital (WGH). The patient safety incident relates to the work of a Consultant Endoscopist (referred to as Clinician Y) employed by WGH who undertook screening colonoscopies on behalf of the BowelScreen Programme since the commencement of the screening programme in WGH in March 2013. Clinician Y also performed non-screening colonoscopies for the diagnosis of symptomatic patients as part of routine surgical service provision at WGH.\\r\

  4. Stalking the ultimate particle

    CERN Multimedia

    2003-01-01

    If you missed the ARTE programme entitled "L'Ultime Particule" broadcast in February, you have another chance to catch it in CERN's Main Auditorium on 13 March. "L'Ultime Particule" is a documentary by the French director Michel Andrieu that seeks to explain particle physics through a contemplative quest for the research physicists of matter of today and yesteryear. Invariably kitted out in a red parka and a soft hat, the programme's investigator scours the planet and the archives in search of the research physicists who are stalking the ultimate particle, the Higgs boson, in their quest to understand the structure of matter. Naturally enough, CERN is an important stage of his journey where Michel Andrieu and his team spent several days last year. Both from the physics and metaphysical points of view, "L'Ultime Particule" is worth seeing. The film's director, Michel Andrieu, will introduce his documentary and answer questions from the audience after the documentary has been shown. L'Ultime Particule by Mic...

  5. Medical management of three workers following a radiation exposure incident

    International Nuclear Information System (INIS)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L.

    1992-01-01

    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms

  6. Medical management of three workers following a radiation exposure incident

    Energy Technology Data Exchange (ETDEWEB)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L. (Department of Occupational and Environmental Health, St. Michael' s Hospital, Toronto, Ontario (Canada))

    1992-01-01

    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms.

  7. The ultimate quotable Einstein

    CERN Document Server

    2011-01-01

    Here is the definitive new edition of the hugely popular collection of Einstein quotations that has sold tens of thousands of copies worldwide and been translated into twenty-five languages. The Ultimate Quotable Einstein features 400 additional quotes, bringing the total to roughly 1,600 in all. This ultimate edition includes new sections--"On and to Children," "On Race and Prejudice," and "Einstein's Verses: A Small Selection"--as well as a chronology of Einstein's life and accomplishments, Freeman Dyson's authoritative foreword, and new commentary by Alice Calaprice.

  8. Obstetric anal sphincter injury: incidence, risk factors, and management.

    Science.gov (United States)

    Dudding, Thomas C; Vaizey, Carolynne J; Kamm, Michael A

    2008-02-01

    Obstetric sphincter damage is the most common cause of fecal incontinence in women. This review aimed to survey the literature, and reach a consensus, on its incidence, risk factors, and management. This systematic review identified relevant studies from the following sources: Medline, Cochrane database, cross referencing from identified articles, conference abstracts and proceedings, and guidelines published by the National Institute of Clinical Excellence (United Kingdom), Royal College of Obstetricians and Gynaecologists (United Kingdom), and American College of Obstetricians and Gynecologists. A total of 451 articles and abstracts were reviewed. There was a wide variation in the reported incidence of anal sphincter muscle injury from childbirth, with the true incidence likely to be approximately 11% of postpartum women. Risk factors for injury included instrumental delivery, prolonged second stage of labor, birth weight greater than 4 kg, fetal occipitoposterior presentation, and episiotomy. First vaginal delivery, induction of labor, epidural anesthesia, early pushing, and active restraint of the fetal head during delivery may be associated with an increased risk of sphincter trauma. The majority of sphincter tears can be identified clinically by a suitably trained clinician. In those with recognized tears at the time of delivery repair should be performed using long-term absorbable sutures. Patients presenting later with fecal incontinence may be managed successfully using antidiarrheal drugs and biofeedback. In those who fail conservative treatment, and who have a substantial sphincter disruption, elective repair may be attempted. The results of primary and elective repair may deteriorate with time. Sacral nerve stimulation may be an appropriate alternative treatment modality. Obstetric anal sphincter damage, and related fecal incontinence, are common. Risk factors for such trauma are well recognized, and should allow for reduction of injury by proactive

  9. Persistent perineal sinus. Incidence, pathogenesis, risk factors, and management

    International Nuclear Information System (INIS)

    Lohsiriwat, V.

    2009-01-01

    This review discusses the incidence, pathogenesis, risk factors, diagnosis, and therapeutic options for persistent perineal sinus (PPS), defined as a perineal wound that remains unhealed more than 6 months after surgery. The incidence of PPS after surgery for inflammatory bowel disease (IBD) ranges from 3% to 70% and after abdominoperineal resection (APR) for Low rectal cancer, it can be up to 30%. These unhealed wounds are frequently related to perioperative pelvic or perineal sepsis. Crohn's disease (CD) and neoadjuvant radiation therapy are also important risk factors. The management of PPS is based on an understanding of pathogenesis and clinical grounds. The advantages and disadvantages of the current therapeutic approaches, including the topical administration of various drugs, vacuum-assisted closure, and perineal reconstruction with a muscle flap or a myocutaneous flap are also discussed. (author)

  10. Orbital cellulitis in Scotland: current incidence, aetiology, management and outcomes.

    Science.gov (United States)

    Murphy, C; Livingstone, I; Foot, B; Murgatroyd, H; MacEwen, C J

    2014-11-01

    Orbital cellulitis is a potentially blinding and life-threatening condition. There are little published data on the incidence of orbital cellulitis and little is known about the differences between children and adults affected. The purpose of this study was to identify the incidence, aetiology, management and outcome of orbital cellulitis in children and adults in Scotland. This study was a 1-year prospective observational study using the Scottish Ophthalmic Surveillance Unit reporting system among Scottish ophthalmologists. The response rate from ophthalmologists was 66.4%. There were 15 children and 5 adults reported giving an incidence of 1.6 per 100 000 and 0.1 per 100 000 in children and adults, respectively. 47% of children had a preceding upper respiratory tract infection with 87% having radiological evidence of sinus disease. Within the adult group, there was preceding immunosuppression and trauma. Streptococcus (66%) and Haemophilus (46%) species were the most commonly isolated pathogens in children. Respiratory pathogens were less predictable in adults. All patients were treated with intravenous antibiotics. All children with orbital and subperiosteal abscesses had surgery; one adult with orbital abscess did not have surgery. There were two cases of series morbidity: one intracranial spread of infection and one evisceration. The incidence of orbital cellulitis is higher in children than in adults. In children, it commonly follows upper respiratory infection and sinus disease; however, in adults, preceding illness and trauma are more common. Respiratory pathogens are common in affected children. Intravenous antibiotics and surgical treatment of abscesses remain the preferred management. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. On Ultimate Epistemic Foundations

    NARCIS (Netherlands)

    van Woudenberg, R.

    1995-01-01

    This paper is a contribution to the debate on epistemic foundationalism. Section I expounds and criticises Hans Albert's critical rationalist antifoundationalism position. Section I1 discusses Karl‐Otto Apel's ‘transcendental pragmatic’ argument for ultimate epistemic foundations. Section III

  12. Management of response to the polonium-210 incident in London

    International Nuclear Information System (INIS)

    Croft, John; Bailey, Michael; Tattersall, Phil; Morrey, Mary; McColl, Neil; Prosser, Lesley; Maguire, Helen; Fraser, Graham; Gross, Roger

    2008-01-01

    On the 23 November 2006, Alexander Litvinenko died in London allegedly from poisoning by 210 Po, an alpha particle emitter. The spread of radioactive contamination, arising from the poisoning and the events leading up to it, involved many locations in London. The potential for intakes of 210 Po arising from the contamination posed a public health risk and generated significant public concern. The scale of the event required a multi-agency response, including top level UK Government emergency response management arrangements. The Health Protection Agency (HPA) had a leading role in co-ordinating and managing the public health response. This paper reviews the management of the incident response and the issues involved. The fatal poisoning of Mr Litvinenko with 210 Po, and the associated public health hazard from the spread of contamination to many locations across London, was an unprecedented event. Fortunately, no one else is known to have suffered any acute effects. Results from the programme of individual monitoring showed that whilst more than 100 people had measurable intakes of 210 Po, only 17 had assessed doses in excess of 6 mSv. The highest dose of about 100 mSv gives rise to an increased risk of fatal cancer of about 0.5%, compared with the natural incidence of about 25%. The incident required a co-ordinated and sustained multi-agency emergency response. The Health Protection Agency, as the lead on public health matters played a significant role in this. Whilst inevitably some lessons have been identified, the response is considered to have been very effective and to have benefited from the wide spectrum of experience and expertise developed through normal work, together with the effort put into emergency preparedness and the various emergency response. (author)

  13. [Second victim : Critical incident stress management in clinical medicine].

    Science.gov (United States)

    Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A

    2013-09-01

    Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.

  14. Program for accident and incident management support, AIMS

    International Nuclear Information System (INIS)

    Putra, M.A.

    1993-12-01

    A prototype of an advisory computer program is presented which could be used in monitoring and analyzing an ongoing incident in a nuclear power plant. The advisory computer program, called the Accident and Incident Management Support (AIMS), focuses on processing a set of data that is to be transmitted from a nuclear power plant to a national or regional emergency center during an incident. The AIMS program will assess the reactor conditions by processing the measured plant parameters. The applied model of the power plant contains a level of complexity that is comparable with the simplified plant model that the power plant operator uses. A standardized decay heat function and a steam water property library is used in the integral balance equations for mass and energy. A simulation of the station blackout accident of the Borssele plant is used to test the program. The program predicts successively: (1) the time of dryout of the steam generators, (2) the time of saturation of the primary system, and (3) the onset of core uncovery. The coolant system with the actual water levels will be displayed on the screen. (orig./HP)

  15. Towards Incidence Management in 5G Based on Situational Awareness

    Directory of Open Access Journals (Sweden)

    Lorena Isabel Barona López

    2017-01-01

    Full Text Available The fifth generation mobile network, or 5G, moves towards bringing solutions to deploying faster networks, with hundreds of thousands of simultaneous connections and massive data transfer. For this purpose, several emerging technologies are implemented, resulting in virtualization and self-organization of most of their components, which raises important challenges related to safety. In order to contribute to their resolution, this paper proposes a novel architecture for incident management on 5G. The approach combines the conventional risk management schemes with the Endsley Situational Awareness model, thus improving effectiveness in different aspects, among them the ability to adapt to complex and dynamical monitoring environments, and countermeasure tracking or the role of context when decision-making. The proposal takes into account all layers for information processing in 5G mobile networks, ranging from infrastructure to the actuators responsible for deploying corrective measures.

  16. Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.

  17. Ultimate disposal of radioactive wastes

    International Nuclear Information System (INIS)

    Roethemeyer, H.

    1991-01-01

    The activities developed by the Federal Institution of Physical Engineering PTB and by the Federal Office for Radiation Protection (BfS) concentrated, among others, on work to implement ultimate storage facilities for radioactive wastes. The book illuminates this development from site designation to the preliminary evaluation of the Gorleben salt dome, to the preparation of planning documents proving that the Konrad ore mine is suitable for a repository. The paper shows the legal provisions involved; research and development tasks; collection of radioactive wastes ready for ultimate disposal; safety analysis in the commissioning and post-operational stages, and product control. The historical development of waste management in the Federal Republic of Germany and international cooperation in this area are outlined. (DG) [de

  18. Lessons Learnt from the Improvement of Customer Support Processes: A Case Study on Incident Management

    Science.gov (United States)

    Jäntti, Marko

    IT Infrastructure Library (ITIL) is the most widely used IT service management framework that provides guidelines how to create, manage and support IT services. Service support processes, such as incident management and problem management, are among the first ITIL processes that organizations start to implement. However, several challenges may exist in the process implementation. The research question of this study is: which issues are important in establishing an ITIL-based incident management process? The main contribution of this paper is to present lessons learnt from an ITIL-based process improvement project that focused on establishing an incident management process in an IS department of a university hospital. Our results show that key issues in implementing incident management are to 1) define the basic concepts of incident management with concrete examples and 2) define process interfaces between incident management and other support processes.

  19. Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management

    Science.gov (United States)

    Naradko, Anthony M.

    2017-01-01

    The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

  20. Development of the decision make supporting system on incident management

    International Nuclear Information System (INIS)

    Kasamatsu, Mizuki; Hanada, Satoshi; Noda, Eisuke

    2017-01-01

    Decision Make Supporting System is designed to support appropriate decision made by top management in the nuclear severe conditions. With crisis response in nuclear power plant (NPP), information entanglement between sites and control centers during intense situations interfere with prompt and accurate decision making. This research started with that kind of background. In order to solve the issue of the information entanglement, Mitsubishi Heavy Industries, Inc. (MHI) carried out the development of the Decision Make Supporting System and the system applies the technology combining the human factors engineering (HFE) and information and communication technology (ICT). During the crisis response, various commands, reactions and communications in a human system need to be managed. Therefore, the combined HFE method including detailed task analysis, user experience (UX), graphic user interface (GUI) and related human-system interface (HSI) design method is applied to the design of the system. These design results systematize the functions that prevent interference with decision-making in the headquarters for incident management. This new solution as a system enhances the safety improvement of the NPP and contributes to develop the skills and abilities of the resources in the NPP. The system has three key features for supporting emergency situations: 'understanding the situation', 'planning the next action', and 'managing resources'. The system helps commanders and responders to grasp the whole situation and allows them to share information in real time to get a whole picture, and the system accumulates the data of the past events in the chronological order to understand correctly how they happened and plan the next action by using a knowledge database that MHI has been developed. If the unexpected event happens which are not in the incident scenario, the system provides support to formulate alternative strategies and measures. With this

  1. Early Detection and Localization of Downhole Incidents in Managed Pressure Drilling

    DEFF Research Database (Denmark)

    Willersrud, Anders; Imsland, Lars; Blanke, Mogens

    2015-01-01

    Downhole incidents such as kick, lost circulation, pack-off, and hole cleaning issues are important contributors to downtime in drilling. In managed pressure drilling (MPD), operations margins are typically narrower, implying more frequent incidents and more severe consequences. Detection...

  2. Antipsychotic Drug-Induced Somnolence: Incidence, Mechanisms, and Management.

    Science.gov (United States)

    Fang, Fang; Sun, Hongwei; Wang, Zuowei; Ren, Ming; Calabrese, Joseph R; Gao, Keming

    2016-09-01

    Somnolence is a common side effect of antipsychotics. To assess the incidence of this side effect, we performed a MEDLINE search for randomized, double-blinded, placebo- or active-controlled studies of adult patients treated with antipsychotics for schizophrenia, mania, bipolar depression, or bipolar disorder. We extracted rates of somnolence from original publications and pooled them based on the dose of each antipsychotic in the same psychiatric condition, then estimated the absolute risk increase (ARI) and the number needed to harm (NNH) of an antipsychotic relative to placebo or an active comparator in the same psychiatric condition. According to the ARI in acute schizophrenia, bipolar mania, and bipolar depression, antipsychotics can be classified as high somnolence (clozapine), moderate somnolence (olanzapine, perphenazine, quetiapine, risperidone, ziprasidone), and low somnolence (aripiprazole, asenapine, haloperidol, lurasidone, paliperidone, cariprazine). The risk of somnolence with blonanserin, brexpiprazole, chlorpromazine, iloperidone, sertindole, and zotepine needs further investigation. The rates of somnolence were positively correlated to dose and duration for some antipsychotics, but not for others. Many factors, including antipsychotic per se, the method used to measure somnolence, patient population, study design, and dosing schedule, might affect the incidence of antipsychotic-induced somnolence. The mechanisms of antipsychotic-induced somnolence are likely multifactorial, although the blockade of histamine 1 receptors and α1 receptors may play a major role. The management of antipsychotic-induced somnolence should include sleep hygiene education, choosing an antipsychotic with a lower risk for somnolence, starting at a lower dose with a slower titration based on psychiatric diagnoses, adjusting doses when necessary, and minimizing concurrent somnolence-prone agents. Since most cases of somnolence were mild to moderate, allowing tolerance to

  3. The Ultimate Technology

    DEFF Research Database (Denmark)

    Riis, Søren

    2013-01-01

    One of the most influential philosophers of the 20th century, Martin Heidegger (1889-1976), died prior to the remarkable cloning of the sheep Dolly and before Dr. Venter started his experiments on creating synthetic life, and he never explicitly discussed living technologies. However, by reinterp......One of the most influential philosophers of the 20th century, Martin Heidegger (1889-1976), died prior to the remarkable cloning of the sheep Dolly and before Dr. Venter started his experiments on creating synthetic life, and he never explicitly discussed living technologies. However......, by reinterpreting his notion of "modern technology," this article shows how it is possible to philosophically assess living technologies and to recognize ways in which Heidegger anticipated this phenomenon with his notion of cybernetics. The interpretation elucidates the fundamental process of technology becoming...... living and simultaneously presents living technology as the ultimate technology. The thesis of this article is that living technology is not just one more technology; rather, it is the perfection of technology as understood by Aristotle. Aristotle's thinking is in this way a key example of a profound...

  4. STUDY OF INCIDENCE & MANAGEMENT OF PARA PHARYNGEAL TUMORS

    Directory of Open Access Journals (Sweden)

    Aruna Kumari

    2015-11-01

    Full Text Available INTRODUCTION: Parapharyngeal tumors are rare, comprising approximately 0.5% of all head and neck tumours. Most of them are benign. These tumors present with difficulties in diagnosis - complementary MRI and CT scanning are necessary for diagnosis, and Fine Needle Aspiration Cytology (FNAC is very specific in the histological diagnosis of these tumours. Open biopsy is not advisable due to bleeding, breaching of the capsule and seeding of the tumor. These tumors presents a challenge to the surgeon due to its anatomical complexities. This study deals with the incidence and management of various parapharyngeal tumors. OBJECTIVE OF THE STUDY: This study deals with the incidence of various tumors in the parapharyngeal space in different age and sex groups, role of sophisticated diagnostic modalities like CT, MRI, MR Angio. Colour Doppler along with FNAC and various surgical approaches to this space. This study also deals with intra-operative and post operative complications. In this series, a total of 25 cases has been studied retrospectively in a time period of 2 years from 2012 to 2014, presenting in our ENT and Head and Neck Dept., Gandhi hospital. RESULTS: According to this study, there is male preponderance (52% and highest incidence is seen in 3rd and 5th decade (24% each. Most common presenting symptoms are difficulty in swallowing (36% and swelling either intraoral or in the neck (28%. Least common symptoms being cranial nerve palsy (4%, difficulty in breathing/noisy breathing (4%, nasal regurgitation (4% and hard of hearing (8%. FNAC was done in 21 cases, in which 13 were correlating with the biopsy report. CT scan was required in all cases. MR Angiography was done in 4 cases and colour Doppler in 2 cases. Surgery is the mainstay of the treatment. Most common tumor in PPS is neurogenic (schwannoma/neurofibroma.i.e 44%. Next commonly occurring tumor in our study is of salivary origin-pleomorphic adenoma (24%, paragangliomas (12%. Other less

  5. Concussion Prevalence in Competitive Ultimate Frisbee Players

    Science.gov (United States)

    Lazar, Damien J.; Lichtenstein, Jonathan D.; Tybor, David J.

    2018-01-01

    Background: Ultimate Frisbee (ultimate) is a fast-growing, popular sport played nationally by over 4 million athletes. While several studies have examined injury rates in ultimate, no work has investigated the prevalence of concussions specifically or players’ knowledge and management of those injuries. Purpose: To estimate the lifetime prevalence of concussions in ultimate and to assess players’ knowledge of concussions as well as their concussion management behaviors. Study Design: Descriptive epidemiology study. Methods: From June to November 2015, we collected ultimate-related concussion data via an anonymous web-based survey, the Concussion in Ultimate Frisbee Survey, from a convenience sample of 787 male and female ultimate players across the United States. Results: There were 553 male and 234 female respondents included in the analysis; 26.58% of men and 24.79% of women reported that they had sustained at least 1 concussion while playing ultimate, with 45.58% and 43.10% of those men and women, respectively, reporting multiple concussions. A total of 67.81% of men and 78.21% of women stated that they would remove themselves from play after sustaining a given concussion, although 45.99% of men and 37.62% of women indicated that they had returned to play in the same game or practice. Conclusion: Our preliminary data suggest that concussions do commonly occur in competitive ultimate and that better education and management of concussions in ultimate athletes are needed. This study is an important first step in deepening our understanding of these issues. PMID:29552572

  6. Acceptability and perceived utility of drone technology among emergency medical service responders and incident commanders for mass casualty incident management.

    Science.gov (United States)

    Hart, Alexander; Chai, Peter R; Griswold, Matthew K; Lai, Jeffrey T; Boyer, Edward W; Broach, John

    2017-01-01

    This study seeks to understand the acceptability and perceived utility of unmanned aerial vehicle (UAV) technology to Mass Casualty Incidents (MCI) scene management. Qualitative questionnaires regarding the ease of operation, perceived usefulness, and training time to operate UAVs were administered to Emergency Medical Technicians (n = 15). A Single Urban New England Academic Tertiary Care Medical Center. Front-line emergency medical service (EMS) providers and senior EMS personnel in Incident Commander roles. Data from this pilot study indicate that EMS responders are accepting to deploying and operating UAV technology in a disaster scenario. Additionally, they perceived UAV technology as easy to adopt yet impactful in improving MCI scene management.

  7. The ultimate nuclear accident

    International Nuclear Information System (INIS)

    Abdus Salam, A.

    1988-01-01

    The estimated energy equivalent of Chernobyl explosion was the 1/150 th of the explosive energy equivalent of atomic bomb dropped on Hiroshima; while the devastation that could be caused by the world's stock pile of nuclear weapons, could be equivalent to 160 millions of Chernobyl-like incidents. As known, the number of nuclear weapons is over 50,000 and 2000 nuclear weapons are sufficient to destroy the world. The Three Mile Island and Chernobyl accidents have been blamed on human factors but also the human element, particularly in the form of psychological stresses on those operating the nuclear weapons, could accidentally bring the world to a nuclear catastrophe. This opinion is encouraged by the London's Sunday Times magazine which gave a graphic description of life inside a nuclear submarine. So, to speak of nuclear reactor accidents and not of nuclear weapons is false security. (author)

  8. Prostate Cancer in Transgender Women: Incidence, Etiopathogenesis, and Management Challenges.

    Science.gov (United States)

    Deebel, Nicholas A; Morin, Jacqueline P; Autorino, Riccardo; Vince, Randy; Grob, Baruch; Hampton, Lance J

    2017-12-01

    To critically analyze the available evidence regarding the incidence, etiopathogenesis, and management of prostate cancer (CaP) in transgender women. In addition, this article aims to present a recent case report of a transgender woman with a unique presentation at the author's institution. An electronic nonsystematic literature search was performed to identify pertinent studies. PubMed search engine was queried by using the following search terms: "prostate cancer," "male to female transsexual," "transgender patient," "androgen + prostate cancer," "estrogen therapy + prostate cancer," and "health care barrier." In addition, a clinical case managed at our institution was reviewed and critically discussed. Including our case, there have been only 10 documented cases of CaP in transgender women. Additionally, an emerging body of literature has questioned the role of androgens in the development of CaP and suggested that estrogen therapy may not be as protective as initially thought. Therefore, the current evidence suggests that the transgender woman should be screened for CaP the same as a nontransgender men. Barriers to care in the transgender female population include accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs pathologizing transgender patients, financial restrictions of the patient, and health system determinants. Although rare, CaP in transgender women has been documented. Both the mechanism and the impact of receiving a bilateral orchiectomy on disease development are unclear. Future study is needed to examine these factors, and to further shape the treatment and screening regimen for these patients. Published by Elsevier Inc.

  9. Policies for managing emergency medical services in mass casualty incidents.

    Science.gov (United States)

    Adini, B; Bodas, M; Nilsson, H; Peleg, K

    2017-09-01

    Diverse decision-making is needed in managing mass casualty incidents (MCIs), by emergency medical services (EMS). The aim of the study was to review consensus among international experts concerning policies of EMS management during MCIs. Applicability of 21 EMS policies was tested through a 2-cycle modified e-Delphi process, in which 38 multi-disciplinary experts from 10 countries participated. Threshold for approving proposed solutions was defined as consensus of >80%. Policies that did not achieve the targeted consensus were reviewed to detect variability according to respondents' origin country. 16 policies were endorsed in the first cycle including collaboration between ambulance service providers; implementing a unified mode of operation; preparing criteria for ground versus aerial evacuation; and, developing support systems for caregivers exposed to violence. An additional policy which proposed that senior EMS officers should not necessarily act as on-site MCI commanders was endorsed in the second cycle. Demographic breakdown of views concerning non-consensual policies revealed differences according to countries of origin. Assigning ambulances to off-duty team members was highly endorsed by experts from Israel and South Africa and strongly rejected by European respondents. Avoiding entry to risk areas until declared safe was endorsed by European, Asian and Oceanic experts, but rejected by Israeli, South African and North American experts. Despite uniqueness of countries and EMS agencies, solutions to most dilemmas were applicable to all organizations, regardless of location or affiliation. Cultural diversity was found concerning readiness to implement military-civilian collaboration in MCIs and a rigid separation between work-leisure responsibilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Management practices associated with the incidence rate of clinical mastitis.

    Science.gov (United States)

    Barkema, H W; Schukken, Y H; Lam, T J; Beiboer, M L; Benedictus, G; Brand, A

    1999-08-01

    Risk factors for the incidence rate of clinical mastitis were studied in 274 Dutch dairy herds. Variables that were associated with resistance to disease were the feeding, housing, and milking machine factors. Variables that were associated with exposure were grazing, combined housing of dry cows and heifers, and calving area hygiene. Postmilking teat disinfection in herds with a low bulk milk somatic cell count and years of practicing dry cow therapy were positively associated with the incidence rate of clinical mastitis. Herds with a low bulk milk somatic cell count and in which postmilking teat disinfection was not used had lower incidence rates of clinical mastitis than did other herds. The incidence rate of clinical mastitis caused by Escherichia coli was mostly related to housing conditions, hygiene, and machine milking. The incidence rate of clinical mastitis caused by Staphylococcus aureus was mostly related to factors associated with bulk milk somatic cell count and factors that might be due to cause and effect reversal. A strong positive correlation existed between the incidence rate of clinical mastitis caused by Streptococcus dysgalactiae and the incidence rate of clinical mastitis caused by Staph. aureus. The incidence rate of clinical mastitis caused by Streptococcus dysgalactiae was related to nutrition, milking technique, and machine milking. The incidence rate of clinical mastitis caused by Streptococcus uberis was associated with factors related to housing, nutrition, and machine milking.

  11. Incidence, diagnosis and management of eye affections in dogs ...

    African Journals Online (AJOL)

    A retrospective study of ocular affections in dogs was conducted at some selected clinics and hospitals in Southwest Nigeria between 2003 and, 2013 to determine the incidence, pattern of distribution, methods of diagnosis and treatment modalities using descriptive statistical tool. Overall incidence of eye affection in dogs ...

  12. The World Trade Center attack. Helping the helpers: the role of critical incident stress management.

    Science.gov (United States)

    Hammond, J; Brooks, J

    2001-12-01

    Healthcare and prehospital workers involved in disaster response are susceptible to a variety of stress-related psychological and physical sequelae. Critical incident stress management, of which critical incident stress debriefing is a component, can mitigate the response to these stressors. Critical incident stress debriefing is a peer-driven, therapist-guided, structured, group intervention designed to accelerate the recovery of personnel. The attack on the World Trade Center, and the impact it may have on rescue, prehospital, and healthcare workers, should urge us to incorporate critical incident stress management into disaster management plans.

  13. Major incident medical management and support the practical approach at the scene

    CERN Document Server

    Advanced Life Support Group

    2012-01-01

    Major Incident Medical Management and Support (MIMMS) is the coursebook for the Advanced Life Support Group's internationally taught training for health care professionals responding to major incidents. The practical approach employed in MIMMS has proved an invaluable aid to both civilian and military doctors, nurses and paramedics working in disaster management worldwide.

  14. Walk the talk: leaders' enacted priority of safety, incident reporting, and error management.

    Science.gov (United States)

    Van Dyck, Cathy; Dimitrova, Nicoletta G; de Korne, Dirk F; Hiddema, Frans

    2013-01-01

    The main goal of the current research was to investigate whether and how leaders in health care organizations can stimulate incident reporting and error management by "walking the safety talk" (enacted priority of safety). Open interviews (N = 26) and a cross-sectional questionnaire (N = 183) were conducted at the Rotterdam Eye Hospital (REH) in The Netherlands. As hypothesized, leaders' enacted priority of safety was positively related to incident reporting and error management, and the relation between leaders' enacted priority of safety and error management was mediated by incident reporting. The interviews yielded rich data on (near) incidents, the leaders' role in (non)reporting, and error management, grounding quantitative findings in concrete case descriptions. We support previous theorizing by providing empirical evidence showing that (1) enacted priority of safety has a stronger relationship with incident reporting than espoused priority of safety and (2) the previously implied positive link between incident reporting and error management indeed exists. Moreover, our findings extend our understanding of behavioral integrity for safety and the mechanisms through which it operates in medical settings. Our findings indicate that for the promotion of incident reporting and error management, active reinforcement of priority of safety by leaders is crucial. Social sciences researchers, health care researchers and health care practitioners can utilize the findings of the current paper in order to help leaders create health care systems characterized by higher incident reporting and more constructive error handling.

  15. Acute Appendicitis: Incidence and Management in Nigeria | Alatise ...

    African Journals Online (AJOL)

    Appendicitis is the leading cause of surgical emergency admission in most hospital in Nigeria. It accounts for about 15-40% of all emergency surgery done in most centers in the country. All age groups can develop the disease including the fetus in utero, but the incidence is higher in the second and third decade of life.

  16. The Critical Incident Technique in Library and Information Management Research.

    Science.gov (United States)

    Fisher, Shelagh; Oulton, Tony

    1999-01-01

    Focuses on the application of the Critical Incident Technique (CIT) in three studies at the Department of Information and Communications, Manchester Metropolitan University, United Kingdom. Examines staff-development needs as a key element in change in higher education; decision-making practices in small- to medium-size libraries; and development…

  17. Incidence, Pattern and Management of Ovarian Cancer at a Tertiary ...

    African Journals Online (AJOL)

    Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku‑Ozalla 1Department of. Histopathology, University of ... ovarian cancer giving an incidence rate of 1/405 gynecological admissions per year or 0.3% (95% .... not found in the records. Follow up of patients was by clinical examination and.

  18. Early Detection and Localization of Downhole Incidents in Managed Pressure Drilling

    DEFF Research Database (Denmark)

    Willersrud, Anders; Imsland, Lars; Blanke, Mogens

    2015-01-01

    Downhole incidents such as kick, lost circulation, pack-off, and hole cleaning issues are important contributors to downtime in drilling. In managed pressure drilling (MPD), operations margins are typically narrower, implying more frequent incidents and more severe consequences. Detection and han...

  19. Using the Critical Incident Technique for Triangulation and Elaboration of Communication Management Competencies

    Science.gov (United States)

    Brunton, Margaret Ann; Jeffrey, Lynn Maud

    2010-01-01

    This paper presents the findings from research using the critical incident technique to identify the use of key competencies for communication management practitioners. Qualitative data was generated from 202 critical incidents reported by 710 respondents. We also present a brief summary of the quantitative data, which identified two superordinate…

  20. Simulation analysis of route diversion strategies for freeway incident management : final report.

    Science.gov (United States)

    1995-02-01

    The purpose of this project was to investigate whether simulation models could : be used as decision aids for defining traffic diversion strategies for effective : incident management. A methodology was developed for using such a model to : determine...

  1. Commitee III.1 Ultimate Strength

    DEFF Research Database (Denmark)

    Jensen, Jørgen Juncher

    1997-01-01

    This report addresses the subject of ductile collapse of ships and offshore structures and their components due to buckling and excessive yielding under overload conditions. Consideration is given to load-deflection predictions for components with fabrication imperfections and in-service damage a...... and to the ultimate strength and post-ultimate behaviour of structural systems in order to identify the reserve strength. The effect of uncertainties in the modelling on the strength predictions is highlighted in two design examples....

  2. Incidence and management of biliary leakage after hepaticojejunostomy

    NARCIS (Netherlands)

    de Castro, Steve M. M.; Kuhlmann, Koert F. D.; Busch, Olivier R. C.; van Delden, Otto M.; Laméris, Johan S.; van Gulik, Thomas M.; Obertop, Hugo; Gouma, Dirk J.

    2005-01-01

    This study analyzes the change in the management of biliary leakage after hepaticojejunostomy. Between 1993 and 2003 all patients (n = 1033) were studied with a hepaticojejunostomv as part of a pancreatoduodenectomy (n = 486), proximal bile duct resection (without liver resection) (n = 35), and

  3. Managing Coil Epoxy Vacuum Impregnation Systems at the Manufacturing Floor Level To Achieve Ultimate Properties in State-of-the-Art Magnet Assemblies

    CERN Document Server

    Hubrig, Jeffrey G

    2005-01-01

    Liquid epoxy resin impregnation systems remain a state-of-the-art polymer material for vacuum and vacuum/pressure impregnation applications in the manufacture of both advanced and conventional coil winding configurations. Epoxy resins inherent latitude in processing parameters accounts for their continued popularity in engineering applications, but also for the tendency to overlook or misinterpret the requisite processing parameters on the manufacturing floor. Resin system impregnation must be managed in detail in order to achieve device life cycle reliability. This closer look reveals how manufacturing floor level management of material acceptance, handling and storage, pre- and post- impregnation processing and cure can be built into a manufacturing plan to increase manufacturing yield, lower unit cost and ensure optimum life cycle performance of the coil.

  4. 76 FR 61371 - All-Hazard Position Task Books for Type 3 Incident Management Teams

    Science.gov (United States)

    2011-10-04

    ...). 11. Division/Group Supervisor. 12. Unit Leader. 13. Strike Team/Task Force Leader. 14. Technical... Teams AGENCY: Federal Emergency Management Agency; DHS. ACTION: Notice of availability; request for comments. SUMMARY: The All-Hazard Position Task Books for Type 3 Incident Management Teams were developed...

  5. [Preclinical and intrahospital management of mass casualties and terrorist incidents].

    Science.gov (United States)

    Franke, A; Bieler, D; Friemert, B; Kollig, E; Flohe, S

    2017-10-01

    Due to the recent terrorist attacks in Paris, Brussels, Ansbach, Munich, Berlin and more recently Manchester and London, terrorism is realized as a present threat to our society and social life, as well as a challenge for the health care system. Without fueling anxiety, there is a need for sensitization to this subject and to familiarize all concerned with the special kind of terrorist attack-related injuries, the operational priorities and tactics and the individual basic principles of preclinical and hospital care. There is a need to adapt the known established medical structure for a conventional mass casualty situation to the special requirements that are raised by this new kind of terrorist threat to our social life. It is the aim of this article, from a surgical point of view, to depict the tactics and challenges of preclinical care of the special kind of terrorist attack-related injuries from the site of the incident, via the advanced medical post or casualty collecting point, to the triage point at the hospital. The special needs of medical care and organizational aspects of the primary treatment in the hospital are highlighted and possible decisional options and different approaches are discussed.

  6. Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment

    Science.gov (United States)

    2017-12-01

    Traffic incidents have long been recognized as the main contributor to congestion in highway networks. Thus, contending with non-recurrent congestion has been a priority task for most highway agencies over the past decades. Under most incident scenar...

  7. Control systems, personnel policies and management initiatives to limit pollution incidents

    International Nuclear Information System (INIS)

    Martin, B.F.

    1991-01-01

    After the regulatory requirements are met, an important collateral step in the continuing Hazardous Waste/Environmental Management cycle of activities is to minimize the possibility of a pollution incident, spill, contamination, mislabeling, mishandling or exposure, since this minimizes a major contingent liability of the company. Human failure accounts for 88% of accidents, 10% occur from mechanical failure and only 2% are unpreventable force majeure. This implies that fully 98% of all accidents can be prevented or minimized. Good engineering, production, management and educational practices can be formulated to minimize the occurrence and effects of accidental pollution incidents. Hazardous Material/Environmental Management tends to focus on technical and regulatory objectives, a reactionary mode caused in part by the rapidly changing regulatory environment and the need to continually adapt to these changes. Management functions such as personnel management and situational management get shortchanged in research and in practice. What is needed is a system that incorporates change readily, adapts personnel to change easily and mobilizes all the human resources of a company in meeting environmental and regulatory goals in the same way other goals of the company are met. Feedback Loop/Control System concepts have been applied to management practice in the popular Management By Objectives School as well as other schools of management practice. An Environmental Management program is proposed which incorporates feedback loop/ control systems to facilitate operations and training objectives and requirements. By incorporating Environmental and Hazardous Waste goals with other management goals in a system involving all levels of management and workers on the same team, the proposed system will reduce the probability of accidental pollution incidents and thus the contingent liability of a spill or other incident

  8. The ultimate disposition of depleted uranium

    Energy Technology Data Exchange (ETDEWEB)

    Lemons, T.R. [Uranium Enrichment Organization, Oak Ridge, TN (United States)

    1991-12-31

    Depleted uranium (DU) is produced as a by-product of the uranium enrichment process. Over 340,000 MTU of DU in the form of UF{sub 6} have been accumulated at the US government gaseous diffusion plants and the stockpile continues to grow. An overview of issues and objectives associated with the inventory management and the ultimate disposition of this material is presented.

  9. Air Force Critical Incident Stress Management outreach with Pentagon staff after the terrorist attack.

    Science.gov (United States)

    Rowan, Anderson B

    2002-09-01

    This article describes the Critical Incident Stress Management outreach to Pentagon staff conducted after the terrorist attack by a team of Air Force mental health and chaplain personnel. Also discussed are lessons learned from the author's experience while leading the mental health component and working in a larger tri-service outreach. Finally, the observed impacts of the outreach effort are examined along with recommendations for future postcritical incident outreach efforts.

  10. Peripartum cardiomyopathy: definition, incidence, etiopathogenesis, diagnosis, and management.

    Science.gov (United States)

    Garg, Jalaj; Palaniswamy, Chandrasekar; Lanier, Gregg M

    2015-01-01

    Peripartum cardiomyopathy (PPCM) is a serious pregnancy-associated disorder of unknown etiology. The precise cellular and molecular mechanisms underlying PPCM are unclear. A heightened awareness among health care providers can result in early diagnosis of heart failure in late pregnancy and the early postpartum period. Though the symptoms of dyspnea and fatigue can result from normal physiologic changes during pregnancy, an electrocardiogram and brain natriuretic peptide level should be obtained in these patients, in addition to baseline laboratory tests such as a complete blood count, and basic metabolic and hepatic function panels. If the electrocardiogram and brain natriuretic peptide level are abnormal, an echocardiogram should be obtained. The role of endomyocardial biopsy for the diagnosis of PPCM is controversial. Patients should be started on diuretics if volume overloaded, and beta-blockers (preferably metoprolol) if no contraindications exist; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy or lactation. There are no standard, universally accepted guidelines for the management of PPCM. Although experimental therapies like bromocriptine, pentoxifylline and immunoglobulins have shown promising results, large double-blind randomized trials are essential to confirm the results of smaller studies. In patients with persistent severe left ventricular (LV) dysfunction, advanced therapies like mechanical circulatory support and heart transplantation should be considered. Owing to recent data demonstrating deterioration of LV systolic function after initial recovery, it is essential to maintain long-term follow up of these patients regardless of initial recovery of LV function. We present a comprehensive review of the literature etiopathogenesis, diagnosis, and management of PPCM.

  11. Managing shoreline assessment data during the Lake Wabamun incident

    Energy Technology Data Exchange (ETDEWEB)

    Lamarche, A. [Environmental Performance and Decision Support, Montreal, PQ (Canada); Martin, V. [Eastern Canada Response Corp. Ltd., Vercheres, PQ (Canada)

    2009-07-01

    A freight train derailed near the shore of Lake Wabamun near Edmonton in August 2003, spilling about 750 m{sup 3} of heavy Bunker C oil on the lakeshore. The nature and extent of oiling was assessed over a period of 3 consecutive summers using a variety of techniques. Surface oiling along the shore was evaluated using the Shoreline Cleanup Assessment Team (SCAT) approach, with some modifications to consider local conditions. Oiling conditions of the submerged tar ball oil in the shallow near shore waters was evaluated in the summer of 2006. Several computerized functions were developed in order to provide reports and maps of the submerged oil conditions, so that the treatment team could remove most of the oil before the next reed growing season. The location of all observations were recorded using GPS. Lake Wabamun includes the following along its shores: industry which uses the lake water for cooling purposes; a provincial park; a First-nations reservation; and private residences. Since all survey data was made available to the general public, it had to be detailed and easy to understand. This paper described how some of the data management issues were addressed within the framework of the shoreline assessment organization. 6 refs., 3 tabs., 13 figs.

  12. EP&R Standards Project Report: Technical Review of National Incident Management Standards

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.

    2007-04-24

    The importance and necessity for a fully developed and implemented National Incident Management System (NIMS) has been demonstrated in recent years by the impact of national events such as Hurricane Katrina in 2005. Throughout the history of emergency response to major disasters, especially when multiple response organizations are involved, there have been systemic problems in the consistency and uniformity of response operations. Identifying national standards that support the development and implementation of NIMS is key to helping solve these systemic problems. The NIMS seeks to provide uniformity and consistency for incident management by using common terminology and protocols that will enable responders to coordinate their efforts to ensure an efficient response.

  13. Ultimate loading of wind turbines

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Ronold, K.; Ejsing Jørgensen, Hans

    1999-01-01

    An extreme loading study has been conducted comprising a general wind climate analysis as well as a wind turbine reliability study. In the wind climate analysis, the distribution of the (horizontal) turbulence standard deviation, conditioned on the meanwind speed, has been approximated by fitting......, a design turbulence intensity for off-shore application is proposed which, in the IEC code framework, is applicable for extreme as well as for fatigue loaddetermination. In order to establish a rational method to analyse wind turbine components with respect to failure in ultimate loading, and in addition...... to the event of failure in ultimate loading in flapwise bending in the normal operating condition of a site-specific turbine....

  14. Two incidents that changed quality management in the Australian livestock export industry

    Directory of Open Access Journals (Sweden)

    Peter R. Stinson

    2008-03-01

    Full Text Available Quality assurance in Australia's livestock export industry arose from a need to address animal welfare concerns. It was initially instigated by industry in the form of an accreditation scheme which contained standards, auditing requirements and training requirements. Two major incidents in long haul shipping of livestock demonstrated that risk management in the industry cannot be achieved through compliance with standards alone. A thorough investigation of the first incident recommended the introduction of formal risk management to complement a standards regime. This approach is applicable to the management of major risks, such as heat stress and disease. It is also especially suited to commercial risks, such as the rejection of cargo and where voyage or market specific treatments are needed and depend upon the expertise of the exporter. However, before these recommendations on risk management could be fully implemented, a significant public incident occurred which altered the direction of quality assurance in industry. The Australian response was to transfer authority to government regulators with a tightening of standards. This focuses on the need to ensure ownership of quality assurance programmes by the exporter. Formal risk management has been a casualty of the second incident and, unfortunately, has not been introduced.

  15. Critical Incident Stress Management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare.

    Science.gov (United States)

    Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim

    2014-07-01

    In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    Science.gov (United States)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.

    2011-01-01

    Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

  17. EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

    Science.gov (United States)

    DeFraia, Gary S

    2013-01-01

    Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

  18. Applying the concept of network enabled capabilities to incident management in the Netherlands

    NARCIS (Netherlands)

    Immers, L.H.; Huisken, G.

    2008-01-01

    The application of Incident Management to the Dutch road network suffers from serious problems in terms of availability of accurate and up-to-date information. In this paper we present an approach aimed at diminishing the occurrence of misunderstandings. This approach is based on the concept of

  19. Smothering in UK free-range flocks. Part 1: incidence, location, timing and management.

    Science.gov (United States)

    Barrett, J; Rayner, A C; Gill, R; Willings, T H; Bright, A

    2014-07-05

    Smothering in poultry is an economic and welfare-related concern. This study presents the first results from a questionnaire addressing the incidence, location, timing and management of smothering of free-range farm managers from two commercial egg companies (representing 35 per cent of the UK free-range egg supply). Overall, nearly 60 per cent of farm mangers experienced smothering in their last flock, with an average of 25.5 birds lost per incidence, although per cent mortality due to smothering was low (x̄=1.6 per cent). The majority of farm managers also reported that over 50 per cent of all their flocks placed had been affected by smothering. The location and timing of smothering (excluding smothering in nest boxes) tended to be unpredictable and varied between farms. Blocking off corners/nest boxes and walking birds more frequently were identified as popular smothering reduction measures, although there was a wide variety of reduction measures reported overall. The motivation to implement reduction measures was related to a farm manager's previous experience of smothering. To our knowledge, this is the first study to provide a representative industry estimate on the incidence, location, timing and management of smothering. The results suggest that smothering is a common problem, unpredictable between flocks with no clear, effective reduction strategies. A follow-up study will investigate the correlations among smothering, disease and other welfare problems and may shed further light on management solutions. British Veterinary Association.

  20. Errors in the management of cardiac arrests: an observational study of patient safety incidents in England.

    Science.gov (United States)

    Panesar, Sukhmeet S; Ignatowicz, Agnieszka M; Donaldson, Liam J

    2014-12-01

    The aim of this qualitative study is to better understand the types of error occurring during the management of cardiac arrests that led to a death. All patient safety incidents involving management of cardiac arrests and resulting in death which were reported to a national patient safety database over a 17-month period were analysed. Structured data from each report were extracted and these together with the free text, were subjected to content analysis which was inductive, with the coding scheme emerged from continuous reading and re-reading of incidents. There were 30 patient safety incidents involving management of cardiac arrests and resulting in death. The reviewers identified a main shortfall in the management of each cardiac arrest and this resulted in 12 different factors being documented. These were grouped into four themes that highlighted systemic weaknesses: miscommunication involving crash number (4/30, 13%), shortfalls in staff attending the arrest (4/30, 13%), equipment deficits (11/30, 36%), and poor application of knowledge and skills (11/30, 37%). The factors identified represent serious shortfalls in the quality of response to cardiac arrests resulting in death in hospital. No firm conclusion can be drawn about how many deaths in the study population would have been averted if the emergency had been managed to a high standard. The effective management of cardiac arrests should be considered as one of the markers of safe care within a healthcare organisation.

  1. Experimental investigation of ultimate loads

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, S.M.; Larsen, G.C.; Antoniou, I.; Lind, S.O.; Courtney, M. [Risoe National Lab., Wind Energy and Atmospheric Physics, Roskilde (Denmark)

    1999-03-01

    Verification of the structural integrity of a wind turbine involves analysis of fatigue loading as well as ultimate loading. With the trend of persistently growing turbines, the ultimate loading seems to become relatively more important. For wind turbines designed according to the wind conditions prescribed in the IEC-61400 code, the ultimate load is often identified as the leading load parameter. Exemplified by the use of an extensive measurement campaign a procedure for evaluation of the extreme flap-wise bending moments, occurring during normal operating of a wind turbine, is presented. The structural measurements are made on a NEG Micon 650 kW wind turbine erected at a complex high wind site in Oak Creek, California. The turbine is located on the top of a ridge. The prevailing wind direction is perpendicular to the ridge, and the annual mean wind speed is 9.5 m/s. The associated wind field measurement, are taken from two instrumented masts erected less than one rotor diameter in front of the turbine in direction of the prevailing wind direction. Both masts are instrumented at different heights in order to gain insight of the 3D-wind speed structure over the entire rotor plane. Extreme distributions, associated with a recurrence period of 10 minutes, conditioned on the mean wind speed and the turbulence intensity are derived. Combined with the wind climate model proposed in the IEC standard, these distributions are used to predict extreme distributions with recurrence periods equal to one and fifty years, respectively. The synthesis of the conditioned PDF`s and the wind climate model is performed by means of Monte Carlo simulation. (au)

  2. A management plan for hospitals and medical centers facing radiation incidents.

    Science.gov (United States)

    Davari, Fereshteh; Zahed, Arash

    2015-09-01

    Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  3. A management plan for hospitals and medical centers facing radiation incidents

    Directory of Open Access Journals (Sweden)

    Fereshteh Davari

    2015-01-01

    Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  4. Analysis of Incident and Accident Reports and Risk Management in Spine Surgery.

    Science.gov (United States)

    Kobayashi, Kazuyoshi; Imagama, Shiro; Ando, Kei; Hida, Tetsuro; Ito, Kenyu; Tsushima, Mikito; Ishikawa, Yoshimoto; Matsumoto, Akiyuki; Morozumi, Masayoshi; Nishida, Yoshihiro; Nagao, Yoshimasa; Ishiguro, Naoki

    2017-08-01

    A review of accident and incident reports. To analyze prevalence, characteristics, and details of perioperative incidents and accidents in patients receiving spine surgery. In our institution, a clinical error that potentially results in an adverse event is usually submitted as an incident or accident report through a web database, to ensure anonymous and blame-free reporting. All reports are analyzed by a medical safety management group. These reports contain valuable data for management of medical safety, but there have been no studies evaluating such data for spine surgery. A total of 320 incidents and accidents that occurred perioperatively in 172 of 415 spine surgeries were included in the study. Incidents were defined as events that were "problematic, but with no damage to the patient," and accidents as events "with damage to the patient." The details of these events were analyzed. There were 278 incidents in 137 surgeries and 42 accidents in 35 surgeries, giving prevalence of 33% (137/415) and 8% (35/415), respectively. The proportion of accidents among all events was significantly higher for doctors than non-doctors [68.0% (17/25) vs. 8.5% (25/295), P < 0.01] and in the operating room compared with outside the operating room [40.5% (15/37) vs. 9.5% (27/283), P < 0.01]. There was no significant difference in years of experience among personnel involved in all events. The major types of events were medication-related, line and tube problems, and falls and slips. Accidents also occurred because of a long-term prone position, with complications such as laryngeal edema, ulnar nerve palsy, and tooth damage. Surgery and procedures in the operating room always have a risk of complications. Therefore, a particular effort is needed to establish safe management of this environment and to provide advice on risk to the doctor and medical care team. 4.

  5. [Incidence and management of ectopic pregnancy in Iceland 2000-2009].

    Science.gov (United States)

    Baldvinsdottir, Áslaug; Gudmundsson, Jens A; Geirsson, Reynir Tómas

    2013-12-01

    Ectopic pregnancy can be life-threatening. Its treatment has changed radically during the last two decades. The study objective was to evaluate incidence and treatment of ectopic pregnancy in the Icelandic population during the decade 2000-2009. Information was collected about all diagnosed cases, place and method of treatment and admissions. The annual incidence was calculated with reference to number of pregnancies (n/1000), number of women aged 15-44 years (n/10 000) and by 5-year age groups, comparing the periods 2000-2004 and 2005-2009. The number of ectopic pregnancies during these 10 years was 836, or 444 during the years 2000-2004 and 392 during 2005-2009. The average annual incidence was 15.6/1000 pregnancies and 12.9/10 000 women. There was an annual incidence reduction from 17.3 to 14.1/1000 pregnancies (ptreatment for 94.9% of women, methotrexate in 3.2% and expectant management in 1.9%. Surgical management decreased from 98.0% to 91.3% between 5-year periods as medical treatment increased (0.4% to 6.4%; pectopic pregnancy is comparable to the development in neighbouring countries. Management has changed with increased use of laparoscopic surgery, medical and expectant treatment.

  6. Ultimate Explanations of the Universe

    CERN Document Server

    Heller, Michael

    2009-01-01

    We humans are collectively driven by a powerful - yet not fully explained - instinct to understand. We would like to see everything established, proven, laid bare. The more important an issue, the more we desire to see it clarified, stripped of all secrets, all shades of gray. What could be more important than to understand the Universe and ourselves as a part of it? To find a window onto our origin and our destiny? This book examines how far our modern cosmological theories - with their sometimes audacious models, such as inflation, cyclic histories, quantum creation, parallel universes - can take us towards answering these questions. Can such theories lead us to ultimate truths, leaving nothing unexplained? Last, but not least, Heller addresses the thorny problem of why and whether we should expect to find theories with all-encompassing explicative power.

  7. Habitat complexity influences fine scale hydrological processes and the incidence of stormwater runoff in managed urban ecosystems.

    Science.gov (United States)

    Ossola, Alessandro; Hahs, Amy Kristin; Livesley, Stephen John

    2015-08-15

    Urban ecosystems have traditionally been considered to be pervious features of our cities. Their hydrological properties have largely been investigated at the landscape scale and in comparison with other urban land use types. However, hydrological properties can vary at smaller scales depending upon changes in soil, surface litter and vegetation components. Management practices can directly and indirectly affect each of these components and the overall habitat complexity, ultimately affecting hydrological processes. This study aims to investigate the influence that habitat components and habitat complexity have upon key hydrological processes and the implications for urban habitat management. Using a network of urban parks and remnant nature reserves in Melbourne, Australia, replicate plots representing three types of habitat complexity were established: low-complexity parks, high-complexity parks, and high-complexity remnants. Saturated soil hydraulic conductivity in low-complexity parks was an order of magnitude lower than that measured in the more complex habitat types, due to fewer soil macropores. Conversely, soil water holding capacity in low-complexity parks was significantly higher compared to the two more complex habitat types. Low-complexity parks would generate runoff during modest precipitation events, whereas high-complexity parks and remnants would be able to absorb the vast majority of rainfall events without generating runoff. Litter layers on the soil surface would absorb most of precipitation events in high-complexity parks and high-complexity remnants. To minimize the incidence of stormwater runoff from urban ecosystems, land managers could incrementally increase the complexity of habitat patches, by increasing canopy density and volume, preserving surface litter and maintaining soil macropore structure. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. PROACTIVE APPROACH TO THE INCIDENT AND PROBLEM MANAGEMENT IN COMMUNICATION NETWORKS

    Directory of Open Access Journals (Sweden)

    Vjeran Strahonja

    2007-06-01

    Full Text Available Proactive approach to communication network maintenance has the capability of enhancing the integrity and reliability of communication networks, as well as of reducing maintenance costs and overall number of incidents. This paper presents approaches to problem and incident prevention with the help of root-cause analysis, aligning that with the goal to foresee software performance. Implementation of proactive approach requires recognition of enterprise's current level of maintenance better insights into available approaches and tools, as well as their comparison, interoperability, integration and further development. The approach we are proposing and elaborating in this paper lies on the construction of a metamodel of the problem management of information technology, particularly the proactive problem management. The metamodel is derived from the original ITIL specification and presented in an object-oriented fashion by using structure (class diagrams conform to UML notation. Based on current research, appropriate metrics based on the concept of Key Performance Indicators is suggested.

  9. Mass Casualty Decontamination Guidance and Psychosocial Aspects of CBRN Incident Management: A Review and Synthesis

    Science.gov (United States)

    Carter, Holly; Amlôt, Richard

    2016-01-01

    Introduction: Mass casualty decontamination is an intervention employed by first responders at the scene of an incident involving noxious contaminants.  Many countries have sought to address the challenge of decontaminating large numbers of affected casualties through the provision of rapidly deployable temporary showering structures, with accompanying decontamination protocols.  In this paper we review decontamination guidance for emergency responders and associated research evidence, in order to establish to what extent psychosocial aspects of casualty management have been considered within these documents. The review focuses on five psychosocial aspects of incident management: likely public behaviour; responder management style; communication strategy; privacy/ modesty concerns; and vulnerable groups. Methods: Two structured literature reviews were carried out; one to identify decontamination guidance documents for first responders, and another to identify evidence which is relevant to the understanding of the psychosocial aspects of mass decontamination.  The guidance documents and relevant research were reviewed to identify whether the guidance documents contain information relating to psychosocial issues and where it exists, that the guidance is consistent with the existing evidence-base. Results: Psychosocial aspects of incident management receive limited attention in current decontamination guidance.  In addition, our review has identified a number of gaps and inconsistencies between guidance and research evidence.  For each of the five areas we identify: what is currently presented in guidance documents, to what extent this is consistent with the existing research evidence and where it diverges.  We present a series of evidence-based recommendations for updating decontamination guidance to address the psychosocial aspects of mass decontamination. Conclusions: Effective communication and respect for casualties’ needs are critical in ensuring

  10. 12 CFR 250.181 - Reports of change in control of bank management incident to a merger.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Reports of change in control of bank management... change in control of bank management incident to a merger. (a) A State member bank has inquired whether Pub. L. 88-593 (78 Stat. 940) requires reports of change in control of bank management in situations...

  11. Mathematical model as means of optimization of the automation system of the process of incidents of information security management

    Directory of Open Access Journals (Sweden)

    Yulia G. Krasnozhon

    2018-03-01

    Full Text Available Modern information technologies have an increasing importance for development dynamics and management structure of an enterprise. The management efficiency of implementation of modern information technologies directly related to the quality of information security incident management. However, issues of assessment of the impact of information security incidents management on quality and efficiency of the enterprise management system are not sufficiently highlighted neither in Russian nor in foreign literature. The main direction to approach these problems is the optimization of the process automation system of the information security incident management. Today a special attention is paid to IT-technologies while dealing with information security incidents at mission-critical facilities in Russian Federation such as the Federal Tax Service of Russia (FTS. It is proposed to use the mathematical apparatus of queueing theory in order to build a mathematical model of the system optimization. The developed model allows to estimate quality of the management taking into account the rules and restrictions imposed on the system by the effects of information security incidents. Here an example is given in order to demonstrate the system in work. The obtained statistical data are shown. An implementation of the system discussed here will improve the quality of the Russian FTS services and make responses to information security incidents faster.

  12. On the Appropriateness of Incident Management Systems in Developing Countries: A Case from the UAE

    Directory of Open Access Journals (Sweden)

    Faouzi Kamoun

    2010-12-01

    Full Text Available Road traffic incidents are eliciting growing public concerns due to their devastating social, economical, and environmental impacts. The severity of these random events is particularly alarming in developing countries, where the situation is just worsening. Recently, Incident Management Systems (IMSs have been proposed as powerful tools to enhance the coordination and management of rescue operations during traffic accidents. However, most of the available commercial IMS solutions are designed for large metropolitan cities and within the contexts of developed nations. This paper explores the issues of appropriateness and customization of IMS solutions in developing countries through an exploratory inquiry consisting of a case study from the United Arab Emirates (UAE. The paper also explores the important issues related to managing the organizational changes that an IMS introduces to the operations of the command and control room. This contribution calls for the development of more comprehensive theoretical frameworks that can guide towards the implementation of appropriate IMS solutions in developing countries. Our research highlights the need for developing countries to acquire appropriate IMS solutions that are tailored to the local organizational work context in which these systems will be used. The experience reported herein can also inspire other public safety agencies in developing countries to consider the option of developing customized IMS solutions that best suit their needs.

  13. Non-medical aspects of civilian-military collaboration in management of major incidents.

    Science.gov (United States)

    Khorram-Manesh, A; Lönroth, H; Rotter, P; Wilhelmsson, M; Aremyr, J; Berner, A; Andersson, A Nero; Carlström, E

    2017-10-01

    Disasters and major incidents demand a multidisciplinary management. Recent experiences from terrorist attacks worldwide have resulted in a search for better assessment of the needs, resources, and knowledge in the medical and non-medical management of these incidents and also actualized the need for collaboration between civilian and military healthcare. The aim of this study was to evaluate the impact of the civilian-military collaboration in a Swedish context with the main focus on its non-medical management. An exercise, simulating a foreign military attack centrally on Swedish soil, was designed, initiated, and conducted by a team consisting of civilian and military staff. Data were collected prospectively and evaluated by an expert team. Specific practical and technical issues were presented in collaboration between civilian and military staffs. In addition, shortcomings in decision-making, follow-up, communication, and collaboration due to prominent lack of training and exercising the tasks and positions in all managerial levels of the hospital were identified. Current social and political unrests and terror attacks worldwide necessitate civilian-military collaboration. Such collaboration, however, needs to be synchronized and adjusted to avoid preventable medical and non-medical consequences. Simulation exercises might be one important source to improve such collaboration.

  14. European Clearinghouse. Incidents related to reactivity management. Contributing factors, failure modes and corrective actions

    International Nuclear Information System (INIS)

    Bruynooghe, Christiane; Noel, Marc

    2009-01-01

    This work is part of the European Clearinghouse on Nuclear Power Plant Operational Experience Feedback (NPP-OEF) activity carried out at the Joint Research Centre/Institute for Energy (JRC/IE) with the participation of nine EU Regulatory Authorities. It investigates the 1999 Shika-1 criticality event together with other shortcomings in reactivity management reported to the IAE4 Incident Reporting System in the period 1981-2008. The aim of the work was to identify reactivity control failure modes, reactor status and corrective actions. Initiating factors and associated root causes were also analysed. Five of the 7 factors identified for all events were present in the 1999 Shika-1 event where criticality has been unexpectedly reached and maintained during 15 minutes. Most of the events resulted in changes in procedures, material or staff and management training. The analysis carried out put in evidence that in several instances appropriate communication based on operational experience feedback would have prevented incident to occur. This paper also summarises the action taken at power plants and by the regulatory bodies in different countries to avoid repetition of similar events. It identifies insights that might be useful to reduce the likelihood of operational events caused by shortcomings in reactivity management. (orig.)

  15. Implementation of the National Incident Management System (NIMS)/Incident Command System (ICS) in the Federal Radiological Monitoring and Assessment Center(FRMAC) - Emergency Phase

    International Nuclear Information System (INIS)

    NSTec Environmental Restoration

    2007-01-01

    Homeland Security Presidential Directive HSPD-5 requires all federal departments and agencies to adopt a National Incident Management System (NIMS)/Incident Command System (ICS) and use it in their individual domestic incident management and emergency prevention, preparedness, response, recovery, and mitigation programs and activities, as well as in support of those actions taken to assist state and local entities. This system provides a consistent nationwide template to enable federal, state, local, and tribal governments, private-sector, and nongovernmental organizations to work together effectively and efficiently to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity, including acts of catastrophic terrorism. This document identifies the operational concepts of the Federal Radiological Monitoring and Assessment Center's (FRMAC) implementation of the NIMS/ICS response structure under the National Response Plan (NRP). The construct identified here defines the basic response template to be tailored to the incident-specific response requirements. FRMAC's mission to facilitate interagency environmental data management, monitoring, sampling, analysis, and assessment and link this information to the planning and decision staff clearly places the FRMAC in the Planning Section. FRMAC is not a mitigating resource for radiological contamination but is present to conduct radiological impact assessment for public dose avoidance. Field monitoring is a fact-finding mission to support this effort directly. Decisions based on the assessed data will drive public protection and operational requirements. This organizational structure under NIMS is focused by the mission responsibilities and interface requirements following the premise to provide emergency responders with a flexible yet standardized structure for incident response activities. The coordination responsibilities outlined in the NRP are based on the NIMS

  16. Implementation of the National Incident Management System (NIMS)/Incident Command System (ICS) in the Federal Radiological Monitoring and Assessment Center(FRMAC) - Emergency Phase

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2007-04-01

    Homeland Security Presidential Directive HSPD-5 requires all federal departments and agencies to adopt a National Incident Management System (NIMS)/Incident Command System (ICS) and use it in their individual domestic incident management and emergency prevention, preparedness, response, recovery, and mitigation programs and activities, as well as in support of those actions taken to assist state and local entities. This system provides a consistent nationwide template to enable federal, state, local, and tribal governments, private-sector, and nongovernmental organizations to work together effectively and efficiently to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity, including acts of catastrophic terrorism. This document identifies the operational concepts of the Federal Radiological Monitoring and Assessment Center's (FRMAC) implementation of the NIMS/ICS response structure under the National Response Plan (NRP). The construct identified here defines the basic response template to be tailored to the incident-specific response requirements. FRMAC's mission to facilitate interagency environmental data management, monitoring, sampling, analysis, and assessment and link this information to the planning and decision staff clearly places the FRMAC in the Planning Section. FRMAC is not a mitigating resource for radiological contamination but is present to conduct radiological impact assessment for public dose avoidance. Field monitoring is a fact-finding mission to support this effort directly. Decisions based on the assessed data will drive public protection and operational requirements. This organizational structure under NIMS is focused by the mission responsibilities and interface requirements following the premise to provide emergency responders with a flexible yet standardized structure for incident response activities. The coordination responsibilities outlined in the NRP are based on the

  17. Coordinating a multiple casualty Critical Incident Stress Management (CISM) response within a medical/surgical hospital setting.

    Science.gov (United States)

    Morrow, H E

    2001-01-01

    The medical/surgical hospital environment presents numerous challenges to a Critical Incident Stress Management (CISM) Team Coordinator responsible for implementing a psychological crisis intervention. Often this person is responsible for managing a response to a large in-house multiple-casualty incident, sometimes involving fatalities. Many mental health professionals have not had the opportunity to work in a medical/surgical healthcare facility and consequently are not familiar with the environment (and agency culture) that exists within these employment settings. This article will review important factors to be considered during the initial assessment of a critical incident in a hospital setting, logistical concerns that are unique to this setting, and the subsequent planning of the Critical Incident Stress Management Team crisis management response.

  18. Critical incident stress management in a school setting following police shooting of an adolescent.

    Science.gov (United States)

    Miller, Ronald L; Grueninger, Carl E

    2010-01-01

    Cincinnati Public Schools Critical Incident Stress Management Team responded when a teenager who was in possession of a pellet gun was killed by police. The themes that emerged had more to do with rage than typical bereavement or trauma responses. The primary objective was the prevention of school and community violence. Strategic planning was critical in preventing violence and responding to the changing needs of students, staff and families during the weeks following this tragedy. Team members had to consider cultural differences related to interpretation of events, grieving rituals, and expectations for appropriate behavior when planning and providing interventions.

  19. Electrical failure during cardiopulmonary bypass: an evaluation of incidence, causes, management and guidelines for preventative measures.

    LENUS (Irish Health Repository)

    Hargrove, M

    2012-02-03

    The incidence of electrical failure during cardiopulmonary bypass (CPB) has been reported to occur in approximately 1 per 1000 cases. While the resultant morbidity and mortality is low, electrical failure is a life-threatening scenario. We report three major electrical failures during CPB in a patient population of 3500 over a 15-year period. These cases involved mains failure and generator shut down, mains failure and generator power surge, and failure of the uninterruptable power supply (UPS), which caused protected sockets to shut down. Protocols for preventative maintenance, necessary equipment, battery backup and guidelines for the successful management of such accidents during CPB are discussed.

  20. [Incidence of acute agitation and variation in acute agitation management by emergency services].

    Science.gov (United States)

    Casado Flórez, Isabel; Sánchez Santos, Luis; Rodríguez Calzada, Rafael; Rico-Villademoros, Fernando; Roset Arissó, Pere; Corral Torres, Ervigio

    2017-07-01

    To describe the management of acute agitation by Spanish emergency medical services (EMS) and assess the incidence of acute agitation. Observational descriptive study based on aggregate data from unpublished internal EMS reports. Seven participating emergency services received 4 306 213 emergency calls in 2013; 111 599 (2.6%, or 6.2 calls per 1000 population) were categorized as psychiatric emergencies. A total of 84 933 interventions (4.2%, or 4 per 1000 population) were required; 37 951 of the calls concerned agitated patients (1.9%, or 2 cases per 1000 population). Only 3 EMS mandated a specific procedure for their responders to use in such cases. The agitated patient is a common problem for EMS responders. Few teams apply specific procedures for managing these patients.

  1. Tick bite anaphylaxis: incidence and management in an Australian emergency department.

    Science.gov (United States)

    Rappo, Tristan B; Cottee, Alice M; Ratchford, Andrew M; Burns, Brian J

    2013-08-01

    Ticks are endemic to the eastern coastline of Australia. The aim of the present study is to describe the incidence of tick bites in such an area, the seasonal and geographical distribution, the incidence of anaphylaxis due to tick bite and its management. We retrospectively analysed emergency presentations of patients with tick bites to Mona Vale Hospital on Sydney's Northern Beaches over a 2 year period from 1 January 2007 to 1 January 2009. We recorded the geographical and seasonal distribution of tick bites as well as the symptoms from tick bite and its emergency management. We report over 500 cases of tick bites presenting to a single New South Wales hospital over a 2 year period, of which 34 resulted in anaphylaxis. Cutaneous symptoms were the most common feature associated with anaphylaxis (32/34, 94%). Forty per cent (13/34) of patients with tick bite anaphylaxis had a history of allergy or previous anaphylaxis. Seventy-six per cent (26/34) of patients were administered adrenaline either prior to presenting or in the ED, while 97% (33/34) were treated with steroids. Fifty-three per cent were referred to an immunologist and only one-quarter were discharged with an adrenaline auto-injector. We report 34 cases of tick bite anaphylaxis over a 2 year period at a single hospital in a tick endemic area. The variation in the presenting symptoms and signs, as well as in management highlights the need for increased awareness for tick bite management in tick endemic areas. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  2. [Teaching non-technical skills for critical incidents: Crisis resource management training for medical students].

    Science.gov (United States)

    Krüger, A; Gillmann, B; Hardt, C; Döring, R; Beckers, S K; Rossaint, R

    2009-06-01

    Physicians have to demonstrate non-technical skills, such as communication and team leading skills, while coping with critical incidents. These skills are not taught during medical education. A crisis resource management (CRM) training was established for 4th to 6th year medical students using a full-scale simulator mannikin (Emergency Care Simulator, ECS, METI). The learning objectives of the course were defined according to the key points of Gaba's CRM concept. The training consisted of theoretical and practical parts (3 simulation scenarios with debriefing). Students' self-assessment before and after the training provided the data for evaluation of the training outcome. A total of 65 students took part in the training. The course was well received in terms of overall course quality, debriefings and didactic presentation, the mean overall mark being 1.4 (1: best, 6: worst). After the course students felt significantly more confident when facing incidents in clinical practice. The main learning objectives were achieved. The effectiveness of applying the widely used ECS full-scale simulator in interdisciplinary teaching has been demonstrated. The training exposes students to crisis resource management issues and motivates them to develop non-technical skills.

  3. [Risk management in the operation room. Results of a pilot project of interdisciplinary "incident reporting"].

    Science.gov (United States)

    Horstmann, R; Hofinger, G; Mäder, M; Gaidzik, P W; Waleczek, H

    2006-08-01

    Methods for error analysis are suitable to increase patients' safety as well as staff satisfaction and may avoid, in a sense of process control, financial damage to the hospital. The aim of the presented pilot study was to establish and evaluate an incident reporting system as a first step towards a new safety culture. In June 2003 an incident reporting system was introduced in the central surgical suite, in which the surgical and anaesthesiologic departments took part as well medical and nursing staff. Besides conceiving a report form, a "board of confidence" was elected, kick-off meetings were held and a baseline study on the basis of industrial psychological knowledge was initialised. The process of creating confidence is arduous and depends elementarily on sincere cooperation of management staff, especially of the heads of the departments. The exclusive participation of only two medical departments led to conflicts. Therefore, after finishing the pilot study, the system was expanded to the whole surgical suite including all operating departments. In order to increase the motivation for the strictly voluntarily participation, the frequency of regular echoes to the staff was optimised. To achieve high acceptance in the whole staff, the board of confidence needs a clearly defined position within the system of quality management. For the first time in Germany an incident reporting system under participation of several medical departments has been installed. After finishing the pilot project, in future we will be able to evaluate changes caused by this system. Simultaneously an electronic database for reported adverse events and strategies to avoid them are being developed based on similar systems in aviation industry. In near future, the system will be of increasing importance likewise for inpatient units and non-operative departments.

  4. Cyber crisis management: a decision-support framework for disclosing security incident information

    NARCIS (Netherlands)

    Kulikova, Olga; Heil, Ronald; van den Berg, Jan; Pieters, Wolter

    2012-01-01

    The growing sophistication and frequency of cyber attacks force modern companies to be prepared beforehand for potential cyber security incidents and data leaks. A proper incident disclosure strategy can significantly improve timeliness and effectiveness of incident response activities, reduce legal

  5. Developing an incident management system to support Ebola response -- Liberia, July-August 2014.

    Science.gov (United States)

    Pillai, Satish K; Nyenswah, Tolbert; Rouse, Edward; Arwady, M Allison; Forrester, Joseph D; Hunter, Jennifer C; Matanock, Almea; Ayscue, Patrick; Monroe, Benjamin; Schafer, Ilana J; Poblano, Luis; Neatherlin, John; Montgomery, Joel M; De Cock, Kevin M

    2014-10-17

    The ongoing Ebola virus disease (Ebola) outbreak in West Africa is the largest and most sustained Ebola epidemic recorded, with 6,574 cases. Among the five affected countries of West Africa (Liberia, Sierra Leone, Guinea, Nigeria, and Senegal), Liberia has had the highest number cases (3,458). This epidemic has severely strained the public health and health care infrastructure of Liberia, has resulted in restrictions in civil liberties, and has disrupted international travel. As part of the initial response, the Liberian Ministry of Health and Social Welfare (MOHSW) developed a national task force and technical expert committee to oversee the management of the Ebola-related activities. During the third week of July 2014, CDC deployed a team of epidemiologists, data management specialists, emergency management specialists, and health communicators to assist MOHSW in its response to the growing Ebola epidemic. One aspect of CDC's response was to work with MOHSW in instituting incident management system (IMS) principles to enhance the organization of the response. This report describes MOHSW's Ebola response structure as of mid-July, the plans made during the initial assessment of the response structure, the implementation of interventions aimed at improving the system, and plans for further development of the response structure for the Ebola epidemic in Liberia.

  6. Technical Review of Law Enforcement Standards and Guides Relative to Incident Management

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Salter, R.; Stanton, J. R.; Fisher, D.

    2009-03-24

    In an effort to locate potential law enforcement-related standards that support incident management, a team from the Pacific Northwest National Laboratory (PNNL) contacted representatives from the National Institute of Standards-Office of Law Enforcement Standards (NIST-OLES), National Institute of Justice (NIJ), Federal Bureau of Investigation (FBI), Secret Service, ASTM International committees that have a law enforcement focus, and a variety of individuals from local and regional law enforcement organizations. Discussions were held with various state and local law enforcement organizations. The NIJ has published several specific equipment-related law enforcement standards that were included in the review, but it appears that law enforcement program and process-type standards are developed principally by organizations that operate at the state and local level. Input is provided from state regulations and codes and from external non-government organizations (NGOs) that provide national standards. The standards that are adopted from external organizations or developed independently by state authorities are available for use by local law enforcement agencies on a voluntary basis. The extent to which they are used depends on the respective jurisdictions involved. In some instances, use of state and local disseminated standards is mandatory, but in most cases, use is voluntary. Usually, the extent to which these standards are used appears to depend on whether or not jurisdictions receive certification from a “governing” entity due to their use and compliance with the standards. In some cases, these certification-based standards are used in principal but without certification or other compliance monitoring. In general, these standards appear to be routinely used for qualification, selection for employment, and training. In these standards, the term “Peace Officer” is frequently used to refer to law enforcement personnel. This technical review of national law

  7. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    International Nuclear Information System (INIS)

    Shah, Chirag; Vicini, Frank A.

    2011-01-01

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  8. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  9. A remotely piloted aircraft system in major incident management: concept and pilot, feasibility study.

    Science.gov (United States)

    Abrahamsen, Håkon B

    2015-06-10

    Major incidents are complex, dynamic and bewildering task environments characterised by simultaneous, rapidly changing events, uncertainty and ill-structured problems. Efficient management, communication, decision-making and allocation of scarce medical resources at the chaotic scene of a major incident is challenging and often relies on sparse information and data. Communication and information sharing is primarily voice-to-voice through phone or radio on specified radio frequencies. Visual cues are abundant and difficult to communicate between teams and team members that are not co-located. The aim was to assess the concept and feasibility of using a remotely piloted aircraft (RPA) system to support remote sensing in simulated major incident exercises. We carried out an experimental, pilot feasibility study. A custom-made, remotely controlled, multirotor unmanned aerial vehicle with vertical take-off and landing was equipped with digital colour- and thermal imaging cameras, a laser beam, a mechanical gripper arm and an avalanche transceiver. We collected data in five simulated exercises: 1) mass casualty traffic accident, 2) mountain rescue, 3) avalanche with buried victims, 4) fisherman through thin ice and 5) search for casualties in the dark. The unmanned aerial vehicle was remotely controlled, with high precision, in close proximity to air space obstacles at very low levels without compromising work on the ground. Payload capacity and tolerance to wind and turbulence were limited. Aerial video, shot from different altitudes, and remote aerial avalanche beacon search were streamed wirelessly in real time to a monitor at a ground base. Electromagnetic interference disturbed signal reception in the ground monitor. A small remotely piloted aircraft can be used as an effective tool carrier, although limited by its payload capacity, wind speed and flight endurance. Remote sensing using already existing remotely piloted aircraft technology in pre

  10. Incidence and management of N-acetylcysteine-related anaphylactoid reactions during the management of acute paracetamol overdose.

    Science.gov (United States)

    Yamamoto, Takahiro; Spencer, Tanya; Dargan, Paul I; Wood, David M

    2014-02-01

    Adverse drug reactions (ADRs) to N-acetylcysteine (NAC) treatment for paracetamol overdose are typically anaphylactoid in origin and occur in 2-48% of treated patients. We explored the incidence and management of NAC ADR in our unit. Case notes of patients who presented with paracetamol overdose and had ADR to NAC between February 2005 and June 2011 were reviewed. A total of 1648 patients presented with suspected paracetamol overdose and 660 received NAC treatment. Within this group, 82 patients had documented NAC-related ADR. ADR developed in 12.4% (82/660) of patients receiving intravenous NAC and 59 had full documentation available and were included in this study (34 women, 25 men). ADR occurred in the 15-min (150 mg/kg) bag in 36 cases (61%), 22 in the 4-h (50 mg/kg) bag (37%) and one in the 16-h (100 mg/kg) bag (2%). Symptoms were classified as minimal (n=16, 27%), moderate (n=26, 44%) and severe (n=17, 29%). Asthma and female sex, which are reported risk factors for ADR, did not lead to the development of more severe ADR (P=0.771 and 0.330, respectively). Treatments administered included stopping the NAC infusion (n=32, 54%), administration of antiemetics (n=36, 61%), H1 antihistamines (n=26, 44%), steroids (n=16, 27%), inhaled B2 agonists (n=6, 10%) and adrenaline (n=3, 5%). The incidence of ADR to NAC was comparable with published studies, although there was no association of severity with asthma or female sex. The management of ADRs is variable, with frequent, inappropriate use of steroids. Education about the pathophysiology of these ADRs may improve management.

  11. Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, Michael B.; Dappa, Evelyn; Jungmann, Florian; Kloeckner, Roman; Schotten, Sebastian; Wirth, Gesine M.; Mildenberger, Peter; Kreitner, Karl-Friedrich; Oberholzer, Katja; Dueber, Christoph [University Hospital of Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Mittler, Jens; Lang, Hauke [University Hospital of Mainz, Department of Abdominal, Visceral and Transplantation Surgery, Mainz (Germany)

    2015-07-15

    To evaluate the incidence, management, and outcome of visceral artery aneurysms (VAA) over one decade. 233 patients with 253 VAA were analyzed according to location, diameter, aneurysm type, aetiology, rupture, management, and outcome. VAA were localized at the splenic artery, coeliac trunk, renal artery, hepatic artery, superior mesenteric artery, and other locations. The aetiology was degenerative, iatrogenic after medical procedures, connective tissue disease, and others. The rate of rupture was much higher in pseudoaneurysms than true aneurysms (76.3 % vs.3.1 %). Fifty-nine VAA were treated by intervention (n = 45) or surgery (n = 14). Interventions included embolization with coils or glue, covered stents, or combinations of these. Thirty-five cases with ruptured VAA were treated on an emergency basis. There was no difference in size between ruptured and non-ruptured VAA. After interventional treatment, the 30-day mortality was 6.7 % in ruptured VAA compared to no mortality in non-ruptured cases. Follow-up included CT and/or MRI after a mean period of 18.0 ± 26.8 months. The current status of the patient was obtained by a structured telephone survey. Pseudoaneurysms of visceral arteries have a high risk for rupture. Aneurysm size seems to be no reliable predictor for rupture. Interventional treatment is safe and effective for management of VAA. (orig.)

  12. Lithiasis in 1,313 kidney transplants: incidence, diagnosis, and management.

    Science.gov (United States)

    Ferreira Cassini, M; Cologna, A J; Ferreira Andrade, M; Lima, G J; Medeiros Albuquerque, U; Pereira Martins, A C; Tucci Junior, S

    2012-10-01

    Renal transplantation remains the optimal treatment of patients with end-stage renal disease. Urinary lithiasis represents an unusual urologic complication in renal transplantation, with an incidence of lithiasis, which does not occur in patients from living donors, owing to screening with computerized tomography. The aim of this study was to evaluate the incidence, diagnosis, and therapeutic management of renal lithiasis in transplanted kidneys at a single institution. We reviewed the medical records for 1,313 patients who underwent kidney transplantation from February 1968 to February 2011. Among the grafts, 17 patients (1.29%) had nephrolithiasis: 9 women and 8 men. Ages ranged from 32 to 63 years (mean = 45.6 years). Fifteen patients received kidneys from cadaveric and only 2 from living related donors. Two stones, both located inside the ureter, were identified during transplant surgery (11.7%). Three instances of lithiasis were incidentally diagnosed by ultrasound during graft evaluation, within 7 days after surgery (17.6%); all 3 were in the calyces. The 12 remaining patients had the stones diagnosed later (70.58%): 6 in the calyces, 3 in the renal pelvis, and 3 inside the ureter. Urinary lithiasis is a rare complication in renal transplantation. In most patients the condition occurs without pain. The diagnosis and treatment options for graft urolithiasis are similar to those patients with nephrolithiasis in the general population. Extracorporeal shock wave lithotripsy (ESWL) was the most common treatment method. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Incidence and management of life-threatening adverse events during cardiac catheterization for congenital heart disease.

    Science.gov (United States)

    Lin, C Huie; Hegde, Sanjeet; Marshall, Audrey C; Porras, Diego; Gauvreau, Kimberlee; Balzer, David T; Beekman, Robert H; Torres, Alejandro; Vincent, Julie A; Moore, John W; Holzer, Ralf; Armsby, Laurie; Bergersen, Lisa

    2014-01-01

    Continued advancements in congenital cardiac catheterization and interventions have resulted in increased patient and procedural complexity. Anticipation of life-threatening events and required rescue measures is a critical component to preprocedural preparation. We sought to determine the incidence and nature of life-threatening adverse events in congenital and pediatric cardiac catheterization, risk factors, and resources necessary to anticipate and manage events. Data from 8905 cases performed at the 8 participating institutions of the Congenital Cardiac Catheterization Project on Outcomes were captured between 2007 and 2010 [median 1,095/site (range 133-3,802)]. The incidence of all life-threatening events was 2.1 % [95 % confidence interval (CI) 1.8-2.4 %], whereas mortality was 0.28 % (95 % CI 0.18-0.41 %). Fifty-seven life-threatening events required cardiopulmonary resuscitation, whereas 9 % required extracorporeal membrane oxygenation. Use of a risk adjustment model showed that age events. Using this model, standardized life-threatening event ratios were calculated, thus showing that one institution had a life-threatening event rate greater than expected. Congenital cardiac catheterization and intervention can be performed safely with a low rate of life-threatening events and mortality; preprocedural evaluation of risk may optimize preparation of emergency rescue and bailout procedures. Risk predictors (age < 1, hemodynamic vulnerability, and procedure risk category) can enhance preprocedural patient risk stratification and planning.

  14. Physical demands in competitive ultimate frisbee

    DEFF Research Database (Denmark)

    Krustrup, Peter; Mohr, Magni

    2015-01-01

    The objective was to study game demands in competitive ultimate Frisbee by performing match analysis during a game. Thirteen moderately trained (Yo-Yo intermittent recovery test levels 1 and 2 [Yo-Yo IR1 and IR2] performance: 1790 ± 382 m and 657 ± 225 m, respectively) competitive male ultimate F...... = 0.74, p ≤ 0.05). Ultimate Frisbee is an intense intermittent team sport with high cardiovascular loading and clear indications of fatigue toward the end of each half. Yo-Yo IR test performances correlate with physical match performance.......The objective was to study game demands in competitive ultimate Frisbee by performing match analysis during a game. Thirteen moderately trained (Yo-Yo intermittent recovery test levels 1 and 2 [Yo-Yo IR1 and IR2] performance: 1790 ± 382 m and 657 ± 225 m, respectively) competitive male ultimate...

  15. Incidence and management of chemotherapy-induced nausea and vomiting in women with breast cancer

    Directory of Open Access Journals (Sweden)

    Thais de Oliveira Gozzo

    Full Text Available The objective of this study was to analyze the incidence of chemotherapy-induced nausea and vomiting in women with breast cancer and identify strategies used by them to control these signs and symptoms. Data for this cross-sectional study were collected through interviews during the last cycle of chemotherapy, between August 2011 and March 2012, in a university hospital in the State of São Paulo. The sample consisted of 22 women between the ages of 31 and 70, of whom 77.3% reported nausea and 50% vomiting during treatment. Regarding symptom management, 82% of the women reported having received some information centered on the use of prescribed medication. However, 27.3% did not know what medication they had taken. We concluded that there is a lack of systematic care and institutional protocol to guide professionals in providing standardized information to women so they can better control nausea and vomiting.

  16. Hepatic adenoma: incidence and management between the year 2002-2006 Hospital R. Calderon Guardia

    International Nuclear Information System (INIS)

    Pages Zamora, Alberto

    2008-01-01

    The incidence and management of hepatic adenoma at the Hospital Calderon Guardia are analyzed between the years 2002-2006. The main hepatic pathologies diagnosed by biopsy are shown. The relationship of hepatic adenoma with the above risk factors and presentation of each case of hepatic adenoma found are analyzed. The media diagnosed in this type of pathology were investigated. The evolution and control of each case of hepatic adenoma have been studied. The results of the management of each case are compared with the recommended in literature. The ideal management of this type of pathology is analyzed. Among the conclusions is given benign liver pathology as the most frequent cause of liver biopsy in the Hospital Calderon Guardia. Metastatic disease of the digestive tract has been the primary neoplastic disease at the hepatic level. Focal nodular hyperplasia has been the biopsy of benign tumor that is performed more frequently. Hepatic adenoma has been a rare entity, but with significant mortality rates. All cases were presented as solitary lesions. It is more common in women of childbearing age but can occur also in older people and in men. A close relationship has existed between the use of oral gestagens and the incidence of hepatic adenoma. Hepatic adenomas and its complications have been related to its size. Most cases of hepatic adenoma were presented with symptoms. The preoperative studies have shown high sensitivity in the detection of lesions, but little specificity. A protocol for the study of hepatic masses is required. A relationship between the size of the adenoma and possible complications was demonstrated. The reason for surgery in most cases has been the possibility of malignancy in the liver injury. The correlation between preoperative diagnosis and the end was unsuccessful in 75 percent of cases. The mortality related to the procedures did not exist, but if a case of morbidity. The study of liver masses should be more exhaustive to improve

  17. Wilderness education: The ultimate commitment to quality wilderness stewardship

    Science.gov (United States)

    Gregory F. Hansen; Tom Carlson

    2007-01-01

    The effective planning, implementation, and monitoring of a wilderness education program will ultimately produce measurable results that can be instrumental in achieving wilderness management goals and objectives. This paper will provide a simple step-by-step overview of how to develop and maintain a successful wilderness education program through planning,...

  18. Safety related aspects of ultimate disposal of radioactive wastes

    International Nuclear Information System (INIS)

    Goemmel, R.

    1992-01-01

    Solutions and questions related to nuclear waste management are presented. In particular, long-term safety of repositories in Germany and Sweden is considered, with special attention being paid to methods of detection, geotechnical barriers and post-operational phase of salt dome repositories, and conditioning of wastes to make them fit for ultimate disposal. (DG) [de

  19. [Incidence and management of monozygotic twin conceived by assisted reproductive techniques].

    Science.gov (United States)

    Mo, Lijing; Jin, Congcong; Wu, Yonggen; Wang, Peiyu; Lin, Jia; Zhao, Junzhao

    2015-08-01

    To analysis the incidence and management of monozygotic twin (MZT) conceived by assisted reproductive techniques (ART). A retrospective analysis of clinical pregnancies and MZT that resulted from ART was performed in Reproductive Medical Center, the First Affiliated Hospital, Wenzhou Medical University between January 2011 and January 2014. A total of 5 908 pregnancies were diagnosed: 2 012 twins, 157 high-order multiple pregnancy (HOMP), including 4 quadruplets. Overall, 51 MZT pregnancies were identified of them including 32 cases HOMP and 19 cases MZT. The incidence of MZT resulting from cleavage-stage embryo transfer was similar to blastocyst transfer (P = 0.960). The percent of MZT resulting from in vitro fertilization [0.93% (28/3 022)], frozen-thawed embryo transfer [0.87% (13/1 502)] and intracytoplamic sperm injection [0.72% (10/1 384)] did not show statistical significance (P = 0.794). The expectantly managed MZT was associated with a significantly greater likelihood of miscarriage [6/19 vs 5.11% (101/1 976)], and low birth weight infant [73.91% (17/23) vs 42.89% (1 453/3 388), P < 0.01], when compared with dizygotic twin (DZT) did not undergo selective embryo reduction (SER). In monozygotic (MZ)-triplets with SER to 2 fetuses or to 1 fetus, there was no cases of preterm birth or low birth weight infant observed in MZ-triplets with SER to 1 fetus; when compared with MZ-triplets with SER to 2 fetuses, the low birth weight infant [56.00% (14/25), P = 0.021] has statistical significance. The likelihood of the survival of two babies was lower in MZ-triplets with SER to 2 fetuses when compared with non-MZ triplets with SER to 2 fetuses [42.86% (9/21) vs 75.21% (91/121), P = 0.003]. The incidence of MZT pregnancies following ART is high. It plays a significant role in the occurrence of HOMP. MZT pregnancies are at an increased risk of adverse outcomes, it should transform to a single embryo thansfer (SET) program to reduce them incideuce. Reduction of MZT

  20. Bleeding complications after oral surgery in outpatients with compromised haemostasis: incidence and management.

    Science.gov (United States)

    Reich, Waldemar; Kriwalsky, Marcus S; Wolf, Hans H; Schubert, Johannes

    2009-06-01

    PURPOSE AND RESULTS: The aim of this prospective study was to determine the incidence of postoperative bleeding after oral surgery under local anaesthesia performed in outpatients with haemostatic disorders within a 5-year period (2003-2007). One hundred twenty one (70 males, 51 females) out of 2,056 outpatients with different haemostatic disorders (acquired or hereditary) were included in this study. The following data were recorded: medical history and general condition; medications; indication for the surgical procedure; specification of local anaesthesia; applied surgical techniques, considering the kind of haemostatic disorder; and peri- or postoperative bleeding complications. Postoperative bleeding was observed in 12 patients (9.9%). In three cases, inpatient treatment became necessary. The management of two patients with a haemostatic disorder (von Willebrand s disease and haemophilia A) is presented in short case reports. In a heterogeneous group of 121 outpatients with known haemostatic disorders, a combination of a few haemostatic agents with appropriate operative technique enables an effective wound management. In cases of failed local interventions after postoperative bleeding, further diagnostic investigations are required.

  1. National Incident Management System (NIMS) Standards Review Panel Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Kirk, Jennifer L.; Stanton, James R.; Shebell, Peter; Schwartz, Deborah S.; Judd, Kathleen S.; Gelston, Gariann M.

    2006-02-07

    The importance and need for full compliant implementation of NIMS nationwide was clearly demonstrated during the Hurricane Katrina event, which was clearly expressed in Secretary Chertoff's October 4, 2005 letter addressed to the State's governors. It states, ''Hurricane Katrina was a stark reminder of how critical it is for our nation to approach incident management in a coordinated, consistent, and efficient manner. We must be able to come together, at all levels of government, to prevent, prepare for, respond to, and recover from any emergency or disaster. Our operations must be seamless and based on common incident management doctrine, because the challenges we face as a nation are far greater than capabilities of any one jurisdiction.'' The NIMS is a system/architecture for organizing response on a ''national'' level. It incorporations ICS as a main component of that structure (i.e., it institutionalizes ICS in NIMS). In a paper published on the NIMS Website, the following statements were made: ''NIMS represents a core set of doctrine, principles, terminology, and organizational processes to enable effective, efficient and collaborative incident management at all levels. To provide the framework for interoperability and compatibility, the NIMS is based on a balance between flexibility and standardization.'' Thus the NIC is challenged with the need to adopt quality SDO generated standards to support NIMS compliance, but in doing so maintain the flexibility necessary so that response operations can be tailored for the specific jurisdictional and geographical needs across the nation. In support of this large and complex challenge facing the NIC, the Pacific Northwest National Laboratory (PNNL) was asked to provide technical support to the NIC, through their DHS Science and Technology ? Standards Portfolio Contract, to help identify, review, and develop key standards for NIMS compliance. Upon

  2. Final Documentation: Incident Management And Probabilities Courses of action Tool (IMPACT).

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, Donna M.; Ray, Jaideep; Tucker, Mark D.; Whetzel, Jonathan; Cauthen, Katherine Regina

    2018-03-01

    This report pulls together the documentation produced for the IMPACT tool, a software-based decision support tool that provides situational awareness, incident characterization, and guidance on public health and environmental response strategies for an unfolding bio-terrorism incident.

  3. Incidental intracardiac thromboemboli during liver transplantation: incidence, risk factors, and management.

    Science.gov (United States)

    Xia, Victor W; Ho, Jonathan K; Nourmand, Hamid; Wray, Christopher; Busuttil, Ronald W; Steadman, Randolph H

    2010-12-01

    Even though numerous cases of massive thromboemboli have been reported in the literature, intracardiac thromboemboli (ICTs) incidentally found during orthotopic liver transplantation (OLT) have not been examined. In this study, we retrospectively examined the incidence, risk factors, and management of incidental ICTs during OLT. After institutional review board approval, adult patients who underwent OLT between January 2004 and December 2008 at our center were reviewed. ICTs were identified and confirmed by the examination of OLT datasheets, anesthesia records, and recorded transesophageal echocardiography (TEE) clips. The clinical presentation, management, and outcomes of the patients with ICTs were reviewed. Risk factors were analyzed by multivariate logistic regression. During the study period, 426 of the 936 adult OLT patients (45.5%) underwent intraoperative TEE monitoring. Incidental ICTs were identified in 8 of these 426 patients (1.9%). Two ICTs occurred before reperfusion, and 6 ICTs occurred after reperfusion. The treatment was at the discretion of the treating physicians; however, none of the patients received an anticoagulant or thrombolytics. Multivariate analysis identified 2 independent risk factors for intraoperative incidental ICTs: the presence of symptomatic or surgically treated portal hypertension (a history of gastrointestinal bleeding, a transjugular intrahepatic portosystemic shunt procedure, or portocaval shunt surgery) before OLT and intraoperative hemodialysis (odds ratios of 4.05 and 7.29, respectively; P ICTs during OLT occurred at a rate of 1.9% and were associated with several preoperative and intraoperative risk factors. The use of TEE allows early identification, which may be important. Our management for incidental ICTs is described; however, no conclusions can be made about the optimal therapy. Copyright © 2010 American Association for the Study of Liver Diseases.

  4. Vertebral artery injury during foraminal decompression in "low-risk" cervical spine surgery: incidence and management.

    Science.gov (United States)

    Obermüller, Thomas; Wostrack, Maria; Shiban, Ehab; Pape, Haiko; Harmening, Kathrin; Friedrich, Benjamin; Prothmann, Sascha; Meyer, Bernhard; Ringel, Florian

    2015-11-01

    Vertebral artery injury (VAI) during foraminal decompression in cervical spine surgery in the absence of repositioning or screw stabilization is rare. Without immediate recognition and treatment, it may have disastrous consequences. We aimed to describe the incidence and management of iatrogenic VAI in low-risk cervical spine surgery. The records of all patients who underwent surgical procedures of the cervical spine between January 2007 and May 2012 were retrospectively consecutively evaluated. Anterior cervical discectomy and fusion or arthroplasty as well as dorsal foraminal decompression through the Frykholm approach in degenerative diseases were defined as low-risk surgeries (n = 992). VAI occurred in 0.3 % (n = 3) of 992 procedures: in one case during a dorsal foraminal decompression, and in two cases during the anterior cervical discectomy and fusion (ACDF) of two or four levels, respectively. In the first case, the VAI was intraoperatively misdiagnosed. Despite an initially uneventful course, the patient suffered hemorrhage from a pseudoaneurysm of the injured VA 1 month after surgery. The aneurysm was successfully occluded by endovascular coiling. In both ACDF cases, angiography and endovascular stenting of the lacerated segment proceeded immediately after the surgery. All three patients suffered no permanent deterioration. In a high-volume surgical center, the incidence of VAI during low-risk cervical spine surgery is extremely low, comprising 0.3 % of all cases. The major risks are delayed sequels of the vessel wall laceration. In cases of VAI, immediate angiographic diagnostics and generous indications for endovascular treatment are obligatory.

  5. Duration and predictors of emergency surgical operations - basis for medical management of mass casualty incidents

    Directory of Open Access Journals (Sweden)

    Huber-Wagner S

    2009-12-01

    Full Text Available Abstract Background Hospitals have a critically important role in the management of mass causality incidents (MCI, yet there is little information to assist emergency planners. A significantly limiting factor of a hospital's capability to treat those affected is its surgical capacity. We therefore intended to provide data about the duration and predictors of life saving operations. Methods The data of 20,815 predominantly blunt trauma patients recorded in the Trauma Registry of the German-Trauma-Society was retrospectively analyzed to calculate the duration of life-saving operations as well as their predictors. Inclusion criteria were an ISS ≥ 16 and the performance of relevant ICPM-coded procedures within 6 h of admission. Results From 1,228 patients fulfilling the inclusion criteria 1,793 operations could be identified as life-saving operations. Acute injuries to the abdomen accounted for 54.1% followed by head injuries (26.3%, pelvic injuries (11.5%, thoracic injuries (5.0% and major amputations (3.1%. The mean cut to suture time was 130 min (IQR 65-165 min. Logistic regression revealed 8 variables associated with an emergency operation: AIS of abdomen ≥ 3 (OR 4,00, ISS ≥ 35 (OR 2,94, hemoglobin level ≤ 8 mg/dL (OR 1,40, pulse rate on hospital admission 120/min (OR 1,39, blood pressure on hospital admission Conclusions The mean operation time of 130 min calculated for emergency life-saving surgical operations provides a realistic guideline for the prospective treatment capacity which can be estimated and projected into an actual incident admission capacity. Knowledge of predictive factors for life-saving emergency operations helps to identify those patients that need most urgent operative treatment in case of blunt MCI.

  6. The incidence and management of infusion reactions to infliximab: a large center experience.

    Science.gov (United States)

    Cheifetz, Adam; Smedley, Michelle; Martin, Sara; Reiter, Monica; Leone, Grace; Mayer, Lloyd; Plevy, Scott

    2003-06-01

    To assess the incidence and management of infusion reactions to infliximab, a chimeric monoclonal antibody that targets human tumor necrosis factor-alpha, in patients with Crohn's disease treated at a large infusion center. A total of 165 consecutive patients who received 479 infliximab infusions in the Division of Clinical Immunology Infusion Center at Mount Sinai Medical Center from July, 1998 to January, 2001 were evaluated. Specific treatment protocols for initial and subsequent acute infusion reactions were followed and the outcomes documented. The overall incidence of infusion reactions to infliximab was 6.1% (29 of 479) of infusions, affecting 9.7% (16 of 165) of patients. Mild, moderate, or severe acute reactions occurred in 3.1% (15 of 479), 1.2% (six of 479), and 1.0% (five of 479) of infliximab infusions, respectively. Use of treatment protocols resulted in rapid resolution of all acute reactions to infliximab. With the prophylaxis protocol, all patients who experienced an initial mild or moderate acute reaction were able to receive additional infusions. Four patients experienced a total of five severe acute reactions. Three patients were retreated: two patients had no further problems, whereas one patient had a second severe acute reaction that rapidly resolved with treatment. Suggesting that acute infusion reactions are not type I hypersensitivity reactions, in 11 patients who experienced 14 acute infusion reactions, serum tryptase levels were normal. Delayed infusion reactions occurred in 0.6% (three of 479) of infusions. Infliximab infusions were accompanied by acute reactions in approximately 5% of infusions. These reactions did not seem to be true IgE-mediated type I hypersensitivity events. Using appropriate treatment protocols, these reactions were effectively treated and prevented upon retreatment in nearly all patients. Delayed reactions were rare, occurring in <1% of infusions.

  7. Do postsurgical interventions optimize ultimate scar cosmesis.

    Science.gov (United States)

    Viera, M H; Amini, S; Konda, S; Berman, B

    2009-06-01

    Keloids and other scars are different manifestations of the normal wound healing process. If located in visible areas, scars may have a psychological impact that could affect the quality of life of the scar-bearing population. Good preoperatory planning including hiding incisions in natural anatomical landmarks or placing them parallel to relaxed skin tension lines are among the techniques used to improve the cosmesis of scars. Once a prominent or noticeable scar has developed, multiple therapeutic modalities can be applied including surgical excision, although high recurrence rates precludes its use as monotherapy. Several advanced surgical correction techniques including Z-plasty and W-plasty may be useful in repositioning scars. Other modalities that have been reported to improve scar cosmesis include cryosurgery, radiotherapy, lasers, and skin substitute grafts. Adjuvant postsurgical treatment modalities have reduced dramatically the recurrence rates associated with the removal of the scar. In this review of the literature the authors discuss evidence based data related to the abovementioned modalities and other topical and intralesional therapies including occlusion, compression, silicone, corticosteroids, interferons, imiquimod, resiquimod, tacrolimus, 5-fluorouracil, retinoids, as well as the role of several over-the-counter agents such as onion extract, vitamin E and the combination of hydrocortisone, vitamin E and silicone. Finally, they address newer modalities including vascular endothelial growth factor inhibitor, transforming growth factor-3, interleukin-10, mannose-6-phosphate, UVA-1, narrowband UVB, intense pulsed light and photodynamic therapy. Ultimately, the decision of choosing the most appropriate postexcisional management treatment should be taken by physicians on a case-by-case basis in order to obtain the best cosmetically acceptable results.

  8. Subclavian Vein Stenosis/Occlusion Following Transvenous Cardiac Pacemaker and Defibrillator Implantation: Incidence, Pathophysiology and Current Management

    Directory of Open Access Journals (Sweden)

    Brian O'Leary

    2015-08-01

    Full Text Available Subclavian vein stenosis is a common, but usually asymptomatic, complication following cardiac device placement. In addition to reviewing the literature on incidence, pathogenesis and management options for this important clinical problem, we describe two cases of symptomatic subclavian vein occlusion following pacemaker/defibrillator placement and successful treatment with venoplasty and stenting.

  9. Incidence of Artifacts and Deviating Values in Research Data Obtained from an Anesthesia Information Management System in Children

    NARCIS (Netherlands)

    Hoorweg, Anne-Lee J; Pasma, Wietze; van Wolfswinkel, Leo; de Graaff, Jurgen C

    BACKGROUND: Vital parameter data collected in anesthesia information management systems are often used for clinical research. The validity of this type of research is dependent on the number of artifacts. METHODS: In this prospective observational cohort study, the incidence of artifacts in

  10. Principles of Emergency Department facility design for optimal management of mass-casualty incidents.

    Science.gov (United States)

    Halpern, Pinchas; Goldberg, Scott A; Keng, Jimmy G; Koenig, Kristi L

    2012-04-01

    The Emergency Department (ED) is the triage, stabilization and disposition unit of the hospital during a mass-casualty incident (MCI). With most EDs already functioning at or over capacity, efficient management of an MCI requires optimization of all ED components. While the operational aspects of MCI management have been well described, the architectural/structural principles have not. Further, there are limited reports of the testing of ED design components in actual MCI events. The objective of this study is to outline the important infrastructural design components for optimization of ED response to an MCI, as developed, implemented, and repeatedly tested in one urban medical center. In the authors' experience, the most important aspects of ED design for MCI have included external infrastructure and promoting rapid lockdown of the facility for security purposes; an ambulance bay permitting efficient vehicle flow and casualty discharge; strategic placement of the triage location; patient tracking techniques; planning adequate surge capacity for both patients and staff; sufficient command, control, communications, computers, and information; well-positioned and functional decontamination facilities; adequate, well-located and easily distributed medical supplies; and appropriately built and functioning essential services. Designing the ED to cope well with a large casualty surge during a disaster is not easy, and it may not be feasible for all EDs to implement all the necessary components. However, many of the components of an appropriate infrastructural design add minimal cost to the normal expenditures of building an ED. This study highlights the role of design and infrastructure in MCI preparedness in order to assist planners in improving their ED capabilities. Structural optimization calls for a paradigm shift in the concept of structural and operational ED design, but may be necessary in order to maximize surge capacity, department resilience, and patient and

  11. Delayed Chemotherapy-Induced Nausea and Vomiting: Pathogenesis, Incidence, and Current Management.

    Science.gov (United States)

    Rapoport, Bernardo L

    2017-01-01

    Even when chemotherapy-induced nausea and vomiting (CINV) can be effectively controlled in the acute phase, it may still occur in the delayed phase. Identifying at-risk patients is complex and requires consideration of clinical, personal, demographic, and behavioral factors. Delayed CINV has a significant detrimental effect on patients' daily life and is responsible for significant healthcare resource utilization. Patients who do not experience acute CINV are not necessarily exempt from delayed CINV, and healthcare professionals have been shown to underestimate the incidence of delayed CINV. Failure to protect against CINV during the first cycle of chemotherapy is the most significant independent risk factor for delayed CINV during subsequent cycles. Addition of a neurokinin-1 receptor antagonist to antiemetic prophylactic regimens involving a 5-hydroxytryptamine type 3 receptor antagonist and a corticosteroid helps to ameliorate delayed CINV, particularly vomiting. Netupitant and rolapitant are second-generation neurokinin-1 receptor antagonists that provide effective prophylaxis against delayed chemotherapy-induced vomiting and also have an antinausea benefit. All of the neurokinin-1 receptor antagonists with the exception of rolapitant inhibit or induce cytochrome P450 3A4 (CYP3A4), and a reduced dose of dexamethasone (a CYP3A4 substrate) should be administered with aprepitant or netupitant; by contrast, this is not necessary with rolapitant. Here we review specific challenges associated with delayed CINV, its pathophysiology, epidemiology, treatment, and outcomes relative to acute CINV, and its management within the larger context of overall CINV.

  12. Acute ureterolithiasis: Incidence of secondary signs on unenhanced helical CT and influence on patient management

    Energy Technology Data Exchange (ETDEWEB)

    Ege, G. E-mail: gurkanege@yahoo.com; Akman, H.; Kuzucu, K.; Yildiz, S

    2003-12-01

    AIM: The purpose of this study was to determine the incidence of secondary signs associated with ureteral stones on unenhanced helical computed tomography (CT) of patients with acute renal colic, and to correlate these with patient management and outcome. MATERIALS AND METHODS: One hundred and ten patients with ureterolithiasis were evaluated prospectively for the secondary signs of obstruction on unenhanced helical CT. Our attention was focused primarily on the presence or absence of seven secondary signs on unenhanced helical CT, including hydronephrosis, unilateral renal enlargement, perinephric oedema, unilateral absence of the white pyramid, hydroureter, periureteral oedema and lateroconal fascial thickening. RESULTS: Of the 110 patients, 91 (82.7%) had hydroureter, 88 (80%) had hydronephrosis, 65 (59%) had periureteric oedema and 63 (57.2%) had unilateral renal enlargement. Ninety stones passed spontaneously and 21 required intervention. CONCLUSION: Secondary signs of urinary tract obstruction are useful and supportive findings in interpretation of the CT examination. In our experience, the most reliable signs indicating ureteral obstruction are hydroureter, hydronephrosis, periureteral oedema and unilateral renal enlargement, respectively. In addition, stones larger than 6 mm, located within the proximal two thirds of the ureter, and seen associated with five or more the secondary signs of obstruction, are more likely to require endoscopic removal and/or lithotripsy.

  13. Incidence, risk factors and management of severe post-transsphenoidal epistaxis.

    Science.gov (United States)

    De Los Reyes, Kenneth M; Gross, Bradley A; Frerichs, Kai U; Dunn, Ian F; Lin, Ning; Rincon-Torroella, Jordina; Annino, Donald J; Laws, Edward R

    2015-01-01

    Among the major complications of transsphenoidal surgery, less attention has been given to severe postoperative epistaxis, which can lead to devastating consequences. In this study, we reviewed 551 consecutive patients treated over a 4 year period by the senior author to evaluate the incidence, risk factors, etiology and management of immediate and delayed post-transsphenoidal epistaxis. Eighteen patients (3.3%) developed significant postoperative epistaxis - six immediately and 12 delayed (mean postoperative day 10.8). Fourteen patients harbored macroadenomas (78%) and 11 of 18 (61.1%) had complex nasal/sphenoid anatomy. In the immediate epistaxis group, 33% had acute postoperative hypertension. In the delayed group, one had an anterior ethmoidal pseudoaneurysm, and one had restarted anticoagulation on postoperative day 3. We treated the immediate epistaxis group with bedside nasal packing followed by operative re-exploration if conservative measures were unsuccessful. The delayed group underwent bedside nasal hemostasis; if unsuccessful, angiographic embolization was performed. After definitive treatment, no patients had recurrent epistaxis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Contemporary, age-based trends in the incidence and management of patients with early-stage kidney cancer.

    Science.gov (United States)

    Tan, Hung-Jui; Filson, Christopher P; Litwin, Mark S

    2015-01-01

    Although kidney cancer incidence and nephrectomy rates have risen in tandem, clinical advances have generated new uncertainty regarding the optimal management of patients with small renal tumors, especially the elderly. To clarify existing practice patterns, we assessed contemporary trends in the incidence and management of patients with early-stage kidney cancer. Using Surveillance, Epidemiology, and End Results data, we identified adult patients diagnosed with T1aN0M0 kidney cancer from 2000 to 2010. We determined age-adjusted and age-specific incidence and management rates (i.e., nonoperative, ablation, partial nephrectomy [PN], and radical nephrectomy) per 100,000 adults and determined the average annual percent change (AAPC). Finally, we compared management groups using multinomial logistic regression accounting for patient characteristics, cancer information, and county-level measures for health. From 2000 to 2010, we identified 41,645 adults diagnosed with T1aN0M0 kidney cancer. Overall incidence increased from 3.7 to 7.0 per 100,000 adults (AAPC = 7.0%, Pmanagement and ablation approached nephrectomy rates for those aged 75 to 84 years and became the predominant strategy for patients older than 84 years. Adjusting for clinical, oncological, and environmental factors, older patients less frequently underwent PN and more often received ablative or nonoperative management (P<0.001). As the incidence of early-stage kidney cancer rises, patients are increasingly treated with nonoperative and nephron-sparing strategies, especially among the most elderly. The broader array of treatment options suggests opportunities to better personalize kidney cancer care for seniors. Published by Elsevier Inc.

  15. Ultimate Strength of Ship Hulls under Torsion

    DEFF Research Database (Denmark)

    Paik, Jeom Kee; Thayamballi, Anil K.; Pedersen, Preben Terndrup

    2001-01-01

    subjected to torsion. A procedure for calculating these stresses is briefly described. As an illustrative example, the distribution and magnitude of warping and shear stresses for a typical container vessel hull cross section under unit torsion is calculated by the procedure. By theoretical and numerical...... analyses, it is shown that the influence of torsion induced warping stresses on the ultimate hull girder bending strength is small for ductile hull materials while torsion induced shear stresses will of course reduce the ship hull ultimate bending moment....

  16. The incidence and management of postoperative chylothorax after pulmonary resection and thoracic mediastinal lymph node dissection.

    Science.gov (United States)

    Bryant, Ayesha S; Minnich, Douglas J; Wei, Benjamin; Cerfolio, Robert James

    2014-07-01

    Our objective was to determine the incidence and optimal management of chylothorax after pulmonary resection with complete thoracic mediastinal lymph node dissection (MLND). This is a retrospective review of patients who underwent pulmonary resection with MLND. Between January 2000 and December 2012, 2,838 patients underwent pulmonary resection with MLND by one surgeon (RJC). Forty-one (1.4%) of these patients experienced a chylothorax. Univariate analysis showed that lobectomy (p<0.001), a robotic approach (p=0.03), right-sided operations (p<0.001), and pathologic N2 disease (p=0.007) were significantly associated with the development of chylothorax. Multivariate analysis showed that lobectomy (p=0.011), a robotic approach (p=0.032), and pathologic N2 disease (p=0.027) remained predictors. All patients were initially treated with cessation of oral intake and 200 μg subcutaneous somatostatin every 8 hours. If after 48 hours the chest tube output was less than 450 mL/day and the effluent was clear, patients was given a medium-chain triglyceride (MCT) diet and were observed for 48 hours in the hospital. If the chest tube output remained below 450 mL/day, the chest tube was removed, they were discharged home with directions to continue the MCT diet and to return in 2 weeks. Patients were instructed to consume a high-fat meal 24 hours before their clinic appointment. If the patient's chest roentgenogram was clear at that time, they were considered "treated." This approach was successful in 37 (90%) patients. The 4 patients in whom the initial treatment was unsuccessful underwent reoperation with pleurodesis and duct ligation. Chylothorax after pulmonary resection and MLND occurred in 1.4% of patients. Its incidence was higher in those with pathologic N2 disease and those who underwent robotic resection. Nonoperative therapy is almost always effective. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Incidence of Artifacts and Deviating Values in Research Data Obtained from an Anesthesia Information Management System in Children.

    Science.gov (United States)

    Hoorweg, Anne-Lee J; Pasma, Wietze; van Wolfswinkel, Leo; de Graaff, Jurgen C

    2018-02-01

    Vital parameter data collected in anesthesia information management systems are often used for clinical research. The validity of this type of research is dependent on the number of artifacts. In this prospective observational cohort study, the incidence of artifacts in anesthesia information management system data was investigated in children undergoing anesthesia for noncardiac procedures. Secondary outcomes included the incidence of artifacts among deviating and nondeviating values, among the anesthesia phases, and among different anesthetic techniques. We included 136 anesthetics representing 10,236 min of anesthesia time. The incidence of artifacts was 0.5% for heart rate (95% CI: 0.4 to 0.7%), 1.3% for oxygen saturation (1.1 to 1.5%), 7.5% for end-tidal carbon dioxide (6.9 to 8.0%), 5.0% for noninvasive blood pressure (4.0 to 6.0%), and 7.3% for invasive blood pressure (5.9 to 8.8%). The incidence of artifacts among deviating values was 3.1% for heart rate (2.1 to 4.4%), 10.8% for oxygen saturation (7.6 to 14.8%), 14.1% for end-tidal carbon dioxide (13.0 to 15.2%), 14.4% for noninvasive blood pressure (10.3 to 19.4%), and 38.4% for invasive blood pressure (30.3 to 47.1%). Not all values in anesthesia information management systems are valid. The incidence of artifacts stored in the present pediatric anesthesia practice was low for heart rate and oxygen saturation, whereas noninvasive and invasive blood pressure and end-tidal carbon dioxide had higher artifact incidences. Deviating values are more often artifacts than values in a normal range, and artifacts are associated with the phase of anesthesia and anesthetic technique. Development of (automatic) data validation systems or solutions to deal with artifacts in data is warranted.

  18. Analysis of eighty-four commercial aviation incidents - Implications for a resource management approach to crew training

    Science.gov (United States)

    Murphy, M. R.

    1980-01-01

    A resource management approach to aircrew performance is defined and utilized in structuring an analysis of 84 exemplary incidents from the NASA Aviation Safety Reporting System. The distribution of enabling and associated (evolutionary) and recovery factors between and within five analytic categories suggests that resource management training be concentrated on: (1) interpersonal communications, with air traffic control information of major concern; (2) task management, mainly setting priorities and appropriately allocating tasks under varying workload levels; and (3) planning, coordination, and decisionmaking concerned with preventing and recovering from potentially unsafe situations in certain aircraft maneuvers.

  19. Articulating (Ultimate) Commitments: Historical, Factual and ...

    African Journals Online (AJOL)

    Acknowledging that religion forms a constitutive part of human life is recently confirmed by Göbekli Tepe, an archaeological site in Turkey, from which it appears that religion is basic to all the other cultural developments within human society. This opened the way to illustrate the interplay between ultimate commitments and ...

  20. Incidental durotomy in lumbar spine surgery - incidence, risk factors and management

    Directory of Open Access Journals (Sweden)

    Adam D.

    2015-03-01

    Full Text Available Incidental durotomy is a common complication of lumbar spine operations for degenerative disorders. Its incidence varies depending on several risk factors and regarding the intra and postoperative management, there is no consensus. Our objective was to report our experience with incidental durotomy in patients who were operated on for lumbar disc herniation, lumbar spinal stenosis and revision surgeries. Between 2009 and 2012, 1259 patients were operated on for degenerative lumbar disorders. For primary operations, the surgical approach was mino-open, interlamar, uni- or bilateral, as for recurrences, the removal of the compressive element was intended: the epidural scar and the disc fragment. 863 patients (67,7% were operated on for lumbar disc herniation, 344 patients (27,3% were operated on for lumbar spinal stenosis and 52 patients (5% were operated for recurrences. The operations were performed by neurosurgeons with the same professional degree but with different operative volume. Unintentional durotomy occurred in 20 (2,3% of the patients with herniated disc, in 14 (4,07% of the patients with lumbar spinal stenosis and in 12 (23% of the patients who were operated on for recurrences. The most frequent risk factors were: obesity, revised surgery and the physician’s low operative volume. Intraoperative dural fissures were repaired through suture (8 cases, by applying muscle, fat graft or by applying curaspon, tachosil. There existed 4 CSF fistulas which were repaired at reoperation. Incidental dural fissures during operations for degenerative lumbar disorders must be recognized and immediately repaired to prevent complications such as CSF fistula, osteodiscitis and increased medical costs. Preventing, identifying and treating unintentional durotomies can be best achieved by respecting a neat surgical technique and a standardized treatment protocol.

  1. Surgical site infections following transcatheter apical aortic valve implantation: incidence and management.

    Science.gov (United States)

    Baillot, Richard; Fréchette, Éric; Cloutier, Daniel; Rodès-Cabau, Josep; Doyle, Daniel; Charbonneau, Éric; Mohammadi, Siamak; Dumont, Éric

    2012-11-13

    The present study was undertaken to examine the incidence and management of surgical site infection (SSI) in patients submitted to transapical transcatheter aortic valve implantation (TA-TAVI). From April 2007 to December 2011, 154 patients underwent TA-TAVI with an Edwards Sapien bioprosthesis (ES) at the Institut Universitaire de Cardiologie et Pneumologie de Québec (IUCPQ) as part of a multidisciplinary program to prospectively evaluate percutaneous aortic valve implantation. Patient demographics, perioperative variables, and postoperative complications were recorded in a prospective registry. Five (3.2%) patients in the cohort presented with an SSI during the study period. The infections were all hospital-acquired (HAI) and were considered as organ/space SSI's based on Center for Disease Control criteria (CDC). Within the first few weeks of the initial procedure, these patients presented with an abscess or chronic draining sinus in the left thoracotomy incision and were re-operated. The infection spread to the apex of the left ventricle in all cases where pledgeted mattress sutures could be seen during debridement. Patients received multiple antibiotic regimens without success until the wound was surgically debrided and covered with viable tissue. The greater omentum was used in three patients and the pectoralis major muscle in the other two. None of the patients died or had a recurrent infection. Three of the patients were infected with Staphylococcus epidermidis, one with Staphylococcus aureus, and one with Enterobacter cloacae. Patients with surgical site infections were significantly more obese with higher BMI (31.4±3.1 vs 26.2±4.4 p=0.0099) than the other patients in the cohort. While TA-TAVI is a minimally invasive technique, SSIs, which are associated with obesity, remain a concern. Debridement and rib resection followed by wound coverage with the greater omentum and/or the pectoralis major muscle were used successfully in these patients.

  2. Surgical site infections following transcatheter apical aortic valve implantation: incidence and management

    Directory of Open Access Journals (Sweden)

    Baillot Richard

    2012-11-01

    Full Text Available Abstract Objective The present study was undertaken to examine the incidence and management of surgical site infection (SSI in patients submitted to transapical transcatheter aortic valve implantation (TA-TAVI. Methods From April 2007 to December 2011, 154 patients underwent TA-TAVI with an Edwards Sapien bioprosthesis (ES at the Institut Universitaire de Cardiologie et Pneumologie de Québec (IUCPQ as part of a multidisciplinary program to prospectively evaluate percutaneous aortic valve implantation. Patient demographics, perioperative variables, and postoperative complications were recorded in a prospective registry. Results Five (3.2% patients in the cohort presented with an SSI during the study period. The infections were all hospital-acquired (HAI and were considered as organ/space SSI’s based on Center for Disease Control criteria (CDC. Within the first few weeks of the initial procedure, these patients presented with an abscess or chronic draining sinus in the left thoracotomy incision and were re-operated. The infection spread to the apex of the left ventricle in all cases where pledgeted mattress sutures could be seen during debridement. Patients received multiple antibiotic regimens without success until the wound was surgically debrided and covered with viable tissue. The greater omentum was used in three patients and the pectoralis major muscle in the other two. None of the patients died or had a recurrent infection. Three of the patients were infected with Staphylococcus epidermidis, one with Staphylococcus aureus, and one with Enterobacter cloacae. Patients with surgical site infections were significantly more obese with higher BMI (31.4±3.1 vs 26.2±4.4 p=0.0099 than the other patients in the cohort. Conclusions While TA-TAVI is a minimally invasive technique, SSIs, which are associated with obesity, remain a concern. Debridement and rib resection followed by wound coverage with the greater omentum and/or the pectoralis major

  3. Incidence, management, and course of cancer in patients with inflammatory bowel disease.

    Science.gov (United States)

    Algaba, Alicia; Guerra, Iván; Marín-Jiménez, Ignacio; Quintanilla, Elvira; López-Serrano, Pilar; García-Sánchez, María Concepción; Casis, Begoña; Taxonera, Carlos; Moral, Ignacio; Chaparro, María; Martín-Rodríguez, Daniel; Martín-Arranz, María Dolores; Manceñido, Noemí; Menchén, Luis; López-Sanromán, Antonio; Castaño, Ángel; Bermejo, Fernando

    2015-04-01

    Patients with inflammatory bowel disease [IBD] are at increased risk for developing some types of neoplasia. Our aims were to determin the risk for cancer in patients with IBD and to describe the relationship with immunosuppressive therapies and clinical management after tumor diagnosis. Retrospective, multicenter, observational, 5-year follow-up, cohort study. Relative risk [RR] of cancer in the IBD cohort and the background population, therapeutic strategies, and cancer evolution were analyzed. A total of 145 cancers were diagnosed in 133 of 9100 patients with IBD (global cumulative incidence 1.6% vs 2.4% in local population; RR = 0.67; 95% confidence interval [CI]: 0.57-0.78). Patients with IBD had a significantly increased RR of non-melanoma skin cancer [RR = 3.85; 2.53-5.80] and small bowel cancer [RR = 3.70; 1.23-11.13]. After cancer diagnosis, IBD treatment was maintained in 13 of 27 [48.1%] patients on thiopurines, in 2 of 3 on methotrexate [66.6%], none on anti-TNF-α monotherapy [n = 6] and 4 of 12 [33.3%] patients on combined therapy. Rate of death and cancer remission during follow-up did not differ [p > 0.05] between patients who maintained the treatment compared with patients who withdrew [5% vs 8% and 95% vs 74%, respectively]. An association between thiopurines [p = 0.20] or anti-TNF-α drugs [p = 0.77] and cancer was not found. Patients with IBD have an increased risk for non-melanoma skin cancer and small bowel cancer. Immunosuppresive therapy is not related to a higher overall risk for cancer or worse tumor evolution in patients who maintain these drugs after cancer diagnosis. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  4. A PROSPECTIVE STUDY ON INCIDENCE, AETIOPATHOGENESIS, CLINICAL PRESENTATION, MANAGEMENT AND PROGNOSIS OF LIVER ABSCESS

    Directory of Open Access Journals (Sweden)

    Geetha Danasekaran

    2017-05-01

    Full Text Available BACKGROUND Liver abscess continues to be a major diagnostic and therapeutic challenge to the medical fraternity. It is a life-threatening and a potentially serious condition if left untreated. Therefore, it is very important for prompt diagnosis and appropriate management at the earliest. This study was conducted to assess the incidence, aetiology, clinical presentation, management and prognosis of liver abscess in patients attending a tertiary care referral hospital. MATERIALS AND METHODS This study was conducted in Madurai Medical College Hospital, Madurai, from March 2015 to August 2016. The study population consists of patients admitted in General Surgery Wards of Madurai Medical College and Hospital, Madurai, with features suggestive of liver abscess. RESULTS Liver abscess was more commonly seen in the age group of 41-50 years. Male predominance 97.9% was seen in liver abscess. Nearly, two thirds of cases of liver abscess had a history of alcohol intake. Majority of liver abscess were amoebic and nearly 10% were pyogenic. Escherichia coli was the commonest organism causing pyogenic liver abscess. Abdominal pain was the commonest symptom of liver abscess followed by abdominal distension and fever. Right hypochondrial tenderness and intercostal tenderness were the common clinical signs in liver abscess. There was a predominant involvement of the right lobe of the liver. Percutaneous aspiration of abscess with antiamoebic and antibiotics forms the mainstay of treatment. Percutaneous catheter drainage is method of choice in failed aspiration and laparoscopic drainage or laparotomy and drainage is indicated in ruptured liver abscess. CONCLUSION Liver abscess was more commonly seen in the age group of 41-50 years. Male predominance 97.9% was seen in liver abscess. Nearly, two-thirds of cases of liver abscess had a history of alcohol intake. Majority of liver abscess were amoebic and nearly 10% were pyogenic. Escherichia coli was the commonest

  5. Application of Real-Time Automated Traffic Incident Response Plan Management System: A Web Structure for the Regional Highway Network in China

    Directory of Open Access Journals (Sweden)

    Yongfeng Ma

    2014-01-01

    Full Text Available Traffic incidents, caused by various factors, may lead to heavy traffic delay and be harmful to traffic capacity of downstream sections. Traffic incident management (TIM systems have been developed widely to respond to traffic incidents intelligently and reduce the losses. Traffic incident response plans, as an important component of TIM, can effectively guide responders as to what and how to do in traffic incidents. In the paper, a real-time automated traffic incident response plan management system was developed, which could generate and manage traffic incident response plans timely and automatically. A web application structure and a physical structure were designed to implement and show these functions. A standard framework of data storage was also developed to save information about traffic incidents and generated response plans. Furthermore, a conformation survey and case-based reasoning (CBR were introduced to identify traffic incident and generate traffic incident response plans automatically, respectively. Twenty-three traffic crash-related incidents were selected and three indicators were used to measure the system performance. Results showed that 20 of 23 cases could be retrieved effectively and accurately. The system is practicable to generate traffic incident response plans and has been implemented in China.

  6. A review and discussion of flight management system incidents reported to the Aviation Safety Reporting System

    Science.gov (United States)

    1992-02-01

    This report covers the activities related to the description, classification and : analysis of the types and kinds of flight crew errors, incidents and actions, as : reported to the Aviation Safety Reporting System (ASRS) database, that can occur as ...

  7. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records.

    Science.gov (United States)

    Cashmore, Aaron W; Indig, Devon; Hampton, Stephen E; Hegney, Desley G; Jalaludin, Bin B

    2012-08-09

    Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71%) was more common than physical abuse (29%). The most (44%) incidents of workplace violence (including both verbal and physical abuse) occurred in adult male prisons, although the most (50%) incidents of physical abuse occurred in a forensic hospital. Most (90%) of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as 'high risk' work duties for verbal abuse and physical abuse, respectively. Most (93%) of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46%) or low (52%) Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury - there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%). Few (6%) victims of verbal abuse sought help from a health professional. Among employees of a large correctional health service, verbal abuse in the workplace was substantially more common than physical abuse. The most incidents of workplace

  8. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

    Directory of Open Access Journals (Sweden)

    Cashmore Aaron W

    2012-08-01

    Full Text Available Abstract Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71% was more common than physical abuse (29%. The most (44% incidents of workplace violence (including both verbal and physical abuse occurred in adult male prisons, although the most (50% incidents of physical abuse occurred in a forensic hospital. Most (90% of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93% of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46% or low (52% Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%. Few (6% victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more

  9. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

    Science.gov (United States)

    2012-01-01

    Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71%) was more common than physical abuse (29%). The most (44%) incidents of workplace violence (including both verbal and physical abuse) occurred in adult male prisons, although the most (50%) incidents of physical abuse occurred in a forensic hospital. Most (90%) of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93%) of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46%) or low (52%) Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%). Few (6%) victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more common than physical

  10. Ultimate Longitudinal Strength of Composite Ship Hulls

    Science.gov (United States)

    Zhang, Xiangming; Huang, Lingkai; Zhu, Libao; Tang, Yuhang; Wang, Anwen

    2017-01-01

    A simple analytical model to estimate the longitudinal strength of ship hulls in composite materials under buckling, material failure and ultimate collapse is presented in this paper. Ship hulls are regarded as assemblies of stiffened panels which idealized as group of plate-stiffener combinations. Ultimate strain of the plate-stiffener combination is predicted under buckling or material failure with composite beam-column theory. The effects of initial imperfection of ship hull and eccentricity of load are included. Corresponding longitudinal strengths of ship hull are derived in a straightforward method. A longitudinally framed ship hull made of symmetrically stacked unidirectional plies under sagging is analyzed. The results indicate that present analytical results have a good agreement with FEM method. The initial deflection of ship hull and eccentricity of load can dramatically reduce the bending capacity of ship hull. The proposed formulations provide a simple but useful tool for the longitudinal strength estimation in practical design.

  11. SPIRITUAL QUOTIENT (SQ: THE ULTIMATE INTELLIGENCE

    Directory of Open Access Journals (Sweden)

    Rus'an Rus'an

    2013-07-01

    Abstract: This paper discusses the spiritual intelligence as the ultimate intelligence which exceeds the IQ and EQ. IQ or intelligence quotient is a form of intelligence that based on reasoning, intellectual ratio, which is a linear way of thinking that in-cludes the ability to count, analyze to evaluate. While EQ or Emotional Quotient based on emotional, namely the intelligence which is capable to control emotions and give empathy so a person is able to act natural. Therefore the true nature of the SQ or spiritual intelligence quotient was based on the soul. This intelligence makes people to have the ability to find meaning in life, as well as refine the manners. According to Danah Zohar SQ as the ultimate intelligence means that the meaning of life is the first and foremost goal of life for humans. Only intelligent people spiritually who can give meaning in his life.

  12. Methods of ultimate carbonaceous BOD determination

    Science.gov (United States)

    Stamer, J.K.; McKenzie, S.W.; Cherry, R.N.

    1979-01-01

    Studies were conducted to provide an accurate and practical technique for determining the concentration of ultimate carbonaceous biochemical oxygen demand and the rate at which this demand is exerted. The three methods evaluated were carbon derived, nitrification adjusted, and nitrification inhibited. The studies indicate that comparable concentrations and reaction rates can be determined from either non-nitrified samples using no chemical nitrifying inhibitor, or from partially nitrified samples using the chemical inhibitors, 1-allyl-2 thiourea or nitrapyrin, and that the combined use of time-series analysis and Lee's graphical method provide a reliable and accurate technique for determining ultimate biochemical oxygen demand concentration and reaction rate in 5 to 7 days.

  13. Ultimate gradient in solid-state accelerators

    Energy Technology Data Exchange (ETDEWEB)

    Whittum, D.H.

    1998-08-01

    The authors recall the motivation for research in high-gradient acceleration and the problems posed by a compact collider. They summarize the phenomena known to appear in operation of a solid-state structure with large fields, and research relevant to the question of the ultimate gradient. They take note of new concepts, and examine one in detail, a miniature particle accelerator based on an active millimeter-wave circuit and parallel particle beams.

  14. Spiritual Quotient (Sq): the Ultimate Intelligence

    OpenAIRE

    Rus'an, Rus'an

    2013-01-01

    : This paper discusses the spiritual intelligence as the ultimate intelligence which exceeds the IQ and EQ. IQ or intelligence quotient is a form of intelligence that based on reasoning, intellectual ratio, which is a linear way of thinking that in-cludes the ability to count, analyze to evaluate. While EQ or Emotional Quotient based on emotional, namely the intelligence which is capable to control emotions and give empathy so a person is able to act natural. Therefore the true nature of the ...

  15. Ultimate gradient in solid-state accelerators

    International Nuclear Information System (INIS)

    Whittum, D.H.

    1998-08-01

    The authors recall the motivation for research in high-gradient acceleration and the problems posed by a compact collider. They summarize the phenomena known to appear in operation of a solid-state structure with large fields, and research relevant to the question of the ultimate gradient. They take note of new concepts, and examine one in detail, a miniature particle accelerator based on an active millimeter-wave circuit and parallel particle beams

  16. Intra-operative periprosthetic fractures associated with press fit stems in revision total knee arthroplasty: incidence, management, and outcomes.

    Science.gov (United States)

    Cipriano, Cara A; Brown, Nicholas M; Della Valle, Craig J; Moric, Mario; Sporer, Scott M

    2013-09-01

    The purpose of this study is to report the incidence, management, and outcomes of periprosthetic fractures associated with the insertion of press-fit stems during revision total knee arthroplasty (TKA). Immediate and six week post-operative radiographs from 634 stemmed implants (307 femoral, 327 tibial) from 420 consecutive revision TKAs were reviewed. Sixteen tibial (4.9%) and 3 femoral (1%) fractures (combined incidence 3.0%) were identified. All healed uneventfully without operative intervention, with no evidence of implant loosening at a mean of 23 months (range 12 to 47 months). The technique of tightly press fitting stems into the diaphysis is associated with a small rate (3%) of periprosthetic fractures; most were non or minimally displaced, all healed uneventfully with non-operative management and were not associated with implant loosening. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Influence of occupational safety management on the incidence rate of occupational accidents in the Spanish industrial and ornamental stone mining.

    Science.gov (United States)

    Sanmiquel, Lluís; Rossell, Josep M; Vintró, Carla; Freijo, Modesto

    2014-01-01

    Mines are hazardous and workers can suffer many types of accidents caused by fire, flood, explosion or collapse. Injury incidence rates in mining are considerably higher than those registered by other economic sectors. One of the main reasons for this high-level incidence rate is the existence of a large number of dangerous workplaces. This work analyzes the influence that occupational safety management had on the accidents that took place in Spanish mining of industrial and ornamental stone during the period 2007-2008. Primary data sources are: (a) Results from a statistical study of the occupational health and safety management practices of 71 quarries defined by a questionnaire of 41 items; and (b) Occupational accidents registered in the Spanish industrial and ornamental stone mining throughout the period 2007-2008. The obtained results indicate that workplaces with a low average score in the analysis of occupational safety management have a higher incidence rate of accidents. Studies on mining workplaces are very important to help detect occupational safety concerns. Results from this study help raise awareness and will encourage the adoption of appropriate measures to improve safety.

  18. Application of Incident Command Structure to clinical trial management in the academic setting: principles and lessons learned.

    Science.gov (United States)

    Reynolds, Penny S; Michael, Mary J; Spiess, Bruce D

    2017-02-09

    Clinical trial success depends on appropriate management, but practical guidance to trial organisation and planning is lacking. The Incident Command System (ICS) is the 'gold standard' management system developed for managing diverse operations in major incident and public health arenas. It enables effective and flexible management through integration of personnel, procedures, resources, and communications within a common hierarchical organisational structure. Conventional ICS organisation consists of five function modules: Command, Planning, Operations, Logistics, and Finance/Administration. Large clinical trials will require a separate Regulatory Administrative arm, and an Information arm, consisting of dedicated data management and information technology staff. We applied ICS principles to organisation and management of the Prehospital Use of Plasma in Traumatic Haemorrhage (PUPTH) trial. This trial was a multidepartmental, multiagency, randomised clinical trial investigating prehospital administration of thawed plasma on mortality and coagulation response in severely injured trauma patients. We describe the ICS system as it would apply to large clinical trials in general, and the benefits, barriers, and lessons learned in utilising ICS principles to reorganise and coordinate the PUPTH trial. Without a formal trial management structure, early stages of the trial were characterised by inertia and organisational confusion. Implementing ICS improved organisation, coordination, and communication between multiple agencies and service groups, and greatly streamlined regulatory compliance administration. However, unfamiliarity of clinicians with ICS culture, conflicting resource allocation priorities, and communication bottlenecks were significant barriers. ICS is a flexible and powerful organisational tool for managing large complex clinical trials. However, for successful implementation the cultural, psychological, and social environment of trial participants must be

  19. Nipple Pain Incidence, the Predisposing Factors, the Recovery Period After Care Management, and the Exclusive Breastfeeding Outcome.

    Science.gov (United States)

    Puapornpong, Pawin; Paritakul, Panwara; Suksamarnwong, Maysita; Srisuwan, Siriwan; Ketsuwan, Sukwadee

    2017-04-01

    Nipple pain is the most common complaint of breastfeeding mothers during the immediate postpartum period. Persistent nipple pain is associated with low breastfeeding rate at 6 months postpartum. To further explore the incidence of nipple pain, associated predisposing factors, time for recovery after management, and the impact on exclusive breastfeeding rates. Included in this study were 1,649 singleton, pregnant women who delivered and had their 1-week follow-up at the breastfeeding clinic during the period of January 2013 to December 2015. The mothers who experienced nipple pain were analyzed for the incidence, the predisposing factors, and the recovery period after care management. The breastfeeding outcome comparison of both, mothers with and without pain, was measured by the exclusive breastfeeding rate at the sixth week postpartum. The incidence of nipple pain was at 9.6% by day 7. A predisposing factor of nipple pain was primiparity (relative risk = 1.8, 95% confidence interval 1.3-2.5). The reasons for nipple pain were inappropriate positioning and latching (72.3%), tongue-tie (23.2%), and oversupply (4.4%). The recovery period after care management was 1-2 weeks. There were no statistically significant differences between the 6-week exclusive breastfeeding rates of the mothers with nipple pain with treatment and the mothers without nipple pain. Persistent nipple pain was a common problem. The active management, including early detection and treatment, would help the mothers recover within a 2-week period and there was no significant difference of exclusive breastfeeding rates between the mothers who had early care management and the mothers without nipple pain.

  20. Error-Based Accidents and Security Incidents in Nuclear Materials Management

    International Nuclear Information System (INIS)

    Pond, Daniel J.; Greitzer, Frank L.

    2005-01-01

    Hazard and risk assessments, along with human error analysis and mitigation techniques, have long been mainstays of effective safety programs. These tools have revealed that worker errors contributing to or resulting in accidents are often the consequence of ineffective system conditions, process features, or individual employee characteristics. At Los Alamos National Laboratory (LANL), security, safety, human error, and organizational analysts determined that the system-induced human errors that make accidents more likely also are contributing to security incidents. A similar set of system conditions has been found to underlie deliberate, non-malevolent deviations from proper security practices - termed breaches - that also can result in a security incident. In fiscal-year (FY) 2002, LANL's Security Division therefore established the ESTHER (Enhanced Security Through Human Error Reduction) program to identify and reduce the influence of the factors that underlie employee errors and breaches and, in turn, security incidents. Recognizing the potential benefits of this program and approach, in FY2004 the Department of Energy (DOE) Office of Security Policy (DOE-SO) funded an expansion of ESTHER implementation to the causal assessment and reporting of security incidents at other DOE sites. This presentation will focus on three applications of error/breach assessment and mitigation techniques. One use is proactive, accomplished through the elimination of contributors to error, whereas two are reactive, implemented in response to accidents or security incidents as well as to near misses, to prevent recurrence. The human performance and safety bases of these techniques will be detailed. Associated tools - including computer-based assessment training and web-based incident reporting modules developed by Pacific Northwest National Laboratory - will be discussed

  1. Boro Silicate Glass: The proven Conditioning of RTR ultimate Waste

    International Nuclear Information System (INIS)

    Bartagnon, O.; Petitjean, V.

    2002-01-01

    The possibility to dispose of the RTR spent fuel in a geological repository is neither internationally foreseen nor seems realistic. This due to degradation phenomena and possible criticality incidents. The conditioning by reprocessing is the only solution for back end management of TRT spent fuels

  2. Tackling TB in low-incidence countries: improving diagnosis and management in vulnerable populations

    Directory of Open Access Journals (Sweden)

    C.C. Heuvelings

    2017-03-01

    Full Text Available In low tuberculosis incidence regions, tuberculosis is mainly concentrated among hard-to-reach populations like migrants, homeless people, drug or alcohol abusers, prisoners and people living with HIV. To be able to eliminate tuberculosis from these low incidence regions tuberculosis screening and treatment programs should focus on these hard-to-reach populations. Here we discuss the barriers and facilitators of health care-seeking, interventions improving tuberculosis screening uptake and interventions improving treatment adherence in these hard-to-reach populations.

  3. Is this the ultimate in recycling?

    International Nuclear Information System (INIS)

    Stern, M.

    1993-01-01

    In Germany, as in the US, packaging waste makes up a third of total municipal solid waste. The principle of polluter pays, or the internalizing of environmental costs by industry is being tested in Germany. Legislation, enacted on June 12, 1991, requires private industry to collect, sort, and ultimately recycle packaging waste including container to hold basic product, secondary packaging, and transport packaging. This article describes the problems and solutions of industry and the reaction of the public. Future legislation is briefly summarized along with possibilities of similar legislation in other countries

  4. Taxonometric Applications in Radiotherapy Incident Analysis

    International Nuclear Information System (INIS)

    Dunscombe, Peter B.; Ekaette, Edidiong U.; Lee, Robert C.; Cooke, David L.

    2008-01-01

    Recent publications in both the scientific and the popular press have highlighted the risks to which patients expose themselves when entering a healthcare system. Patient safety issues are forcing us to, not only acknowledge that incidents do occur, but also actively develop the means for assessing and managing the risks of such incidents. To do this, we ideally need to know the probability of an incident's occurrence, the consequences or severity for the patient should it occur, and the basic causes of the incident. A structured approach to the description of failure modes is helpful in terms of communication, avoidance of ambiguity, and, ultimately, decision making for resource allocation. In this report, several classification schemes or taxonomies for use in risk assessment and management are discussed. In particular, a recently developed approach that reflects the activity domains through which the patient passes and that can be used as a basis for quantifying incident severity is described. The estimation of incident severity, which is based on the concept of the equivalent uniform dose, is presented in some detail. We conclude with a brief discussion on the use of a defined basic-causes table and how adding such a table to the reports of incidents can facilitate the allocation of resources

  5. Characterization of post-disaster environmental management for Hazardous Materials Incidents: Lessons learnt from the Tianjin warehouse explosion, China.

    Science.gov (United States)

    Zhang, Hui; Duan, Huabo; Zuo, Jian; Song, MingWei; Zhang, Yukui; Yang, Bo; Niu, Yongning

    2017-09-01

    Hazardous Materials Incidents (HMIs) have attracted a growing public concern worldwide. The health risks and environmental implications associated with HMIs are almost invariably severe, and underscore the urgency for sound management. Hazardous Materials Explosion incidents (HMEIs) belong to a category of extremely serious HMIs. Existing studies placed focuses predominately on the promptness and efficiency of emergency responses to HMIs and HMEIs. By contrast, post-disaster environmental management has been largely overlooked. Very few studies attempted to examine the post-disaster environmental management plan particularly its effectiveness and sufficiency. In the event of the Tianjin warehouse explosion (TWE), apart from the immediate emergency response, the post-disaster environmental management systems (P-EMSs) have been reported to be effective and sufficient in dealing with the environmental concerns. Therefore, this study aims to critically investigate the P-EMSs for the TWE, and consequently to propose a framework and procedures for P-EMSs in general for HMIs, particularly for HMEIs. These findings provide a useful reference to develop P-EMSs for HMIs in the future, not only in China but also other countries. Copyright © 2017. Published by Elsevier Ltd.

  6. Reflexión sobre el fin último de la gestión en el sector hospitalario español On the ultimate goal of management in Spanish hospitals

    Directory of Open Access Journals (Sweden)

    Jesús Pastor Tejedor

    2009-04-01

    Full Text Available El Modelo Europeo de Gestión de la Calidad (European Foundation for Quality Management, EFQM es el más implantado en los hospitales españoles. Este modelo tiene como fin último la satisfacción del cliente interno y externo. El modelo de gestión estratégica Cuadro de Mando Integral (CMI facilita la alineación de la gestión con la misión y la visión del hospital. En este estudio se propone un modelo de gestión integrado EFQM-CMI. Para la obtención de los ítems del estudio se realizó una encuesta a los responsables de la gestión de los hospitales españoles, con una batería de 46 indicadores seleccionados del EFQM, priorizados y englobados en las cuatro perspectivas del modelo de gestión CMI. El estudio efecto final sería la perspectiva del cliente (satisfacción del paciente, personal y de la sociedad en general, o el modelo financiero, cuyo efecto final serían los resultados económico-financieros. Tras un análisis exploratorio de fiabilidad y dimensionalidad, y con un análisis discriminante, se obtienen los indicadores más consistentes y que mejor explican cada una de las perspectivas. Las relaciones entre estas perspectivas se determinan mediante ecuaciones estructurales, basadas en técnicas de mínimos cuadrados parciales. El estudio confirma que el modelo del cliente refleja una mayor consistencia en sus hipótesis.The European Foundation for Quality Management (EFQM is the most introduced model in Spanish hospitals. The main target of this model is the internal and external client's satisfaction. The model of strategic management Balanced Scorecard (BSC facilitates the alignment between management and the mission and vision of hospitals. For this reason, we propose a model of integrated management: EFQM-BSC. In order to obtain the items of this research, a survey was conducted among managers of Spanish hospitals on a battery of 46 indicators, selected from the EFQM model, and prioritised and included in the four

  7. Food risk management quality: Consumer evaluations of past and emerging food safety incidents

    NARCIS (Netherlands)

    Kleef, van E.; Ueland, O.; Theodoridis, G.; Rowe, G.; Pfenning, U.; Houghton, J.R.; Dijk, van H.; Chryssochoidis, G.; Frewer, L.J.

    2009-01-01

    In European countries, there has been growing consumer distrust regarding the motives of food safety regulators and other actors in the food chain, partly as a result of recent food safety incidents. If consumer confidence in food safety is to be improved, a systematic understanding of what

  8. Inner Ear Disease and Benign Paroxysmal Positional Vertigo: A Critical Review of Incidence, Clinical Characteristics, and Management

    Directory of Open Access Journals (Sweden)

    M. Riga

    2011-01-01

    Full Text Available Background. This study is a review of the incidence, clinical characteristics, and management of secondary BPPV. The different subtypes of secondary BPPV are compared to each other, as well as idiopathic BPPV. Furthermore, the study highlights the coexistence of BPPV with other inner ear pathologies. Methods. A comprehensive search for articles including in the abstract information on incidence, clinical characteristics, and management of secondary BPPV was conducted within the PubMed library. Results. Different referral patterns, different diagnostic criteria used for inner ear diseases, and different patient populations have led to greatly variable incidence results. The differences regarding clinical characteristics and treatment outcomes may support the hypothesis that idiopathic BPPV and the various subtypes of secondary BPPV do not share the exact same pathophysiological mechanisms. Conclusions. Secondary BPPV is often under-diagnosed, because dizziness may be atypical and attributed to the primary inner ear pathology. Reversely, a limited number of BPPV patients may not be subjected to a full examination and characterized as idiopathic, while other inner ear diseases are underdiagnosed. A higher suspicion index for the coexistence of BPPV with other inner ear pathologies, may lead to a more integrated diagnosis and consequently to a more efficient treatment of these patients.

  9. Transcending matter: physics and ultimate meaning.

    Science.gov (United States)

    Paulson, Steve; Frank, Adam; Kaiser, David; Maudlin, Tim; Natarajan, Priyamvada

    2015-12-01

    From the discovery of new galaxies and nearly undetectable dark energy to the quantum entanglement of particles across the universe, new findings in physics naturally elicit a sense of awe and wonder. For the founders of modern physics-from Einstein and Bohr to Heisenberg, Pauli, and Bohm-a fascination with deeper questions of meaning and ultimate reality led some of them to explore esoteric traditions and metaphysics. More recently, however, physicists have largely shunned such philosophical and spiritual associations. What can contemporary physics offer us in the quest to understand our place in the universe? Has physics in some ways become a religion unto itself that rejects the search for existential meaning? Discussion of these and related questions is presented in this paper. © 2015 New York Academy of Sciences.

  10. Ultimate load capacities of expansion anchor bolts

    International Nuclear Information System (INIS)

    Czarnecki, R.M.; Manrique, M.A.; Samaddar, S.K.

    1993-01-01

    A summary of available experimental expansion anchor bolt test data is presented. These data were collected as part of programs by the nuclear industry to address generic issues related to verification of seismic adequacy of equipment in nuclear power plants. Some of the data presented are suitable for use in seismic probabilistic risk assessments. For example, mean values of ultimate strength, along with their standard deviation and coefficients of variation, for a range of most typical expansion anchor bolt sizes are presented. Effects of interaction between shear and tension, edge distance, spacing, and cracking of the concrete are presented in a manner that is more suitable for use in deterministic evaluations. Related industry programs to derive anchor bolt capacities are briefly discussed. Recommendations for areas of further investigation are also presented

  11. Vuosaari Harbour Road Tunnel Traffic Management and Incident Detection System Design Issues

    Directory of Open Access Journals (Sweden)

    Caj Holm

    2006-11-01

    Full Text Available Helsinki is constructing in Vuosaari a new modem and effectivecargo harbour. All cargo harbour activities will be concentratedthere. The total project includes the harbour, a logisticsarea, traffic connections (road, railway and fairway and aBusiness Park. The road connection goes through the Porvarinlahtiroad tunnel. The harbour will commence operatingin 2008. This paper gives an oveTView of the tunnel design phasefunctional studies and risk analysis tunnel incident detectionsystem design issues and some specific environmental featuresof the tunnel.

  12. UHS, Ultimate Heat Sink Cooling Pond Analysis

    International Nuclear Information System (INIS)

    Codell, R.; Nuttle, W.K.

    1998-01-01

    1 - Description of program or function: Three programs model performance of an ultimate heat sink cooling pond. National Weather Service data is read and analyzed to predict periods of lowest cooling performance and highest evaporative loss. The data is compared to local site data for significant differences. Then the maximum pond temperature is predicted. Five programs model performance of an ultimate heat sink spray pond. The cooling performance, evaporative water loss, and drift water loss as a function of wind speed are estimated for a spray field. These estimates are used in conjunction with National Weather Service data to predict periods of lowest cooling performance and highest evaporative loss. This data is compared to local site data for significant differences. Then the maximum pond temperature is predicted. 2 - Method of solution: The transfer of heat and water vapor is modeled using an equilibrium temperature procedure for an UHS cooling pond. The UHS spray pond model considers heat, mass, and momentum transfer from a single water drop with the surrounding air, and modification of the surrounding air resulting from the heat, mass, and momentum transfer from many drops in different parts of a spray field. 3 - Restrictions on the complexity of the problem: The program SPRCO uses RANF, a uniform random number generator which is an intrinsic function on the CDC. All programs except COMET use the NAMELIST statement, which is non standard. Otherwise these programs conform to the ANSI Fortran 77 standard. The meteorological data scanning procedure requires tens of years of recorded data to be effective. The models and methods, provided as useful tool for UHS analyses of cooling ponds and spray ponds, are intended as guidelines only. Use of these methods does not automatically assure NRC approval, nor are they required procedures for nuclear-power-plant licensing

  13. Management of resources at major incidents and disasters in relation to patient outcome: a pilot study of an educational model.

    Science.gov (United States)

    Nilsson, Heléne; Rüter, Anders

    2008-06-01

    Organizations involved in disaster response often have a defined operative level of management (command and control) that can take the overall decisions regarding the mobilization and distribution of resources and distribution of casualties. This level of management can be referred to as strategic management. The aim of this pilot study was to show the possibility, in simulation exercises, to relate decisions made regarding resources to patient outcome. The simulation system used measures to determine if lifesaving interventions are performed in time or not in relation to patient outcome. Evaluation was made with sets of performance indicators as templates and all management groups were evaluated not only as to how the decisions were made (management skills), but also how staff work was performed (staff procedure skills). Owing to inadequate response and insufficient distribution of patients to hospitals, 11 'patients' died in the simulated incident, a fire at a football stand with subsequent collapse. The strategic level of management received 16 points out of a possible 22 according to a predesigned template of performance indicators. The pilot study demonstrated the possibility to, in simulation exercises, relate decisions made regarding resources to patient outcome. This training technique could possibly lead to increased knowledge in what decisions are crucial to make in an early phase to minimize mortality and morbidity.

  14. Decision making for wildfires: A guide for applying a risk management process at the incident level

    Science.gov (United States)

    Mary A. Taber; Lisa M. Elenz; Paul G. Langowski

    2013-01-01

    This publication focuses on the thought processes and considerations surrounding a risk management process for decision making on wildfires. The publication introduces a six element risk management cycle designed to encourage sound risk-informed decision making in accordance with Federal wildland fire policy, although the process is equally applicable to non-Federal...

  15. Incidence and Management of Thrombotic and Thromboembolic Complications Following the Norwood Procedure: A Systematic Review.

    Science.gov (United States)

    Agarwal, Arnav; Firdouse, Mohammed; Brar, Nishaan; Yang, Andy; Lambiris, Panos; Chan, Anthony K; Mondal, Tapas K

    2017-11-01

    The stage 1 Norwood procedure and its variants represent the first step of palliation for hypoplastic left heart syndrome. Although appropriate postoperative thromboprophylaxis is integral, significant variance remains across institutional practices. The purpose of this systematic review is to estimate the incidence of thrombosis and thromboembolism following the Norwood or modified Blalock-Taussig shunt procedure and examine current thromboprophylaxis regimens. Ovid MEDLINE and Embase were searched from January 2000 to June 2016 for primary studies explicitly reporting incidence of thrombosis, thromboembolism (strokes and pulmonary embolisms), or shunt occlusion in neonates, infants, and children undergoing the Norwood procedure or any variant. All-cause mortality was a secondary outcome of interest. Of 887 identified articles, 15 cohort studies were deemed eligible, the majority including modified Blalock-Taussig shunt patients. Reported incidence of thrombosis ranged from 0% to 40%; thromboembolic events were rarely reported. Overall mortality ranged from 4.5% to 31.3% across studies. Although most studies involved the long-term acetylsalicylic acid use, thromboprophylaxis strategies varied across studies. Due to substantial variability in event rates, no correlation was identified with thrombotic complications. Clinical practice guidelines recommend that patients receive intraoperative unfractionated heparin therapy and either aspirin or no antithrombotic therapy postoperatively. Our findings suggest a substantial risk of thrombosis and thromboembolism and demonstrate substantial variation in thromboprophylaxis practices. Although postoperative thromboprophylaxis seems optimal, it remains controversial whether the long-term aspirin use is most effective. Our findings highlight the lack of a gold-standard thromboprophylaxis strategy and emphasize the need for more consistency.

  16. Crisis management during the SOCATRI incident in July 2008: lessons learned by the IRSN

    International Nuclear Information System (INIS)

    Champion, D.

    2010-01-01

    This report describes the successive events which occurred in July 2008 in the SOCATRI plant where a uranium-bearing solution was accidentally released, causing a temporary pollution of two rivers. Then, he reports how this event has been managed, firstly through a mobilization of public authorities and early decisions, secondly through sampling and measurements performed by the IRSN (the management of the obtained results is also commented), thirdly through expertise investigations by the IRSN, fourthly through relationship with local authorities, and finally through media and public information. For each of these aspects, the author discusses the lessons learned, and proposes ways to improve the management of such an accident

  17. Waste Management Decision-Making Process During a Homeland Security Incident Response

    Science.gov (United States)

    A step-by-step guide on how to make waste management-related decisions including how waste can be minimized, collected and treated, as well as where waste can be sent for staging, storage and final disposal.

  18. Incidents in Czechoslovakian "Socialist Management" between 1956 and 1989. Conflict and Reconciliation

    Czech Academy of Sciences Publication Activity Database

    Vilímek, Tomáš; Tůma, Oldřich

    42/43, Spring-Summer (2016), s. 187-240 ISSN 1310-9456 Institutional support: RVO:68378114 Keywords : socialist management * centrally planned economy * Czechoslovakia 1956-1989 Subject RIV: AB - History

  19. A Real-Time Expert System Approach To Freeway Incident Management

    OpenAIRE

    Ritchie, Stephen G.; Prosser, Neil A.

    1992-01-01

    Fundamental to the operation of most Intelligent Vehicle-Highway System (IVHS) projects are advanced systems for surveillance, control and management of integrated freeway and arterial networks. A Major concern in the development of such Smart Roads, and the focus of this paper, is the provision of decision support for traffic management center personnel, particularly for addressing non-recurring congestion in large or complex networks. Decision support for control room staff is necessary to ...

  20. International Commission for Mountain Emergency Medicine Consensus Guidelines for On-Site Management and Transport of Patients in Canyoning Incidents.

    Science.gov (United States)

    Strapazzon, Giacomo; Reisten, Oliver; Argenone, Fabien; Zafren, Ken; Zen-Ruffinen, Greg; Larsen, Gordon L; Soteras, Inigo

    2018-02-13

    Canyoning is a recreational activity that has increased in popularity in the last decade in Europe and North America, resulting in up to 40% of the total search and rescue costs in some geographic locations. The International Commission for Mountain Emergency Medicine convened an expert panel to develop recommendations for on-site management and transport of patients in canyoning incidents. The goal of the current review is to provide guidance to healthcare providers and canyoning rescue professionals about best practices for rescue and medical treatment through the evaluation of the existing best evidence, focusing on the unique combination of remoteness, water exposure, limited on-site patient management options, and technically challenging terrain. Recommendations are graded on the basis of quality of supporting evidence according to the classification scheme of the American College of Chest Physicians. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  1. Surveillance of Otitis Media With Effusion in Thai Children With Cleft Palate: Cumulative Incidence and Outcome of the Management.

    Science.gov (United States)

    Ungkanont, Kitirat; Boonyabut, Panrasee; Komoltri, Chulaluk; Tanphaichitr, Archwin; Vathanophas, Vannipa

    2018-04-01

    To study the incidence and outcome of management of otitis media with effusion in Thai children with cleft palate. Retrospective cohort study in the tertiary care center. Ninety-five children with cleft palate were referred for ear evaluation, from June 1997 to January 2015. Fifteen children (15.8%) had associated craniofacial syndromic anomalies. Cumulative incidence of otitis media with effusion, rate of ventilation tube insertion, duration of indwelling tubes, hearing outcome, and complications of ventilation tubes. Ear examinations were done every 8 to 12 weeks throughout the study. Cumulative incidence of otitis media with effusion was 53.7% in children within 12 months of age and 81.1% within 24 months of age. At the end of the study, all of the patients had at least 1 episode of otitis media with effusion. Eighty-eight children (92.6%) had palatoplasty, and there was no significant difference in the incidence of otitis media before and after palatoplasty. The mean hearing level at recruitment was 40.8 ±18.4 dB. Ventilation tube insertion was done in 76 patients (80%). The median time for indwelling tubes was 11.7 months. Rate of ventilation tube insertion was 0.5/year. The mean hearing level at last follow-up was 23.5 ± 14 dB. Otorrhea through tube was found in 24 cases (31.6%). Otitis media with effusion was common in Thai children with cleft palate. Surveillance of middle ear effusion and ventilation tube insertion contributed to a favorable hearing outcome.

  2. Incidence and management of hip dislocation in tumour patients with a modular prosthesis of the proximal femur.

    Science.gov (United States)

    Puchner, Stephan E; Funovics, Philipp T; Hipfl, Christian; Dominkus, Martin; Windhager, Reinhard; Hofstaetter, Jochen G

    2014-08-01

    Little data is available about the incidence and especially the management of hip dislocation following the implantation of modular tumor prostheses of the proximal femur. In this retrospective single-centre study we assessed the incidence of hip dislocation following implantation of a proximal femoral modular prosthesis as well as the success of the subsequent surgical or non-surgical treatment in tumor patients. Between 1982 and 2008, 166 tumor patients received a modular prosthesis of the proximal femur at our institution. The average age at the time of surgery was 50 ± 20 years (range, six to 84 years). An additional pelvic reconstruction was done in 14 patients. An artificial band for soft tissue reconstruction of the hip was used in 19 patients. The average time of follow-up was 46 ± 64 months (range, one to 277 months). The overall dislocation rate after proximal femoral replacement was 13% after a mean time of seven ± eight months (range, 0.3-33 months) after surgery. Between 1982 and 1986 the dislocation rate was 33% and declined to 9% in subsequent years (1987-2008). Patients who had received an additional pelvic reconstruction had a three fold higher dislocation rate (p prosthesis of the proximal femur is a common complication, especially in cases with additional pelvic resection with extensive bone and soft-tissue defects. Open surgical management may be more effective in preventing re-dislocation than closed reduction and bracing alone.

  3. Incidence and management of leukopenia/neutropenia in 233 kidney transplant patients following single dose alemtuzumab induction.

    Science.gov (United States)

    Smith, A; Couvillion, R; Zhang, R; Killackey, M; Buell, J; Lee, B; Saggi, B H; Paramesh, A S

    2014-12-01

    The purpose of this study was to determine the incidence and management strategies for post-transplant leukopenia/neutropenia in kidney recipients receiving alemtuzumab induction during the first year following transplantation. We prospectively identified 233 adult patients who underwent kidney transplantation with alemtuzumab induction at a single institution. The incidence and severity of leukopenia (white blood cell count [WBC] ≤2500/mm(3)) and neutropenia (absolute neutrophil count [ANC] ≤500/mm(3)) were evaluated at 1, 3, 6, and 12 months post-transplantation. We determined any association with cytomegalovirus (CMV) infection, graft rejection, and infections requiring hospitalization. We also reviewed interventions performed, including medication adjustments, treatment with granulocyte stimulating factor, and hospitalization. The combined incidence of either leukopenia or neutropenia was 47.5% (n = 114/233) with an average WBC nadir of 1700 ± 50/mm(3) at 131.0 ± 8.5 days and an average ANC nadir of 1500 ± 100/mm(3) at 130.4 ± 9.6 days. No significant difference in graft rejection, CMV infection, or infections requiring hospitalization was found in the leukopenia/neutropenia group vs the normal WBC group (P = .3). The most common intervention performed for leukopenia/neutropenia group was prophylactic medication adjustment. Six patients (5.2%) required a change in >1 medication. The majority of these patients also required granulocyte stimulating factor (61.5%; 32/52), with an average of 2.5 doses given. A total of 25 patients (21.9%) required hospitalization due to leukopenia/neutropenia with an average length of stay of 6 days. Kidney transplant patients receiving alemtuzumab induction required significant interventions due to leukopenia/neutropenia in the first year post-transplantation. These results suggest the need for additional studies aimed at defining the optimum management strategies of leukopenia/neutropenia in this population

  4. Temporal trends in outpatient management of incident pulmonary embolism and associated mortality.

    Science.gov (United States)

    Klil-Drori, Adi J; Coulombe, Janie; Suissa, Samy; Hirsch, Andrew; Tagalakis, Vicky

    2018-01-01

    In clinical trial settings, outpatient management of pulmonary embolism (PE) is feasible and safe, but less is known on its use in routine care. We determined trends in outpatient management of PE and associated mortality in a large non-select patient population. All residents of Quebec, Canada with a first-ever work-up for suspected PE in the emergency department (ED) over 10years were included. Patients could transition to outpatient management and from unconfirmed to confirmed PE in a time-varying fashion. Comparing the years 2005-9 with 2000-4, we assessed the odds ratio (OR) for outpatient management, and relative risk (RR) for all-cause mortality, readmissions for PE, and major bleeding in 30days. We adjusted the RR for a mortality risk score. Of 15,217 patients included, 7583 were outpatients (7.5% confirmed PE) and 7634 were inpatients (60.6% confirmed PE). In all, 10.9% of patients with confirmed PE were outpatients, but outpatient management of confirmed PE was more likely in the latter study period (OR 1.73, 95%CI 1.44-2.09). Among outpatients with confirmed PE, mortality (RR 0.84, 95%CI 0.15-4.61) and readmission (RR 1.25, 95%CI 0.45-3.48) rates were stable, and only 3 major bleeding events were noted. Inpatients with confirmed PE had stable mortality rates (RR 0.95, 95%CI 0.72-1.24). Outpatient PE management increased over 10years while remaining fairly uncommon. Nevertheless, stable mortality and readmission rates indicate this practice is safe in routine care, and add to the growing evidence in support of outpatient PE management. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Using total quality management approach to improve patient safety by preventing medication error incidences*.

    Science.gov (United States)

    Yousef, Nadin; Yousef, Farah

    2017-09-04

    Whereas one of the predominant causes of medication errors is a drug administration error, a previous study related to our investigations and reviews estimated that the incidences of medication errors constituted 6.7 out of 100 administrated medication doses. Therefore, we aimed by using six sigma approach to propose a way that reduces these errors to become less than 1 out of 100 administrated medication doses by improving healthcare professional education and clearer handwritten prescriptions. The study was held in a General Government Hospital. First, we systematically studied the current medication use process. Second, we used six sigma approach by utilizing the five-step DMAIC process (Define, Measure, Analyze, Implement, Control) to find out the real reasons behind such errors. This was to figure out a useful solution to avoid medication error incidences in daily healthcare professional practice. Data sheet was used in Data tool and Pareto diagrams were used in Analyzing tool. In our investigation, we reached out the real cause behind administrated medication errors. As Pareto diagrams used in our study showed that the fault percentage in administrated phase was 24.8%, while the percentage of errors related to prescribing phase was 42.8%, 1.7 folds. This means that the mistakes in prescribing phase, especially because of the poor handwritten prescriptions whose percentage in this phase was 17.6%, are responsible for the consequent) mistakes in this treatment process later on. Therefore, we proposed in this study an effective low cost strategy based on the behavior of healthcare workers as Guideline Recommendations to be followed by the physicians. This method can be a prior caution to decrease errors in prescribing phase which may lead to decrease the administrated medication error incidences to less than 1%. This improvement way of behavior can be efficient to improve hand written prescriptions and decrease the consequent errors related to administrated

  6. Comparing Student Perceptions of Coping Strategies and School Interventions in Managing Bullying and Cyberbullying Incidents

    Science.gov (United States)

    Paul, Simone; Smith, Peter K.; Blumberg, Herbert H.

    2012-01-01

    A total of 407 students in a central London secondary school participated in a survey of different approaches to managing traditional bullying and cyberbullying. Student perceptions of individual coping strategies and school interventions for traditional bullying and cyberbullying were measured. Rankings of the strategies for traditional bullying…

  7. Rapid population growth and environmental degradation: ultimate versus proximate factors.

    Science.gov (United States)

    Shaw, R P

    1989-01-01

    This philosophical review of 2 arguments about responsibility for and solutions to environmental degradation concludes that both sides are correct: the ultimate and the proximal causes. Ultimate causes of pollution are defined as the technology responsible for a given type of pollution, such as burning fossil fuel; proximate causes are defined as situation-specific factors confounding the problem, such as population density or rate of growth. Commoner and others argue that developed countries with low or negative population growth rates are responsible for 80% of world pollution, primarily in polluting technologies such as automobiles, power generation, plastics, pesticides, toxic wastes, garbage, warfaring, and nuclear weapons wastes. Distortionary policies also contribute; examples are agricultural trade protection, land mismanagement, urban bias in expenditures, and institutional rigidity., Poor nations are responsible for very little pollution because poverty allows little waste or expenditures for polluting, synthetic technologies. The proximal causes of pollution include numbers and rate of growth of populations responsible for the pollution. Since change in the ultimate cause of pollution remains out of reach, altering the numbers of polluters can make a difference. Predictions are made for proportions of the world's total waste production, assuming current 1.6 tons/capita for developed countries and 0.17 tons/capita for developing countries. If developing countries grow at current rates and become more wealthy, they will be emitting half the world's waste by 2025. ON the other hand, unsustainable population growth goes along with inadequate investment in human capital: education, health, employment, infrastructure. The solution is to improve farming technologies in the 117 non-self-sufficient countries, fund development in the most unsustainable enclaves of growing countries, break institutionalized socio-political rigidity in these enclaves, and focus on

  8. Clinical management of the induction of labor in intrauterine fetal death: evaluation of incidence of cesarean section and related conditions

    Directory of Open Access Journals (Sweden)

    Maria Isabel do Nascimento

    2014-03-01

    Full Text Available OBJECTIVE: To assess the incidence and conditions associated with cesarean section in a cohort of pregnant women with intrauterine fetal death (IUFD, and clinical management to anticipate the childbirth. METHODS: It was a retrospective cohort study with 163 mothers with IUFD, at the second half of pregnancy, who were managed to anticipate childbirth using pharmacological preparations and/or a mechanical method (Foley catheter in a teaching hospital in Rio de Janeiro State, Brazil. Cox regression was used to evaluate the effect of the clinical methods on the kind of delivery. RESULTS: The Subgroups A (misoprostol or Oxytocin, B (misoprostol and Oxytocin, and C (Foley catheter alone or combined with misoprostol and/or Oxytocin were formed according to the applied methods. Nine out of 163 cases ended with cesarean section. The incidence of cesarean section was 3.5 per 1,000 people-hours, meaning that a pregnant woman with IUFD had a 15.6% risk of cesarean section during the first 48 hours of clinical management to anticipate childbirth. The conditions significantly associated with the mode of delivery were placental abruption (HR: 44.97, having two or more previous cesarean deliveries (HR: 10.03, and mechanical method with Foley catheter (HR: 5.01. CONCLUSION: Cesarean section was an essential conduct in this cohort and followed previous cesarean delivery and placental abruption. The effect of the mechanical method on the abdominal route suggests that the Foley catheter method was used in the most difficult cases and that the surgery was performed to ensure maternal health.

  9. Colorectal cancer liver metastases - a population-based study on incidence, management and survival.

    Science.gov (United States)

    Engstrand, Jennie; Nilsson, Henrik; Strömberg, Cecilia; Jonas, Eduard; Freedman, Jacob

    2018-01-15

    Colorectal cancer (CRC) is a leading cause of cancer-associated deaths with liver metastases developing in 25-30% of those affected. Previous data suggest a survival difference between right- and left-sided liver metastatic CRC, even though left-sided cancer has a higher incidence of liver metastases. The aim of the study was to describe the liver metastatic patterns and survival as a function of the characteristics of the primary tumour and different combinations of metastatic disease. A retrospective population-based study was performed on a cohort of patients diagnosed with CRC in the region of Stockholm, Sweden during 2008. Patients were identified through the Swedish National Quality Registry for Colorectal Cancer Treatment (SCRCR) and additional information on intra- and extra-hepatic metastatic pattern and treatment were retrieved from electronic patient records. Patients were followed for 5 years or until death. Factors influencing overall survival (OS) were investigated by means of Cox regression. OS was compared using Kaplan-Meier estimations and the log-rank test. Liver metastases were diagnosed in 272/1026 (26.5%) patients within five years of diagnosis of the primary. Liver and lung metastases were more often diagnosed in left-sided colon cancer compared to right-sided cancer (28.4% versus 22.1%, p = 0.029 and 19.7% versus 13.2%, p = 0.010, respectively) but the extent of liver metastases were more extensive for right-sided cancer as compared to left-sided (p = 0.001). Liver metastatic left-sided cancer, including rectal cancer, was associated with a 44% decreased mortality risk compared to right-sided cancer (HR = 0.56, 95% CI: 0.39-0.79) with a 5-year OS of 16.6% versus 4.3% (p < 0.001). In liver metastatic CRC, the presence of lung metastases did not significantly influence OS as assessed by multivariate analysis (HR = 1.11, 95% CI: 0.80-1.53). The worse survival in liver metastatic right-sided colon cancer could possibly be

  10. Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: a review

    OpenAIRE

    Panelli, Danielle M.; Phillips, Catherine H.; Brady, Paula C.

    2015-01-01

    Background: Ectopic pregnancy is a potentially life-threatening condition occurring in 1-2 % of all pregnancies. The most common ectopic implantation site is the fallopian tube, though 10 % of ectopic pregnancies implant in the cervix, ovary, myometrium, interstitial portion of the fallopian tube, abdominal cavity or within a cesarean section scar. Findings: Diagnosis involves a combination of clinical symptoms, serology, and ultrasound. Medical management is a safe and effective option in mo...

  11. Incidence and management of severe odontogenic infections-a retrospective analysis from 2004 to 2011.

    Science.gov (United States)

    Opitz, Daniel; Camerer, Christian; Camerer, Doris-Maria; Raguse, Jan-Dirk; Menneking, Horst; Hoffmeister, Bodo; Adolphs, Nicolai

    2015-03-01

    The management of odontogenic infections is a typical part of the spectrum of maxillofacial surgery. Normally these infections can be managed in a straight forward way however under certain conditions severe and complicated courses can arise which require interdisciplinary treatment including intensive care. A retrospective analysis of all patients affected by an odontogenic infection that received surgical therapy from 2004 to 2011 under stationary conditions was performed. Surgical treatment consisted in incision and drainage of the abscess supported by additional i.v. antibiotic medication in all patients. Detailed analysis of all patients that required postoperative intensive medical care was additionally performed with respect to special risk factors. During 8 years 814 patients affected by odontogenic infections received surgical treatment under stationary conditions representing 4% of all patients that have been treated during that period (n = 18981). In 14 patients (1.7%) intensive medical therapy after surgery was required, one lethal outcome was documented (0.12%). In all of these 14 patients a history of typical risk factors was present. According to these results two patients per week affected by an odontogenic infection required stationary surgical treatment, about two patients per year were likely to require additional intensive medical care. If well-known risk factors are present in patients affected by odontogenic infection appropriate interdisciplinary management should be considered as early as possible. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  12. High Incidence of De Novo and Subclinical Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy and Cardiac Rhythm Management Device.

    Science.gov (United States)

    Wilke, Iris; Witzel, Katrin; Münch, Julia; Pecha, Simon; Blankenberg, Stephan; Reichenspurner, Hermann; Willems, Stephan; Patten, Monica; Aydin, Ali

    2016-07-01

    Atrial fibrillation (AF) is an important prognostic parameter in patients with hypertrophic cardiomyopathy (HCM). Though cardiac rhythm management (CRM) devices (e.g., ICD, pacemaker or implantable loop recorder) can detect subclinical AF, data describing the incidence of AF are rare. We therefore investigated the incidence and clinical impact of de novo and subclinical AF detected by CRM devices in patients with HCM. In our retrospective single-center study, we included patients with HCM and need for CRM devices. The primary endpoint of the study was the incidence of clinical and subclinical de novo AF. During follow-up, patients were screened for adverse events like stroke, ventricular arrhythmia, heart failure, or death. From 192 HCM patients, 44 patients received a CRM device (38 ICDs, 5 pacemakers, 1 implantable loop recorder). In 14 of these patients (32%), AF had been documented before device implantation. Thirty (68%) patients were free from AF at the time of implantation. During a median follow-up of 595 days (interquartile range, 367-890 days), de novo AF was recorded in 16 of these 30 patients (53%). Fourteen (88%) of the 16 patients with de novo AF were free from any clinical symptoms, so these patients were classified to have subclinical AF. In logistic regression analysis, age was the only significant predictor for an increased risk of AF. AF is common in patients with HCM who need a CRM device. More than 50% of these patients develop de novo AF that was predominantly subclinical in our cohort. © 2016 Wiley Periodicals, Inc.

  13. Incidence of stress on top management and its impact upon health and work area

    Directory of Open Access Journals (Sweden)

    Dana Maria Staňková

    2009-01-01

    Full Text Available Within the frame of this paper the key theoretical knowledge to the selected topic is described, the presentation of partial results and discussion on the issue of the psychological aspects of managerial work, focusing on stress and its manifestations are submitted. The aim of this research was to identify the most frequent stress symptoms in the physiological, emotional and behavioral field and to define the main factors which cause them in work and private life terms. For the purpose of this research of stress effects on health area a questionnaire technology of our own design was chosen. For a deeper understanding of sources of an increased psychological stress in managerial activities a technique of interviews with the top managers was used. Research investigation has showed the action of stress on the senior managers, particularly increased during the current economic recession. The most significant signs of stress are manifested in physiological area, especially by fatigue, headache, digestion problems and sleep disturbances, as in the emotional area by anxiety, excessive concern and overall irritability. At the same time stress impacts also the behavioral area, where it has a negative impact to the work and family life. In the course of processing this subject, an absolutely obvious need occurred for a deeper processing of this large area of work stress, which will be subsequently dealing with, and whose output will be, the methodology of anti-stress strategy for HR (Human Resources managers and Senior Executives of companies to prevent stress, promote health and quality of living conditions in the workplace.

  14. End-stage renal disease in India and Pakistan: incidence, causes, and management.

    Science.gov (United States)

    Sakhuja, Vinay; Kohli, Harbir S

    2006-01-01

    Chronic renal failure is a devastating medical, social, and economic problem for patients and their families in India and Pakistan. Reliable data on the true incidence and prevalence of end-stage renal disease (ESRD) in India and Pakistan are lacking because no national registries exist. Among reported cases, chronic glomerulonephritis is the most common cause, accounting for more than one third of patients, while diabetic nephropathy accounts for approximately 20% of all patients in India. Delayed diagnosis and failure to institute measures to slow the progression of renal failure have resulted in a predominantly young ESRD population, with a median age of 44 years. Because of financial constraints, less than one third of all patients referred to a tertiary care center receive any kind of renal replacement therapy. Most hemodialysis patients who stop treatment and die do so because of cost constraints within the first three months, and approximately 5% of patients are started on ambulatory peritoneal dialysis. Renal transplantation is the cheapest option, but < 10% of all patients with ESRD have a transplant. Cyclosporine, azathioprine, and prednisolone continue to be the backbone of post-transplant immunosuppression, but cyclosporine is stopped in a significant proportion of patients at one year post-transplant to cut down costs. Living related donor transplants constitute 70% of all transplants; two thirds of the donors are females, while more than three fourths of all recipients are males. Spouses account for 20% of donors from within families. Almost 30% of transplanted kidneys are donated by living unrelated donors, while cadaver donors account for only 2%. More resources must be mobilized to care for these patients; early detection of renal disease must be facilitated, and measures to delay ESRD must be implemented.

  15. Incidence and management of Kaposi sarcoma in renal transplant recipients: the Greek experience.

    Science.gov (United States)

    Zavos, G; Moris, D; Vernadakis, S; Bokos, J; Lionaki, S; Mamarelis, G; Panagiotellis, K; Zavvos, V; Boletis, I

    2014-11-01

    One of the most common malignancies in kidney transplant recipients is Kaposi sarcoma. The incidence of Kaposi sarcoma, which develops after renal transplantation, is 400-500 times higher than that in the general population. The aims of this study were to review the experience with Kaposi sarcoma in the highest-volume transplantation Unit in Greece and to analyze clinical characteristics and response to treatment, with respect to both the patients' survival and the renal graft function. The records of 2008 renal graft recipients between March 1983 and December 2012 were retrospectively reviewed. Kaposi sarcoma was diagnosed based on clinical, laboratory, radiological, endoscopic, and histopathologic examinations. The disease was staged according to the classification of Al-Khader et al. The prevalence of Kaposi sarcoma was 1.2% in our renal transplant population. Of these, 1006 recipients underwent living-donor renal transplantation, whereas 1002 received their graft from deceased donors. Post-transplantation malignancy developed in 153 patients, among which, Kaposi sarcoma has been found in 24 cases. Of the 24 cases of Kaposi sarcoma, lesions were mainly cutaneous in 14 cases, visceral and cutaneous in 8, and concomitant visceral and lymph node involvement was observed in 2 patients. With regard to the final outcome, 20 patients (83.3%) showed remission of the disease, whereas 4 patients with visceral involvement (16.6%) did not respond to chemotherapy and discontinuation of immunosuppression and died. Moreover, 8 deaths occurred due to apparently unrelated causes. Kaposi sarcoma is an important part (15.7%) of all post-transplantation neoplasias in our series. Furthermore, our findings confirmed the previously described close association between human herpesvirus-8 and post-transplantation Kaposi sarcoma. Reduction of immunosuppression or discontinuation of calcineurin inhibitors results in remission of the disease in most of the cases. Prognosis in patients with

  16. Effectiveness of a stress management pilot program aimed at reducing the incidence of sports injuries in young football (soccer) players.

    Science.gov (United States)

    Olmedilla-Zafra, Aurelio; Rubio, Victor J; Ortega, Enrique; García-Mas, Alexandre

    2017-03-01

    Several attempts to reduce the incidence of sport injuries using psychosocial interventions produced fruitful, although inconclusive results. This paper presents the effectiveness and implementation issues of a pilot 3-month stress-management and muscle relaxation program aimed at reducing sport injury incidence. Pre-post treatment-non treatment group comparison. The program was administered by a trained psychologist on a once-a-week, 1-h session basis. Seventy-four male soccer players from four National Youth league teams voluntarily participated. Teams were randomly assigned to either treatment/non-treatment group. Injury protocol, Self-monitoring cards, Athletes' satisfaction and commitment survey, Coaches' interview. Group main effect and Time-Group interaction effect were both statistically significant, F(1,60) = 8.30, p = 0.005, η 2 p  = 0.121, with the average number of injuries larger in the post-treatment phase of non-treatment group (p = 0.005, η 2 p  = 0.077). There was a significant decrease in the average number of injuries for the intervention group before and after implementing the program (p sport injuries, with a high level of satisfaction and commitment from the athletes, as well as high acceptance from the coaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Back to school: the ultimate pediatric call.

    Science.gov (United States)

    Marciano, Samuel D

    2004-07-01

    EMS agencies will continue to respond to calls that have varying levels of seriousness in the school setting. Although most calls will be routine, the potential for a large-scale incident is ever-present. School districts and EMS agencies have to be proactive in developing a plan for responding to these situations. This proactive attitude is essential in fostering cooperation and communication between the school and EMS. It enables us to achieve the goal of making our schools safer. The process in reaching this goal is ongoing and evolving. As an EMS provider, I am aware of the high anxiety that accompanies a call involving a seriously injured child. If the call involves five, 10 or more severely injured kids, the stress can be unbelievable. A plan of action that has been carefully developed, practiced and critiqued will lessen the anxiety and stress. As a teacher, I want my workplace and my students to be safe. If a situation arises, knowing that a planned response is in place, and knowing what I'm supposed to do, gives me the confidence to deal with the event so I can help my students. Finally, as a parent, it is important that my children are in a safe environment in which to learn. If an emergency response is needed, I want to know a good plan will go into effect. That would assure me that the people responsible for the health and safety of my children have done all they can to make school a safer place.

  18. ACE Inhibitor-Induced Angioedema of the Intestine: Case Report, Incidence, Pathophysiology, Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Gavin Oudit

    2001-01-01

    Full Text Available A case report of fosinopril-induced angioedema of the intestine with a chronic course accompanied by multiple acute exacerbations is described. Angiotensin-converting enzyme (ACE inhibitor-induced angioedema of the intestine (AIAI occurs in a minority of patients taking an ACE inhibitor. The clinical presentation encompasses acute abdominal symptoms, pronounced bowel edema and ascites with occasional facial and/or oropharyngeal swelling. AIAI is diagnosed based on the temporal relationship between the symptomatic presentation and drug use, absence of alternative diagnoses including other causes of angioedema, and the prompt resolution of symptoms upon discontinuation of the ACE inhibitor. Prompt radiological investigation (abdominal computerized tomography and/or ultrasound is critical in making an early diagnosis and in preventing unnecessary surgical intervention. There is a female predominance of AIAI, which may reflect the interaction of estradiol with the various pathways involved in the pathophysiology of AIAI. Management of AIAI consists mainly of conservative measures and discontinuation of the ACE inhibitor. Angiotensin II receptor antagonists should not be considered as appropriate alternatives. Awareness and knowledge of AIAI are important because of the increasing use of ACE inhibitors, current delays in making the diagnosis, obvious management strategies once the diagnosis is made and the dysutility of alternative diagnoses, which may lead to considerable morbidity. AIAI must be considered in patients taking ACE inhibitors who develop gastrointestinal complaints irrespective of the duration of the therapy.

  19. FEMA's Earthquake Incident Journal: A Web-Based Data Integration and Decision Support Tool for Emergency Management

    Science.gov (United States)

    Jones, M.; Pitts, R.

    2017-12-01

    For emergency managers, government officials, and others who must respond to rapidly changing natural disasters, timely access to detailed information related to affected terrain, population and infrastructure is critical for planning, response and recovery operations. Accessing, analyzing and disseminating such disparate information in near real-time are critical decision support components. However, finding a way to handle a variety of informative yet complex datasets poses a challenge when preparing for and responding to disasters. Here, we discuss the implementation of a web-based data integration and decision support tool for earthquakes developed by the Federal Emergency Management Agency (FEMA) as a solution to some of these challenges. While earthquakes are among the most well- monitored and measured of natural hazards, the spatially broad impacts of shaking, ground deformation, landslides, liquefaction, and even tsunamis, are extremely difficult to quantify without accelerated access to data, modeling, and analytics. This web-based application, deemed the "Earthquake Incident Journal", provides real-time access to authoritative and event-specific data from external (e.g. US Geological Survey, NASA, state and local governments, etc.) and internal (FEMA) data sources. The journal includes a GIS-based model for exposure analytics, allowing FEMA to assess the severity of an event, estimate impacts to structures and population in near real-time, and then apply planning factors to exposure estimates to answer questions such as: What geographic areas are impacted? Will federal support be needed? What resources are needed to support survivors? And which infrastructure elements or essential facilities are threatened? This presentation reviews the development of the Earthquake Incident Journal, detailing the data integration solutions, the methodology behind the GIS-based automated exposure model, and the planning factors as well as other analytical advances that

  20. Trustworthy information sharing for biosecurity incident management - The AU2EU project

    Science.gov (United States)

    Zic, John

    2013-10-01

    Managing sensitive information between partners collaborating to address an exotic disease outbreak is crucial in preserving the medical, economic and social well-being of the affected population (whether it is human, animal or plant). Further, the ability to respond quickly to the outbreak by providing real-time, interactive access to shared (collaborative) information will minimise the impact of an outbreak. The sharing of information must be done carefully, with agreement between the partners and enforced by specific protocols. This paper presents an overview of a new joint project between EU partners and AU partners, total value of around €8.64 million, which is examining the issue of authentication and authorisation required to ensure that collaborative information in such situations is kept within the control of the collaborating partners and that accidental (or deliberate) release to unauthorised partners can be mitigated.

  1. Acute diarrhea in adults consulting a general practitioner in France during winter: incidence, clinical characteristics, management and risk factors.

    Science.gov (United States)

    Arena, Christophe; Amoros, Jean Pierre; Vaillant, Véronique; Ambert-Balay, Katia; Chikhi-Brachet, Roxane; Jourdan-Da Silva, Nathalie; Varesi, Laurent; Arrighi, Jean; Souty, Cécile; Blanchon, Thierry; Falchi, Alessandra; Hanslik, Thomas

    2014-10-30

    Data describing the epidemiology and management of viral acute diarrhea (AD) in adults are scant. The objective of this study was to identify the incidence, clinical characteristics, management and risk factors of winter viral AD in adults. The incidence of AD in adults during two consecutive winters (from December 2010 to April 2011 and from December 2011 to April 2012) was estimated from the French Sentinelles network. During these two winters, a subset of Sentinelles general practitioners (GPs) identified and included adult patients who presented with AD and who filled out a questionnaire and returned a stool specimen for virological examination. All stool specimens were tested for astrovirus, group A rotavirus, human enteric adenovirus, and norovirus of genogroup I and genogroup II. Age- and sex-matched controls were included to permit a case-control analysis with the aim of identifying risk factors for viral AD. During the studied winters, the average incidence of AD in adults was estimated to be 3,158 per 100,000 French adults (95% CI [2,321 - 3,997]). The most reported clinical signs were abdominal pain (91.1%), watery diarrhea (88.5%), and nausea (83.3%). GPs prescribed a treatment in 95% of the patients with AD, and 80% of the working patients with AD could not go to work. Stool examinations were positive for at least one enteric virus in 65% (95% CI [57 - 73]) of patients with AD with a predominance of noroviruses (49%). Having been in contact with a person who has suffered from AD in the last 7 days, whether within or outside the household, and having a job (or being a student) were risk factors significantly associated with acquiring viral AD. During the winter, AD of viral origin is a frequent disease in adults, and noroviruses are most often the cause. No preventable risk factor was identified other than contact with a person with AD. Thus, at the present time, reinforcement of education related to hand hygiene remains the only way to reduce the

  2. Incidence of root rot diseases of soybean in Multan Pakistan and its management by the use of plant growth promoting rhizobacteria

    International Nuclear Information System (INIS)

    Haq, M.I.; Tahir, M.I.; Mahmood, S.

    2012-01-01

    Eight villages in Multan district were surveyed to record incidence of disease and losses of soybean (Glycine max L.) caused by root rot fungi. The root incidence ranged 10-17% and losses ranged 6.75-15.5%. The evaluation of four PGPR isolates was used in combination with organic amendment for the management of root-rot disease incidence and to reduce the population of root pathogenic fungi and to increase the yield in field. This study demonstrated effective biological control by the PGPR isolates tested, thereby indicating the possibility of application of rhizobacteria for control of soil bor ne diseases of soybean in Pakistan and other countries. (author)

  3. Major incident medical management and support: The practical approach at the scene Kevin Mackway-Jones Major Incident Medical Management and Support: The Practical Approach at the Scene Wiley-Blackwell £41.99 196pp 9781405187572 1405187573 [Formula: see text].

    Science.gov (United States)

    2012-06-12

    ALTHOUGH THIS excellent, informative book is intended primarily to be a manual for the pre-major incident medical management and support course, it would be a useful resource in any emergency department and a useful guide for individual nurses who provide care at major incident scenes.

  4. The incidence and management of cutaneous adverse events of the epidermal growth factor receptor inhibitors

    Directory of Open Access Journals (Sweden)

    Witold Owczarek

    2017-10-01

    Full Text Available Overexpression of the epidermal growth factor receptor (EGFR is found in many cancers, including those of the head and neck area, non-small-cell lung cancer, and colorectal, cervical, prostate, breast, ovary, stomach, and pancreatic cancer. The EGFR inhibitors are used at present in the treatment of such cancers. Skin lesions that develop during and after cancer treatment may be due to specific cytostatics, molecular-targeted drugs, radiation therapy, complementary therapy, or the cancer itself, and hence knowledge is essential to distinguish between them. The mechanism through which skin toxicity arises during treatment with EGFR inhibitors is not well known, but seems to be due to the modification of the RAS/RAF/MEK/ERK signal path associated with its activation, which results in the similarity between the adverse effects of EGFR inhibitors and the treatment of melanoma with BRAF and MEK inhibitors. The most common side effects are pruritus, xerosis, papulopustular rash, hand-foot skin reaction, alopecia and dystrophy of the hair, and paronychia. This work presents options for prevention and suggestions for managing these adverse events, which are of importance in the care of patients undergoing oncological treatment.

  5. Decontamination and Management of Human Remains Following Incidents of Hazardous Chemical Release

    Energy Technology Data Exchange (ETDEWEB)

    Hauschild, Veronique [U.S. Army Public Health Command; Watson, Annetta Paule [ORNL; Bock, Robert Eldon [ORNL

    2012-01-01

    Abstract Objective: To provide specific procedural guidance and resources for identification, assessment, control, and mitigation of compounds that may contaminate human remains resulting from chemical attack or release. Design: A detailed technical, policy, and regulatory review is summarized. Setting: Guidance is suitable for civilian or military settings where human remains potentially contaminated with hazardous chemicals may be present. Settings would include sites of transportation accidents, natural disasters, terrorist or military operations, mortuary affairs or medical examiner processing and decontamination points, and similar. Patients, Participants: While recommended procedures have not been validated with actual human remains, guidance has been developed from data characterizing controlled experiments with fabrics, materiel, and laboratory animals. Main Outcome Measure(s): Presentation of logic and specific procedures for remains management, protection and decontamination of mortuary affairs personnel, as well as decision criteria for determining when remains are sufficiently decontaminated so as to pose no chemical health hazard. Results: Established procedures and existing equipment/materiel available for decontamination and verification provide appropriate and reasonable means to mitigate chemical hazards from remains. Extensive characterization of issues related to remains decontamination indicates that supra-lethal concentrations of liquid chemical warfare agent VX may prove difficult to decontaminate and verify in a timely fashion. Specialized personnel can and should be called upon to assist with monitoring necessary to clear decontaminated remains for transport and processing. Conclusions: Once appropriate decontamination and verification have been accomplished, normal procedures for remains processing and transport to the decedent s family and the continental United States can be followed.

  6. A CLINICAL STUDY ON THE INCIDENCE AND MANAGEMENT OF BIOLOGICAL COMPLICATIONS IN IMPLANT THERAPY

    Directory of Open Access Journals (Sweden)

    Nicolae VASILE

    2015-09-01

    Full Text Available The scope of the study was to evidence the methods recommended for avoiding, managing and implementing an efficient treatment capable of reducing the biological complications accompanying implant therapies. Materials and method. The study evaluates the patients with prosthesis charged implants - or during their osseointegration period - inserted in the Clinic of The Emergency Military Hospital of Sibiu, over a 5 year period (2009-2014. Retrospective investigation was based on the evaluation of the treatment files and on the imagistic and clinical analyses of the 125 patients to whom 385 implants had been inserted. Results and discussion. The study demonstrates that, when implants are the support of an overdenture, surrounded by either limited keratinized gingiva or mobile tissues, the presence of the bacterial plaque is considerable, the peri-implant pocket exceeds 5 mm, and sensitivity and bleeding are produced on contact with the probe. In susceptible patients, or in those with pathological periodontal antecedents, the re-infection potential has been always higher. The clinical study confirms that, invariably, peri-implantitis is associated with the existence of the bacterial plaque and also with the presence of a peri-implant pocket exceeding 4 mm (8.9%, with partial exposure of the covering screw (4.5% and fixed restaurations without self-cleaning spaces (2%. Conclusions. Out of the post-surgery biological complications, peri-implantitis is the most frequent one, causing a – sometimes total – loss of the alveolar bone around the osseointegrated implant.

  7. Nurses' experiences of managing patient deterioration following a post-registration education programme: A critical incident analysis study.

    Science.gov (United States)

    Butler, Clare

    2018-01-01

    The aim of this study was to explore nurses' experiences assessing and managing deteriorating patients in practice following completion of a relevant post-registration education programme. Recognising the increasing acuity of ward patients, nurses are faced with patients who are at an increased risk of deterioration. Patients who are acutely ill or deteriorating often exhibit periods of physiological deterioration; however there is evidence illustrating that these clinical changes are frequently missed, misinterpreted or mismanaged in practice. In order to prepare nurses to competently assess and manage the deteriorating patient, education as a care initiative is offered to develop the knowledge and skills required. A qualitative study using critical incident analysis was conducted to acquire narrative data from nurses, describing their clinical practice experiences of patient deterioration. Thematic analysis was used to analyse the data. Findings revealed improvements in nurses' abilities to recognise patient deterioration, greater application of the evidence base and an increase in confidence and assertiveness. There was some evidence of applying the knowledge and skills learned, however equally some nurses indicated that they remained ill-prepared to apply the skills in practice. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  8. Management of an incident of failed sterilization of surgical instruments in a dental clinic in Hong Kong

    Directory of Open Access Journals (Sweden)

    Vincent Chi-Chung Cheng

    2013-11-01

    Conclusion: Rapid response is extremely crucial in minimizing the impact of this incident and relieving the anxiety of the affected patients. Proper recording and documentation of autoclave cycles and regular auditing should be enforced to prevent similar incidents.

  9. The impact of anti HPV vaccination on cervical cancer incidence and HPV induced cervical lesions: consequences for clinical management.

    Science.gov (United States)

    Brinkman, J A; Caffrey, A S; Muderspach, L I; Roman, L D; Kast, W M

    2005-01-01

    prevent persistent infection with the virus are high and may be implemented in the near future. The consequences for clinical management may include a significant reduction in the frequency of Pap smear screening in the case of prophylactic vaccines, and the availability of less invasive and disfiguring treatment options for women with pre-existing HPV associated lesions in the case of therapeutic vaccines. Implementation of both prophylactic and therapeutic vaccine regimens could result in a significant reduction of health care costs and reduction of worldwide cervical cancer incidence.

  10. Design and Testing of BACRA, a Web-Based Tool for Middle Managers at Health Care Facilities to Lead the Search for Solutions to Patient Safety Incidents.

    Science.gov (United States)

    Carrillo, Irene; Mira, José Joaquín; Vicente, Maria Asuncion; Fernandez, Cesar; Guilabert, Mercedes; Ferrús, Lena; Zavala, Elena; Silvestre, Carmen; Pérez-Pérez, Pastora

    2016-09-27

    Lack of time, lack of familiarity with root cause analysis, or suspicion that the reporting may result in negative consequences hinder involvement in the analysis of safety incidents and the search for preventive actions that can improve patient safety. The aim was develop a tool that enables hospitals and primary care professionals to immediately analyze the causes of incidents and to propose and implement measures intended to prevent their recurrence. The design of the Web-based tool (BACRA) considered research on the barriers for reporting, review of incident analysis tools, and the experience of eight managers from the field of patient safety. BACRA's design was improved in successive versions (BACRA v1.1 and BACRA v1.2) based on feedback from 86 middle managers. BACRA v1.1 was used by 13 frontline professionals to analyze incidents of safety; 59 professionals used BACRA v1.2 and assessed the respective usefulness and ease of use of both versions. BACRA contains seven tabs that guide the user through the process of analyzing a safety incident and proposing preventive actions for similar future incidents. BACRA does not identify the person completing each analysis since the password introduced to hide said analysis only is linked to the information concerning the incident and not to any personal data. The tool was used by 72 professionals from hospitals and primary care centers. BACRA v1.2 was assessed more favorably than BACRA v1.1, both in terms of its usefulness (z=2.2, P=.03) and its ease of use (z=3.0, P=.003). BACRA helps to analyze incidents of safety and to propose preventive actions. BACRA guarantees anonymity of the analysis and reduces the reluctance of professionals to carry out this task. BACRA is useful and easy to use.

  11. Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

    NARCIS (Netherlands)

    Berger, Ferco H.; Körner, Markus; Bernstein, Mark P.; Sodickson, Aaron D.; Beenen, Ludo F.; McLaughlin, Patrick D.; Kool, Digna R.; Bilow, Ronald M.

    2016-01-01

    In the setting of mass casualty incidents (MCIs), hospitals need to divert from normal routine to delivering the best possible care to the largest number of victims. This should be accomplished by activating an established hospital disaster management plan (DMP) known to all staff through prior

  12. GIS-based tools to identify tradeoffs between waste management and remediation strategies from radiological dispersal device incidents

    International Nuclear Information System (INIS)

    Lemieux, P.; Wood, J.; Snyder, E.; Boe, T.; Schulthiesz, D.; Peake, T.; Ierardi, M.; Hayes, C.; Rodgers, M.

    2011-01-01

    Management of waste and debris from the detonation of a Radiological Dispersal Device (RDD) will likely comprise a significant portion of the overall remediation effort and possibly contribute to a significant portion of the overall remediation costs. As part of the recent National Level Exercise, Liberty RadEx, that occurred in Philadelphia in April 2010, a methodology was developed by EPA to generate a first-order estimate of a waste inventory for the hypothetical RDD from the exercise scenario. Determination of waste characteristics and whether the generated waste is construction and demolition (C&D) debris, municipal solid waste (MSW), hazardous waste, mixed waste, or low level radioactive waste (LLRW), and characterization of the wastewater that is generated from the incident or subsequent cleanup activities will all influence the cleanup costs and timelines. Decontamination techniques, whether they involve chemical treatment, abrasive removal, or aqueous washing, will also influence the waste generated and associated cleanup costs and timelines. This paper describes the ongoing effort to develop a tool to support RDD planning and response activities by assessing waste quantities and characteristics as a function of potential mitigation strategies and targeted cleanup levels. (author)

  13. Sensitivity analysis on ultimate strength of aluminium stiffened panels

    DEFF Research Database (Denmark)

    Rigo, P.; Sarghiuta, R.; Estefen, S.

    2003-01-01

    This paper presents the results of an extensive sensitivity analysis carried out by the Committee III.1 "Ultimate Strength" of ISSC?2003 in the framework of a benchmark on the ultimate strength of aluminium stiffened panels. Previously, different benchmarks were presented by ISSC committees on ul...

  14. Reliability of Hull Girder Ultimate Strength of Steel Ships

    Science.gov (United States)

    Da-wei, Gao; Gui-jie, Shi

    2018-03-01

    Hull girder ultimate strength is an evaluation index reflecting the true safety margin or structural redundancy about container ships. Especially, after the hull girder fracture accident of the MOL COMFORT, the 8,000TEU class large container ship, on June 17 2013, larger container ship safety has been paid on much more attention. In this paper, different methods of calculating hull girder ultimate strength are firstly discussed and compared with. The bending ultimate strength can be analyzed by nonlinear finite element method (NFEM) and increment-iterative method, and also the shear ultimate strength can be analyzed by NFEM and simple equations. Then, the probability distribution of hull girder wave loads and still water loads of container ship are summarized. At last, the reliability of hull girder ultimate strength under bending moment and shear forces for three container ships is analyzed by using a first order method. The conclusions can be applied to give guidance for ship design and safety evaluation.

  15. Ultimate strength of stiffened plates with pitting corrosion

    Directory of Open Access Journals (Sweden)

    Ahmad Rahbar-Ranji

    2015-05-01

    Full Text Available Predicting residual strength of corroded plates is of crucial importance for service life estimation of aged structures. A series of nonlinear finite element method is employed for ultimate strength analysis of stiffened plates with pitting corrosion. Influential parameters, including plate thickness, type and size of stiffeners, pit depth and degree of pitting are varied and more than 208 finite element models are analyzed. It is found that ultimate strength is reduced by increasing pit depth to thickness ratio. Thin and intermediate plates have minimum and maximum reduction of ultimate strength with stronger stiffeners, respectively. In weak stiffener, reduction of ultimate strength in thin and intermediate plates depends on DOP. Reduction of ultimate strength in thick plates depends on thickness ofplate and DOP. For intermediate plates, reduction for all stiffeners regardless of shape and size are the same.

  16. C2-Related Incidents Reported by UAS Pilots

    Science.gov (United States)

    Hobbs, Alan; Cardoza, Colleen; Null, Cynthia

    2016-01-01

    It has been estimated that aviation accidents are typically preceded by numerous minor incidents arising from the same causal factors that ultimately produced the accident. Accident databases provide in-depth information on a relatively small number of occurrences, however incident databases have the potential to provide insights into the human factors of Remotely Piloted Aircraft System (RPAS) operations based on a larger volume of less-detailed reports. Currently, there is a lack of incident data dealing with the human factors of unmanned aircraft systems. An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from RPAS pilots. Twenty-three experienced RPAS pilots volunteered to participate in focus groups in which they described critical incidents from their own experience. Participants were asked to recall (1) incidents that revealed a system flaw, or (2) highlighted a case where the human operator contributed to system resilience or mission success. Participants were asked to only report incidents that could be included in a public document. During each focus group session, a note taker produced a de-identified written record of the incident narratives. At the end of the session, participants reviewed each written incident report, and made edits and corrections as necessary. The incidents were later analyzed to identify contributing factors, with a focus on design issues that either hindered or assisted the pilot during the events. A total of 90 incidents were reported. This presentation focuses on incidents that involved the management of the command and control (C2) link. The identified issues include loss of link, interference from undesired transmissions, voice latency, accidental control transfer, and the use of the lost link timer, or lost link OK features.

  17. Spatial-Temporal Hotspot Pattern Analysis of Provincial Environmental Pollution Incidents and Related Regional Sustainable Management in China in the Period 1995–2012

    Directory of Open Access Journals (Sweden)

    Lei Ding

    2015-10-01

    Full Text Available Spatial-temporal hotspot pattern analysis of environmental pollution incidents provides an indispensable source of information for the further development of incident prevention measures. In this study, the spatial-temporal patterns of environmental pollution incidents in China in the period of 1995–2012 were analyzed, using the Spatial Getis-Ord statistic and an Improved Prediction Accuracy Index (IAPI. The results show that, in this period, the occurrence of environmental incidents exhibited a dynamic growth pattern but then dropped and continued to drop after the year 2006, which was considered a crucial turning point. Not coincidentally, this corresponds to the year when the State Council issued its National Environmental Emergency Plan, and following the examination of major incidents, special actions were taken to strengthen the control of incidents and emergency responses. The results from Getis-Ord General G statistical analysis show that the spatial agglomeration phenomenon was statistically significant after 1999 and that the level of spatial agglomeration was rising, while the Getis-Ord Gi* statistical analysis reveals that environmental pollution incidents were mainly agglomerated in the Pan Yangtze River Delta and Pan Pearl River Delta regions. Accordingly, the spatial-temporal hotspot pattern based on the IAPI values at the provincial scale could be categorized into: stable hotspots, unstable hotspots, and cold-spot areas. The stable hotspots category was further divided into three subtypes: industrial distribution type, industrial transfer type, and extensive economic growth type. Finally, the corresponding measures for sustainable management were proposed: stable hotspots were classified as essential regions requiring the immediate prevention and control of environmental pollution incidents; unstable hotspots were characterized by their need for ongoing and continual prevention measures, and cold-spots were those areas that

  18. Influence of initial imperfections on ultimate strength of spherical shells

    Directory of Open Access Journals (Sweden)

    Chang-Li Yu

    2017-09-01

    Full Text Available Comprehensive consideration regarding influence mechanisms of initial imperfections on ultimate strength of spherical shells is taken to satisfy requirement of deep-sea structural design. The feasibility of innovative numerical procedure that combines welding simulation and non-linear buckling analysis is verified by a good agreement to experimental and theoretical results. Spherical shells with a series of wall thicknesses to radius ratios are studied. Residual stress and deformations from welding process are investigated separately. Variant influence mechanisms are discovered. Residual stress is demonstrated to be influential to stress field and buckling behavior but not to the ultimate strength. Deformations are proved to have a significant impact on ultimate strength. When central angles are less than critical value, concave magnitudes reduce ultimate strengths linearly. However, deformations with central angles above critical value are of much greater harm. Less imperfection susceptibility is found in spherical shells with larger wall thicknesses to radius ratios.

  19. Assessment and characterization of radioactive waste for ultimate storage

    International Nuclear Information System (INIS)

    Brennecke, P.; Warnecke, E.

    1986-01-01

    The waste specifications determined from site safety analyses define the requirements to be met by waste forms for ultimate storage. Product quality control is the process step ensuring compliance with the conditions to be met for ultimate storage. For this purpose, radionuclide inventory, fixation method, container type, waste form and quantity, and type of waste are the most significant items on the checking list. (DG) [de

  20. Ultimate - a new generation of gasoline and diesel fuels; Ultimate - eine neue Generation von Otto- und Dieselkraftstoffen

    Energy Technology Data Exchange (ETDEWEB)

    Strempel, G. [Aral Forschung/Global Fuels Technology, Bochum (Germany); Beckwith, P. [BP Fuels Management Group, Pangbourne (United Kingdom); Froehling, J. [Aral Forschung, Bochum (Germany). Labor/Analytik; Baron, U. [Aral Forschung, Bochum (Germany). Motor- und Fahrzeuglaboratorium; Sauermann, P.; Balfanz, U. [Aral Forschung, Bochum (Germany). Produktentwicklung; Doermer, W. [Aral Forschung, Bochum (Germany). Produktqualitaet

    2005-06-01

    With the launch of Ultimate 100 gasoline and Ultimate Diesel, motorists in Germany now have the opportunity to choose new advanced performance fuels designed to get the very best from their engines. This article gives details of the technical development behind these fuels, their wide range of benefits, and how it is possible to manufacture fuels which meet the considerable technical challenge of achieving both more performance and less pollution. (orig.)

  1. THE ULTIMATE STATE CONCEPT APPLIED TO TUNNEL SUPPORT

    Directory of Open Access Journals (Sweden)

    Mladen Hudec

    2000-12-01

    Full Text Available The most questionable are the values of pressures between rock and support resulting from common deformations on the contact area between rock and support. Therefore the modelling and design of the tunnel support is not reliable, if it is based on active rock pressure resulting from this common deformations. The inversion of the design procedure is proposed. Instead of the active extreme pressure of the rock on support, the influence of ultimate reaction of the support on the rock has to be analysed. This procedure can be performed using the ultimate load principle, as proposed by Eurocodc 7 (Geotechnies. Normally, the rock has the tendency to increase the common conver¬gence until the support reaches its ultimate state. So, loading of profile boundary with the ultimate possible reaction of the support is very plausible. The reactive support pressures have to be probable and itself in equilibrium. The ultimate reactive load has to be reduced by Euro-code safety factor for structural elements and applied on the rock with given properties, or alternatively (as proposed by Eurocode 7 the soil or rock properties have to be diminished and calculated with full ultimate support pressures. If the rock with given (or proposed pro¬perties and loaded with ultimate reactive pressures resulting from supposed support, satisfy its failure criterion, then is the compound system support-rock verificatcd. By this procedure, the number of relevant material properties is reduce to the primary stress ratio and the constants defining the failure criterion. The verification can be performed by any of numerical methods, but we prefer here used boundary elements method (the paper is published in Croatian.

  2. Prophylactic antibiotics are associated with a lower incidence of pneumonia in cardiac arrest survivors treated with targeted temperature management

    DEFF Research Database (Denmark)

    Gagnon, David J; Nielsen, Niklas; Fraser, Gilles L

    2015-01-01

    -34 °C were enrolled in the registry. Differences were analyzed in univariate analyses and with logistic regression models to evaluate independent associations of clinical factors with incidence of pneumonia and good functional outcome. RESULTS: 416 of 1240 patients (33.5%) received PRO. Groups were...... of a good functional outcome (41.1 vs. 36.6%, p = 0.19) were similar between groups. Backwards stepwise logistic regression demonstrated PRO were independently associated with a lower incidence of pneumonia (OR 0.09, 95% 0.06-0.14, p

  3. Critical incident stress management (CISM) in support of special agents and other first responders responding to the Fort Hood shooting: summary and recommendations.

    Science.gov (United States)

    Strand, Russell; Felices, Karina; Williams, Kenneth

    2010-01-01

    On November 5, 2009, an individual entered the Fort Hood Soldier Readiness Processing (SRP) site and opened fire with a handgun. The result of the shooting was a total of 13 people killed and 31 wounded. A two-person critical incident peer support (CIPS) team from the United States Army Military Police School (USAMPS) provided critical incident stress management (CISM) in the forms of critical incident stress debriefings (CISD) and one-on-one crisis intervention for investigators and their spouses. This article provides a summary and discussion of the results of the interventions that were conducted. Key results for successful CISM were accessibility of CIPS team, the credibility of trained peers and the development of supportive relationships, the reduction of stigma by requiring attendance at interventions, and the commitment of the CIPS team to the principles of CISM (e.g., homogenous groups, utilizing a multicomponent approach, and facilitating the normalization of emotional reactions to the crisis). Recommendations include mandating critical incident peer support cells for Criminal Investigation Division (CID) units, Director of Emergency Services (DES) on military installations, and Military Police units; providing a pool of trained peers in the above-mentioned organizations; providing permanent funding for USAMPS' CIPS Course; and recognition of CIPS/CISMas an essential element of Comprehensive Soldier Fitness and Army Human Capital in promoting Soldier Family, and Civilian well-being and resiliency. This article would benefit leaders, chaplains, mental health professionals, and emergency services personnel in investigative, operational, and U.S. Army Garrison units.

  4. Measuring the association between artemisinin-based case management and malaria incidence in southern Vietnam, 1991-2010.

    Science.gov (United States)

    Peak, Corey M; Thuan, Phung Duc; Britton, Amadea; Nguyen, Tran Dang; Wolbers, Marcel; Thanh, Ngo Viet; Buckee, Caroline O; Boni, Maciej F

    2015-04-01

    In addition to being effective, fast-acting, and well tolerated, artemisinin-based combination therapies (ACTs) are able to kill certain transmission stages of the malaria parasite. However, the population-level impacts of ACTs on reducing malaria transmission have been difficult to assess. In this study on the history of malaria control in Vietnam, we assemble annual reporting on malaria case counts, coverage with insecticide-treated nets (ITN) and indoor residual spraying (IRS), and drug purchases by provincial malaria control programs from 1991 to 2010 in Vietnam's 20 southern provinces. We observe a significant negative association between artemisinin use and malaria incidence, with a 10% absolute increase in the purchase proportion of artemisinin-containing regimens being associated with a 29.1% (95% confidence interval: 14.8-41.0%) reduction in slide-confirmed malaria incidence, after accounting for changes in urbanization, ITN/IRS coverage, and two indicators of health system capacity. One budget-related indicator of health system capacity was found to have a smaller association with malaria incidence, and no other significant factors were found. Our findings suggest that including an artemisinin component in malaria drug regimens was strongly associated with reduced malaria incidence in southern Vietnam, whereas changes in urbanization and coverage with ITN or IRS were not. © The American Society of Tropical Medicine and Hygiene.

  5. Sensitivity analysis on ultimate strength of aluminium stiffened panels

    DEFF Research Database (Denmark)

    Rigo, P.; Sarghiuta, R.; Estefen, S.

    2003-01-01

    on ultimate strength. The goal has typically been to give guidance to the designer on how to predict the ultimate strength and to indicate what level of accuracy would be expected. This time, the target of this benchmark is to present reliable finite element methods to study the behaviour of axial compressed...... members analysed the same structure with a defined set of parameters and using different codes. It wa expected that all the codes/models predict the same results. In Phase B, to boost the scope of the analysis, the different members Uusing their own model) performed FE analyses for a range of variation...

  6. Trump er gældsøkonomiens ultimative illusionist

    DEFF Research Database (Denmark)

    Nielsen, Peter

    2018-01-01

    Trump giver ikke kun gevaldige skattelettelser og nærer en illusion om, at vækst vil løse alle problemer. Han fortrænger også gældsøkonomiens ultimative bundlinje i form af klimaforandringerne.......Trump giver ikke kun gevaldige skattelettelser og nærer en illusion om, at vækst vil løse alle problemer. Han fortrænger også gældsøkonomiens ultimative bundlinje i form af klimaforandringerne....

  7. Ductility and Ultimate Capacity of Prestressed Steel Reinforced Concrete Beams

    Directory of Open Access Journals (Sweden)

    Chengquan Wang

    2017-01-01

    Full Text Available Nonlinear numerical analysis of the structural behaviour of prestressed steel reinforced concrete (PSRC beams was carried out by using finite element analysis software ABAQUS. By comparing the load-deformation curves, the rationality and reliability of the finite element model have been confirmed; moreover, the changes of the beam stiffness and stress in the forcing process and the ultimate bearing capacity of the beam were analyzed. Based on the model, the effect of prestressed force, and H-steel to the stiffness, the ultimate bearing capacity and ductility of beam were also analyzed.

  8. The ultimate solution. Disposal of disused sealed radioactive sources (DSRS)

    International Nuclear Information System (INIS)

    Heard, R.G.

    2011-01-01

    The borehole disposal concept (BDC) was first presented to ICEM by Potier, J-M in 2005. This paper repeats the basics introduced by Potier and relates further developments. It also documents the history of the development of the BDC. For countries with no access to existing or planned geological disposal facilities for radioactive wastes, the only options for managing high activity or long-lived disused radioactive sources are to store them indefinitely, return them to the supplier or find an alternative method of disposal. Disused sealed radioactive sources (DSRS) pose an unacceptable radiological and security risk if not properly managed. Out of control sources have already led to many high-profile incidents or accidents. One needs only to remember the recent accident in India that occurred earlier this year. Countries without solutions in place need to consider the future management of DSRSs urgently. An on-going problem in developing countries is what to do with sources that cannot be returned to the suppliers, sources for which there is no further use, sources that have not been maintained in a working condition and sources that are no longer suitable for their intended purpose. Disposal in boreholes is intended to be simple and effective, meeting the same high standards of long-term radiological safety as any other type of radioactive waste disposal. It is believed that the BDC can be readily deployed with simple, cost-effective technologies. These are appropriate both to the relatively small amounts and activities of the wastes and the resources that can realistically be found in developing countries. The South African Nuclear Energy Corporation Ltd (Necsa) has carried out project development and demonstration activities since 1996. The project looked into the technical feasibility, safety and economic viability of BDC under the social, economic, environmental and infrastructural conditions currently prevalent in Africa. Implementation is near at hand with

  9. A prospective study on the incidence of dog bites and management in a rural Cambodian, rabies-endemic setting.

    Science.gov (United States)

    Ponsich, Aurelia; Goutard, Flavie; Sorn, San; Tarantola, Arnaud

    2016-08-01

    Rabies circulates intensely in Cambodia, mainly affecting rural populations. We conducted a prospective study to estimate the baseline incidence of potentially infective dog bites in rural villages of Siem Reap province, Cambodia. The study was conducted in a convenience sample of 844 families totaling 1779 persons in four villages. The study collected data in a total of 802.3 person-years. Trained village health workers (VHW) exhaustively documented consecutive dog bites at the end of each month. Between May 15th and November 15th, 2011, a total of 40 attacks (43 bites; 1.07 bites per attack) were notified by 39 persons (50% female; one suffered two distinct incidents) to VHW. The all-age attack rate for bites over this 6-month period was 2.3% (CI95%: 1.7-3.1%), with a global incidence rate estimated at 4.84 bites/100 person-years (CI95%: 3.5-6.6). The mean age in bite victims was 20.8±18.9years (median 12.5; interquartile range 6-36; range 1-63). The dog was identified in 39 (97.5%) of cases, being the household dog in 9 (22.5%) of cases. Bites were classified as severe (WHO Category III-broken skin with bleeding) in 33 (82.5%) of cases with a severe dog bites incidence estimated at 4/100 person-years (CI95%: 2.8-5.6). The bites involved the hand or face in 1 (2.5%) case each (both Category III). In 20 incidents (50%), only rice was applied to the wounds. There were no suspected or confirmed human rabies deaths during the study period but one dog died after biting (2 others were lost to follow-up and 14 were put down by their owner). Our study documented an extremely high incidence of dog bites in of rural Cambodian adults and children. Adapted control policies for canine vaccination are urgently needed. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Ultimate 100m world records through extreme-value theory

    NARCIS (Netherlands)

    Einmahl, J.H.J.; Smeets, S.G.W.R.

    2011-01-01

    We use extreme-value theory to estimate the ultimate world records for the 100-m running, for both men and women. For this aim we collected the fastest personal best times set between January 1991 and June 2008. Estimators of the extreme-value index are based on a certain number of upper order

  11. Geotechnical Ultimate Limit State Design Using Finite Elements

    NARCIS (Netherlands)

    Brinkgreve, R.B.J.; Post, M.

    2015-01-01

    Displacement-based finite element calculations are primarily used for serviceability limit state (SLS) analysis, but the finite element method also offers possibilities for ultimate limit state (ULS) design in geotechnical engineering. The combined use of SLS and ULS calculations with partial safety

  12. Ultimate 100m World Records Through Extreme-Value Theory

    NARCIS (Netherlands)

    Einmahl, J.H.J.; Smeets, S.G.W.R.

    2009-01-01

    We use extreme-value theory to estimate the ultimate world records for the 100m running, for both men and women. For this aim we collected the fastest personal best times set between January 1991 and June 2008. Estimators of the extreme-value index are based on a certain number of upper order

  13. 49 Stories That Make an Ultimate STEM Lesson Plan

    Science.gov (United States)

    Mehta, Swati; Mehta, Rohit; Berzina-Pitcher, Inese; Seals, Christopher; Mishra, Punya

    2016-01-01

    In this paper we reviewed what 49 large urban public school district STEM teachers enrolled in a year-long graduate certificate and fellowship program at a large Midwestern university considered as their amazing teaching moments. They were asked to share their amazing teaching moments that would make an Ultimate Lesson Plan in STEM. In smaller…

  14. Reprocessing and ultimate disposal of spent nuclear fuels

    International Nuclear Information System (INIS)

    Lukner, C.

    1986-01-01

    The booklet is intended as a source of information for school instruction or adult education. The material presented explains aspects of the nuclear fuel cycle, such as reprocessing and ultimate storage of spent nuclear fuels and radioactive waste. Safety engineering and research is dealt with, as well as aspects of a possible complete shut-down of nuclear installations in our country. (DG) [de

  15. Analysis of ultimate-heat-sink spray ponds. Technical report

    International Nuclear Information System (INIS)

    Codell, R.

    1981-08-01

    This report develops models which can be utilized in the design of certain types of spray ponds used in ultimate heat sinks at nuclear power plants, and ways in which the models may be employed to determine the design basis required by U.S. Nuclear Regulatory Commission Regulatory Guide 1.27

  16. A Retrospective Study of the Incidence of Missed Opportunities in Identifying, Managing and Referring At-Risk of Overweight and Overweight Children and Adolescents in an Outpatient Primary Care Setting

    National Research Council Canada - National Science Library

    Quirke, Amy

    2004-01-01

    A descriptive study of the incidence of missed opportunities in identifying, managing and referring children and adolescents at-risk of overweight and overweight were conducted using a retrospective...

  17. Effects of Comprehensive Risk Management Program on the Preparedness of Rofeide Rehabilitation Hospital in Disasters and Incidents

    Directory of Open Access Journals (Sweden)

    Samira Rajabi

    2017-07-01

    Conclusion: Considering the positive impact of the implementation of the risk management program on the preparedness of Rofeide Rehabilitation Hospital and promotion of its preparedness level from poor to moderate, as well as relatively high vulnerability of hospitals against internal and external risks, national hospitals are recommended to use the comprehensive hospital risk management model to be more prepared for disasters.

  18. The relationship between the implementation of voluntary Five-Star occupational health and safety management system and the incidence of fatal and permanently disabling injury

    DEFF Research Database (Denmark)

    Hedlund, Frank Huess

    2014-01-01

    This paper examines two properties of the South African NOSA 5-Star System, a voluntary occupational health and safety (OHS) management system. The first property is the association between system implementation and final OHS outcomes measured as incidence rates of fatal and permanently disabling...... injury. The second is the association between the Star audit rating and rates of serious occupational injury. Although there are many uncertainties involved the paper argues that companies committed to the NOSA system experienced fewer fatal and permanently disabling injuries than the general...

  19. Wheelchair incidents

    NARCIS (Netherlands)

    Drongelen AW van; Roszek B; Hilbers-Modderman ESM; Kallewaard M; Wassenaar C; LGM

    2002-01-01

    This RIVM study was performed to gain insight into wheelchair-related incidents with powered and manual wheelchairs reported to the USA FDA, the British MDA and the Dutch Center for Quality and Usability Research of Technical Aids (KBOH). The data in the databases do not indicate that incidents with

  20. Ultimate horizons probing the limits of the universe

    CERN Document Server

    Satz, Helmut

    2013-01-01

    In the last hundred years, modern physics and cosmology have shown that there exist regions of the universe forever beyond our reach, hidden by truly ultimate horizons. Such regions exist in those remote parts of the universe where, from our point of view, space expands faster than the speed of light. They are found in black holes, where the gravity is strong enough to retain even light within its field of attraction. And in the realm of the very small, quarks must remain forever confined to their world of extreme density and can never be removed from it. The aim of this book is to describe these ultimate horizons, how they were discovered, how they shape our view of the world, and what clues we have about a world beyond them.

  1. Landau damping: the mechanics model and its ultimate entropy gain

    International Nuclear Information System (INIS)

    Hannay, J H; Kluge, Michel

    2011-01-01

    Classical mechanics has only been invoked to account for Landau damping in a rather half-hearted way, alongside plasma perturbation theory. In particular this invocation is essential for the study of the saturation, or post-linear (or 'nonlinear') regime of the damping initiated by Dawson and O'Neill. By embracing mechanics wholeheartedly here, with its attendant phase space, one can access results, old and new, cleanly and directly, and with one fewer numerical integration for the post-linear regime. By using a summation technique familiar in semiclassical quantum mechanics (Poisson summation), the one remaining numerical integration can be much improved in accuracy. Also accessible from mechanics is the ultimate entropy gain. Though zero for any finite time (in the absence of coarse graining), the entropy gain is ultimately non-zero (at infinite time the required coarse graining is zero). It is calculated analytically by using the appropriate asymptotics, hitherto not fully exploited.

  2. The ultimate challenge of pregnancy-associated breast carcinoma

    International Nuclear Information System (INIS)

    Raja, R.; Tahira, A.

    2005-01-01

    Pregnancy associated breast carcinoma requires making judicious use of all diagnostic modalities and the therapeutic options of surgery, irradiation, chemotherapy and hormonal therapy to enhance survival rates. Individualization of treatment for each patient is the key to success. The effects on future fertility, the time interval before next conception, and whether to breast feed or not are all well-documented. A multidisciplinary coordinated team approach to this ultimate challenge of patient care will prove fruitful. (author)

  3. Ultimate Gradient Limitation in Niobium Superconducting Accelerating Cavities

    Energy Technology Data Exchange (ETDEWEB)

    Checchin, Mattia [Illinois Inst. of Technology, Chicago, IL (United States); Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Grassellino, Anna [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Martinello, Martina [Illinois Inst. of Technology, Chicago, IL (United States); Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Posen, Sam [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Romanenko, Alexander [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Zasadzinski, John [Illinois Inst. of Technology, Chicago, IL (United States)

    2016-06-01

    The present study is addressed to the theoretical description of the ultimate gradient limitation in SRF cavities. Our intent is to exploit experimental data to confirm models which provide feed-backs on how to improve the current state-of-art. New theoretical insight on the cavities limiting factor can be suitable to improve the quench field of N-doped cavities, and therefore to take advantage of high Q0 at high gradients.

  4. Incidence and management of infusion reactions to infliximab in 186 italian patient’s with rheumatoid arthritis: the Padua experience

    Directory of Open Access Journals (Sweden)

    S. Todesco

    2011-09-01

    Full Text Available Objective: We report the incidence and treatment of infusion reactions to infliximab, a chimeric monoclonal IgG1 antibody against tumor necrosis factor a, in a large cohort of patients with rheumatoid arthritis. Patients and methods: One hundred eighty six patients with rheumatoid arthritis treated with infliximab for a total of 216.6 patient years were retrospectively evaluated. Patients received 2160 infliximab infusions at the Division of Rheumatology at the University Hospital of Padua from May, 2000 to April, 2004. Specific treatment protocols for initial and subsequent acute infusion reactions were followed and the outcomes documented. Results: The overall incidence of infusion reactions to infliximab was 0.8% (19 out of 2160 of infusions, affecting 10.2% of patients (19 out of 186. Mild, moderate, or severe acute reactions occurred in 0.1% (3 of 2160, 0.6% (13 of 2160, and 0.04% (1 of 2160 of infliximab infusions, respectively. Delayed infusion reactions occurred in 0.09% (2 of 2160 of infusions. Use of specific treatment protocols resulted in rapid resolution of all acute reactions to infliximab. With a prophylaxis protocol, all patients who experienced an initial mild acute reaction were able to receive additional infusions. Conclusions: Using appropriate treatment protocols, infliximab infusion reactions were effectively treated and prevented in patients with mild acute reactions upon retreatment. In the case of moderate to severe infusion reactions, the risks and the benefits of the continuation of infliximab therapy need to be carefully considered.

  5. Ultimate concerns in late modernity: Archer, Bourdieu and reflexivity.

    Science.gov (United States)

    Farrugia, David; Woodman, Dan

    2015-12-01

    Through a critique of Margaret Archer's theory of reflexivity, this paper explores the theoretical contribution of a Bourdieusian sociology of the subject for understanding social change. Archer's theory of reflexivity holds that conscious 'internal conversations' are the motor of society, central both to human subjectivity and to the 'reflexive imperative' of late modernity. This is established through critiques of Bourdieu, who is held to erase creativity and meaningful personal investments from subjectivity, and late modernity is depicted as a time when a 'situational logic of opportunity' renders embodied dispositions and the reproduction of symbolic advantages obsolete. Maintaining Archer's focus on 'ultimate concerns' in a context of social change, this paper argues that her theory of reflexivity is established through a narrow misreading and rejection of Bourdieu's work, which ultimately creates problems for her own approach. Archer's rejection of any pre-reflexive dimensions to subjectivity and social action leaves her unable to sociologically explain the genesis of 'ultimate concerns', and creates an empirically dubious narrative of the consequences of social change. Through a focus on Archer's concept of 'fractured reflexivity', the paper explores the theoretical necessity of habitus and illusio for understanding the social changes that Archer is grappling with. In late modernity, reflexivity is valorized just as the conditions for its successful operation are increasingly foreclosed, creating 'fractured reflexivity' emblematic of the complex contemporary interaction between habitus, illusio, and accelerating social change. © London School of Economics and Political Science 2015.

  6. Hydrogeological problems in the ultimate storage of radioactive wastes

    International Nuclear Information System (INIS)

    Uerpmann, E.P.

    1980-01-01

    The following work shows how one can achieve the safe closure of ultimate-stored radioactive wastes by connecting a series of various barriers to the biosphere. The propagation of radionuclides by ground water is considered to be the most important long-term transport mechanism. Salt occurences in the Federal Republic of Germany are considered to be the best form suitable for end storage formations for known reasons. When not observing mining and hydrogeological knowledge, the danger of uncontrollable water flow in the end storage can arise from the water solubility of the salt rocks. Therefore the filling of salt mines and the subsequent procedures are dealt with in detail. The leading of radioactive nuclides is influenced by the properties of the ultimately stored wastes and by the quality of the remaining filling of the caves. These problems are dealt with in detail. A series of barriers to the closure of the underground caves are suggested and discussed. The most important barriers consist of the stability of the corresponding selected end storage structure. Possible arrangements of the storage cave are given which even after storage must maintain a high stability. Proposals are made on how the ultimately stored wastes can protect themselves against contact with free water or salt solutions. (orig.) [de

  7. Planck scale physics and Newton's ultimate object conjecture

    International Nuclear Information System (INIS)

    Winterberg, F.

    1996-01-01

    According to Newton, the ultimate building blocks of matter are hard frictionless spheres. This conjecture is here analyzed under different assumptions, which are: 1. The ultimate objects of matter are frictionless positive and negative Planck mass particles obeying nonrelativistic Newtonian mechanics. 2. The Planck mass particles interact with the Planck force c 4 G (c velocity of light, G Newton's constant) locally within a Planck length r p , with the positive Planck mass particles exerting a repulsive and the negative Planck mass particles an attractive force, whereby particles of equal sign are accelerated away from each other and those of opposite sign - as a particle-hole interaction - accelerated towards each other. 3. Space if filled with an equal number of positive and negative Planck mass particles, whereby each Planck length volume r p 3 occupies one Planck mass particle. Making these three assumptions we derive: 1. Nonrelativistic quantum mechanics as an approximation with departures from this approximation suppressed by the Planck length. 2. Lorentz invariance as a dynamic symmetry for energies small compared to the Planck energy. 3. The operator field equation for the previously proposed Planck either model of an unified theory of elementary particles. In contrast to theories in which the ultimate objects are strings at the Planck scale, the alternative theory proposed here does not need a higher dimensional space, but rather can be formulated in 3+1 dimensions. (author)

  8. [Incidence, management and costs of adverse effects in chronic hepatitis C patients on triple therapy with telaprevir or boceprevir: first 12 weeks of treatment].

    Science.gov (United States)

    Guglieri-López, Beatriz; Ventura-Cerdá, José Manuel; Gómez-Álvarez, Sandra; Climente-Martí, Mónica

    2015-05-01

    The aim of the study was to analyze the incidence, management and cost associated to hematological and dermatological adverse effects (AE) in chronic hepatitis C patients on triple therapy (TT) with telaprevir (TVR) or boceprevir (BOC). An analysis was made on the data recorded on patients who started treatment with TVR or BOC associated with peginterferon alfa and ribavirin in a 12-week follow-up period. Fifty-three patients were included (TVR n=36; BOC n=17). Thrombocytopenia (83% TVR vs. 88% BOC) followed by neutropenia (89% TVR vs. 82% BOC) were the most common AE. Dermatological AE were observed in 32% of patients. Eleven patients required treatment discontinuation (all of them received TVR), and toxicity was the main reason for discontinuation (64%). The percentage of patients who required supportive treatment for management of AE was 66%. The most used supportive treatment was erythropoietin. Eight patients required emergency health care, and 2 were hospitalized due to AE. Total cost of additional supportive resources was 32,522€ (625 [SD=876]€/patient) (TVR 759 [SD=1,022]€/patient vs. BOC 349 [SD=327]€/patient; P>.05). Patients with gradeiii-iv toxicity required greater supportive care with higher costs, compared to patients with gradei-ii toxicity (849 [SD=1,143]€/patient vs. 387 [SD=397]€/patient; P=.053). The addition of new protease inhibitors to conventional treatment leads to a higher incidence of hematological AE in our study, compared to data described in clinical trials. The elevated incidence of AE involves the use of supportive care, increasing total costs of therapy. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  9. Descriptive study of current therapeutic practices, clinical reproductive findings and incidence of pregnancy loss in intensively managed thoroughbred mares.

    Science.gov (United States)

    Rose, B V; Firth, M; Morris, B; Roach, J M; Wathes, D C; Verheyen, K L P; de Mestre, A M

    2018-01-01

    Therapeutic practices in equine reproductive medicine have dramatically evolved over the last 20 years but current usage is not described. The aims of this study were to provide a description of medication use and clinical findings of reproductive examinations alongside measures of reproductive efficiency in thoroughbreds. A prospective cohort study was conducted in the 2013 and 2014 breeding seasons. Mare and stallion details, information on veterinary interventions and findings of reproductive ultrasound scans were collected using questionnaires and entered into a custom-designed Microsoft Access database. Descriptive summary statistics were derived directly from the database and using Microsoft Excel. Information was collected from 2246 pregnancies in 1754 mares from 29 stud farms. Ovulatory induction agents were used in 91.8% of cases, oestrus induction agents in 38.4% and covering therapies in 62.7%. Intrauterine antimicrobials were used in 49.6% of mares. Single pregnancies accounted for 83.9% of pregnancies, twins for 15.3% and triplets for 0.7%. The overall incidence of pregnancy loss between days 15-42 was 6.4% (95% CI 5.4%, 7.4%) and 1.6% (95% CI 1.1%, 2.1%) between days 43-65. A further 1.3% of pregnancies were lost by October and 4.5% by birth (including stillbirths). Eighty-three percent of all pregnancies resulted in a live foal. In conclusion, there has been a considerable increase in the use of reproductive therapeutics over the last 12 years. Nonetheless, incidence of pregnancy loss and live foal percentages remain essentially unchanged. Risk factor studies are required to determine if the substantial increase in therapeutic usage is conferring positive benefits. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Reducing the Incidence of Acute Pesticide Poisoning by Educating Farmers on Integrated Pest Management in South India

    NARCIS (Netherlands)

    Mancini, F.; Jiggins, J.L.S.; O'Malley, M.

    2009-01-01

    Sixty-five farmers reported on pesticide use and the signs and symptoms of acute pesticide poisoning when using two different plant protection strategies: in 2003 using chemical controls and in 2004 using an approach to Integrated Pest Management (IPM) based on an ecological analysis of the field

  11. Utilizing Social Networks in Times of Crisis: Understanding, Exploring and Analyzing Critical Incident Management at Institutions of Higher Education

    Science.gov (United States)

    Asselin, Martha Jo

    2012-01-01

    With the rising number of major crises on college campuses today (Security on Campus Inc., 2009), institutions of higher education can benefit from understanding of how social networks may be used in times of emergency. What is currently known about the usage of social networks is not integral to the current practices of crisis management that are…

  12. Incidences of Unfavorable Events in the Management of Low-Risk Papillary Microcarcinoma of the Thyroid by Active Surveillance Versus Immediate Surgery.

    Science.gov (United States)

    Oda, Hitomi; Miyauchi, Akira; Ito, Yasuhiro; Yoshioka, Kana; Nakayama, Ayako; Sasai, Hisanori; Masuoka, Hiroo; Yabuta, Tomonori; Fukushima, Mitsuhiro; Higashiyama, Takuya; Kihara, Minoru; Kobayashi, Kaoru; Miya, Akihiro

    2016-01-01

    The incidence of papillary microcarcinoma (PMC) of the thyroid is rapidly increasing globally, making the management of PMC an important clinical issue. Excellent oncological outcomes of active surveillance for low-risk PMC have been reported previously. Here, unfavorable events following active surveillance and surgical treatment for PMC were studied. From February 2005 to August 2013, 2153 patients were diagnosed with low-risk PMC. Of these, 1179 patients chose active surveillance and 974 patients chose immediate surgery. The oncological outcomes and the incidences of unfavorable events of these groups were analyzed. In the active surveillance group, 94 patients underwent surgery for various reasons; tumor enlargement and the appearance of novel lymph node metastases were the reasons in 27 (2.3%) and six patients (0.5%), respectively. One of the patients with conversion to surgery had nodal recurrence, and five patients in the immediate surgery group had a recurrence in a cervical node or unresected thyroid lobe. All of these recurrences were successfully treated. None of the patients had distant metastases, and none died of the disease. The immediate surgery group had significantly higher incidences of transient vocal cord paralysis (VCP), transient hypoparathyroidism, and permanent hypoparathyroidism than the active-surveillance group did (4.1% vs. 0.6%, p < 0.0001; 16.7% vs. 2.8%, p < 0.0001; and 1.6% vs. 0.08%, p < 0.0001, respectively). Permanent VCP occurred only in two patients (0.2%) in the immediate surgery group. The proportion of patients on L-thyroxine for supplemental or thyrotropin (TSH)-suppressive purposes was significantly larger in the immediate surgery group than in the active surveillance group (66.1% vs. 20.7%, p < 0.0001). The immediate surgery group had significantly higher incidences of postsurgical hematoma and surgical scar in the neck compared with the active surveillance group (0.5% vs. 0%, p < 0.05; and 8.0% vs

  13. Results of an online questionnaire to survey calf management practices on dairy cattle breeding farms in Austria and to estimate differences in disease incidences depending on farm structure and management practices.

    Science.gov (United States)

    Klein-Jöbstl, Daniela; Arnholdt, Tim; Sturmlechner, Franz; Iwersen, Michael; Drillich, Marc

    2015-08-19

    Calf disease may result in great economic losses. To implement prevention strategies it is important to gain information on management and to point out risk factors. The objective of this internet based survey was to describe calf management practices on registered dairy breeding farms in Austria and to estimate differences in calf disease incidences depending on farm structure and management practices. A total of 1287 questionnaires were finally analysed (response rate 12.2 %). Herd characteristics and regional distribution of farms indicated that this survey gives a good overview on calf management practices on registered dairy farms in Austria. The median number of cows per farm was 20 (interquartile range 13-30). Significant differences regarding farm characteristics and calf management between small and large farms (≤20 vs >20 cows) were present. Only 2.8 % of farmers tested first colostrum quality by use of a hydrometer. Storing frozen colostrum was more prevalent on large farms (80.8 vs 64.2 %). On 85.1 % of the farms, whole milk, including waste milk, was fed to the calves. Milk replacer and waste milk were more often used on large farms. In accordance with similar studies from other countries, calf diarrhoea was indicated as the most prevalent disease. Multivariable logistic regression analysis revealed that herd size was associated with calf diarrhoea and calf respiratory tract disease, with higher risk of disease on large farms. Furthermore, feeding waste milk to the calves was associated with increasing calf diarrhoea incidence on farm. In the final model with calf respiratory tract disease as outcome, respondents from organic farms reported less often a respiratory tract disease incidence of over 10 % compared with conventional farms [odds ratio (OR) 0.40, 95 % confidence interval (CI) 0.21-0.75] and farmers that housed calves individually or in groups after birth significantly reported more often to have an incidence of respiratory tract

  14. Determination of Ultimate Torque for Multiply Connected Cross Section Rod

    Directory of Open Access Journals (Sweden)

    V. L. Danilov

    2015-01-01

    Full Text Available The aim of this work is to determine load-carrying capability of the multiply cross-section rod. This calculation is based on the model of the ideal plasticity of the material, so that the desired ultimate torque is a torque at which the entire cross section goes into a plastic state.The article discusses the cylindrical multiply cross-section rod. To satisfy the equilibrium equation and the condition of plasticity simultaneously, two stress function Ф and φ are introduced. By mathematical transformations it has been proved that Ф is constant along the path, and a formula to find its values on the contours has been obtained. The paper also presents the rationale of the line of stress discontinuity and obtained relationships, which allow us to derive the equations break lines for simple interaction of neighboring circuits, such as two lines, straight lines and circles, circles and a different sign of the curvature.After substitution into the boundary condition at the end of the stress function Ф and mathematical transformations a formula is obtained to determine the ultimate torque for the multiply cross-section rod.Using the doubly connected cross-section and three-connected cross-section rods as an example the application of the formula of ultimate torque is studied.For doubly connected cross-section rod, the paper offers a formula of the torque versus the radius of the rod, the aperture radius and the distance between their centers. It also clearly demonstrates the torque dependence both on the ratio of the radii and on the displacement of hole. It is shown that the value of the torque is more influenced by the displacement of hole, rather than by the ratio of the radii.For the three-connected cross-section rod the paper shows the integration feature that consists in selection of a coordinate system. As an example, the ultimate torque is found by two methods: analytical one and 3D modeling. The method of 3D modeling is based on the Nadai

  15. Adobe Photoshop CS5 for Photographers The Ultimate Workshop

    CERN Document Server

    Evening, Martin

    2010-01-01

    If you already have a good knowledge of Adobe Photoshop and are looking to advance your skills, Adobe Photoshop CS5 for Photographers: The Ultimate Workshop is the book you've been waiting for.  Renowned photographers Martin Evening and Jeff Schewe impart their Photoshop tips and workflow, showing you how to use a vast array of rarely seen advanced Photoshop techniques.  Whether the subject is serious retouching work, weird and wonderful compositions, or planning a shoot before you've even picked up a camera, you can be sure that the advice is based on years of practical experience.

  16. Incidents analysis

    International Nuclear Information System (INIS)

    Francois, P.

    1996-01-01

    We undertook a study programme at the end of 1991. To start with, we performed some exploratory studies aimed at learning some preliminary lessons on this type of analysis: Assessment of the interest of probabilistic incident analysis; possibility of using PSA scenarios; skills and resources required. At the same time, EPN created a working group whose assignment was to define a new approach for analysis of incidents on NPPs. This working group gave thought to both aspects of Operating Feedback that EPN wished to improve: Analysis of significant incidents; analysis of potential consequences. We took part in the work of this group, and for the second aspects, we proposed a method based on an adaptation of the event-tree method in order to establish a link between existing PSA models and actual incidents. Since PSA provides an exhaustive database of accident scenarios applicable to the two most common types of units in France, they are obviously of interest for this sort of analysis. With this method we performed some incident analyses, and at the same time explores some methods employed abroad, particularly ASP (Accident Sequence Precursor, a method used by the NRC). Early in 1994 EDF began a systematic analysis programme. The first, transient phase will set up methods and an organizational structure. 7 figs

  17. 75 FR 60133 - Agency Information Collection Activities: Declaration of Ultimate Consignee That Articles Were...

    Science.gov (United States)

    2010-09-29

    ... Activities: Declaration of Ultimate Consignee That Articles Were Exported for Temporary Scientific or... the Declaration of Ultimate Consignee That Articles Were Exported for Temporary Scientific or...: Title: Declaration of Ultimate Consignee That Articles Were Exported for Temporary Scientific or...

  18. Method to increase ultimate bearing capacity of skirted circular footing

    Science.gov (United States)

    Renaningsih, Satria, Isvan Fajar; Susanto, Agus; Listyawan, Anto Budi

    2017-06-01

    Bearing capacity is the most important factor in designing foundation. It is necessary to find a method to improve the bearing capacity. Skirts that are attached on the below of footing can be used as an alternative of the improvement. The method is implemented to improve the bearing capacity of shallow footing on sand soil. The aim of this study was to find the effect of additional skirt on the circular footing towards the bearing capacity of soil and towards the settlement. This study performed twelve laboratory experiments on steel circular footing with various diameters and skirt lengths. In addition, the type of soil used in this study was sand soil in which the formation of water content and compaction method was maintained. The laboratory tests indicated that skirts are very effective to improve the ultimate bearing capacity, as they can increase the length hence the ultimate bearing capacity can be enhanced by 4.70 times in certain study condition. Skirts are also capable to reduce the settlement. In general, the analysis on the same value of load of 2.00 kN indicated the decrease of the settlement is in accordance with the increase of the skirt length attached on the circular footing.

  19. Ultimate internal pressure capacity assessment of SC structure

    International Nuclear Information System (INIS)

    Park, Hyungkui; Choi, Inkil

    2013-01-01

    An SC structure applied to a containment building can be quite effective. However, an SC structure cannot be applied to a containment building, because its internal pressure resistance performance has not been verified. The containment building, which undergoes ultimate internal pressure, resists the internal pressure through a pre-stress tendon. It is hard to apply a tendon to an SC structure because of its structural characteristics. Therefore, the internal pressure resistance performance of the SC structure itself should be ensured to apply it to a structure with internal pressure resistance. In this study, the suitability of an SC structure as a substitution for the tendon of a pressure resistant structure was evaluated. A containment structure model was used in this study, because it was representative structures that resistance of ultimate internal pressure be required. In this study, a nonlinear analysis was performed to evaluate and compare the behaviors of tendon model and SC structure model. By comparing the internal pressure-displacement according to the structure type, the stability of SC structure model was assessed

  20. Major incidents in rural areas: managing a pandemic A/H1N1/2009 cluster.

    Science.gov (United States)

    Stark, Cameron; Garman, Elaine; McMenamin, Jim; McCormick, Duncan; Oates, Ken

    2010-01-01

    Pandemic Influenza (A/H1N1/2009) caused worldwide concern because of its potential to spread rapidly in human populations. In Scotland, Government policy had been to seek to contain the spread of the virus for as long as possible in order to allow time for service preparations, and for vaccine development and supply. The first major Scottish outbreak of pandemic A/H1N1/2009 was in the rural area of Cowal and Bute. After two initial cases were identified, contact tracing found a cluster of cases associated with a football supporters' bus. Within 3 weeks, 130 cases had been identified in the area. Rapid provision of treatment doses of anti-viral medication to cases and prophylactic treatment of asymptomatic close contacts, advice on self-isolation and, where required, interruption of transmission by temporary school closure, were successful in containing the outbreak. Pre-existing Major Incident and Pandemic Flu plans were used and adapted to the particular circumstances of the outbreak and the area. Supporting operational decision-making as close to the cases as possible allowed for speed and flexibility of response. Contact tracing and tracking of cases and results was performed by specialist public health staff who were geographically removed from the cases. This was possible because of effective use of existing telephone conferencing facilities, clarity of roles, and frequent communication among staff working on all areas of the response. Basing the work on established plans, staff experience of rural areas and rural service provision was successful.

  1. Anastomotic Strictures after Esophageal Atresia Repair: Incidence, Investigations, and Management, Including Treatment of Refractory and Recurrent Strictures

    Directory of Open Access Journals (Sweden)

    Renato Tambucci

    2017-05-01

    Full Text Available Improved surgical techniques, as well as preoperative and postoperative care, have dramatically changed survival of children with esophageal atresia (EA over the last decades. Nowadays, we are increasingly seeing EA patients experiencing significant short- and long-term gastrointestinal morbidities. Anastomotic stricture (AS is the most common complication following operative repair. An esophageal stricture is defined as an intrinsic luminal narrowing in a clinically symptomatic patient, but no symptoms are sensitive or specific enough to diagnose an AS. This review aims to provide a comprehensive view of AS in EA children. Given the lack of evidence-based data, we critically analyzed significant studies on children and adults, including comments on benign strictures with other etiologies. Despite there is no consensus about the goal of the luminal diameter based on the patient’s age, esophageal contrast study, and/or endoscopy are recommended to assess the degree of the narrowing. A high variability in incidence of ASs is reported in literature, depending on different definitions of AS and on a great number of pre-, intra-, and postoperative risk factor influencing the anastomosis outcome. The presence of a long gap between the two esophageal ends, with consequent anastomotic tension, is determinant for stricture formation and its response to treatment. The cornerstone of treatment is endoscopic dilation, whose primary aims are to achieve symptom relief, allow age-appropriate capacity for oral feeding, and reduce the risk of pulmonary aspiration. No clear advantage of either balloon or bougie dilator has been demonstrated; therefore, the choice is based on operator experience and comfort with the equipment. Retrospective evidences suggest that selective dilatations (performed only in symptomatic patients results in significantly less number of dilatation sessions than routine dilations (performed to prevent symptoms with equal long

  2. On the ultimate uncertainty of the top quark pole mass

    Energy Technology Data Exchange (ETDEWEB)

    Beneke, M. [Technische Univ. Muenchen, Garching (Germany). Physik-Department; Marquard, P. [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany); Nason, P. [INFN, Sezione di Milano Bicocca (Italy); Steinhauser, M. [Karlsruher Institut fuer Technologie (Germany). Inst. fuer Theoretische Teilchenphysik

    2016-05-15

    We combine the known asymptotic behaviour of the QCD perturbation series expansion, which relates the pole mass of a heavy quark to the MS mass, with the exact series coefficients up to the four-loop order to determine the ultimate uncertainty of the top-quark pole mass due to the renormalon divergence. We perform extensive tests of our procedure by varying the number of colours and flavours, as well as the scale of the strong coupling and the MS mass, and conclude that this uncertainty is around 70 MeV. We further estimate the additional contribution to the mass relation from the five-loop correction and beyond to be 250 MeV.

  3. ONE FINANCIAL REPORTING GLOBAL LANGUAGE: THE ULTIMATE GOAL?

    Directory of Open Access Journals (Sweden)

    Amelia Limijaya

    2017-05-01

    Full Text Available This article aims to analyse the extent to which international accounting standards is applied and whether it is the ultimate goal. Up until the end of 2016, approximately there are 84% of the 149 jurisdictions analysed which require IFRS for all or most domestic publicly accountable entities. This may indicate that we are not that much further from having a single set of globally-accepted accounting standards. However, there is more to financial reporting than just accounting standards alone, such as the political aspect of accounting standard-setting, translation issues surrounding IFRS adoption, the US position and the complexity of financial reporting. Improving financial reporting quality needs more than just having global accounting standards, rather, it is also essential to consider the preparers’ incentives and other institutions surrounding the firm. Stakeholders need to broaden the perspective when viewing financial reporting, so that it will not be focused merely on accounting standards alone.

  4. Ultimate Capacity of Uniaxially Compressed Steel Plates Strengthened by CFRP

    Science.gov (United States)

    Tao, Xin; Cao, S. Y.

    2017-06-01

    This paper presents experimental studies on the ultimate capacity of steel plates strengthened by Carbon Fiber-reinforced polymer (CFRP). Some 40 plates are tested under uniaxial compression along its longitudinal direction. The effect of CFRP pasting, plate slenderness ratio and the boundary conditions are illustrated on the studies. The study shows that the steel plates strengthened by CFRP exhibited higher capacity in comparison to similar plates without CFRP. It also can be seen that multi-layers CFRP pasting were better than the single layer, pasting multi-direction is better than pasting uni-direction, pasting the transverse layer outside is better than pasting the longitudinal layer outside, and the effect of longitudinal layer was better than the transverse layer.

  5. The ultimate fate of life in universes which undergo inflation

    Science.gov (United States)

    Tipler, Frank J.

    1992-07-01

    It is shown that life - in its most general sense as an entity which codes information that is preserved by natural selection - cannot continue forever in any of the standard inflationary models. In these cosmologies, the continuation of life is ultimately stopped by the Eternal Return Problem: the complexity of a living entity, or more generally the entire bioshpere, is bounded above, and once this upper bound is reached, life either dies out, or begins to repeat its previous states. I argue that this need not happen in a closed universe, because if the Wheeler boundary condition is imposed on the universal wave function, quantum gravity will permit life to increase its complexity without limit below the Planck length as the universe goes into the final singularity. Permanent address.

  6. Increased incidence of syphilis in men who have sex with men and risk management strategies, Germany, 2015.

    Science.gov (United States)

    Jansen, Klaus; Schmidt, Axel J; Drewes, Jochen; Bremer, Viviane; Marcus, Ulrich

    2016-10-27

    In Germany, the number of reported syphilis cases increased between 11% and 22% per year between 2010 and 2014. We analysed syphilis surveillance data and data of four behavioural surveys on men who have sex with men (MSM) in Germany (2003, 2007, 2010, 2013) to assess if this rise is ongoing and to find possible explanations for it. Syphilis notifications increased in 2015 by 19% to a total of 6,834. This was mainly due to increasing notifications in MSM of all age groups in larger German cities. Data from the behavioural surveys on MSM in Germany showed a simultaneous increase of selective condom use as HIV-status-bases risk management strategy and the number of syphilis cases. MSM diagnosed with HIV reported condomless anal intercourse with non-steady partners more frequent than MSM not diagnosed with HIV or untested for HIV, but the latter also reported higher frequencies of this behaviour in the more recent surveys. Transmission in HIV-positive MSM probably plays an important, but not exclusive role, for the syphilis dynamics in Germany. A risk adapted routine screening for sexually active MSM and potentially innovative approaches to increase early screening and treatment of syphilis such as internet counselling, home sampling, home testing and broadening venue-based (rapid) testing, should be critically evaluated to effectively reduce syphilis infections. This article is copyright of The Authors, 2016.

  7. Modeling retrospective attribution of responsibility to hazard-managing institutions: an example involving a food contamination incident.

    Science.gov (United States)

    Johnson, Branden B; Hallman, William K; Cuite, Cara L

    2015-03-01

    Perceptions of institutions that manage hazards are important because they can affect how the public responds to hazard events. Antecedents of trust judgments have received far more attention than antecedents of attributions of responsibility for hazard events. We build upon a model of retrospective attribution of responsibility to individuals to examine these relationships regarding five classes of institutions that bear responsibility for food safety: producers (e.g., farmers), processors (e.g., packaging firms), watchdogs (e.g., government agencies), sellers (e.g., supermarkets), and preparers (e.g., restaurants). A nationally representative sample of 1,200 American adults completed an Internet-based survey in which a hypothetical scenario involving contamination of diverse foods with Salmonella served as the stimulus event. Perceived competence and good intentions of the institution moderately decreased attributions of responsibility. A stronger factor was whether an institution was deemed (potentially) aware of the contamination and free to act to prevent or mitigate it. Responsibility was rated higher the more aware and free the institution. This initial model for attributions of responsibility to impersonal institutions (as opposed to individual responsibility) merits further development. © 2014 Society for Risk Analysis.

  8. Trauma centers with higher rates of angiography have a lesser incidence of splenectomy in the management of blunt splenic injury.

    Science.gov (United States)

    Capecci, Louis M; Jeremitsky, Elan; Smith, R Stephen; Philp, Frances

    2015-10-01

    Nonoperative management (NOM) for blunt splenic injury (BSI) is well-established. Angiography (ANGIO) has been shown to improve success rates with NOM. Protocols for NOM are not standardized and vary widely between centers. We hypothesized that trauma centers that performed ANGIO at a greater rate would demonstrate decreased rates of splenectomy compared with trauma centers that used ANGIO less frequently. A large, multicenter, statewide database (Pennsylvania Trauma Systems Foundation) from 2007 to 2011 was used to generate the study cohort of patients with BSI (age ≥ 13). The cohort was divided into 2 populations based on admission to centers with high (≥13%) or low (Splenectomy rates were then compared between the 2 groups, and multivariable logistic regression for predictors of splenectomy (failed NOM) were also performed. The overall rate of splenectomy in the entire cohort was 21.0% (1,120 of 5,333 BSI patients). The high ANGIO group had a lesser rate of splenectoy compared with the low ANGIO group (19% vs 24%; P splenectomy compared with low ANGIO centers (odds ratio, 0.68; 95% CI 0.58-0.80; P splenectomy rates compared with centers with lesser rate of ANGIO. Inclusion of angiographic protocols for NOM of BSI should be considered strongly. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Postoperative vesicoureteral reflux after high-pressure balloon dilation of the ureterovesical junction in primary obstructive megaureter. Incidence, management and predisposing factors.

    Science.gov (United States)

    García-Aparicio, Luis; Blázquez-Gómez, Eva; de Haro, Irene; Garcia-Smith, Natalie; Bejarano, Miguel; Martin, Oriol; Rodo, Joan

    2015-12-01

    To describe the incidence, predisposing factors and management of postoperative vesicoureteral reflux (VUR) after high-pressure balloon dilation to treat primary obstructive megaureter (POM). We have reviewed patients that underwent endoscopic treatment for POM from May 2008 to November 2013. All patients were evaluated with renal ultrasound, voiding cystourethrography and diuretic renogram. Endoscopic treatment was done with high-pressure balloon dilation of the ureterovesical junction under general anesthesia; a double-J stenting was done in all patients. Follow-up was performed with ultrasonography, voiding cystourethrography and a diuretic renogram in all patients. Fifteen boys and five girls with a mean age of 14.18 months (3-103) were reviewed. A total of 22 ureters underwent HPBD to treat POM. Ureterohydronephrosis improves in 19 ureters. After endoscopic treatment, six ureters developed VUR. Four ureters were managed surgically, and in the other two, VUR disappeared in a second cystogram. The presence of parameatal diverticulum in the preoperative cystography and those patients with bilateral POM are factors related to postoperative VUR (p < 0.05). Urinary tract infection after HPBD was observed in four patients, but only one of them was affected with VUR.

  10. Advance Liquid Metal Reactor Discrete Dynamic Event Tree/Bayesian Network Analysis and Incident Management Guidelines (Risk Management for Sodium Fast Reactors)

    Energy Technology Data Exchange (ETDEWEB)

    Denman, Matthew R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Groth, Katrina M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Cardoni, Jeffrey N. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Wheeler, Timothy A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-04-01

    Accident management is an important component to maintaining risk at acceptable levels for all complex systems, such as nuclear power plants. With the introduction of self-correcting, or inherently safe, reactor designs the focus has shifted from management by operators to allowing the system's design to manage the accident. Inherently and passively safe designs are laudable, but nonetheless extreme boundary conditions can interfere with the design attributes which facilitate inherent safety, thus resulting in unanticipated and undesirable end states. This report examines an inherently safe and small sodium fast reactor experiencing a beyond design basis seismic event with the intend of exploring two issues : (1) can human intervention either improve or worsen the potential end states and (2) can a Bayesian Network be constructed to infer the state of the reactor to inform (1). ACKNOWLEDGEMENTS The authors would like to acknowledge the U.S. Department of Energy's Office of Nuclear Energy for funding this research through Work Package SR-14SN100303 under the Advanced Reactor Concepts program. The authors also acknowledge the PRA teams at Argonne National Laboratory, Oak Ridge National Laboratory, and Idaho National Laboratory for their continue d contributions to the advanced reactor PRA mission area.

  11. Future Synchrotron Light Sources Based on Ultimate Storage Rings

    Energy Technology Data Exchange (ETDEWEB)

    Cai, Yunhai; /SLAC

    2012-04-09

    The main purpose of this talk is to describe how far one might push the state of the art in storage ring design. The talk will start with an overview of the latest developments and advances in the design of synchrotron light sources based on the concept of an 'ultimate' storage ring. The review will establish how bright a ring based light source might be, where the frontier of technological challenges are, and what the limits of accelerator physics are. Emphasis will be given to possible improvements in accelerator design and developments in technology toward the goal of achieving an ultimate storage ring. An ultimate storage ring (USR), defined as an electron ring-based light source having an emittance in both transverse planes at the diffraction limit for the range of X-ray wavelengths of interest for a scientific community, would provide very high brightness photons having high transverse coherence that would extend the capabilities of X-ray imaging and probe techniques beyond today's performance. It would be a cost-effective, high-coherence 4th generation light source, competitive with one based on energy recovery linac (ERL) technology, serving a large number of users studying material, chemical, and biological sciences. Furthermore, because of the experience accumulated over many decades of ring operation, it would have the great advantage of stability and reliability. In this paper we consider the design of an USR having 10-pm-rad emittance. It is a tremendous challenge to design a storage ring having such an extremely low emittance, a factor of 100 smaller than those in existing light sources, especially such that it has adequate dynamic aperture and beam lifetime. In many ultra-low emittance designs, the injection acceptances are not large enough for accumulation of the electron beam, necessitating on-axis injection where stored electron bunches are completely replaced with newly injected ones. Recently, starting with the MAX-IV 7-bend

  12. Efficiency Of Different Teaching Models In Teaching Of Frisbee Ultimate

    Directory of Open Access Journals (Sweden)

    Žuffová Zuzana

    2015-05-01

    Full Text Available The aim of the study was to verify the efficiency of two frisbee ultimate teaching models at 8-year grammar schools relative to age. In the experimental group was used a game based model (Teaching Games for Understanding and in the control group the traditional model based on teaching techniques. 6 groups of female students took part in experiment: experimental group 1 (n=10, age=11.6, experimental group 2 (n=12, age=13.8, experimental group 3 (n=14, age =15.8, control group 1 (n=11, age =11.7, control group 2 (n=10, age =13.8 and control group 3 (n=9, age =15.8. Efficiency of the teaching models was evaluated based of game performance and special knowledge results. Game performance was evaluated by the method of game performance assessment based on GPAI (Game Performance Assessment Instrument through video record. To verify level of knowledge, we used a knowledge test, which consisted of questions related to the rules and tactics knowledge of frisbee ultimate. To perform statistical evaluation Mann-Whitney U-test was used. Game performance assessment and knowledge level indicated higher efficiency of TGfU in general, but mostly statistically insignificant. Experimental groups 1 and 2 were significantly better in the indicator that evaluates tactical aspect of game performance - decision making (p<0.05. Experimental group 3 was better in the indicator that evaluates skill execution - disc catching. The results showed that the students of the classes taught by game based model reached partially better game performance in general. Experimental groups achieved from 79.17 % to 80 % of correct answers relating to the rules and from 75 % to 87.5 % of correct answers relating to the tactical knowledge in the knowledge test. Control groups achieved from 57.69 % to 72.22 % of correct answers relating to the rules and from 51.92 % to 72.22 % of correct answers relating to the tactical knowledge in the knowledge test.

  13. ZIO: The Ultimate Linux I/O Framework

    CERN Document Server

    Gonzalez Cobas, J D; Rubini, A; Nellaga, S; Vaga, F

    2014-01-01

    ZIO (with Z standing for “The Ultimate I/O” Framework) was developed for CERN with the specific needs of physics labs in mind, which are poorly addressed in the mainstream Linux kernel. ZIO provides a framework for industrial, high-bandwith, high-channel count I/O device drivers (digitizers, function generators, timing devices like TDCs) with performance, generality and scalability as design goals. Among its features, it offers abstractions for • both input and output channels, and channel sets • run-time selection of trigger types • run-time selection of buffer types • sysfs-based configuration • char devices for data and metadata • a socket interface (PF ZIO) as alternative to char devices In this paper, we discuss the design and implementation of ZIO, and describe representative cases of driver development for typical and exotic applications: drivers for the FMC (FPGAMezzanine Card, see [1]) boards developed at CERN like the FMC ADC 100Msps digitizer, FMC TDC timestamp counter, and FMC DEL ...

  14. Thermal performance measurements on ultimate heat sinks--cooling ponds

    International Nuclear Information System (INIS)

    Hadlock, R.K.; Abbey, O.B.

    1977-12-01

    The primary objective of the studies described is to obtain the requisite data, with respect to modeling requirements, to characterize thermal performance of heat sinks for nuclear facilities existing at elevated water temperatures in result of experiencing a genuinely large heat load and responding to meteorological influence. The data should reflect thermal performance for combinations leading to worst-case meteorological influence. A geothermal water retention basin has been chosen as the site for the first measurement program and data have been obtained in the first of several experiments scheduled to be performed there. These data illustrate the thermal and water budgets during episodes of cooling from an initially high pond water bulk temperature. Monitoring proceeded while the pond experienced only meteorological and seepage influence. The data are discussed and are presented as a data volume which may be used for calculation purposes. Suggestions for future measurement programs are stated with the intent to maintain and improve relevance to nuclear ultimate heat sinks while continuing to examine the performance of the analog geothermal pond. It is further suggested that the geothermal pond, with some modification, may be a suitable site for spray pond measurements

  15. Launching GUPPI: the Green Bank Ultimate Pulsar Processing Instrument

    Science.gov (United States)

    DuPlain, Ron; Ransom, Scott; Demorest, Paul; Brandt, Patrick; Ford, John; Shelton, Amy L.

    2008-08-01

    The National Radio Astronomy Observatory (NRAO) is launching the Green Bank Ultimate Pulsar Processing Instrument (GUPPI), a prototype flexible digital signal processor designed for pulsar observations with the Robert C. Byrd Green Bank Telescope (GBT). GUPPI uses field programmable gate array (FPGA) hardware and design tools developed by the Center for Astronomy Signal Processing and Electronics Research (CASPER) at the University of California, Berkeley. The NRAO has been concurrently developing GUPPI software and hardware using minimal software resources. The software handles instrument monitor and control, data acquisition, and hardware interfacing. GUPPI is currently an expert-only spectrometer, but supports future integration with the full GBT production system. The NRAO was able to take advantage of the unique flexibility of the CASPER FPGA hardware platform, develop hardware and software in parallel, and build a suite of software tools for monitoring, controlling, and acquiring data with a new instrument over a short timeline of just a few months. The NRAO interacts regularly with CASPER and its users, and GUPPI stands as an example of what reconfigurable computing and open-source development can do for radio astronomy. GUPPI is modular for portability, and the NRAO provides the results of development as an open-source resource.

  16. Screening test for assessment of ultimate biodegradability: linear alkylbenzene sulfonates.

    Science.gov (United States)

    Gledhill, W E

    1975-01-01

    A relatively simple shake-flask system for determining CO2 evolution was developed to assess the ultimate biodegradability by soil and sewage micro-organisms of chemicals which enter the environment. Linear alkylbenzene sulfonates (LAS) were used as model compounds to evaluate the method and were found to undergo substantial biodegradation in this dilute system. At the 30 mg/liter test concentration, higher-molecular-weight LAS compounds were biodegraded at a slower rate and to a lesser extent than lower-molecular-weight LAS, an effect which was eliminated or greatly reduced upon incremental addition of the LAS to the test medium during the first week of incubation. LA35S was used to demonstrate rapid LAS desulfonation, and 14CO2 evolution studies with (14C) benzene ring-labeled LAS indicated concomitant biodegradation of the entire LAS molecule as well as the LAS aromatic component. The test can be employed to examine numerous compounds at the same time and is readily adapted to studies of the effect of variation in temperature and oxygen concentration on biodegradation. PMID:1211937

  17. Exploring Ultimate Water Capillary Evaporation in Nanoscale Conduits.

    Science.gov (United States)

    Li, Yinxiao; Alibakhshi, Mohammad Amin; Zhao, Yihong; Duan, Chuanhua

    2017-08-09

    Capillary evaporation in nanoscale conduits is an efficient heat/mass transfer strategy that has been widely utilized by both nature and mankind. Despite its broad impact, the ultimate transport limits of capillary evaporation in nanoscale conduits, governed by the evaporation/condensation kinetics at the liquid-vapor interface, have remained poorly understood. Here we report experimental study of the kinetic limits of water capillary evaporation in two dimensional nanochannels using a novel hybrid channel design. Our results show that the kinetic-limited evaporation fluxes break down the limits predicated by the classical Hertz-Knudsen equation by an order of magnitude, reaching values up to 37.5 mm/s with corresponding heat fluxes up to 8500 W/cm 2 . The measured evaporation flux increases with decreasing channel height and relative humidity but decreases as the channel temperature decreases. Our findings have implications for further understanding evaporation at the nanoscale and developing capillary evaporation-based technologies for both energy- and bio-related applications.

  18. Incidence, Clinical Characteristics, and Management of Psoriasis Induced by Anti-TNF Therapy in Patients with Inflammatory Bowel Disease: A Nationwide Cohort Study.

    Science.gov (United States)

    Guerra, Iván; Pérez-Jeldres, Tamara; Iborra, Marisa; Algaba, Alicia; Monfort, David; Calvet, Xavier; Chaparro, María; Mañosa, Miriam; Hinojosa, Esther; Minguez, Miguel; Ortiz de Zarate, Jone; Márquez, Lucía; Prieto, Vanessa; García-Sánchez, Valle; Guardiola, Jordi; Rodriguez, G Esther; Martín-Arranz, María Dolores; García-Tercero, Iván; Sicilia, Beatriz; Masedo, Ángeles; Lorente, Rufo; Rivero, Montserrat; Fernández-Salazar, Luis; Gutiérrez, Ana; Van Domselaar, Manuel; López-SanRomán, Antonio; Ber, Yolanda; García-Sepulcre, Marifé; Ramos, Laura; Bermejo, Fernando; Gisbert, Javier P

    2016-04-01

    Psoriasis induced by anti-tumor necrosis factor-α (TNF) therapy has been described as a paradoxical side effect. To determine the incidence, clinical characteristics, and management of psoriasis induced by anti-TNF therapy in a large nationwide cohort of inflammatory bowel disease patients. Patients with inflammatory bowel disease were identified from the Spanish prospectively maintained Estudio Nacional en Enfermedad Inflamatoria Intestinal sobre Determinantes genéticos y Ambientales registry of Grupo Español de Trabajo en Enfermedad de Croh y Colitis Ulcerosa. Patients who developed psoriasis by anti-TNF drugs were the cases, whereas patients treated with anti-TNFs without psoriasis were controls. Cox regression analysis was performed to identify predictive factors. Anti-TNF-induced psoriasis was reported in 125 of 7415 patients treated with anti-TNFs (1.7%; 95% CI, 1.4-2). The incidence rate of psoriasis is 0.5% (95% CI, 0.4-0.6) per patient-year. In the multivariate analysis, the female sex (HR 1.9; 95% CI, 1.3-2.9) and being a smoker/former smoker (HR 2.1; 95% CI, 1.4-3.3) were associated with an increased risk of psoriasis. The age at start of anti-TNF therapy, type of inflammatory bowel disease, Montreal Classification, and first anti-TNF drug used were not associated with the risk of psoriasis. Topical steroids were the most frequent treatment (70%), achieving clinical response in 78% of patients. Patients switching to another anti-TNF agent resulted in 60% presenting recurrence of psoriasis. In 45 patients (37%), the anti-TNF therapy had to be definitely withdrawn. The incidence rate of psoriasis induced by anti-TNF therapy is higher in women and in smokers/former smokers. In most patients, skin lesions were controlled with topical steroids. More than half of patients switching to another anti-TNF agent had recurrence of psoriasis. In most patients, the anti-TNF therapy could be maintained.

  19. Biodosimetry: Medicine, Science, and Systems to Support the Medical Decision-Maker Following a Large Scale Nuclear or Radiation Incident

    International Nuclear Information System (INIS)

    Coleman, C. Norman; Koerner, John F.

    2016-01-01

    The public health and medical response to a radiological or nuclear incident requires the capability to sort, assess, treat, triage and to ultimately discharge, refer or transport people to their next step in medical care. The size of the incident and scarcity of resources at the location of each medical decision point will determine how patients are triaged and treated. This will be a rapidly evolving situation impacting medical responders at regional, national and international levels. As capabilities, diagnostics and medical countermeasures improve, a dynamic system-based approach is needed to plan for and manage the incident, and to adapt effectively in real time. In that the concepts and terms can be unfamiliar and possibly confusing, resources and a concept of operations must be considered well in advance. An essential underlying tenet is that medical evaluation and care will be managed by health-care professionals with biodosimetry assays providing critical supporting data. (authors)

  20. Interindividual variability in social insects - proximate causes and ultimate consequences.

    Science.gov (United States)

    Jeanson, Raphaël; Weidenmüller, Anja

    2014-08-01

    Individuals within social groups often show consistent differences in behaviour across time and context. Such interindividual differences and the evolutionary challenge they present have recently generated considerable interest. Social insects provide some of the most familiar and spectacular examples of social groups with large interindividual differences. Investigating these within-group differences has a long research tradition, and behavioural variability among the workers of a colony is increasingly regarded as fundamental for a key feature of social insects: division of labour. The goal of this review is to illustrate what we know about both the proximate mechanisms underlying behavioural variability among the workers of a colony and its ultimate consequences; and to highlight the many open questions in this research field. We begin by reviewing the literature on mechanisms that potentially introduce, maintain, and adjust the behavioural differentiation among workers. We highlight the fact that so far, most studies have focused on behavioural variability based on genetic variability, provided by e.g. multiple mating of the queen, while other mechanisms that may be responsible for the behavioural differentiation among workers have been largely neglected. These include maturational, nutritional and environmental influences. We further discuss how feedback provided by the social environment and learning and experience of adult workers provides potent and little-explored sources of differentiation. In a second part, we address what is known about the potential benefits and costs of increased behavioural variability within the workers of a colony. We argue that all studies documenting a benefit of variability so far have done so by manipulating genetic variability, and that a direct test of the effect of behavioural variability on colony productivity has yet to be provided. We emphasize that the costs associated with interindividual variability have been largely

  1. Incident Management Systems are essential for Effective Coordination of Large Disease Outbreaks: Perspectives from the Coordination of the Ebola Outbreak Response in Sierra Leone

    Directory of Open Access Journals (Sweden)

    Olushayo Oluseun Olu

    2016-11-01

    Full Text Available Background: Response to the 2014–2015 Ebola Virus Disease (EVD outbreak in Sierra Leone overwhelmed the national capacity to contain it and necessitated a massive international response and strong coordination platform. Consequently, the Sierra Leone Government, with support of the international humanitarian community, established and implemented various models for national coordination of the outbreak. In this article we review the strengths and limitations of the EVD outbreak response coordination systems in Sierra Leone and propose recommendations for improving coordination of similar outbreaks in the future. Conclusions: There were two main frameworks used for the coordination of the outbreak; the Emergency Operation Center (EOC and the National Ebola Response Center (NERC. We observed an improvement in outbreak coordination as the management mechanism evolved from the EOC to the NERC. Both coordination systems had their advantages and disadvantages; however the NERC coordination mechanism appeared to be more robust. We identified challenges, such as competition and duplication of efforts between the numerous coordination groups, slow resource mobilization, inadequate capacity of NERC/EOC staff for health coordination and an overtly centralized coordination and decision making system as the main coordination challenges during the outbreak. Recommendations: We recommend the establishment of emergency operation centers with simple incident management system-based coordination prior to outbreaks, strong government leadership, decentralization of coordination systems and functions to the epicenter of outbreaks, with clear demarcation of roles and responsibilities between different levels, regular training of key coordination leaders and better community participation as methods to improve coordination of future disease outbreaks.

  2. SU-C-BRD-05: Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Yang, R; Wang, J [Peking University Third Hospital, Beijing, Beijing (China)

    2014-06-15

    Purpose: To explore the implementation and effectiveness of incident learning for the safety and quality of radiotherapy in a new established radiotherapy program with advanced technology. Methods: Reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically designed for reporting, investigating, and learning of individual radiotherapy incidents in a new established radiotherapy program, with 4D CBCT, Ultrasound guided radiotherapy, VMAT, gated treatment delivered on two new installed linacs. The incidents occurring in external beam radiotherapy from February, 2012 to January, 2014 were reported. Results: A total of 33 reports were analyzed, including 28 near misses and 5 incidents. Among them, 5 originated in imaging for planning, 25 in planning, 1 in plan transfer, 1 in commissioning and 1 in treatment delivery. Among them, three near misses originated in the safety barrier of the radiotherapy process. In terms of error type, 1 incident was classified as wrong patient, 7 near misses/incidents as wrong site, 6 as wrong laterality, 5 as wrong dose, 7 as wrong prescription, and 7 as suboptimal plan quality. 5 incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, inadequate training, failure to develop an effective plan, and communication contributed to 19, 15, 12, 5 and 3 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4; this rate fell to 0.28% in the second year from 0.56% in the first year. The rate of near miss fell to 1.24% from 2.22%. Conclusion: Effective incident learning can reduce the occurrence of near miss/incidents, enhance the culture of safety. Incident learning is an effective proactive method for improving the quality and safety of radiotherapy.

  3. SU-C-BRD-05: Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Techniques

    International Nuclear Information System (INIS)

    Yang, R; Wang, J

    2014-01-01

    Purpose: To explore the implementation and effectiveness of incident learning for the safety and quality of radiotherapy in a new established radiotherapy program with advanced technology. Methods: Reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically designed for reporting, investigating, and learning of individual radiotherapy incidents in a new established radiotherapy program, with 4D CBCT, Ultrasound guided radiotherapy, VMAT, gated treatment delivered on two new installed linacs. The incidents occurring in external beam radiotherapy from February, 2012 to January, 2014 were reported. Results: A total of 33 reports were analyzed, including 28 near misses and 5 incidents. Among them, 5 originated in imaging for planning, 25 in planning, 1 in plan transfer, 1 in commissioning and 1 in treatment delivery. Among them, three near misses originated in the safety barrier of the radiotherapy process. In terms of error type, 1 incident was classified as wrong patient, 7 near misses/incidents as wrong site, 6 as wrong laterality, 5 as wrong dose, 7 as wrong prescription, and 7 as suboptimal plan quality. 5 incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, inadequate training, failure to develop an effective plan, and communication contributed to 19, 15, 12, 5 and 3 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4; this rate fell to 0.28% in the second year from 0.56% in the first year. The rate of near miss fell to 1.24% from 2.22%. Conclusion: Effective incident learning can reduce the occurrence of near miss/incidents, enhance the culture of safety. Incident learning is an effective proactive method for improving the quality and safety of radiotherapy

  4. Ultimate strength of a large wind turbine blade

    Energy Technology Data Exchange (ETDEWEB)

    Moelholt Jensen, Find

    2008-05-15

    of the profile, also called 'local deformations', to verify a more complex response than that of a Bernoulli-Euler Beam. A large number of mechanical displacement sensors and strain gauges were mounted inside and outside the structure. These measurements further proved highly useful when validating Finite Element based analysis and failure mechanisms should be decided. Finally, comparisons of the ultimate failure loads observed in the full-scale tests are presented and conclusions are drawn based on the mechanisms found. (au)

  5. Ultimate VHF Broadband Interferometer Zen KAWASAKI and Manabu AKITA

    Science.gov (United States)

    Kawasaki, Z.; Akita, M.

    2013-12-01

    propagation, like electromagnetic wave propagation in non-dispersive medium. This procedure presented exciting results of lightning channel imaging, and the bi-directional leader propagation can be visualized in terms of azimuth and elevation as a function of time. Moreover all of the VHF radiation process for an entire lightning flash from initiation to termination can be imaged, and it is concluded that the system might be an ultimate broad band digital interferometer. The authors would like to show their appreciation to Paul Krehbiel, NMIMT, who gave a chance and suggestion of a continuous recording scheme for BDITF. M. Stock et al. : Continuous Broadband Digital Interferometry of Lightning using a Generalized Cross Correlation Algorithm M. Akita et al. : Data Processing Procedure 1 using Distribution of Slopes of Phase Differences for Broadband VHF Interferometer

  6. Ultimate resistance of a reinforced concrete foundation under impulsive loading

    International Nuclear Information System (INIS)

    Aquaro, D.; Forasassi, G.; Marconi, M.

    2003-01-01

    The impact of a spent nuclear fuel cask against a reinforced concrete slab of a temporary repository for spent nuclear fuel is numerically analysed. The analysis considers accidental events in which a spent nuclear fuel cask would drop against the floor of a repository during lifting operations. Two types of solutions have been taken into account: a simple reinforced concrete structure and a structure provided with a 40 mm thick steel liner on the impacted surface, connected to a 1600 mm thick concrete bed. The model is assumed to be axisymmetric and positioned on an elastic ground (Winkler model). The concrete has been simulated as: elastic perfectly plastic under compressive stresses limited by a crushing strain; elastic linear under tensile stresses until a cracking stress value and a following decrease of stress characterized by a constant or variable softening modulus; limited ability to resist at shear stresses after cracking characterized by a shear retention factor. The steel of the reinforcement bars and of the cask has been simulated as an elastic perfectly plastic material. Several numerical simulations have been performed in order to determine the influence, on the ultimate resistance of the structure under examination, of the steel liner, of some characteristic parameters of concrete (as the softening module and the shear retention factor) and of the Winkler coefficient values, simulating the elastic behaviour of the ground. The obtained results demonstrate that a steel liner produces a lower stress in the concrete as well as in the reinforcement but the bed is still subjected to the cracking phenomenon throughout its entire width although the crushing is localized to only a few elements near the impact zone. The use of a more complex constitutive equation for the concrete considering the shear retention factor and the softening module has given results which do not differ greatly from those related to a more simplified model. A different degree of

  7. Ulnar artery: The Ulysses ultimate resort for coronary procedures

    Directory of Open Access Journals (Sweden)

    George Hahalis, MD, PhD

    2016-07-01

    Full Text Available Despite the increasing worldwide adoption of the transradial access site, the ulnar artery (UA only very infrequently serves as a primary option for coronary procedures. In contrast to the uncertainty surrounding previous reports regarding the feasibility and safety, recent data from larger registries and randomized trials provide more conclusive evidence that the transulnar route may be safely selected as an alternative arterial access approach. However, a default transulnar strategy appears time-consuming and is associated with higher crossover rates compared with the radial artery (RA. Once arterial access is obtained, the likelihood of a successful coronary procedure is high and similar between the two forearm arteries. The UA has similar flow-mediating vasodilating properties with and seems at least as vulnerable as the RA with regard to incident occlusion, with UA occlusion (UAO rates being probably higher than previously anticipated. A learning curve effect may not be apparent for crossover rates among experienced radialists, but increasing experience is associated with reduction in the fluoroscopy time, contrast volume and frequency of large hematoma formation. The UA may represents an important alternative access site for coronary procedures, and experienced radial operators should obtain additional skills to perform the transulnar approach. Nevertheless, in view of this method's lower feasibility compared to the RA, an initial ulnar access strategy should be reserved for carefully selected patients to ensure satisfactory cannulation rates.

  8. Ulnar artery: The Ulysses ultimate resort for coronary procedures.

    Science.gov (United States)

    Hahalis, George; Deftereos, Spyridon; Bertrand, Olivier F

    2016-08-20

    Despite the increasing worldwide adoption of the transradial access site, the ulnar artery (UA) only very infrequently serves as a primary option for coronary procedures. In contrast to the uncertainty surrounding previous reports regarding the feasibility and safety, recent data from larger registries and randomized trials provide more conclusive evidence that the transulnar route may be safely selected as an alternative arterial access approach. However, a default transulnar strategy appears time-consuming and is associated with higher crossover rates compared with the radial artery (RA). Once arterial access is obtained, the likelihood of a successful coronary procedure is high and similar between the two forearm arteries. The UA has similar flow-mediating vasodilating properties with and seems at least as vulnerable as the RA with regard to incident occlusion, with UA occlusion (UAO) rates being probably higher than previously anticipated. A learning curve effect may not be apparent for crossover rates among experienced radialists, but increasing experience is associated with reduction in the fluoroscopy time, contrast volume and frequency of large hematoma formation. The UA may represents an important alternative access site for coronary procedures, and experienced radial operators should obtain additional skills to perform the transulnar approach. Nevertheless, in view of this method's lower feasibility compared to the RA, an initial ulnar access strategy should be reserved for carefully selected patients to ensure satisfactory cannulation rates. Copyright © 2016 Hellenic Cardiological Society. Published by Elsevier B.V. All rights reserved.

  9. Examining memorandum: Ultimate store for nuclear reactor wastes - SFR-1

    International Nuclear Information System (INIS)

    Bergman, C.; Ericsson, G.; Godaas, T.; Haegg, C.; Johansson, G.

    1988-01-01

    The report constitutes the basis for the position of the National Institute of Radiation Protection as regards permission to operate SFR-1 at Forsmark. The memorandum describes: - existing conditions regarding commissioning SFR-1, - summarily the final safety report from the Swedish Fuel and Waste Management Co, - consultant contributions ordered in connection with the examination, - the judgement of the institute in all questions relevant to radiation protection conditions in SFR-1. The institute has made it's own estimates of the radiation doses the repository could be the source of. It is concluded that the radiation doses from the repository are acceptable and consequently operation permission is recommended. (O.S.)

  10. 78 FR 69101 - Agency Information Collection Activities: Declaration of the Ultimate Consignee That Articles...

    Science.gov (United States)

    2013-11-18

    ... Activities: Declaration of the Ultimate Consignee That Articles Were Exported for Temporary Scientific or... the Declaration of the Ultimate Consignee that Articles were Exported for Temporary Scientific or...: Title: Declaration of the Ultimate Consignee that Articles were Exported for Temporary Scientific or...

  11. 26 CFR 48.6427-8 - Diesel fuel and kerosene; claims by ultimate purchasers.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Diesel fuel and kerosene; claims by ultimate... kerosene; claims by ultimate purchasers. (a) Overview. This section provides rules under which ultimate purchasers of taxed diesel fuel and kerosene may claim the income tax credits or payments allowed by section...

  12. BOOK REVIEW: Seeking Ultimates. An Intuitive Guide to Physics

    Science.gov (United States)

    Brown, Neil

    2000-05-01

    Physics has the reputation of being a difficult and dry subject. Many books have been written in attempts to show that the difficulties are not insurmountable, even for the layman, and to convey some of the fascination it provides for those within it. In Seeking Ultimates Peter Landsberg avoids mathematics, the source of so many difficulties, entirely, and seeks to make physics comprehensible by what he terms intuition. He also emphasizes that there is almost no part of science that is completely understood; there are always areas of incompleteness and uncertainty, capable of providing exciting new results, and examples of this are highlighted throughout the book. After an introduction Landsberg starts with macroscopic phenomena for ease of understanding, though one might question whether the chosen topic of thermodynamics is ever going to be easy. Next he looks at microscopic effects, from atomic structure to the fundamental particles of the standard model and their interactions. There follow chapters on time and entropy, on chaos theory, on quantum mechanics and then cosmology. The final chapters look at physical constants (including the anthropic principle), whether physics has room for a creator God (the conclusion is that this is not the province of science), and some thoughts on science as a human activity. The chosen topics are those which have been important in the late twentieth century and remain important. Each chapter cites an eminent scientist as a `hero', though little is made of this. There are occasional historical notes, set in boxes, and a few short poems to leaven the text. What the book achieves is difficult to assess. Removing mathematics and adding a glossary of technical terms do not necessarily allow non-scientists to enjoy the text, as the publisher's note on the back cover suggests. The concepts can baffle the layman even more than the mathematics, and one of the most difficult of all physical concepts permeates so much of this book

  13. Pilot Critical Incident Reports as a Means to Identify Human Factors of Remotely Piloted Aircraft

    Science.gov (United States)

    Hobbs, Alan; Cardoza, Colleen; Null, Cynthia

    2016-01-01

    It has been estimated that aviation accidents are typically preceded by numerous minor incidents arising from the same causal factors that ultimately produced the accident. Accident databases provide in-depth information on a relatively small number of occurrences, however incident databases have the potential to provide insights into the human factors of Remotely Piloted Aircraft System (RPAS) operations based on a larger volume of less-detailed reports. Currently, there is a lack of incident data dealing with the human factors of unmanned aircraft systems. An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from RPAS pilots. Twenty-three experienced RPAS pilots volunteered to participate in focus groups in which they described critical incidents from their own experience. Participants were asked to recall (1) incidents that revealed a system flaw, or (2) highlighted a case where the human operator contributed to system resilience or mission success. Participants were asked to only report incidents that could be included in a public document. During each focus group session, a note taker produced a de-identified written record of the incident narratives. At the end of the session, participants reviewed each written incident report, and made edits and corrections as necessary. The incidents were later analyzed to identify contributing factors, with a focus on design issues that either hindered or assisted the pilot during the events. A total of 90 incidents were reported. Human factor issues included the impact of reduced sensory cues, traffic separation in the absence of an out-the-window view, control latencies, vigilance during monotonous and ultra-long endurance flights, control station design considerations, transfer of control between control stations, the management of lost link procedures, and decision-making during emergencies. Pilots participated willingly and enthusiastically in the study

  14. Operational Resilience Improving Criteria in case of Information Security Incidents

    Directory of Open Access Journals (Sweden)

    P. A. Demin

    2012-12-01

    Full Text Available Resilience management system states and behavior are described with the use of fuzzy Petri net. Operational resilience improving criteria in case of information security incidents is defined. Information security incident response management model is introduced.

  15. Meniscal root tears: from basic science to ultimate surgery.

    Science.gov (United States)

    Papalia, Rocco; Vasta, Sebastiano; Franceschi, Francesco; D'Adamio, Stefano; Maffulli, Nicola; Denaro, Vincenzo

    2013-01-01

    In meniscal root tears (MRTs), the disruption of collagen fibers that provide hoop strength results in extrusion of the menisci, altering their biomechanical properties. Clinical diagnosis is difficult, but magnetic resonance imaging usually allows to identify the lesion. Located into the vascularized zone of the meniscus, management is preferentially arthroscopic, aimed at repairing the lesions with arthroscopic transosseous sutures or suture anchors. PubMed, Cochrane Library, Google Scholar and Ovid Medline were searched in July 2012 to find literature on MRT tears. We reviewed the literature on biomechanics, imaging features and current treatments of these tears. Twenty-seven appropriate articles were identified and included in the study: 6 biomechanical studies, 11 imaging-based investigations for diagnosis, 1 study on clinical diagnosis and 9 studies about treatment. MRTs are infrequent, accounting for 10.1% of all arthroscopic meniscectomies. When the damage occurs to the roots, the transmission of the circumferential hoop tension is impaired and, consequently, the menisci tend to be displaced anteriorly and posteriorly, altering the biomechanics and possibly the kinematics of the knee. Although the importance of the integrity of the meniscal roots is well established, their diagnosis and treatment are still controversial. Biomechanical and clinical studies demonstrate that surgical repair of acute, traumatic meniscal root injuries fully restores the biomechanical features of the menisci, leading to pain relief and functional improvement. The current available surgical techniques for the meniscal root repair (suture anchors and pullout repair) are comparable. Level of evidence IV.

  16. A Knowledge-based System for Estimating Incident Clearance Duration for Maryland : I-95 a Case Study for the Project of MD-17-SHA/UM/4-19 : “Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment”

    Science.gov (United States)

    2017-12-01

    For the incident response operations to be appreciated by the general public, it is essential that responsible highway agencies be capable of providing the estimated clearance duration of a detected incident at the level sufficiently reliable for mot...

  17. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2006-04-01

    Full Text Available Abstract Background We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. Method During one calendar year, 195 general practitioners in 104 practices in the Netherlands registered all their patient contacts. This study was performed by the Netherlands Institute for Health Services Research (NIVEL in 2001. Of 82,053 children aged 0 to 18 years, the following variables were collected: number of episodes per patient, number of contacts per episode, month of the year in which the diagnosis of urinary tract infection was made, age, gender, urbanisation level, drug prescription and referral. Results The overall incidence rate was 19 episodes per 1000 person years. The incidence rate in girls was 8 times as high as in boys. The incidence rate in smaller cities and rural areas was 2 times as high as in the three largest cities. Throughout the year, incidence rates varied with a decrease in summertime for children at the age of 0 to 12 years. Of the prescriptions, 66% were in accordance with current guidelines, but only 18% of the children who had an indication were actually referred. Conclusion This study shows that incidence rates of urinary tract infections are not only related to gender and season, but also to urbanisation. General practitioners in the Netherlands frequently do not follow the clinical guidelines for urinary tract infections, especially with respect to referral.

  18. Treatment of the loss of ultimate heat sink initiating events in the IRSN level 1 PSA

    International Nuclear Information System (INIS)

    Dupuy, Patricia; Georgescu, Gabriel; Corenwinder, Francois

    2014-01-01

    The total loss of the ultimate heat sink is an initiating event which, even it is mainly of external origin, has been considered in the frame of internal events Level 1 PSA by IRSN. The on-going actions on the development of external hazards PSA and the recent incident of loss of the heat sink induced by the ingress of vegetable matter that occurred in France in 2009 have pointed out the need to improve the modeling of the loss of the heat sink initiating event and sequences to better take into account the fact that this loss may be induced by external hazards and thus affect all the site units. The paper presents the historical steps of the modeling of the total loss of the heat sink, the safety stakes of this modeling, the main assumptions used by IRSN in the associated PSA for the 900 MWe reactors and the results obtained. The total loss of the heat sink was not initially addressed in the safety demonstration of French NPPs. On the basis of the insights of the first probabilistic assessments performed in the 80's, the risks associated to this 'multiple failure situation' turned out to be very significant and design and organisational improvements were implemented on the plants. Reviews of the characterization of external hazards and of their consequences on the installations and French operating feedback have revealed that extreme hazards may induce a total loss of the heat sink. Moreover, the accident that occurred at Fukushima in 2011 has pointed out the risk of such a loss of long duration at all site units in case of extreme hazards. In this context, it seems relevant to further improve the modelling of the total loss of the heat sink by considering the external hazards that may cause this loss. In a first step, IRSN has improved the assumptions and data used in the loss of the heat sink PSA model, in particular by considering that such a loss may affect all the site units. The next challenge will be the deeper analysis of the impact of external hazards on

  19. Ultimate disposition of aluminum clad spent nuclear fuel in the United States

    International Nuclear Information System (INIS)

    Messick, C.E.; Clark, W.D.; Clapper, M.; Mustin, T.P.

    2001-01-01

    Treatment and disposition of spent nuclear fuel (SNF) in the United States has changed significantly over the last decade due to change in world climate associated with nuclear material. Chemical processing of aluminum based SNF is ending and alternate disposition paths are being developed that will allow for the ultimate disposition of the enriched uranium in this SNF. Existing inventories of aluminum based SNF are currently being stored primarily in water-filled basins at the Savannah River Site (SRS) while these alternate disposition paths are being developed and implemented. Nuclear nonproliferation continues to be a worldwide concern and it is causing a significant influence on the development of management alternatives for SNF. SRS recently completed an environmental impact statement for the management of aluminum clad SNF that selects alternatives for all of the fuels in inventory. The U.S. Department of Energy and SRS are now implementing a dual strategy of processing small quantities of 'problematic' SNF while developing an alternative technology to dispose of the remaining aluminum clad SNF in the proposed monitored geologic repository. (author)

  20. A novel technique for treating auricular hematomas in mixed martial artists (ultimate fighters).

    Science.gov (United States)

    Roy, Soham; Smith, Lee P

    2010-01-01

    This study aimed to describe a "bolsterless" technique for managing auricular hematomas in professional fighters. Eight auricular hematomas were drained under local anesthesia by incising along an anatomical auricular crease. After evacuation of the hematoma and copious irrigation, the resultant skin flap was replaced in anatomical position, and through-and-through absorbable mattress sutures were used to secure the flap in place. Incision sites were left open and dressed with antimicrobial ointment. No bolsters were placed. The patients were given 1 week of oral antibiotic therapy. All 8 hematomas resolved without further intervention. All 8 ears returned to their preinjury cosmetic state. Fighters were able to return to training within a week of the initial injury. No postoperative infections or other complications were noted. In contrast to wrestlers, mixed martial artists (also called "ultimate fighters") do not routinely wear protective head gear. As a result, they are at increased risk of recurrent auricular hematomas, often resulting in severe auricular deformities (cauliflower ear). These patients are anxious to return to training and fighting, and are reluctant to wear a bolster after repair. At their urging, we agreed to attempt this bolsterless technique. Although 2 patients in this series already had a significant cauliflower ear before being treated for the current hematoma, in all cases the auricle returned to its preinjury condition. Bolsterless treatment using mattress sutures and cosmetically placed incisions represents a successful technique for management of auricular hematomas in this population.

  1. Contaminated Mexican steel incident

    International Nuclear Information System (INIS)

    1985-01-01

    This report documents the circumstances contributing to the inadvertent melting of cobalt 60 (Co-60) contaminated scrap metal in two Mexican steel foundries and the subsequent distribution of contaminated steel products into the United States. The report addresses mainly those actions taken by US Federal and state agencies to protect the US population from radiation risks associated with the incident. Mexico had much more serious radiation exposure and contamination problems to manage. The United States Government maintained a standing offer to provide technical and medical assistance to the Mexican Government. The report covers the tracing of the source to its origin, response actions to recover radioactive steel in the United States, and return of the contaminated materials to Mexico. The incident resulted in significant radiation exposures within Mexico, but no known significant exposure within the United States. Response to the incident required the combined efforts of the Nuclear Regulatory Commission (NRC), Department of Energy, Department of Transportation, Department of State, and US Customs Service (Department of Treasury) personnel at the Federal level and representatives of all 50 State Radiation Control Programs and, in some instances, local and county government personnel. The response also required a diplomatic interface with the Mexican Government and cooperation of numerous commercial establishments and members of the general public. The report describes the factual information associated with the event and may serve as information for subsequent recommendations and actions by the NRC. 8 figures

  2. The Ultimate Cookbook for Cultural Managers : Social Security in International Context

    NARCIS (Netherlands)

    D. Molenaar (Dick)

    2017-01-01

    markdownabstractActivities of artists are rarely limited to their own country. Nowadays artists (and other cultural professionals) are very mobile and easily accept a job offer or an activity abroad. All these situations show a vibrant and highly mobile sector that is not defined by borders.

  3. Laparoscopic ovarian drilling: An alternative but not the ultimate in the management of polycystic ovary syndrome

    Science.gov (United States)

    Mitra, Subarna; Nayak, Prasanta Kumar; Agrawal, Sarita

    2015-01-01

    Since its introduction in 1984, laparoscopic ovarian drilling has evolved into a safe and effective surgical treatment for anovulatory, infertile women with polycystic ovary syndrome (PCOS), unresponsive to clomiphene citrate. It is as effective as gonadotropins in terms of pregnancy and live birth rates, but without the risks of ovarian hyperstimulation syndrome and multiple pregnancies. It improves ovarian responsiveness to successive ovulation induction agents. Its favorable reproductive and endocrinal effects are sustained long. Despite its advantages, its use in unselected cases of PCOS or for non-fertility indications is not prudent owing to the potential risks of iatrogenic adhesions and ovarian insufficiency. PMID:25810633

  4. Ultimate architecture

    CERN Multimedia

    Jencks, Charles

    2007-01-01

    "European physics hothouse CERN recently unveiled Atlas, the world's most powerful particle detector, which it will use to search for the fundamental building blocks of nature from May next year. Charles Jencks describes the experience of getting up clsoe to the engineering marvel that could en up creating a mini-black hole."(5 pages with photos).

  5. A Sequential Mixed Methods Study: An Exploration of the Use of Emotional Intelligence by Senior Student Affairs Officers in Managing Critical Incidents

    Science.gov (United States)

    Johnson, Brian

    2013-01-01

    Emotional intelligence is a relatively new academic discipline that began forming in the early 1990s. Currently, emotional intelligence is used in academia and in business as a new intelligence quotient. This research study investigates how Senior Student Affairs Officers' use their emotional intelligence ability during critical incidents. The…

  6. 75 FR 76746 - Agency Information Collection Activities: Declaration of Ultimate Consignee That Articles Were...

    Science.gov (United States)

    2010-12-09

    ... Activities: Declaration of Ultimate Consignee That Articles Were Exported for Temporary Scientific or... That Articles Were Exported for Temporary Scientific or Educational Purposes. This is a proposed... forms of information. Title: Declaration of Ultimate Consignee That Articles Were Exported for Temporary...

  7. The ultimate commission: The key for the gospel according to Matthew

    African Journals Online (AJOL)

    It is frequently acknowledged that the ultimate commission is important for understanding the whole gospel of Matthew. In this article, we investigate how several themes incorporated in the ultimate commission (28:18-20) are connected to the whole gospel. Thus readers of Matthew will not be surprised at their encounter ...

  8. 7 CFR 4280.21 - Eligible REDG Ultimate Recipients and Projects.

    Science.gov (United States)

    2010-01-01

    ... care providers; (5) Projects that utilize Advanced Telecommunications or computer networks to... 7 Agriculture 15 2010-01-01 2010-01-01 false Eligible REDG Ultimate Recipients and Projects. 4280... Economic Development Loan and Grant Programs § 4280.21 Eligible REDG Ultimate Recipients and Projects. The...

  9. 26 CFR 48.6427-11 - Kerosene; claims by registered ultimate vendors (blending).

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Kerosene; claims by registered ultimate vendors... Administrative Provisions of Special Application to Retailers and Manufacturers Taxes § 48.6427-11 Kerosene... certain registered ultimate vendors of taxed kerosene may claim the income tax credits or payments allowed...

  10. Influence of cracks and pitting corrosion on residual ultimate strength of stiffened plates

    Directory of Open Access Journals (Sweden)

    ZHANG Jing

    2018-02-01

    Full Text Available [Objectives] Ships and offshore platforms serve in the harsh sea environment for a long time. Cracks and pitting corrosion will occur in such a structure and the damage will affect its ultimate strength.[Methods] To investigate the influence of cracks and pitting corrosion on ultimate bearing capacity, the ultimate strength of a structure under axial compression is studied by using a nonlinear finite element. The mesh size of a stiffened plate with cracks and pitting corrosion is first discussed. Then the influence of the relative positions of cracks and pitting corrosion, number of corrosion points and crack length impact on the residual ultimate strength of damaged stiffened plates is discussed via a series of calculations.[Results] The results indicate that the increase in crack length and pitting corrosion significantly decreases the ultimate strength of a stiffened plate. [Conclusions] This provides a useful reference for designing and maintaining ships and offshore structures in their life cycles.

  11. A novel stepwise method to predict ultimate strength reduction in offshore structures with pitting corrosion

    Directory of Open Access Journals (Sweden)

    Sajad Rahmdel

    2015-08-01

    Full Text Available Corrosion is a factor that decreases the ultimate strength of a structure, which can lead to structural failure in an aged structure. This study proposes a reliable method to predict the ultimate strength reduction caused by pitting corrosion of a structure at various ages. Hence, the objectives of this study are as follows: (1 finding relationship between the ultimate strength reduction and pit depth and (2 finding relationship between the ultimate strength reduction and the age of structure. The presented method has six steps and was assessed by applying it to the simplified example of a thin-plate panel structure. The ultimate strengths of the panel with different pit depths were calculated using finite element analysis. The effects of material and geometric nonlinearities as well as the initial imperfections and buckling were also considered. A linear regression model, representing the relationship between the ultimate strength reduction and pit depth, was then developed. Furthermore, using the experimental data, the weighted mean value of ultimate strength reduction was acquired for different age groups of the panel. The introduced stepwise approach contemplates the nonlinearity of pitting corrosion with time by considering the experimental data. As corroborated by the successful application of the presented methodology, this method is more accurate, compared to the accepted practices available in the literature.

  12. Seismic shear wall ISP NUPEC's seismic ultimate dynamic response test. Comparison report

    International Nuclear Information System (INIS)

    1996-01-01

    In the seismic design of a nuclear power plant, evaluation of the ultimate strength of the nuclear reactor building is an important subject for assessment of seismic reliability of the plant. In order to carry out the evaluation, the response characteristics of reinforced concrete seismic shear walls up to their ultimate state have to be understood. For this purpose, there is a need to develop reliable non-linear response analysis methods which enables the reliable ultimate strength evaluation of nuclear reactor buildings. Along with this need, many computer codes have been developed. These computer codes are compared. (K.A.)

  13. Preslaughter transportation and shower management on broiler chicken Dead on Arrival (DOA incidenceManejo pré-abate de transporte e banho sobre a incidência de mortalidade de frangos de corte

    Directory of Open Access Journals (Sweden)

    Alexandre Oba

    2011-07-01

    Full Text Available The aim of this work was to evaluate the influence of the management conditions and distance to a commercial plant on chicken broilers Dead on Arrival (DOA. This work was conducted in the winter and summer seasons of 2008 in a commercial plant. In the winter season, the transport distances were 15 and 57 km, and in the summer season the distances were 15 and 55 km from the farm to the slaughterhouse and the experiments were carried out in duplicate. In the summer, to evaluate the effect of water bath over the birds before the actual transportation, a group of two trucks were submitted to a water bath (GWthB and the other without water bath treatment (GWoutB. The results showed that in the winter, the DOA was not influenced to distance of transport. In the summer, the DOA values for GWthB group varied from 0.12 to 0.17% while for the GWoutB the DOA values ranged from 0.16 to 0.27% indicating that the bath treatment after broilers truck loading and before transportation reduced broiler chicken mortality.O objetivo deste trabalho foi avaliar o efeito da distância de transporte e do banho após o carregamento sobre a mortalidade de frangos na chegada ao abatedouro, denominada Mortalidade na Chegada, do ingles Dead on Arrival – DOA. O estudo foi conduzido no inverno e no verão de 2008 em abatedouro comercial. No inverno, as distâncias de transporte foram de 15 e 57 km, e no verão foram de 15 e 55 km, sendo os experimentos realizados em duplicata. No verão, para avaliar o efeito do banho sobre os frangos após o carregamento no caminhão, foram avaliados dois lotes em cada distância, lote sem banho (LSB e lote com banho (LCB. Pelos resultados verificou-se que, no inverno o DOA não foi alterado pela distância de transporte. Enquanto que no verão, o DOA variou de 0,16% a 0,27 % nos lotes LSB e de 0,12% a 0,17% nos lotes LCB. No verão, foram observados menores valores de DOA nos lotes LCB nas duas distâncias de transporte indicando que o

  14. [Deniss Hanovs, Valdis Tēraudkalns: Ultimate Freedom - no choice] / Olaf Mertelsmann

    Index Scriptorium Estoniae

    Mertelsmann, Olaf, 1969-

    2014-01-01

    Arvustus: Deniss Hanovs, Valdis Tēraudkalns: Ultimate Freedom - no choice. The culture of authoritarianism in Latvia, 1934-1940. (Central and Eastern Europe. Reginal perspectives in global context, Bd. 2.) Brill. Leiden-Boston 2013

  15. LRFD software for design and actual ultimate capacity of confined rectangular columns.

    Science.gov (United States)

    2013-04-01

    The analysis of concrete columns using unconfined concrete models is a well established practice. On the : other hand, prediction of the actual ultimate capacity of confined concrete columns requires specialized nonlinear : analysis. Modern codes and...

  16. Metropolitan transportation management center : a case study : Boston Central Artery/Tunnel Integrated Project control system : responding to incidents rapidly and effectively

    Science.gov (United States)

    1999-10-01

    The following case study provides a snapshot of the Boston Central Artery/Tunnel Integration Project Control System (IPCS) operations control center. It follows the outline provided in the companion document, Metropolitan Transportation Management Ce...

  17. Ultimate Strength of Ferro-Geopolymer Composite Built-Up I Joist

    Science.gov (United States)

    Vipin, K. T.; Ganesan, N.; Indira, P. V.

    2017-07-01

    An experimental study was carried out to study the behaviour of ferro-geopolymer built-up I- joist with different types of mesh reinforcements under flexure. Mesh reinforcements considered in this study are square welded meshes, square woven meshes and hexagonal meshes. First crack load as well as ultimate strength of ferro-geopolymer built-up I-joist in flexure was obtained. An attempt was made to predict the first crack load and ultimate moment capacity of the specimen.

  18. Incidence and Management Costs of Freshwater Aquatic Nuisance Species at Projects Operated by the U.S. Army Corps of Engineers

    Science.gov (United States)

    2010-07-01

    and large aquatic plants. Most ANS in the Great Lakes are animal species, although filamentous algae (e.g., Cladophora spp.) are a common local...large aquatic plants, which incurred 98% of the management cost. Algae management made up most of the remaining cost. Based on a literature review...species have become troublesome under certain conditions, but only a few are repeatedly identified as “nuisance” species. Certain blue-green algae

  19. Excess glycogen does not resolve high ultimate pH of oxidative muscle.

    Science.gov (United States)

    England, Eric M; Matarneh, Sulaiman K; Oliver, Emily M; Apaoblaza, Ariel; Scheffler, Tracy L; Shi, Hao; Gerrard, David E

    2016-04-01

    Skeletal muscle glycogen content can impact the extent of postmortem pH decline. Compared to glycolytic muscles, oxidative muscles contain lower glycogen levels antemortem which may contribute to the higher ultimate pH. In an effort to explore further the participation of glycogen in postmortem metabolism, we postulated that increasing the availability of glycogen would drive additional pH decline in oxidative muscles to equivalent pH values similar to the ultimate pH of glycolytic muscles. Glycolysis and pH declines were compared in porcine longissimus lumborum (glycolytic) and masseter (oxidative) muscles using an in vitro system in the presence of excess glycogen. The ultimate pH of the system containing longissimus lumborum reached a value similar to that observed in intact muscle. The pH decline of the system containing masseter samples stopped prematurely resulting in a higher ultimate pH which was similar to that of intact masseter muscle. To investigate further, we titrated powdered longissimus lumborum and masseter samples in the reaction buffer. As the percentage of glycolytic sample increased, the ultimate pH decreased. These data show that oxidative muscle produces meat with a high ultimate pH regardless of glycogen content and suggest that inherent muscle factors associated with glycolytic muscle control the extent of pH decline in pig muscles. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Educational attainment and ultimate fertility among Swedish women born in 1955-59

    Directory of Open Access Journals (Sweden)

    Gerda Neyer

    2006-05-01

    Full Text Available This is the second of two companion papers addressing the association between educational attainment and fertility for some sixty educational groups of Swedish women, defined according to field of education as well as level of education. The first paper is about childlessness and education, the present one about the mean number of children ever born. We find that ultimate fertility decreases somewhat with an increasing educational level, but its dependence on the field of education is much more impressive. In general, educational groups with relatively little childlessness also have relatively high ultimate fertility, and educational groups with much childlessness have relatively low ultimate fertility. In particular, women educated for the teaching or health-care professions have less childlessness and a higher ultimate fertility than others. Conversely, women with an education for esthetic or (non-teacher humanist occupations have unusually high fractions childless and low ultimate fertility. Women with religious educations stand out by having very high fractions childless but quite ordinary mean ultimate fertility nevertheless; such women have very little childbearing outside of marriage. Women with research degrees have remarkably ordinary childbearing behavior; they do not forego motherhood to the extent that some theories would predict.

  1. MCFRS Incidents by Station

    Data.gov (United States)

    Montgomery County of Maryland — This dataset contains the monthly summary data indicating incident occurred in each fire station response area. The summary data is the incident count broken down by...

  2. Police Incident Reports Written

    Data.gov (United States)

    Town of Chapel Hill, North Carolina — This table contains incident reports filed with the Chapel Hill Police Department. Multiple incidents may have been reported at the same time. The most serious...

  3. Serious incidents after death: content analysis of incidents reported to a national database.

    Science.gov (United States)

    Yardley, Iain E; Carson-Stevens, Andrew; Donaldson, Liam J

    2018-02-01

    Objectives To describe serious incidents occurring in the management of patient remains after their death. Design Incidents occurring after patient deaths were analysed using content analysis to determine what happened, why it happened and the outcome. Setting The Strategic Executive Information System database of serious incidents requiring investigation occurring in the National Health Service in England. Participants All cases describing an incident that occurred following death, regardless of the age of the patient. Main outcome measures The nature of the incident, the underlying cause or causes of the incident and the outcome of the incident. Results One hundred and thirty-two incidents were analysed; these related to the storage, management or disposal of deceased patient remains. Fifty-four incidents concerned problems with the storage of bodies or body parts. Forty-three incidents concerned problems with the management of bodies, including 25 errors in postmortem examination, or postmortems on the wrong body. Thirty-one incidents related to the disposal of bodies, 25 bodies were released from the mortuary to undertakers in error; of these, nine were buried or cremated by the wrong family. The reported underlying causes were similar to those known to be associated with safety incidents occurring before death and included weaknesses in or failures to follow protocol and procedure, poor communication and informal working practices. Conclusions Serious incidents in the management of deceased patient remains have significant implications for families, hospitals and the health service more broadly. Safe mortuary care may be improved by applying lessons learned from existing patient safety work.

  4. Cyber Incidents Involving Control Systems

    Energy Technology Data Exchange (ETDEWEB)

    Robert J. Turk

    2005-10-01

    The Analysis Function of the US-CERT Control Systems Security Center (CSSC) at the Idaho National Laboratory (INL) has prepared this report to document cyber security incidents for use by the CSSC. The description and analysis of incidents reported herein support three CSSC tasks: establishing a business case; increasing security awareness and private and corporate participation related to enhanced cyber security of control systems; and providing informational material to support model development and prioritize activities for CSSC. The stated mission of CSSC is to reduce vulnerability of critical infrastructure to cyber attack on control systems. As stated in the Incident Management Tool Requirements (August 2005) ''Vulnerability reduction is promoted by risk analysis that tracks actual risk, emphasizes high risk, determines risk reduction as a function of countermeasures, tracks increase of risk due to external influence, and measures success of the vulnerability reduction program''. Process control and Supervisory Control and Data Acquisition (SCADA) systems, with their reliance on proprietary networks and hardware, have long been considered immune to the network attacks that have wreaked so much havoc on corporate information systems. New research indicates this confidence is misplaced--the move to open standards such as Ethernet, Transmission Control Protocol/Internet Protocol, and Web technologies is allowing hackers to take advantage of the control industry's unawareness. Much of the available information about cyber incidents represents a characterization as opposed to an analysis of events. The lack of good analyses reflects an overall weakness in reporting requirements as well as the fact that to date there have been very few serious cyber attacks on control systems. Most companies prefer not to share cyber attack incident data because of potential financial repercussions. Uniform reporting requirements will do much to make this

  5. A feasibility study of the use of incidents and accidents reports to evaluate effects of team resource management in air traffic control

    DEFF Research Database (Denmark)

    Andersen, V.; Bove, T.

    2000-01-01

    Valuable improvements in performance have been obtained by 'Crew Resource Management' (CRM) courses performed in the domain of aviation related to the crew in a cockpit, and in the maritime domain related to the crew on the bridge of large ships. CRM courses are currently being adapted to the dom...

  6. Ultimate pier and contraction scour prediction in cohesive soils at selected bridges in Illinois

    Science.gov (United States)

    Straub, Timothy D.; Over, Thomas M.; Domanski, Marian M.

    2013-01-01

    The Scour Rate In COhesive Soils-Erosion Function Apparatus (SRICOS-EFA) method includes an ultimate scour prediction that is the equilibrium maximum pier and contraction scour of cohesive soils over time. The purpose of this report is to present the results of testing the ultimate pier and contraction scour methods for cohesive soils on 30 bridge sites in Illinois. Comparison of the ultimate cohesive and noncohesive methods, along with the Illinois Department of Transportation (IDOT) cohesive soil reduction-factor method and measured scour are presented. Also, results of the comparison of historic IDOT laboratory and field values of unconfined compressive strength of soils (Qu) are presented. The unconfined compressive strength is used in both ultimate cohesive and reduction-factor methods, and knowing how the values from field methods compare to the laboratory methods is critical to the informed application of the methods. On average, the non-cohesive method results predict the highest amount of scour, followed by the reduction-factor method results; and the ultimate cohesive method results predict the lowest amount of scour. The 100-year scour predicted for the ultimate cohesive, noncohesive, and reduction-factor methods for each bridge site and soil are always larger than observed scour in this study, except 12% of predicted values that are all within 0.4 ft of the observed scour. The ultimate cohesive scour prediction is smaller than the non-cohesive scour prediction method for 78% of bridge sites and soils. Seventy-six percent of the ultimate cohesive predictions show a 45% or greater reduction from the non-cohesive predictions that are over 10 ft. Comparing the ultimate cohesive and reduction-factor 100-year scour predictions methods for each bridge site and soil, the scour predicted by the ultimate cohesive scour prediction method is less than the reduction-factor 100-year scour prediction method for 51% of bridge sites and soils. Critical shear stress

  7. An Investigation on the Ultimate Strength of Cold-Formed Steel Bolted Connections

    Directory of Open Access Journals (Sweden)

    N. Konkong

    2017-08-01

    Full Text Available This paper presents experimental results and finite element analysis of the cold-formed steel bolted connection under shear loading. Experiments are conducted to study the ultimate behaviors, such as ultimate strength and failure mode of connections. The samples were fabricated into three different groups, single bolted, double bolted and quadruple bolted connection. Material properties were determined by tensile coupon testing. Bearing failure modes were detected in the bolted connection tests. The ultimate capacities were compared with the nominal strengths calculated using the AISI (2012. The comparisons show that the nominal strength parameters predicted by this specification is conservative. The finite element analysis shell elements were used to model the cold-formed steel plate while solid elements were used to model the bolted fastenings for the purpose of studying the structural behavior of bolted connections. Material nonlinearities, contact problem and geometry nonlinearities analysis are carried out in order to predict ultimate strength and failure mode of connections. The results show that the proposed model accurately represents the failure mode and ultimate strength of bolted connection, as determined from experimental investigation. The new factor for type of bearing connection has a good agreement with the tested bearing strength of bolt connection.

  8. The Ultimate Factor of Safety for Aircraft and Spacecraft Its History, Applications and Misconceptions

    Science.gov (United States)

    Zipay, John J.; Modlin, C. Thomas, Jr.; Larsen, Curtis E.

    2016-01-01

    The ultimate factor of safety (FOSULT) concept used in aircraft and spacecraft has evolved over many decades. Currently an FOSULT 1.5 is the FAR-mandated value for aircraft while an FOSULT of 1.4 has been used in various spacecraft. This paper was motivated by the desire to concisely explain the origins, proper interpretation and application of the ultimate factor of safety concept, since the authors have seen throughout their careers many misconceptions and incorrect applications of this concept. The history of the ultimate factor of safety concept is briefly summarized, the proper application of the factor of safety in aircraft design, structural analysis and operations is covered in detail, examples of limit load exceedance in aircraft and spacecraft are discussed, the evolution of the 1.4 FOSULT for spacecraft is described and some misconceptions regarding the ultimate factor of safety concept are addressed. It is hoped that this paper can be a summary resource for engineers to understand the origin, purpose and proper application of the ultimate factor of safety.

  9. Incidence of Pancreatic Fistula after Distal Pancreatectomy and Efficacy of Endoscopic Therapy for Its Management: Results from a Tertiary Care Center

    Directory of Open Access Journals (Sweden)

    Savio C. Reddymasu

    2013-08-01

    Full Text Available Pancreatic fistula is a known complication of distal pancreatectomy. Endotherapy with pancreatic duct stent placement and pancreatic sphincterotomy has been shown to be effective in its management; however, experience of endotherapy in the management of this complication has not been extensively reported from the United States. Preoperative endoscopic retrograde cholangiopancreatography (ERCP with pancreatic stent placement has also been proposed to prevent this complication after distal pancreatectomy. In our cohort of 59 patients who underwent distal pancreatectomy, 13 (22% developed a pancreatic fistula in the immediate postoperative period, of whom 8 (14% patients (5 female, mean age 52 years were referred for an ERCP because of ongoing symptoms related to the pancreatic fistula. The pancreatic fistula resolved in all patients after a median duration of 62 days from the index ERCP. The median number of ERCPs required to document resolution of the pancreatic fistula was 2. Although a sizeable percentage of patients develop a pancreatic fistula after distal pancreatectomy, only a small percentage of patients require ERCP for management of this complication. Given the high success rate of endotherapy in resolving pancreatic fistula and the fact that the majority of patients who undergo distal pancreatectomy never require an ERCP, performing ERCP for prophylactic pancreatic duct stent prior to distal pancreatectomy might not be necessary.

  10. Viruses of managed alfalfa leafcutting bees (Megachille rotundata Fabricus) and honey bees (Apis mellifera L.) in Western Canada: Incidence, impacts, and prospects of cross-species viral transmission.

    Science.gov (United States)

    Melathopoulos, Andony; Ovinge, Lynae; Veiga, Patricia Wolf; Castillo, Carlos; Ostermann, David; Hoover, Shelley

    2017-06-01

    We examined whether alfalfa leafcutting bees (ALCB, Megachille rotundata) experienced a higher incidence of seven viruses commonly found honey bees (Apis mellifera) when placed alongside honey bees for hybrid canola seed pollination. Although two viruses - sacbrood virus (SBV) and deformed wing virus (DWV) - were detected in ALCB adults, their presence appeared independent of whether honey bees were present in the same field or not. A further survey of viruses among ALCB adults in three different alfalfa seed growing regions in Western Canada confirmed the ubiquity of sacbrood virus (SBV) as well as the infrequent presence of acute bee paralysis virus (ABPV), both of which had not been previously reported on ALCB. Moreover, SBV and ABPV were detected in the cocoon stage and only in one region. Co-infection among pools of ALCB adults with both of these viruses was more closely correlated with decreasing levels of cocoon viability than infection levels in cocoons themselves. This research suggests ongoing viral transmission between honey bees and ALCB in the same fields is likely low but that co-infection with these viruses may lower ALCB productivity. Copyright © 2017. Published by Elsevier Inc.

  11. Maintained ship hull girder ultimate strength reliability considering corrosion and fatigue

    DEFF Research Database (Denmark)

    Hu, Yong; Cui, W.; Pedersen, Preben Terndrup

    2004-01-01

    The prupose of this paper is to propose a methodology to assess the time-variant ultimate strength of ship hull girder under the degradations of corrosion and fatigue. The effects of fatigue cracks on the tensile and compressive residual ultimate strength of stiffened panels and unstiffened plates...... are analyzed by an FE method. Based on FE analysis restuls, some empirical formulae are provided for effective calculation of the compressive or tensile ultimate strength of cracked or intact unstiffened plates or stiffened panels. A non-linear corrosion model is used to determine the corrosion rate of plates......, webs and flanges, respectively. The effects of inspections and repair are taken into account. A minimum net thickness rule is used to determine repair policies. A procedure is proposed to determine the maximum allowable corrosion thickness of different parts of the hull cross section. The procedure...

  12. Ultimate Owner and Firm Performance - Evidence from Romanian Mining and Quarrying Listed Firms

    Directory of Open Access Journals (Sweden)

    Cosmin MIHAI

    2012-08-01

    Full Text Available The main objectives of this paper are to describe the necessary steps to identify the ultimate owner and to investigate the relation between the ultimate ownership and the financial performance of Romanian mining and quarrying listed firms. The study was conducted for the companies listed on Bucharest Stock Exchange, in both regulated and non-regulated segments. The final sample included 17 companies of mining and quarrying. Return on Equity was used for measuring the financial performance of the firms. The ultimate ownership was measured by the percentage of voting rights held by a shareholder. Econometric tools like multiple linear regression analysis were used for analysis. The results of the study suggest that there is a significant negative link between financial performance and divergence between voting rights and cash-flow rights.

  13. Optimization and Prediction of Ultimate Tensile Strength in Metal Active Gas Welding.

    Science.gov (United States)

    Ampaiboon, Anusit; Lasunon, On-Uma; Bubphachot, Bopit

    2015-01-01

    We investigated the effect of welding parameters on ultimate tensile strength of structural steel, ST37-2, welded by Metal Active Gas welding. A fractional factorial design was used for determining the significance of six parameters: wire feed rate, welding voltage, welding speed, travel angle, tip-to-work distance, and shielded gas flow rate. A regression model to predict ultimate tensile strength was developed. Finally, we verified optimization of the process parameters experimentally. We achieved an optimum tensile strength (558 MPa) and wire feed rate, 19 m/min, had the greatest effect, followed by tip-to-work distance, 7 mm, welding speed, 200 mm/min, welding voltage, 30 V, and travel angle, 60°. Shield gas flow rate, 10 L/min, was slightly better but had little effect in the 10-20 L/min range. Tests showed that our regression model was able to predict the ultimate tensile strength within 4%.

  14. The importance of mines for ultimate storage at Deilmann-Haniel Shaft Sinking

    International Nuclear Information System (INIS)

    Greinacher, Jochen; Oellers, Thomas; Ahlbrecht, Thomas

    2011-01-01

    Deilmann-Haniel Shaft Sinking GmbH and its predecessor and associate companies have been involved in projects for underground ultimate storage in Germany, Europe and America for over 45 years. The field of activities previously comprised surveying, planning and sinking of shafts, repair and conversion work, design of underground sealing structures, planning of conveyors and support of the BfS in planning approval procedures. Following discontinuation of activities in the German coal mining industry the use of mines for ultimate storage is an important support for German specialist mining companies. The use of mines for ultimate storage ensures that the existing mining know how in Germany is maintained, because training of the younger generation on the commercial and engineering side of the companies is made possible by the imminent major projects.

  15. Ultimate strength and ductility of steel reinforced concrete beam-columns

    International Nuclear Information System (INIS)

    Shohara, Ryoichi

    1991-01-01

    The ultimate strength and ductility of SRC beam-columns are investigated using the data gathered in Architectural Institute of Japan. Though the simple superposed strength formula in AIJ standard underestimates the strength of SRC beam-column failed in flexure, the generalized superposed strength formula estimates it satisfactory. The strength formula in AIJ standard does not good agreement with test data. The SRC beam-column failed in shear has almost equalductility with that failed in flexure owing to the encased steel. Author presents the formulas which estimate the ultimate deformation angle for SRC beam-columns. (author)

  16. Conception of electron beam-driven subcritical molten salt ultimate safety reactor

    Energy Technology Data Exchange (ETDEWEB)

    Abalin, S.S.; Alekseev, P.N.; Ignat`ev, V.V. [Kurchatov Institute, Moscow (Russian Federation)] [and others

    1995-10-01

    This paper is a preliminary sketch of a conception to develop the {open_quotes}ultimate safety reactor{close_quotes} using modern reactor and accelerator technologies. This approach would not require a long-range R&D program. The ultimate safety reactor could produce heat and electric energy, expand the production of fuel, or be used for the transmutation of long-lived wastes. The use of the combined double molten salt reactor system allows adequate neutron multiplication to permit using an electron accelerator for the initial neutron flux. The general parameters of such a system are discussed in this paper.

  17. Ultimate Limit State Model Basis for Assessment of Offshore Wind Energy Converters

    DEFF Research Database (Denmark)

    Thöns, Sebastian; Faber, M. H.; Rücker, W.

    2012-01-01

    This paper establishes the model basis regarding the ultimate limit state consisting of structural, loading, and probabilistic models of the support structure of offshore wind energy converters together with a sensitivity study. The model basis is part of a risk based assessment and monitoring...... structure and the tripod structure are determined with a geometrically and materially nonlinear finite element analysis. The observed failure mechanisms are the basis for the definition of the ultimate limit state responses. A probabilistic model accounting for the uncertainties involved is derived...

  18. Behaviour of concrete nuclear containment structures upto ultimate failure with special reference to MAPP-1 containment

    International Nuclear Information System (INIS)

    Appa Rao, T.V.S.R.

    1975-01-01

    Theoretical and experimental methods for investigating the behaviour of concrete secondary containment structures subjected to loads upto their ultimate failure have been discussed in the paper. Need for inelastic nonlinear analysis of containments has been emphasized. Different contitutive models of concrete that can be employed in the nonlinear analysis of concrete structures were briefly reviewed. Based on the experimental results obtained in a 1:12 scale model test conducted at the Structural Engineering Research (Regional) Centre, Madras, behaviour of the MAPP-1 containment to internal pressure loading upto its ultimate failure has been discussed. (author)

  19. Study of optimal transformation of liquid effluents resulting from the destruction of radioactive sodium by water into ultimate solid wastes

    International Nuclear Information System (INIS)

    Rodriguez, G.; Camaro, S.; Fiquet, O.; Bernard, A.; Le Bescop, P.

    1997-01-01

    In the framework of sodium waste processing, it has been proposed to retain only processes that treat the sodium using water, thus generating the same by-products: hydrogen and sodium hydroxide. As the objective is to minimise radioactive liquid releases and as, moreover, the authorizations with respect to sodium salt releases are highly restrictive, several solutions have been envisaged for transforming the active sodium hydroxide coming from sodium destruction processes into ultimate solid wastes that can be stored on the surface in a storage site approved by the ANDRA (National Radioactive Waste Management Agency): the Aube Storage Site (CSA). Two processes have been considered and compared: immobilisation in concrete (cementation) and immobilisation in ceramic (ceramisation). These two processes are evaluated according to several criteria: the state of advancement of the process, the quantity of sodium hydroxide (and therefore of sodium) that can be treated per package. (author)

  20. Prisoner Fasting as Symbolic Speech: The Ultimate Speech-Action Test.

    Science.gov (United States)

    Sneed, Don; Stonecipher, Harry W.

    The ultimate test of the speech-action dichotomy, as it relates to symbolic speech to be considered by the courts, may be the fasting of prison inmates who use hunger strikes to protest the conditions of their confinement or to make political statements. While hunger strikes have been utilized by prisoners for years as a means of protest, it was…

  1. Ultimate heat sink and directly associated heat transport systems for nuclear power plants

    International Nuclear Information System (INIS)

    1981-01-01

    The scope of the Guide covers design considerations for various types of ultimate heat sinks (UHS) and directly associated heat transport systems, and for types and sources of related heat transport fluids. The scope encompasses the conditions for using the UHS for reactor safety following postulated initiating events, as well as its selection, sizing and reliability

  2. proximate and ultimate analysis of fuel pellets from oil palm residues

    African Journals Online (AJOL)

    HOD

    This study carried out an investigation on the proximate and ultimate analysis of fuel pellets from oil palm residues such as palm kernel shell, PKS, palm fibre, PF and empty fruit bunch, EFB using the ASTM standards. The results obtained were compared. The percentage moisture content of the pellets, PKS, PF and EFB ...

  3. Reliability analysis of production ships with emphasis on load combination and ultimate strength

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xiaozhi

    1995-05-01

    This thesis deals with ultimate strength and reliability analysis of offshore production ships, accounting for stochastic load combinations, using a typical North Sea production ship for reference. A review of methods for structural reliability analysis is presented. Probabilistic methods are established for the still water and vertical wave bending moments. Linear stress analysis of a midships transverse frame is carried out, four different finite element models are assessed. Upon verification of the general finite element code ABAQUS with a typical ship transverse girder example, for which test results are available, ultimate strength analysis of the reference transverse frame is made to obtain the ultimate load factors associated with the specified pressure loads in Det norske Veritas Classification rules for ships and rules for production vessels. Reliability analysis is performed to develop appropriate design criteria for the transverse structure. It is found that the transverse frame failure mode does not seem to contribute to the system collapse. Ultimate strength analysis of the longitudinally stiffened panels is performed, accounting for the combined biaxial and lateral loading. Reliability based design of the longitudinally stiffened bottom and deck panels is accomplished regarding the collapse mode under combined biaxial and lateral loads. 107 refs., 76 refs., 37 tabs.

  4. 26 CFR 48.6427-10 - Kerosene; claims by registered ultimate vendors (blocked pumps).

    Science.gov (United States)

    2010-04-01

    ... (blocked pumps). 48.6427-10 Section 48.6427-10 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE...; claims by registered ultimate vendors (blocked pumps). (a) Overview. This section provides rules under... allowed by section 6427(l)(5)(B)(i). These claims relate to kerosene sold from a blocked pump. Claims...

  5. On the Independent Determination of the Ultimate Density of Physical Vacuum

    Directory of Open Access Journals (Sweden)

    Belyakov A. V.

    2011-04-01

    Full Text Available In this paper, we attempt to present physical vacuum as a topologically non-unitary coherent surface. This representation follows with J. A. Wheeler's idea about fluctuating topology, and provides a possibility to express some parameters of the unit space element through the fundamental constants. As a result, we determined the ultimate density of physical vacuum without use of Hubble's constant.

  6. Study of ultimate heat sink to Angra-1,2 and 3 Nuclear Power Plants

    International Nuclear Information System (INIS)

    Moreira, R.M.; Pinto, A.M.F.

    1985-03-01

    This report presents the premises, results and conclusion of study done to ultimate heat sink of Angra 1,2 and 3 units, with base in postulated accidents that generate transient heat discharges to environment. It's explicitily presumed the eventuality of discharging heat water recirculation. (C.M.) [pt

  7. Too many journals? Towards a theory of repeated rejections and ultimate acceptance

    NARCIS (Netherlands)

    Oosterhaven, Jan

    Under a set of reasonable assumptions, it is shown that all manuscripts submitted to any journal will ultimately be published, either by the first journal or by one of the following journals to which a manuscript is resubmitted. This suggests that low quality manuscripts may also be published, which

  8. A comparison of international criteria for the ultimate storage of radioactive wastes

    International Nuclear Information System (INIS)

    Mielke, H.

    1985-01-01

    In countries other than the Federal Republic of Germany and internationally there are no comprehensive codes referring to criteria and safety requirements except those of the IAEA and USA. In other countries there exist safety goals for the ultimate storage or for purely geological criteria. The degree of detailing regulations differs widely abroad and internationally. Safety goals abroad and internationally as well as measures for their realisation in the ultimate storage of radioactive wastes in deep geological formations are in line with the German safety goals. The IAEA refers to general aspects of geological, waste technology and ultimate storage technology criteria. In the USA, ultimate storage technology criteria have been quantified in part. The quantitative geological criteria existing in Great Britain and in the Netherlands are only relevant in as much as safety analyses must be performed for a specific site to provide evidence for the safety of this site. The comparison shows that most requirements pronounced abroad are also made for the Federal Republic of Germany. Some requirements are more specified in the Federal Republic of Germany, some are more detailed abroad. (orig./HP) [de

  9. Estimation of Ultimate Tensile Strength of dentin Using Finite Element Analysis from Endodontically Treated Tooth

    Science.gov (United States)

    Sinthaworn, S.; Puengpaiboon, U.; Warasetrattana, N.; Wanapaisarn, S.

    2018-01-01

    Endodontically treated teeth were simulated by finite element analysis in order to estimate ultimate tensile strength of dentin. Structures of the endodontically treated tooth cases are flared root canal, restored with different number of fiber posts {i.e. resin composite core without fiber post (group 1), fiber post No.3 with resin composite core (group 2) and fiber post No.3 accessory 2 fiber posts No.0 with resin composite core (group 3)}. Elastic modulus and Poisson’s ratio of materials were selected from literatures. The models were loaded by the average fracture resistances load of each groups (group 1: 361.80 N, group 2: 559.46 N, group 3: 468.48 N) at 135 degree angulation in respect to the longitudinal axis of the teeth. The stress analysis and experimental confirm that fracture zone is at dentin area. To estimate ultimate tensile strength of dentin, trial and error of ultimate tensile strength were tested to obtain factor of safety (FOS) equal to 1.00. The result reveals that ultimate tensile strength of dentin of group 1, 2, 3 are 38.89, 30.96, 37.19 MPa, respectively.

  10. Discussion of the Method to Determine the Ultimate Bearing Capacity of Soil Foundation

    Science.gov (United States)

    Du, Peng; Liu, Xiaoling; Zhang, Yangfu

    2017-12-01

    Combining literature examples, this paper has carried out Contrastive analysis of the theoretical formula method and finite element method about the ultimate bearing capacity of foundation, To verify rationality and superiority of the incremental load method in finite element ABAQUS in solving the bearing capacity of foundation soil. The study can provide certain reference for practical engineering calculation and analysis of foundation bearing capacity.

  11. 7 CFR 4280.15 - Ultimate Recipient Projects eligible for Rural Economic Development Loan funding.

    Science.gov (United States)

    2010-01-01

    ... Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF... when it has a pre-approved Ultimate Recipient and Project that have an immediate need for the Zero... may only be used to provide the following assistance: (a) Start-Up Venture costs, including, but not...

  12. Prediction of Local Ultimate Strain and Toughness of Trabecular Bone Tissue by Raman Material Composition Analysis

    Directory of Open Access Journals (Sweden)

    Roberto Carretta

    2015-01-01

    Full Text Available Clinical studies indicate that bone mineral density correlates with fracture risk at the population level but does not correlate with individual fracture risk well. Current research aims to better understand the failure mechanism of bone and to identify key determinants of bone quality, thus improving fracture risk prediction. To get a better understanding of bone strength, it is important to analyze tissue-level properties not influenced by macro- or microarchitectural factors. The aim of this pilot study was to identify whether and to what extent material properties are correlated with mechanical properties at the tissue level. The influence of macro- or microarchitectural factors was excluded by testing individual trabeculae. Previously reported data of mechanical parameters measured in single trabeculae under tension and bending and its compositional properties measured by Raman spectroscopy was evaluated. Linear and multivariate regressions show that bone matrix quality but not quantity was significantly and independently correlated with the tissue-level ultimate strain and postyield work (r=0.65–0.94. Principal component analysis extracted three independent components explaining 86% of the total variance, representing elastic, yield, and ultimate components according to the included mechanical parameters. Some matrix parameters were both included in the ultimate component, indicating that the variation in ultimate strain and postyield work could be largely explained by Raman-derived compositional parameters.

  13. Prediction of local ultimate strain and toughness of trabecular bone tissue by Raman material composition analysis.

    Science.gov (United States)

    Carretta, Roberto; Stüssi, Edgar; Müller, Ralph; Lorenzetti, Silvio

    2015-01-01

    Clinical studies indicate that bone mineral density correlates with fracture risk at the population level but does not correlate with individual fracture risk well. Current research aims to better understand the failure mechanism of bone and to identify key determinants of bone quality, thus improving fracture risk prediction. To get a better understanding of bone strength, it is important to analyze tissue-level properties not influenced by macro- or microarchitectural factors. The aim of this pilot study was to identify whether and to what extent material properties are correlated with mechanical properties at the tissue level. The influence of macro- or microarchitectural factors was excluded by testing individual trabeculae. Previously reported data of mechanical parameters measured in single trabeculae under tension and bending and its compositional properties measured by Raman spectroscopy was evaluated. Linear and multivariate regressions show that bone matrix quality but not quantity was significantly and independently correlated with the tissue-level ultimate strain and postyield work (r = 0.65-0.94). Principal component analysis extracted three independent components explaining 86% of the total variance, representing elastic, yield, and ultimate components according to the included mechanical parameters. Some matrix parameters were both included in the ultimate component, indicating that the variation in ultimate strain and postyield work could be largely explained by Raman-derived compositional parameters.

  14. Electrocardiographic spatial QRS-T angle and incident cardiovascular disease in HIV-infected patients (from the Strategies for the Management of Antiretroviral Therapy [SMART] study)

    DEFF Research Database (Denmark)

    Dawood, Farah Z; Khan, Faraaz; Roediger, Mollie P

    2013-01-01

    the baseline resting 12-lead electrocardiogram of 4,453 HIV-infected patients aged 43.5 ± 9.3 years from the Strategies for Management of Antiretroviral Therapy (SMART) trial. CVD events were identified during a median follow-up of 28.7 months. Quartiles of the spatial QRS-T angle was calculated for men...... risk of CVD events compared to a normal spatial QRS-T angle (hazard ratio 1.53, 95% confidence interval 1.07 to 2.17; p = 0.02). No interaction was seen by SMART trial arm (p value for interaction = 0.37) or gender (p value for interaction = 0.84). In conclusion, a widened spatial QRS-T angle...

  15. Development of incident data collection standards for Virginia Department of Transportation freeway operations.

    Science.gov (United States)

    2005-01-01

    The effective management of incidents is necessary in order to maintain efficient freeway operations. Within the Virginia Department of Transportation (VDOT), there are a number of units responsible for supporting incident management. These groups co...

  16. Customer focused incident monitoring in anaesthesia.

    Science.gov (United States)

    Khan, F A; Khimani, S

    2007-06-01

    The database of incident forms relating to anaesthesia services in an institutional risk management programme were reviewed for 2003-2005, the aim being to identify any recurring patterns. Incidents were prospectively categorised as relating to attitude/behaviour, communication breakdown, delay in service, or were related to care, cost, environment, equipment, security, administrative process, quality of service or miscellaneous. The total number of anaesthesia-related incidents reported during the period was 287, which related to 0.44% of the total number of anaesthetics administered during the time period. In all, 170 incidents were reported by the department, 96 by internal customers and 21 by external customers. Only 30% of the complaints came from the operating room. Thirty-four per cent of all incidents related to communication, behaviour and delay in service. A requirement to teach communication skills and stress handling formally in anaesthesia training programmes, and at the time of induction of staff into the department, has been identified.

  17. Influence of black-oats chemical management periods on the incidence of weeds and productive performance of maizeInfluência das épocas de manejo químico da aveia-preta sobre a incidência de plantas daninhas e desempenho produtivo do milho

    Directory of Open Access Journals (Sweden)

    Rodrigo Campagnolo

    2012-05-01

    Full Text Available Maize sowing in succession to the cultivation of black oat is a practice widely adopted in southern Brazil, especially in no-tillage system. The time management of oats in relation to the sowing of corn is a determining factor, because it depends on the residence time of oat straw on the ground and may even interfere with the productivity of successor culture. In this sense, the objective was to evaluate the influence of time of chemical management of black oat on yield components of maize. The experiment was conducted at the experimental unit PUCPR – Campus Toledo, in the 2008/2009 and 2009/2010 agricultural years. The experimental design was randomized blocks with five treatments (maize sowing at 0, 7, 14, 21 and 28 days after chemical management of black oat with four replications. For each treatment, black-oats was sown weekly, and later in the flowering stage managed chemically with 48 g L-1 a.i. of glyphosate at a dosage of 2.0 L ha-1 of the commercial product, using a spray volume of 150 L ha-1, the plants were left intact at the maize sowing period. The variables evaluated were black oat dry matter production, weed incidence, percentage of emerged plants, height of ear insertion, stem diameter, ear length and diameter, number of rows of kernels per ear, weight of 1000 and grain yield. The incidence of weeds decreased gradually decreasing the time between the management of black oat and maize sowing in both agriculture years. The time management of black oat did not affect most yield components of maize, especially productivity.A semeadura do milho em sucessão ao cultivo da aveia-preta é uma prática amplamente adotada no Sul do Brasil, especialmente em sistema de agricultura conservacionista. A época de manejo da aveia-preta em relação à semeadura do milho é um fator determinante, pois dela depende o tempo de permanência dos resíduos de aveia sobre o solo, podendo ainda interferir na produtividade da cultura sucessora. Neste

  18. Acute incidents during anaesthesia

    African Journals Online (AJOL)

    Incidents can occur during induction, maintenance and emergence from anaesthesia. The following acute critical incidents are discussed in this article: • Anaphylaxis. • Aspiration ..... Already used in South Africa and Malawi, a scale-up of the technique is under way in Tanzania, Rwanda and Ghana. The report found that.

  19. Radiological incidents in radiotherapy

    International Nuclear Information System (INIS)

    Hobzova, L.; Novotny, J.

    2008-01-01

    In many countries a reporting system of radiological incidents to national regulatory body exists and providers of radiotherapy treatment are obliged to report all major and/or in some countries all incidents occurring in institution. State Office for Nuclear Safety (SONS) is providing a systematic guidance for radiotherapy departments from 1997 by requiring inclusion of radiation safety problems into Quality assurance manual, which is the basic document for obtaining a license of SONS for handling with sources of ionizing radiation. For that purpose SONS also issued the recommendation 'Introduction of QA system for important sources in radiotherapy-radiological incidents' in which the radiological incidents are defined and the basic guidance for their classification (category A, B, C, D), investigation and reporting are given. At regular periods the SONS in co-operation with radiotherapy centers is making a survey of all radiological incidents occurring in institutions and it is presenting obtained information in synoptic communication (2003 Motolske dny, 2005 Novy Jicin). This presentation is another summary report of radiological incidents that occurred in our radiotherapy institutions during last 3 years. Emphasis is given not only to survey and statistics, but also to analysis of reasons of the radiological incidents and to their detection and prevention. Analyses of incidents in radiotherapy have led to a much broader understanding of incident causation. Information about the error should be shared as early as possible during or after investigation by all radiotherapy centers. Learning from incidents, errors and near misses should be a part of improvement of the QA system in institutions. Generally, it is recommended that all radiotherapy facilities should participate in the reporting, analyzing and learning system to facilitate the dissemination of knowledge throughout the whole country to prevent errors in radiotherapy.(authors)

  20. Social, institutional, and psychological factors affecting wildfire incident decision making

    Science.gov (United States)

    Matthew P. Thompson

    2014-01-01

    Managing wildland fire incidents can be fraught with complexity and uncertainty. Myriad human factors can exert significant influence on incident decision making, and can contribute additional uncertainty regarding programmatic evaluations of wildfire management and attainment of policy goals. This article develops a framework within which human sources of uncertainty...

  1. Theoretical considerations on the ultimate depth that could be reached by saturation human divers

    Directory of Open Access Journals (Sweden)

    Jacques H Abraini

    2016-01-01

    Full Text Available The occurrence of paroxysmal narcotic episodes including psychotic-like symptoms in divers participating to experimental deep diving programs with various gas mixtures has constituted, beyond the classical symptoms of the high-pressure neurological syndrome, the major limitation for deep diving. With the development of new saturation deep diving programs and experiments by the eastern nations, such as India and China, we believed that it is of interest to examine what could be the ultimate depth that could be reached by saturation human divers. Based on previous data and the critical volume model of inert gas narcosis, we propose that the ultimate depth for saturation diving could be around 1,000 m.

  2. Andy Warhol : l’œuvre ultime (1972‑1987

    Directory of Open Access Journals (Sweden)

    Jakuta Alikavazovic

    2006-03-01

    Full Text Available Andy Warhol : l’oeuvre ultime se présente d’emblée comme un projet d’envergure. Y sont exposées plus de deux cents œuvres ; outre des toiles magistrales, on y découvre de nombreuses photos et planches de contact inédites, documents vidéo, interviews et films. Il s’agit bien d’une exposition majeure, couvrant la production des quinze dernières années de l’artiste, sans négliger ses facettes moins connues, du designer au « social observer » new yorkais. L’œuvre ultime ressemble presque à un pro...

  3. Ultimate uniaxial compressive strength of stiffened panel with opening under lateral pressure

    Directory of Open Access Journals (Sweden)

    Chang-Li Yu

    2015-03-01

    Full Text Available This paper concentrated on the ultimate uniaxial compressive strength of stiffened panel with opening under lateral load and also studied the design-oriented formulae. For this purpose, three series of well executed experiments on longitudinal stiffened panel with rectangular opening subjected to the combined load have been selected as test models. The finite element analysis package, ABAQUS, is used for simulation with considering the large elasticplastic deflection behavior of stiffened panels. The feasibility of the numerical procedure is verified by a good agreement of experimental results and numerical results. More cases studies are executed employing nonlinear finite element method to analyze the influence of design variables on the ultimate strength of stiffened panel with opening under combined pressure. Based on data, two design formulae corresponding to different opening types are fitted, and accuracy of them is illustrated to demonstrate that they could be applied to basic design of practical engineering structure.

  4. Ultimate analysis of PWR prestressed concrete containment subjected to internal pressure

    International Nuclear Information System (INIS)

    Hu, H.-T.; Lin, Y.-H.

    2006-01-01

    Numerical analyses are carried out by using the ABAQUS finite element program to predict the ultimate pressure capacity and the failure mode of the PWR prestressed concrete containment at Maanshan nuclear power plant. Material nonlinearity such as concrete cracking, tension stiffening, shear retention, concrete plasticity, yielding of prestressing tendon, yielding of steel reinforcing bar and degradation of material properties due to high temperature are all simulated with proper constitutive models. Geometric nonlinearity due to finite deformation has also been considered. The results of the analysis show that when the prestressed concrete containment fails, extensive cracks take place at the apex of the dome, the junction of the dome and cylinder, and the bottom of the cylinder connecting to the base slab. In addition, the ultimate pressure capacity of the containment is higher than the design pressure by 86%

  5. Diferences of concepts of ultimate limit states of soils and rocks

    Czech Academy of Sciences Publication Activity Database

    Koudelka, Petr

    2008-01-01

    Roč. 51, č. 1 (2008), s. 322-326 ISSN 0474-8484 R&D Projects: GA AV ČR(CZ) IAA2071302 Grant - others:GA ČR(CZ) GA103/05/2130 Program:GA Institutional research plan: CEZ:AV0Z20710524 Keywords : ultimate limit states * characteristic values * statistical definition Subject RIV: DB - Geology ; Mineralogy

  6. Remembering the ultimate goal of environmental protection: including protection of impoverished citizens in China's environmental policy.

    Science.gov (United States)

    Cao, Shixiong; Chen, Li; Zhu, Qingke

    2010-01-01

    The life of impoverished people can be damaged by adverse environmental conditions, but these people can also be harmed by environmental conservation programs, particularly when the guiding policy ignores their needs. To improve the social and economic effectiveness of environmental protection, governments must understand that the ultimate goal of environmental protection is to improve human livelihoods, not just restore vegetation. The elimination of poverty by the development of sustainable, long-term enterprises is a precondition for successful ecological restoration.

  7. Qualtum cosmics-and-chaotics--the ultimate tortoise in physics and modern medicine.

    Directory of Open Access Journals (Sweden)

    Kothari M

    1997-10-01

    Full Text Available Qualtum cosmics is the qualitative opposite of quantum mechanics. The flip-side of qualtum cosmics is qualtum chaotics, the two governing much of what is seen as inscrutable in medicine. The Ultimate (Last Tortoise is close to Einsteinean idea of a Unified Theory, a single concept that can explain whatsoever there is in physics, (and in medicine, or what have you.

  8. Experimental and finite element study of ultimate strength of continuous composite concrete slabs with steel decking

    Science.gov (United States)

    Gholamhoseini, Alireza

    2018-02-01

    Composite one-way concrete slabs with profiled steel decking as permanent formwork are commonly used in the construction industry. The steel decking supports the wet concrete of a cast in situ reinforced or post-tensioned concrete slab and, after the concrete sets, acts as external reinforcement. In this type of slab, longitudinal shear failure between the concrete and the steel decking is the most common type of failure at the ultimate load stage. Design codes require the experimental evaluation of the ultimate load capacity and longitudinal shear strength of each type of steel decking using full-scale tests on simple-span slabs. There is also no procedure in current design codes to evaluate the ultimate load capacity and longitudinal shear strength of continuous composite slabs and this is often assessed experimentally by full-scale tests. This paper presents the results of three full-scale tests up to failure on continuous composite concrete slabs cast with trapezoidal steel decking profile (KF70) that is widely used in Australia. Slab specimens were tested in four-point bending at each span with shear spans of span/4. The longitudinal shear failure of each slab is evaluated and the measured mid-span deflection, the end slip and the mid-span steel and concrete strains are also presented and discussed. Redistribution of bending moment in each slab is presented and discussed. A finite element model is proposed and verified by experimental data using interface element to model the bond properties between steel decking and concrete slab and investigate the ultimate strength of continuous composite concrete slabs.

  9. Results from large scale ultimate strength tests of K-braced jacket frame structures

    Energy Technology Data Exchange (ETDEWEB)

    Bolt, H.M.

    1995-12-01

    Phase 2 of the JIP Frames Project included four large scale collapse tests of K-braced frames in which both gap and overlap K joints were the critical components. The results are presented in this paper. The local failure modes differed from typical isolated component tests, yet were representative of structural damage observed following Hurricane Andrew. The frame test results therefore provide important insight to the ultimate response of offshore jacket structures.

  10. Experimental and finite element study of ultimate strength of continuous composite concrete slabs with steel decking

    Science.gov (United States)

    Gholamhoseini, Alireza

    2018-03-01

    Composite one-way concrete slabs with profiled steel decking as permanent formwork are commonly used in the construction industry. The steel decking supports the wet concrete of a cast in situ reinforced or post-tensioned concrete slab and, after the concrete sets, acts as external reinforcement. In this type of slab, longitudinal shear failure between the concrete and the steel decking is the most common type of failure at the ultimate load stage. Design codes require the experimental evaluation of the ultimate load capacity and longitudinal shear strength of each type of steel decking using full-scale tests on simple-span slabs. There is also no procedure in current design codes to evaluate the ultimate load capacity and longitudinal shear strength of continuous composite slabs and this is often assessed experimentally by full-scale tests. This paper presents the results of three full-scale tests up to failure on continuous composite concrete slabs cast with trapezoidal steel decking profile (KF70) that is widely used in Australia. Slab specimens were tested in four-point bending at each span with shear spans of span/4. The longitudinal shear failure of each slab is evaluated and the measured mid-span deflection, the end slip and the mid-span steel and concrete strains are also presented and discussed. Redistribution of bending moment in each slab is presented and discussed. A finite element model is proposed and verified by experimental data using interface element to model the bond properties between steel decking and concrete slab and investigate the ultimate strength of continuous composite concrete slabs.

  11. Dual characteristics of yield and ultimate strength as applied to two grades of beryllium

    International Nuclear Information System (INIS)

    Priddy, T.G.; Benzley, S.E.; Johnson, R.L.

    1977-02-01

    Published yield and ultimate biaxial strength data for two grades of beryllium are correlated with the use of a macroscopic failure model. Cross sections of the resulting surfaces in three-dimensional stress space are drawn to illustrate the expected transition from ductile to brittle fracture for triaxial tension states of stress. The usefulness of these models to the prediction of fracture in ductile materials is discussed. 5 tables, 8 figures, 11 references

  12. Proximate, intermediate and ultimate causality: Theories and experiences of growth and development

    OpenAIRE

    Szirmai, Adam

    2012-01-01

    For a better understanding of development, we are interested in why in the long run some countries or societies forge ahead, while others stagnate or fall behind. We are especially interested in the conditions under which growth and catch- up can be realised in developing countries. In section 1 of this paper, we develop a framework of proximate, intermediate and ultimate sources of growth and development which serves to structure the analysis and measurement of economic development. Sections...

  13. Ultimate costs of sporophyte production in the clonal moss Hylocomium splendens

    OpenAIRE

    Rydgren, Knut; Økland, Rune H.

    2002-01-01

    A richly sporophyte-producing population of the dioecious perennial clonal moss Hylocomium splendens was followed for five years in order to investigate the longterm costs of sporophyte production. Female mature segments were divided into two subpopulations: sporophyte producing and reference without sporophytes. Ultimate (long-term) population growth rates of l 5 1.091 and 1.258, respectively, were found for the two subpopulations by building separate deterministic transition ...

  14. Prediction of Ultimate Strain and Strength of FRP-Confined Concrete Cylinders Using Soft Computing Methods

    Directory of Open Access Journals (Sweden)

    Iman Mansouri

    2017-07-01

    Full Text Available This paper investigates the effectiveness of four different soft computing methods, namely radial basis neural network (RBNN, adaptive neuro fuzzy inference system (ANFIS with subtractive clustering (ANFIS-SC, ANFIS with fuzzy c-means clustering (ANFIS-FCM and M5 model tree (M5Tree, for predicting the ultimate strength and strain of concrete cylinders confined with fiber-reinforced polymer (FRP sheets. The models were compared according to the root mean square error (RMSE, mean absolute relative error (MARE and determination coefficient (R2 criteria. Similar accuracy was obtained by RBNN and ANFIS-FCM, and they provided better estimates in modeling ultimate strength of confined concrete. The ANFIS-SC, however, performed slightly better than the RBNN and ANFIS-FCM in estimating ultimate strain of confined concrete, and M5Tree provided the worst strength and strain estimates. Finally, the effects of strain ratio and the confinement stiffness ratio on strength and strain were investigated, and the confinement stiffness ratio was shown to be more effective.

  15. Numerical Study on Ultimate Behaviour of Bolted End-Plate Steel Connections

    Directory of Open Access Journals (Sweden)

    R.E.S. Ismail

    Full Text Available Abstract Bolted end-plate steel connections have become more popular due to ease of fabrication. This paper presents a three dimension Finite Element Model (FEM, using the multi-purpose software ABAQUS, to study the effect of different geometrical parameters on the ultimate behavior of the connection. The proposed model takes into account material and geometrical non-linearities, initial imperfection, contact between adjacent surfaces and the pretension force in the bolts. The Finite Element results are calibrated with published experimental results ''briefly reviewed in this paper'' and verified that the numerical model can simulate and analyze the overall and detailed behavior of different types of bolted end-plate steel connections. Using verified FEM, parametric study is then carried out to study the ultimate behavior with variations in: bolt diameter, end-plate thickness, length of column stiffener, angle of rib stiffener. The results are examined with respect to the failure modes, the evolution of the resistance, the initial stiffness, and the rotation capacity. Finally, the ultimate behavior of the bolted end-plate steel connection is discussed in detail, and recommendations for the design purpose are made.

  16. Ultimate load design and testing of a cylindrical prestressed concrete vessel

    International Nuclear Information System (INIS)

    Stefanou, G.D.

    1982-01-01

    The object of this research was to design, construct and test to failure a prestressed concrete pressure vessel model that could be used to investigate the behavior of a full scale structure underworking and ultimate load. The properties and the design of the model was based generally on full scale vessels already constructed to house the nuclear reactors used in atomic power stations. To design the model the ultimate load approach was adopted throughout. All load factors associated with the prestressing have been defined and kept to a minimum in order that the vessel's behavior may be predicted. The tests on the vessel were carried out first on the elastic range to observe its behavior at working load and then at the ultimate range to observe the modes of failure and compare the actual results in both cases with the predicted values. Although full agreement between observed results and predicted values was not obtained, the conclusions drawn from the study were useful for the design of full scale vessels. (author)

  17. Marine Animal Incident Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Large whale stranding, death, ship strike and entanglement incidents are all recorded to monitor the health of each population and track anthropogenic factors that...

  18. Police Incident Blotter (Archive)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The Police Blotter Archive contains crime incident data after it has been validated and processed to meet Uniform Crime Reporting (UCR) standards, published on a...

  19. Prediction of Safety Incidents

    Data.gov (United States)

    National Aeronautics and Space Administration — Safety incidents, including injuries, property damage and mission failures, cost NASA and contractors thousands of dollars in direct and indirect costs. This project...

  20. 2011 Japanese Nuclear Incident

    Science.gov (United States)

    EPA’s RadNet system monitored the environmental radiation levels in the United States and parts of the Pacific following the Japanese Nuclear Incident. Learn about EPA’s response and view historical laboratory data and news releases.

  1. Incident Duration Modeling Using Flexible Parametric Hazard-Based Models

    Directory of Open Access Journals (Sweden)

    Ruimin Li

    2014-01-01

    Full Text Available Assessing and prioritizing the duration time and effects of traffic incidents on major roads present significant challenges for road network managers. This study examines the effect of numerous factors associated with various types of incidents on their duration and proposes an incident duration prediction model. Several parametric accelerated failure time hazard-based models were examined, including Weibull, log-logistic, log-normal, and generalized gamma, as well as all models with gamma heterogeneity and flexible parametric hazard-based models with freedom ranging from one to ten, by analyzing a traffic incident dataset obtained from the Incident Reporting and Dispatching System in Beijing in 2008. Results show that different factors significantly affect different incident time phases, whose best distributions were diverse. Given the best hazard-based models of each incident time phase, the prediction result can be reasonable for most incidents. The results of this study can aid traffic incident management agencies not only in implementing strategies that would reduce incident duration, and thus reduce congestion, secondary incidents, and the associated human and economic losses, but also in effectively predicting incident duration time.

  2. 15 CFR Supplement No. 3 to Part 748 - BIS-711, Statement by Ultimate Consignee and Purchaser Instructions

    Science.gov (United States)

    2010-01-01

    ...” include: contractual, franchise, distributor, wholesaler, continuing and regular individual business, etc... the required information. Block 3: Nature of Business of Ultimate Consignee named in Block 1. Complete...

  3. Modelling and Simulation for Major Incidents

    Directory of Open Access Journals (Sweden)

    Eleonora Pacciani

    2015-11-01

    Full Text Available In recent years, there has been a rise in Major Incidents with big impact on the citizens health and the society. Without the possibility of conducting live experiments when it comes to physical and/or toxic trauma, only an accurate in silico reconstruction allows us to identify organizational solutions with the best possible chance of success, in correlation with the limitations on available resources (e.g. medical team, first responders, treatments, transports, and hospitals availability and with the variability of the characteristic of event (e.g. type of incident, severity of the event and type of lesions. Utilizing modelling and simulation techniques, a simplified mathematical model of physiological evolution for patients involved in physical and toxic trauma incident scenarios has been developed and implemented. The model formalizes the dynamics, operating standards and practices of medical response and the main emergency service in the chain of emergency management during a Major Incident.

  4. HHV Predicting Correlations for Torrefied Biomass Using Proximate and Ultimate Analyses

    Directory of Open Access Journals (Sweden)

    Daya Ram Nhuchhen

    2017-01-01

    Full Text Available Many correlations are available in the literature to predict the higher heating value (HHV of raw biomass using the proximate and ultimate analyses. Studies on biomass torrefaction are growing tremendously, which suggest that the fuel characteristics, such as HHV, proximate analysis and ultimate analysis, have changed significantly after torrefaction. Such changes may cause high estimation errors if the existing HHV correlations were to be used in predicting the HHV of torrefied biomass. No study has been carried out so far to verify this. Therefore, this study seeks answers to the question: “Can the existing correlations be used to determine the HHV of the torrefied biomass”? To answer this, the existing HHV predicting correlations were tested using torrefied biomass data points. Estimation errors were found to be significantly high for the existing HHV correlations, and thus, they are not suitable for predicting the HHV of the torrefied biomass. New correlations were then developed using data points of torrefied biomass. The ranges of reported data for HHV, volatile matter (VM, fixed carbon (FC, ash (ASH, carbon (C, hydrogen (H and oxygen (O contents were 14.90 MJ/kg–33.30 MJ/kg, 13.30%–88.57%, 11.25%–82.74%, 0.08%–47.62%, 35.08%–86.28%, 0.53%–7.46% and 4.31%–44.70%, respectively. Correlations with the minimum mean absolute errors and having all components of proximate and ultimate analyses were selected for future use. The selected new correlations have a good accuracy of prediction when they are validated using another set of data (26 samples. Thus, these new and more accurate correlations can be useful in modeling different thermochemical processes, including combustion, pyrolysis and gasification processes of torrefied biomass.

  5. A Simplified Method for predicting Ultimate Compressive Strength of Ship Panels

    DEFF Research Database (Denmark)

    Paik, Jeom Kee; Pedersen, Preben Terndrup

    1996-01-01

    A simplified method for predicting ultimate compressive strength of ship panels which have complex shape of the initial deflection is described. The procedure consist of the elastic large deflection theory and the rigid-plastic analysis based on the collapse mechanism taking into account large...... deformation effects. By taking only one component for the selected deflection function, the computer time for the elastic large deflection analysis will be drastically reduced. The validity of the procedure is checked by comparing the present solutions with the finite-element results for actual ship panels...

  6. Investigations on the ultimate compressive strength of composite plates with geometrical imperfections

    DEFF Research Database (Denmark)

    Misirlis, K.; Downes, J.; Dow, R.S.

    2009-01-01

    with initial geometric imperfections. This paper presents the validation of finite element models against a series of plate tests that were performed within this framework and parametric studies that were carried out to identify the effects of geometric imperfections on the ultimate compressive strength......A series of studies has been performed within the MARSTRUCT Network of Excellence on Marine Structures in order to investigate the buckling response of glass fibre reinforced polymer plates. These studies include the fabrication, testing and finite element analysis of a large number of plates...

  7. Ultimate Failure of Debond Damaged Sandwich Panels Loaded with Lateral Pressure

    DEFF Research Database (Denmark)

    Jolma, Perttu; Segercrantz, Sebastian; Berggreen, Christian

    2007-01-01

    variation of all geometric and material entities. The fracture mechanics calculation uses crack flank displacements obtained from the finite element analysis solution and experimentally measured mixed-mode fracture toughness values to determine the ultimate failure load. The analysis tool is validated...... with a number of different ship type panels. Debond criticality is evaluated by using the developed tool and by comparing the test results from panel experiments. The comparison shows that the analysis tool predicts both failure load and failure mode well. The tool can be used to determine the residual strength...

  8. DHC in Helsinki - The Ultimate Heating and Cooling Solution for a Large Urban Area

    Energy Technology Data Exchange (ETDEWEB)

    Wirgentius, Niko; Riipinen, Marko

    2010-09-15

    Since the 1950s there has been successful district energy business in Helsinki. It has been the main factor for superior energy efficiency and low CO2 emissions both in heating and cooling as well as providing clean air for the metropolitan area. The system has been grown by commercial basis based on customers' own willingness to select district energy solution. It also provided a profitable energy business to local energy company, Helsinki Energy. Helsinki DHC system is a good example of ultimate urban energy solution that provides benefits for the customer, energy company, metropolitan area and for the whole society as well.

  9. Disaster Incidence and Management in Nigeria | Olorunfemi ...

    African Journals Online (AJOL)

    Le faible niveau de préparation contre les catastrophes qui arrivent d'une manière spontanée, juxtaposé aux urgences environnementales dû au changement climatique et à l'urbanisation est dangereux pour le pays. Cette réalité s'explique par le fait que ces désastres peuvent constituer des obstacles au développement.

  10. Incident Management Systems Evaluation and Usability Assessment

    Science.gov (United States)

    2011-06-01

    unpleasant and potentially unsuccessful experience. SOFTWARE USABILITY Definition Usability consultant Jakob Nielson [4] suggests that the usability...Bevan, N., User Requirements Analysis, Proceedings of IFIP 17th World Computer Congress, Montreal, Canada, August 2002. 4. Nielsen , J., Usability 101

  11. Incidence and Disability-Adjusted Life Years

    African Journals Online (AJOL)

    GB

    ABSTRACT. BACKGROUND: Leishmaniasis covers a range of clinical manifestations. Estimation of the burden of leishmaniasis may help guide healthcare management personnel and policy-makers in applying effective interventions. The present study aimed to calculate the incidence and burden of cutaneous and visceral.

  12. reputation Risks through Information Security Incidents

    Directory of Open Access Journals (Sweden)

    Vitaly Eduardovich Dorokhov

    2014-05-01

    Full Text Available The article deals with accounting reputational risks arising through information security breaches in the management of a business entity. Security breach incidents which results to the loss of reputation are identified. Based on this analysis the definition of reputational risk in information security is given.

  13. Radiation incidents in dentistry

    International Nuclear Information System (INIS)

    Lovelock, D.J.

    1996-01-01

    Most dental practitioners act as their own radiographer and radiologist, unlike their medical colleagues. Virtually all dental surgeons have a dental X-ray machine for intraoral radiography available to them and 40% of dental practices have equipment for dental panoramic tomography. Because of the low energy of X-ray equipment used in dentistry, radiation incidents tend to be less serious than those associated with other aspects of patient care. Details of 47 known incidents are given. The advent of the 1985 and 1988 Ionising Radiation Regulations has made dental surgeons more aware of the hazards of radiation. These regulations, and general health and safety legislation, have led to a few dental surgeons facing legal action. Because of the publicity associated with these court cases, it is expected that there will be a decrease in radiation incidents arising from the practice of dentistry. (author)

  14. The theoretical ultimate magnetoelectric coefficients of magnetoelectric composites by optimization design

    Science.gov (United States)

    Wang, H.-L.; Liu, B.

    2014-03-01

    This paper investigates what is the largest magnetoelectric (ME) coefficient of ME composites, and how to realize it. From the standpoint of energy conservation, a theoretical analysis is carried out on an imaginary lever structure consisting of a magnetostrictive phase, a piezoelectric phase, and a rigid lever. This structure is a generalization of various composite layouts for optimization on ME effect. The predicted theoretical ultimate ME coefficient plays a similar role as the efficiency of ideal heat engine in thermodynamics, and is used to evaluate the existing typical ME layouts, such as the parallel sandwiched layout and the serial layout. These two typical layouts exhibit ME coefficient much lower than the theoretical largest values, because in the general analysis the stress amplification ratio and the volume ratio can be optimized independently and freely, but in typical layouts they are dependent or fixed. To overcome this shortcoming and achieve the theoretical largest ME coefficient, a new design is presented. In addition, it is found that the most commonly used electric field ME coefficient can be designed to be infinitely large. We doubt the validity of this coefficient as a reasonable ME effect index and consider three more ME coefficients, namely the electric charge ME coefficient, the voltage ME coefficient, and the static electric energy ME coefficient. We note that the theoretical ultimate value of the static electric energy ME coefficient is finite and might be a more proper measure of ME effect.

  15. The theoretical ultimate magnetoelectric coefficients of magnetoelectric composites by optimization design

    International Nuclear Information System (INIS)

    Wang, H.-L.; Liu, B.

    2014-01-01

    This paper investigates what is the largest magnetoelectric (ME) coefficient of ME composites, and how to realize it. From the standpoint of energy conservation, a theoretical analysis is carried out on an imaginary lever structure consisting of a magnetostrictive phase, a piezoelectric phase, and a rigid lever. This structure is a generalization of various composite layouts for optimization on ME effect. The predicted theoretical ultimate ME coefficient plays a similar role as the efficiency of ideal heat engine in thermodynamics, and is used to evaluate the existing typical ME layouts, such as the parallel sandwiched layout and the serial layout. These two typical layouts exhibit ME coefficient much lower than the theoretical largest values, because in the general analysis the stress amplification ratio and the volume ratio can be optimized independently and freely, but in typical layouts they are dependent or fixed. To overcome this shortcoming and achieve the theoretical largest ME coefficient, a new design is presented. In addition, it is found that the most commonly used electric field ME coefficient can be designed to be infinitely large. We doubt the validity of this coefficient as a reasonable ME effect index and consider three more ME coefficients, namely the electric charge ME coefficient, the voltage ME coefficient, and the static electric energy ME coefficient. We note that the theoretical ultimate value of the static electric energy ME coefficient is finite and might be a more proper measure of ME effect

  16. A New Algorithm for Determining Ultimate Pit Limits Based on Network Optimization

    Directory of Open Access Journals (Sweden)

    Ali Asghar Khodayari

    2013-12-01

    Full Text Available One of the main concerns of the mining industry is to determine ultimate pit limits. Final pit is a collection of blocks, which can be removed with maximum profit while following restrictions on the slope of the mine’s walls. The size, location and final shape of an open-pit are very important in designing the location of waste dumps, stockpiles, processing plants, access roads and other surface facilities as well as in developing a production program. There are numerous methods for designing ultimate pit limits. Some of these methods, such as floating cone algorithm, are heuristic and do not guarantee to generate optimum pit limits. Other methods, like Lerchs–Grossmann algorithm, are rigorous and always generate the true optimum pit limits. In this paper, a new rigorous algorithm is introduced. The main logic in this method is that only positive blocks, which can pay costs of their overlying non-positive blocks, are able to appear in the final pit. Those costs may be paid either by positive block itself or jointly with other positive blocks, which have the same overlying negative blocks. This logic is formulated using a network model as a Linear Programming (LP problem. This algorithm can be applied to two- and three-dimension block models. Since there are many commercial programs available for solving LP problems, pit limits in large block models can be determined easily by using this method.

  17. Evaluation of micro structure by fusion of three dimensional shape measurement and ultimate analysis using SEM

    Directory of Open Access Journals (Sweden)

    Arai Yasuhiko

    2015-01-01

    Full Text Available The 3-D measurement method by SEM has already been proposed by using the principle of projection moiré. In this method, by the mechanism of producing some shadows of grid on the surface of the object by back scattering electron beam, a micro-size object can be measured in high resolution. However, in the case of measurement of industrial elements, not only 3-D shape measurement, but also the physical properties of material is sometimes required to check strongly for practical uses. For example, the precise patterning lines and the existence of some kinds of atoms in IC circuits are parameters concerning important feature of the circuits. The distribution of atoms in fractured sections is also an important feature in destructive inspection. In this paper, the realization of such inspection technology by combining the ultimate analysis and 3-D measurement method by SEM is discussed. The new measurement technology by fusion of 3-D shape measurement and ultimate analysis is proposed. In experimental results, the 3-D shape measurement of the micro object made of alloy material is measured. From measured results, the validity of the new method is discussed.

  18. Plasticity and constraints on social evolution in African mole-rats: ultimate and proximate factors.

    Science.gov (United States)

    Faulkes, Chris G; Bennett, Nigel C

    2013-05-19

    Here, we review comparative studies of African mole-rats (family Bathyergidae) to explain how constraints acting at the ultimate (environmental) and proximate (organismal) levels have led to convergent gains and losses of sociality within this extensive adaptive radiation of subterranean rodents endemic to sub-Saharan Africa. At the ultimate level, living in environments that range from mesic through to arid has led to both variation and flexibility in social organization among species, culminating in the pinnacle of social evolution in the eusocial naked and Damaraland mole-rats (Heterocephalus glaber and Fukomys damarensis). The common mole-rat (Cryptomys hottentotus) provides a model example of how plasticity in social traits exists within a single species inhabiting areas with different ecological constraint. At the proximate level, reproductive strategies and cooperative breeding may be constrained by the correlated evolution of a suite of traits including physiological suppression of reproduction, the development of physiological and morphological castes, and the mode of ovulatory control and seasonality in breeding. Furthermore, recent neurobiological advances indicate that differential patterns of neurotransmitter expression within the forebrain may underpin (and limit) either a solitary or group living/cooperative lifestyle not only in mole-rats, but also more widely among disparate mammalian taxa.

  19. Ultimate strength capacity of a square hollow section filled with fibrous foamed concrete

    Science.gov (United States)

    Amirah Azra Khairuddin, Siti; Rahman, Norashidah Abd; Jamaluddin, Norwati; Jaini, Zainorizuan Mohd; Ali, Noorwirdawati

    2017-11-01

    Concrete-filled sections used as building columns have become popular due to their architectural and structural elements. In recent years, there has been a renewed call for the improvement of materials used as concrete to fill the composite columns. Among these materials, foamed concrete has received great attention due to its structural characteristics and its potential as a construction material used in hollow sections. However, its behaviors as infill material in a hollow section, such as its strength and failure mode, should be investigated. In this study, experimental research was conducted to compare the experimental and theoretical values of its ultimate strength capacity. Eight specimens of hollow steel sections with two different thicknesses were filled with fibrous foamed concrete and then subjected to compression load. The obtained results were compared with those obtained from a hollow section with the same thicknesses, but were filled with normal foamed concrete. Results show that the ultimate strength capacity of the experimental value is the same as that of the theoretical value based on Eurocode 4. The largest percentage values between theoretical and experimental results for thicknesses of 2 and 4 mm are 58% and 55%, respectively.

  20. Ultimate strength performance of tankers associated with industry corrosion addition practices

    Directory of Open Access Journals (Sweden)

    Do Kyun Kim

    2014-09-01

    Full Text Available In the ship and offshore structure design, age-related problems such as corrosion damage, local denting, and fatigue damage are important factors to be considered in building a reliable structure as they have a significant influence on the residual structural capacity. In shipping, corrosion addition methods are widely adopted in structural design to prevent structural capacity degradation. The present study focuses on the historical trend of corrosion addition rules for ship structural design and investigates their effects on the ultimate strength performance such as hull girder and stiffened panel of double hull oil tankers. Three types of rules based on corrosion addition models, namely historic corrosion rules (pre-CSR, Common Structural Rules (CSR, and harmonised Common Structural Rules (CSRH are considered and compared with two other corrosion models namely UGS model, suggested by the Union of Greek Shipowners (UGS, and Time-Dependent Corrosion Wastage Model (TDCWM. To identify the general trend in the effects of corrosion damage on the ultimate longitudinal strength performance, the corrosion addition rules are applied to four representative sizes of double hull oil tankers namely Panamax, Aframax, Suezmax, and VLCC. The results are helpful in understanding the trend of corrosion additions for tanker structures.

  1. Ultimate strength performance of tankers associated with industry corrosion addition practices

    Directory of Open Access Journals (Sweden)

    Kim Do Kyun

    2014-09-01

    Full Text Available In the ship and offshore structure design, age-related problems such as corrosion damage, local denting, and fatigue damage are important factors to be considered in building a reliable structure as they have a significant influence on the residual structural capacity. In shipping, corrosion addition methods are widely adopted in structural design to prevent structural capacity degradation. The present study focuses on the historical trend of corrosion addition rules for ship structural design and investigates their effects on the ultimate strength performance such as hull girder and stiffened panel of double hull oil tankers. Three types of rules based on corrosion addition models, namely historic corrosion rules (pre-CSR, Common Structural Rules (CSR, and harmonised Common Structural Rules (CSRH are considered and compared with two other corrosion models namely UGS model, suggested by the Union of Greek Shipowners (UGS, and Time-Dependent Corrosion Wastage Model (TDCWM. To identify the general trend in the effects of corrosion damage on the ultimate longitudinal strength performance, the corrosion addition rules are applied to four representative sizes of double hull oil tankers namely Panamax, Aframax, Suezmax, and VLCC. The results are helpful in understanding the trend of corrosion additions for tanker structures

  2. A cryogenic clamping technique that facilitates ultimate tensile strength determinations in tendons and ligaments.

    Science.gov (United States)

    Bowser, J E; Elder, S H; Rashmir-Raven, A M; Swiderski, C E

    2011-01-01

    To describe the use of a cryogenic clamp of novel design for tensile strength testing of tendinous and ligamentous tissues with inherently high tensile strength. Inexpensive, easily machined steel clamps were manufactured to facilitate rapid insertion into a standard wedge-screw grip apparatus installed on a testing system with a control system attached. The deep digital flexor tendon (DDFT) of six horses was trimmed to a uniform dumbbell shape and secured in clamps using partial submersion in liquid nitrogen for approximately 45 seconds and immediately tested. Approximate time between removal from liquid nitrogen and failure of tendon was four minutes. Failure was achieved in all tendons tested in a region approximating a midpoint between the clamps. Ultimate failure loads of up to 6745 N were achieved without slippage of the tissue from the grips. The ultimate tensile strength of the normal equine DDFT determined in this study was 111.82 ± 11.53 N/mm2, and the stress versus grip-to-grip elongation plots for our equine DDFT were representative of a standard non-linear elastic curve obtained in similar studies. We present a low cost device for quantifying physical properties of specimens with high connective tissue concentrations and inherent high tensile strength. Results of this study indicate that this device provides a practical alternative to other more costly methods of adequately securing larger tendons and ligaments for tensile strength testing.

  3. Secondary Moments due to Prestressing with Different Bond at the Ultimate Limit State

    Directory of Open Access Journals (Sweden)

    Halvoník Jaroslav

    2018-03-01

    Full Text Available Secondary effects of prestressing develop in statically indeterminate structures (e.g., continuous beams due to the restraint of deformations imposed by hyperstatic restraints. These effects may significantly influence internal forces and stresses in prestressed structures. Secondary effects are influenced by the redundancy of a structural system, which raises the question of whether they will remain constant after a change in the structural system, e.g., due to the development of plastic hinge(s in a critical cross-section(s or after the development of a kinematic mechanism, or if they will disappear when the structure changes into a sequence of simply supported beams. The paper deals with an investigation of the behavior of continuous post-tensioned beams subjected to an ultimate load with significant secondary effects from prestressing. A total of 6 two-span beams prestressed by tendons with different bonds were tested in a laboratory with a load that changed their structural system into a kinematic mechanism. The internal forces and secondary effects of the prestressing were controlled through measurements of the reactions in all the supports. The results revealed that the secondary effects remained as a permanent part of the action on the experimental beams, even after the development of the kinematic mechanism. The results obtained confirmed that secondary effects should be included in all combinations of actions for verifications of ultimate limit states (ULS.

  4. The n-of-1 clinical trial: the ultimate strategy for individualizing medicine?

    Science.gov (United States)

    Lillie, Elizabeth O; Patay, Bradley; Diamant, Joel; Issell, Brian; Topol, Eric J; Schork, Nicholas J

    2011-03-01

    N-of-1 or single subject clinical trials consider an individual patient as the sole unit of observation in a study investigating the efficacy or side-effect profiles of different interventions. The ultimate goal of an n-of-1 trial is to determine the optimal or best intervention for an individual patient using objective data-driven criteria. Such trials can leverage study design and statistical techniques associated with standard population-based clinical trials, including randomization, washout and crossover periods, as well as placebo controls. Despite their obvious appeal and wide use in educational settings, n-of-1 trials have been used sparingly in medical and general clinical settings. We briefly review the history, motivation and design of n-of-1 trials and emphasize the great utility of modern wireless medical monitoring devices in their execution. We ultimately argue that n-of-1 trials demand serious attention among the health research and clinical care communities given the contemporary focus on individualized medicine.

  5. Evaluation of the Safety Issue Concerning the Potential for Loss of Decay Heat Removal Function due to Crude Oil Spill in the Ultimate Heat Sink of Nuclear Reactors

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Jong Chull; Roh, Kyung Wan; Yune, Young Gill; Kang, Dong Gu; Kim, Hho Jhung [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2008-05-15

    A barge crashed into a moored oil tanker at about 7:15 a.m., Dec. 12, 2007, dumping around 10,500 tons of crude oil into the sea in Korea. The incident took place about 15 kilometers northwest of Manripo beach in South Chungcheong where is Korea's west coast in the Yellow Sea. In a few days, the oil slicks spread to the northern and southern tips of the Taean Peninsula by strong winds and tides. As time went the spilled oil floating on the surface of sea water was volatilized to become tar-balls and lumps and drifted far away in the southern direction. 13 days after the incident, some of oil slicks and tar lumps were observed to flow in the service water intake at the Younggwang nuclear power plants (NPPs) operating 6 reactors, which are over 150 km away from the incident spot in the southeastern direction. According to the report by the Younggwang NPPs, a total weight 83 kg of tar lumps was removed for about 3 days. Oil spills in the sea can happen in any country or anytime due to human errors or mistakes, wars, terrors, intentional dumping of waste oils, and natural disasters like typhoon and tsunami. In fact, there have been 7 major oil spills over 10,000 tons that have occurred around the world since 1983. As such serious oil spill incidents may happen near the operating power plants using the sea water as ultimate heat sink. To ensure the safe operation of nuclear reactors it is required to evaluate the potential for loss of decay heat removal function of nuclear reactors due to the spilled oils flowing in the service water intake, from which the service water is pumped. Thus, Korea Institute of Nuclear Safety identified this problem as one of the important safety. When an incident of crude oil spill from an oil carrier occurs in the sea near the nuclear power plants, the spilled oil can be transported to the intake pit, where all service water pumps locate, by sea current and wind drift (induced) current. The essential service water pumps take the

  6. Long-term experience in salt mining and experience in salt mine decommissioning - a chance for ultimate storage?

    International Nuclear Information System (INIS)

    Sitz, P.; Rauche, H.

    2003-01-01

    The author discusses similarities between salt mining and ultimate storage and the possibility of using abandoned salt mines as ultimate storage site. He states that with all the numeric prediction tools now available, expert knowledge of mining engineers is still indispensable [de

  7. 26 CFR 48.6427-9 - Diesel fuel and kerosene; claims by registered ultimate vendors (farming and State use).

    Science.gov (United States)

    2010-04-01

    ... ultimate vendors (farming and State use). 48.6427-9 Section 48.6427-9 Internal Revenue INTERNAL REVENUE... Manufacturers Taxes § 48.6427-9 Diesel fuel and kerosene; claims by registered ultimate vendors (farming and...)(A). These claims relate to diesel fuel and kerosene sold for use on a farm for farming purposes and...

  8. Incidents in nuclear installations

    International Nuclear Information System (INIS)

    Franzen, L.F.; Wienhold, W.

    1976-09-01

    With reference to the incident list of the Ministry for the period 1971-74, Prof. Bechert has expressed a lot of questions and statements in a letter to the Government. The letter is quoted in full. Inadequate conclusions drawn by Prof. Bechert in connection with quotations from daily newspapers and other documents are put right. (HP) [de

  9. Lightning incidents in Mongolia

    Directory of Open Access Journals (Sweden)

    Myagmar Doljinsuren

    2015-11-01

    Full Text Available This is one of the first studies that has been conducted in Mongolia on the distribution of lightning incidents. The study covers a 10-year period from 2004 to 2013. The country records a human death rate of 15.4 deaths per 10 million people per year, which is much higher than that of many countries with similar isokeraunic level. The reason may be the low-grown vegetation observed in most rural areas of Mongolia, a surface topography, typical to steppe climate. We suggest modifications to Gomes–Kadir equation for such countries, as it predicts a much lower annual death rate for Mongolia. The lightning incidents spread over the period from May to August with the peak of the number of incidents occurring in July. The worst lightning affected region in the country is the central part. Compared with impacts of other convective disasters such as squalls, thunderstorms and hail, lightning stands as the second highest in the number of incidents, human deaths and animal deaths. Economic losses due to lightning is only about 1% of the total losses due to the four extreme weather phenomena. However, unless precautionary measures are not promoted among the public, this figure of losses may significantly increase with time as the country is undergoing rapid industrialization at present.

  10. Fire Incident Reporting Manual

    Science.gov (United States)

    1984-02-01

    the result of an incident that requires (or should require) treatment by a practitioner of medicine , a registered emergency medical technician, or a...UNANNOUNCED AIRCRAFT EMERGENCYS ~~PRIOR TO TAKE OFF OR AFTERLADN 5 FUEL OPERATIONS REQUIRING 1AREING G A FIRE10 ARRESTING GEAR’BARRIER FR . ENGAGEMENTS AND

  11. Behaviour of reinforced concrete beams with confined concrete related to ultimate bending and shear strength

    Science.gov (United States)

    Tee, Horng Hean; Al-Sanjery, Kousay; Chiang, Jeffrey Choong Luin

    2017-03-01

    This research is to investigate the behaviour of over-balanced High Strength Reinforced Concrete Beams with the compression zone confined with spiral / helical steel reinforcements. The study covered beam behaviour with respect to flexural strength, shear strength, deflection and cracking related to confined concrete. Six 200mm (width) X 300mm (depth) X 3000mm (length) Reinforced Concrete (RC) Beams, the first three beams incorporating steel ratio of 1.42ρb and the remaining 1.64ρb were tested under a four point static load test. The confinement of the concrete was carried out using spiral reinforcements of diameter 6mm and yield stress of 406N/mm2 with pitches of 50mm and 100mm. Measurements of deflection, cracking, and strains on both main reinforcements and concrete of the beams were taken. At the same level of stress, beams with confined concrete strained less than control beams without confinement for both tensile strain at the main steel reinforcement and compressive strain across the compression zone of concrete. Deflections of beams with helical confinement were less than the control beams. All beams failed in shear / flexural mode and gave fair warning against failure, more specifically beams with 1.42ρb, which is not normally associated with shear-type failure of beams which are over reinforced. The early shear failure prevented the beams from achieving its full utilisation of the ultimate strength. It is recommended that for over-reinforced confined concrete beams, the shear strength of beams should be based on using the diagonal compressive strut angle (θ) of more than 22 degrees recommended in Eurocode 2 (EC2), hence giving the beam higher safety factor against shear failure. All samples exhibited flexure and shear cracks in a manner which gave a good warning against failure. The ratio of the failure load to the theoretical ultimate load for shear ranged between 0.98 and 1.25 while the ratio of the failure load to the ultimate flexural load ranged

  12. Health care quality, access, cost, workforce, and surgical education: the ultimate perfect storm.

    Science.gov (United States)

    Schwartz, Marshall Z

    2012-01-01

    The discussions on health care reform over the past two years have focused on cost containment while trying to maintain quality of care. Focusing on just cost and quality unfortunately does not address other very important factors that impact on our health care delivery system. Availability of a well-trained workforce, maintaining the sophisticated medical/surgical education system, and ultimately access to quality care by the public are critical to maintaining and enhancing our health care delivery system. Unfortunately, all five of these components are under at risk. Thus, we have evolving the ultimate perfect storm affecting our health care delivery system. Although not ideal and given the uniqueness of our population and their expectations, our current delivery system is excellent compared to other countries. However, the cost of our current system is rising at an alarming rate. Currently, health care consumes 17% of our gross domestic product. If our system is not revised this will continue to rise and by 2025 it will consume 48%. The dilemma, given the current state of our overall economy and rising debt, is how to address this major problem. Unfortunately, the Affordable Care Act, which is now law, does not address most of the issues and the cost was initially grossly under estimated. Furthermore, the law does not address the issues of workforce, maintaining our medical education system or ultimately, access. A major revision of our system will be necessary to truly create a system that protects and enhances all five of the components of our health care delivery system. To effectively accomplish this will require addressing those issues that lead to wasteful spending and diversion of our health care dollars to profit instead of care. Improved and efficient delivery systems that reduce complications, reduction of duplication of tertiary and quaternary programs or services within the same markets (i.e. regionalization of care), health insurance reform, and

  13. Management

    OpenAIRE

    2008-01-01

    La globalisation des activités avec son lot de relocalisations, d’alliances stratégiques par-delà les frontières, défie les pratiques traditionnelles du management, nécessairement construites sur les systèmes nationaux. Cas pratiques à l’appui (dont Aventis, BASF, Novartis ou Siemens), les auteurs, tous deux professeurs de management international, détaillent en les analysant les nouveaux impératifs de management et d’organisation que doivent affronter les entreprises. Ils distinguent clairem...

  14. Management

    OpenAIRE

    Ughetto , Pascal

    2012-01-01

    International audience; Quand il s'agit de rendre compte du travail et de ses conditions, le management exerce autant un fort pouvoir de séduction que de répulsion. Le travail d'aujourd'hui est directement confronté à l'empire des dispositifs de gestion. Il importe de reconstituer les mondes sociaux du management - le top management, les directions spécialisées, les cadres de terrain - si l'on veut comprendre où et comment se jouent les marges de manoeuvre accordées à l'activité de travail ou...

  15. Miras, Mass Loss, and the Ultimate Fate of the Earth (Abstract)

    Science.gov (United States)

    Willson, L. A.

    2016-12-01

    (Abstract only) The broad category of pulsating red giants includes semi-regular variables and Mira variables. The Miras are distinguished by their large amplitude variation in visible light, late spectral types (cool atmospheres), and the presence of emission lines during part of the cycle. The emission lines result from shock waves generated by pulsation that traverse their atmospheres. These stars' atmosphere are often dusty, an indication of mass loss. Based on decades of detailed modeling we can recognize that the Mira stage corresponds to the onset of devastating mass loss, a process that removes most of the remaining envelope and reveals the degenerate core, a new white dwarf star. I'll review the evidence for this claim, and then examine the effects of Mira stage mass loss on the future solar system. Finally, I shall draw some very general conclusions about the ultimate fate of the Earth.

  16. Design proposal for ultimate shear strength of tapered steel plate girders

    Directory of Open Access Journals (Sweden)

    A. Bedynek

    2017-03-01

    Full Text Available Numerous experimental and numerical studies on prismatic plate girders subjected to shear can be found in the literature. However, the real structures are frequently designed as non-uniform structural elements. The main objective of the research is the development of a new proposal for the calculation of the ultimate shear resistance of tapered steel plate girders taking into account the specific behaviour of such members. A new mechanical model is presented in the paper and it is used to show the differences between the behaviour of uniform and tapered web panels subjected to shear. EN 1993-1-5 design specifications for the determination of the shear strength for rectangular plates are improved in order to assess the shear strength of tapered elements. Numerical studies carried out on tapered steel plate girders subjected to shear lead to confirm the suitability of the mechanical model and the proposed design expression.

  17. BACKUP AND ULTIMATE HEAT SINKS IN CANDU REACTORS FOR PROLONGED SBO ACCIDENTS

    Directory of Open Access Journals (Sweden)

    T. NITHEANANDAN

    2013-10-01

    The efficacy of available backup and ultimate heat sinks, available in a CANDU 6 reactor, in mitigating the consequences of a prolonged station blackout scenario was analysed using the MAAP4-CANDU code. The analysis indicated that the steam generator secondary side water inventory is the most effective heat sink during the accident. Additional heat sinks such as the primary coolant, moderator, calandria vault water and end shield water are also able to remove decay heat; however, a gradually increasing mismatch between heat generation and heat removal occurs over the course of the postulated event. This mismatch is equivalent to an additional water inventory estimated to be 350,000 kg at the time of calandria vessel failure. In the Enhanced CANDU 6 reactor ∼2,040,000 kg of water in the reserve water tank is available for prolonged emergencies requiring heat sinks.

  18. Fuzzy stochastic analysis of serviceability and ultimate limit states of two-span pedestrian steel bridge

    Science.gov (United States)

    Kala, Zdeněk; Sandovič, GiedrÄ--

    2012-09-01

    The paper deals with non-linear analysis of ultimate and serviceability limit states of two-span pedestrian steel bridge. The effects of random material and geometrical characteristics on limit states are analyzed. The Monte Carlo method was applied to stochastic analysis. For the serviceability limit state, also influence of fuzzy uncertainty of the limit deflection value on random characteristics of load capacity of variable action was studied. The results prove that, for the type of structure studied, the serviceability limit state is decisive from the point of view of design. The present paper opens a discussion on the use of stochastic analysis to verify the limit deflections given in the standards EUROCODES.

  19. Aging characteristics of containment building and sensitivity on ultimate pressure capacity

    International Nuclear Information System (INIS)

    Seo, Jeong Moon; Choun, Young Sun; Choi, In Kil; Ha, Jae Joo

    1998-03-01

    For the reliable safety assessment of the containment building, structural and material conditions can be investigated in detail and pertinent assessment technologies have to be established. Also, an understanding on the aging-related degradations for the construction materials is required to predict long-term structural safety of the containment building. For the development of reliable aging prediction models, an extensive data base system related to aging properties of the containment building has to be prepared. The objectives of this research are to develop aging models representing long-term degradation of materials and a structural performance assessment program for containment building considering aging-related degradation. According to the results of sensitivity analysis, as the mechanical properties of the constituent materials degrade, the ultimate pressure capacity of containment building may decrease and severe damage may occur around the mid-level of the containment wall. (author). 28 refs., 11 tabs., 36 figs

  20. The fiber-optic gyroscope, a century after Sagnac's experiment: The ultimate rotation-sensing technology?

    Science.gov (United States)

    Lefèvre, Hervé C.

    2014-12-01

    Taking advantage of the development of optical-fiber communication technologies, the fiber-optic gyroscope (often abbreviated FOG) started to be investigated in the mid-1970s, opening the way for a fully solid-state rotation sensor. It was firstly seen as dedicated to medium-grade applications (1 ° / h range), but today, it reaches strategic-grade performance (10-4 ° / h range) and surpasses its well-established competitor, the ring-laser gyroscope, in terms of bias noise and long-term stability. Further progresses remain possible, the challenge being the ultimate inertial navigation performance of one nautical mile per month corresponding to a long-term bias stability of 10-5 ° / h. This paper is also the opportunity to recall the historical context of Sagnac's experiment, the origin of all optical gyros. xml:lang="fr"

  1. An experimental investigation on the ultimate strength of epoxy repaired braced partial infilled RC frames

    Science.gov (United States)

    Dubey, Shailendra Kumar Damodar; Kute, Sunil

    2014-09-01

    Due to earthquake, buildings are damaged partially or completely. Particularly structures with soft storey are mostly affected. In general, such damaged structures are repaired and reused. In this regard, an experimental investigation was planned and conducted on models of single-bay, single-storey of partial concrete infilled reinforced concrete (RC) frames up to collapse with corner, central and diagonal steel bracings. Such collapsed frames were repaired with epoxy resin and retested. The initiative was to identify the behaviour, extent of restored ultimate strength and deflection of epoxy-retrofitted frames in comparison to the braced RC frames. The performance of such frames has been considered only for lateral loads. In comparison to bare RC frames, epoxy repaired partial infilled frames have significant increase in the lateral load capacity. Central bracing is more effective than corner and diagonal bracing. For the same load, epoxy repaired frames have comparable deflection than similar braced frames.

  2. Assessment of Wind Parameter Sensitivity on Ultimate and Fatigue Wind Turbine Loads: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, Amy N [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Sethuraman, Latha [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Jonkman, Jason [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Quick, Julian [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2018-02-13

    Wind turbines are designed using a set of simulations to ascertain the structural loads that the turbine could encounter. While mean hub-height wind speed is considered to vary, other wind parameters such as turbulence spectra, sheer, veer, spatial coherence, and component correlation are fixed or conditional values that, in reality, could have different characteristics at different sites and have a significant effect on the resulting loads. This paper therefore seeks to assess the sensitivity of different wind parameters on the resulting ultimate and fatigue loads on the turbine during normal operational conditions. Eighteen different wind parameters are screened using an Elementary Effects approach with radial points. As expected, the results show a high sensitivity of the loads to the turbulence standard deviation in the primary wind direction, but the sensitivity to wind shear is often much greater. To a lesser extent, other wind parameters that drive loads include the coherence in the primary wind direction and veer.

  3. Ultimate Limit State Design Of Sheet Pile Walls By Finite Elements And Nonlinear Programming

    DEFF Research Database (Denmark)

    Krabbenhøft, Kristian; Damkilde, Lars; Krabbenhøft, Sven

    2002-01-01

    Limit analysis has been used for decades in civil and mechanical engineering practice as a means of analyzing structures of materials which with reasonable accuracy can be described as being rigid-perfectly plastic. Such materials include steel, concrete and soils. Traditionally, most attention has...... of reinforced concrete slabs or the stability of slopes, and generally, whenever all information about the structure, except for the ultimate magnitude of the load set, is known. However, in the design of structures the situation is the opposite. Here the loads are known whereas the necessary dimensions......, boundary conditions, material strengths, etc. must be determined in such a way that the structure is able to sustain the given loads. Thus, limit analysis embraces two different scenarios, one where everything except the maximal permissible load intensity is known, and one where all that is known...

  4. SoundScapes - Beyond Interaction... in search of the ultimate human-centred interface

    DEFF Research Database (Denmark)

    Brooks, Tony

    2006-01-01

    that can also benefit communication. To achieve this a new generation of intuitive natural interfaces will be required and SoundScapes (see below) is a step toward this goal to discover the ultimate interface for matching the human experience to technology. Emergent hypothesis that have developed...... on stage and to create interactive art installations which have been exhibited at leading Museums for Modern Art. The research evolved from performance art experiences which inspired my creation of idiosyncratic and personalised environments for others who had different abilities and challenges in life. My...... art thus became a way to stimulate creative expression in others and to offer new opportunities for improved life quality. Games are also involved in the participant's development. In this case the ludic engagement involved in playing the game and the exercise involved in the interaction that utilises...

  5. FIMic: design for ultimate 3D-integral microscopy of in-vivo biological samples.

    Science.gov (United States)

    Scrofani, G; Sola-Pikabea, J; Llavador, A; Sanchez-Ortiga, E; Barreiro, J C; Saavedra, G; Garcia-Sucerquia, J; Martínez-Corral, M

    2018-01-01

    In this work, Fourier integral microscope (FIMic), an ultimate design of 3D-integral microscopy, is presented. By placing a multiplexing microlens array at the aperture stop of the microscope objective of the host microscope, FIMic shows extended depth of field and enhanced lateral resolution in comparison with regular integral microscopy. As FIMic directly produces a set of orthographic views of the 3D-micrometer-sized sample, it is suitable for real-time imaging. Following regular integral-imaging reconstruction algorithms, a 2.75-fold enhanced depth of field and [Formula: see text]-time better spatial resolution in comparison with conventional integral microscopy is reported. Our claims are supported by theoretical analysis and experimental images of a resolution test target, cotton fibers, and in-vivo 3D-imaging of biological specimens.

  6. Silicon coupled-ring resonator structures for slow light applications: potential, impairments and ultimate limits

    International Nuclear Information System (INIS)

    Canciamilla, A; Torregiani, M; Ferrari, C; Morichetti, F; Melloni, A; De La Rue, R M; Samarelli, A; Sorel, M

    2010-01-01

    Coupled-ring resonator-based slow light structures are reported and discussed. By combining the advantages of high index contrast silicon-on-insulator technology with an efficient thermo-optical activation, they provide an on-chip solution with a bandwidth of up to 100 GHz and a slowdown factor of up to 16, as well as a continuous reconfiguration scheme and a fine tunability. The performance of these devices is investigated in detail for both static and dynamic operation, in order to evaluate their potential in optical signal processing applications at high bit rate. The main impairments imposed by fabrication imperfections are also discussed in relation to the slowdown factor. In particular, the analysis of the impact of backscatter, disorder and two-photon absorption on the device transfer function reveals the ultimate limits of these structures and provides valuable design rules for their optimization

  7. Methodological Challenges of Identifying Ultimate Land Use Changes Caused by Biofuel Production

    DEFF Research Database (Denmark)

    Wenzel, Henrik; Kløverpris, Jesper; Nielsen, Per Henning

    2007-01-01

    that is only poorly dealt with by LCA methods. Even though the use of land, or change of land cover and its eco-systems, is acknowledged to be a very important impact of human activities, a methodology for assessing this impact category has not yet  been properly developed within LCA. Some LCA scientists have......-of-the-art is that such inventories typically include data from crop production in the country in which the crop is used  (or from where it is exported) and, thereby, the inventories do not necessarily consider crop and land displacements through market mechanisms and do, thus, not identify the land ultimately affected...... LCA, which means that the consequences of changes in consumption are studied in a market-based perspective. Based on the current market trend for crops and an analysis of basic mechanisms in crop production, concepts for modelling how crop consumption affects the global agricultural area...

  8. Premature death as the ultimate failure: predictors of death in the US drug user treatment population.

    Science.gov (United States)

    Schildhaus, Sam; Dugoni, Bernard

    2012-01-01

    Premature death is the ultimate failure in public health. Failure to complete substance user treatment increases the likelihood of death. Using the five-year follow-up (1990/91-1995/96) of a representative sample of 3,047 clients discharged from drug user treatment, this article documents that deaths after treatment were 4.7 times higher for substance user treatment clients than for the U.S. population matched by age, sex, and race; death rates ranged from 3.5 times as likely for Black males to nine times as likely for White females. Logistic regression models show that completion of treatment is associated with a three-fifths decreased likelihood of death.

  9. Factors associated with triage assignment of emergency department patients ultimately diagnosed with acute myocardial infarction.

    Science.gov (United States)

    Ryan, Kimberley; Greenslade, Jaimi; Dalton, Emily; Chu, Kevin; Brown, Anthony F T; Cullen, Louise

    2016-02-01

    The objective of this study was to explore factors associated with the triage category assigned by the triage nurse for patients ultimately diagnosed with acute myocardial infarction. This was a retrospective analysis of 12 months of data, on adult emergency department patients ultimately diagnosed with acute myocardial infarction. Data were obtained from hospital databases and included patient demographics, patient clinical characteristics and nurses' experience. Of the 153 patients, 20% (95% CI: 14-27%) were given a lower urgency triage category than recommended by international guidelines. Compared to patients who were triaged Australasian Triage Category 1 or 2, patients with an Australasian Triage Category 3-5 were older (mean age 76 versus 68 years), more likely to be female (63% versus 32%), more likely to present without chest pain (93% versus 35%) and less likely to have a cardiac history (3.3% versus 17.9%). A slightly higher proportion of patients Australasian Triage Category 3-5 were triaged by an experienced nurse (50%) compared to patients categorised Australasian Triage Category 1-2 (35.2%) but this finding did not reach statistical significance. One in five presentations was given a lower urgency triage category than recommended by international guidelines, potentially leading to delays in medical treatment. The absence of chest pain was the defining characteristic in this group of patients, along with other factors identified by previous research such as being of female sex and elderly. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Incident Command System - Environmental Unit responsibilities

    International Nuclear Information System (INIS)

    Hillman, S. O.

    1997-01-01

    The Incident Command System (ICS) for crisis management, used for response to oil spills by the Alyeska Pipeline Service Company throughout its facilities, including the Trans Alaska Pipeline and the Valdez Marine Terminal, was described. Special attention was given to the Environmental Unit within the ICS which functions as a primary support unit for the Incident Operations Section. Details of the Unit's function were provided. These include the collection, evaluation and dissemination of information on all environmental issues concerning the crisis, provision of advice and direction on environmental aspects, and up-front agency interaction. A checklist of tasks is included. 7 refs

  11. Constipation and Incident CKD.

    Science.gov (United States)

    Sumida, Keiichi; Molnar, Miklos Z; Potukuchi, Praveen K; Thomas, Fridtjof; Lu, Jun Ling; Matsushita, Kunihiro; Yamagata, Kunihiro; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba P

    2017-04-01

    Constipation is one of the most prevalent conditions in primary care settings and increases the risk of cardiovascular disease, potentially through processes mediated by altered gut microbiota. However, little is known about the association of constipation with CKD. In a nationwide cohort of 3,504,732 United States veterans with an eGFR ≥60 ml/min per 1.73 m 2 , we examined the association of constipation status and severity (absent, mild, or moderate/severe), defined using diagnostic codes and laxative use, with incident CKD, incident ESRD, and change in eGFR in Cox models (for time-to-event analyses) and multinomial logistic regression models (for change in eGFR). Among patients, the mean (SD) age was 60.0 (14.1) years old; 93.2% of patients were men, and 24.7% were diabetic. After multivariable adjustments, compared with patients without constipation, patients with constipation had higher incidence rates of CKD (hazard ratio, 1.13; 95% confidence interval [95% CI], 1.11 to 1.14) and ESRD (hazard ratio, 1.09; 95% CI, 1.01 to 1.18) and faster eGFR decline (multinomial odds ratios for eGFR slope constipation associated with an incrementally higher risk for each renal outcome. In conclusion, constipation status and severity associate with higher risk of incident CKD and ESRD and with progressive eGFR decline, independent of known risk factors. Further studies should elucidate the underlying mechanisms. Copyright © 2017 by the American Society of Nephrology.

  12. Cancer incidence among firefighters

    DEFF Research Database (Denmark)

    Pukkala, Eero; Martinsen, Jan Ivar; Weiderpass, Elisabete

    2014-01-01

    .51), adenocarcinoma of the lung (SIR=1.90, 95% CI 1.34 to 2.62), and mesothelioma (SIR=2.59, 95% CI 1.24 to 4.77). By contrast with earlier studies, the incidence of testicular cancer was decreased (SIR=0.51, 95% CI 0.23 to 0.98). CONCLUSIONS: Some of these associations have been observed previously, and potential...

  13. Cancer incidence among waiters

    DEFF Research Database (Denmark)

    Reijula, Jere; Kjaerheim, Kristina; Lynge, Elsebeth

    2015-01-01

    AIMS: To study cancer risk patterns among waiters in the Nordic countries. METHODS: We identified a cohort of 16,134 male and 81,838 female waiters from Denmark, Finland, Iceland, Norway and Sweden. During the follow-up period from 1961 to 2005, we found that 19,388 incident cancer cases were...... diagnosed. Standardised incidence ratio (SIR) was defined as the observed number of cancer cases divided by the expected number, based on national age, time period and gender-specific cancer incidence rates in the general population. RESULTS: The SIR of all cancers in waiters, in the five countries combined......, was 1.46 (95% CI 1.41-1.51) in men and 1.09 (1.07-1.11) in women. In male waiters, the SIR decreased from 1.79 (1.63-1.96) in 1961-1975, to 1.33 (1.26-1.40) in 1991-2005, but remained stable among women. The SIR among male waiters was highest for cancers in the pharynx (6.11; 95% CI 5.02-7.37), oral...

  14. Addressing the common pathway underlying hypertension and diabetes in people who are obese by maximizing health: the ultimate knowledge translation gap.

    Science.gov (United States)

    Dean, Elizabeth; Lomi, Constantina; Bruno, Selma; Awad, Hamzeh; O'Donoghue, Grainne

    2011-03-06

    In accordance with the WHO definition of health, this article examines the alarming discord between the epidemiology of hypertension, type 2 diabetes mellitus (T2DM), and obesity and the low profile of noninvasive (nondrug) compared with invasive (drug) interventions with respect to their prevention, reversal and management. Herein lies the ultimate knowledge translation gap and challenge in 21st century health care. Although lifestyle modification has long appeared in guidelines for medically managing these conditions, this evidence-based strategy is seldom implemented as rigorously as drug prescription. Biomedicine focuses largely on reducing signs and symptoms; the effects of the problem rather than the problem. This article highlights the evidence-based rationale supporting prioritizing the underlying causes and contributing factors for hypertension and T2DM, and, in turn, obesity. We argue that a primary focus on maximizing health could eliminate all three conditions, at best, or, at worst, minimize their severity, complications, and medication needs. To enable such knowledge translation and maximizing health outcome, the health care community needs to practice as an integrated team, and address barriers to effecting maximal health in all patients. Addressing the ultimate knowledge translation gap, by aligning the health care paradigm to 21st century needs, would constitute a major advance.

  15. Addressing the Common Pathway Underlying Hypertension and Diabetes in People Who Are Obese by Maximizing Health: The Ultimate Knowledge Translation Gap

    Directory of Open Access Journals (Sweden)

    Elizabeth Dean

    2011-01-01

    Full Text Available In accordance with the WHO definition of health, this article examines the alarming discord between the epidemiology of hypertension, type 2 diabetes mellitus (T2DM, and obesity and the low profile of noninvasive (nondrug compared with invasive (drug interventions with respect to their prevention, reversal and management. Herein lies the ultimate knowledge translation gap and challenge in 21st century health care. Although lifestyle modification has long appeared in guidelines for medically managing these conditions, this evidence-based strategy is seldom implemented as rigorously as drug prescription. Biomedicine focuses largely on reducing signs and symptoms; the effects of the problem rather than the problem. This article highlights the evidence-based rationale supporting prioritizing the underlying causes and contributing factors for hypertension and T2DM, and, in turn, obesity. We argue that a primary focus on maximizing health could eliminate all three conditions, at best, or, at worst, minimize their severity, complications, and medication needs. To enable such knowledge translation and maximizing health outcome, the health care community needs to practice as an integrated team, and address barriers to effecting maximal health in all patients. Addressing the ultimate knowledge translation gap, by aligning the health care paradigm to 21st century needs, would constitute a major advance.

  16. Impact of Incidents on Traffic Congestion in Dar es Salaam City

    Directory of Open Access Journals (Sweden)

    David Mfinanga

    2013-06-01

    Full Text Available Poorly managed traffic incidents have largely contributed to congestion and delay in the city of Dar es Salaam. A thorough understanding of travel delays caused by incidents is therefore essential for effective countermeasures against the increasing congestion. The method used to determine delays in this research is based on the deterministic queuing theory. Information on incidents was obtained from traffic surveys, traffic police and road users. Counting of the number of vehicles passing the incident location was done on incident and incident-free days. The cumulative traffic counts on incident and incident-free days were then calculated and used to plot the queuing diagram used to determine incident induced delay. This method turned out to be a useful tool for estimating incident induced delay in areas with less sophisticated equipment i.e. where there are no sensors, CCTV cameras, etc. The method provided good estimates of incident induced delay which may help planners and transportation officials in better understanding incident related congestion and in selecting more effective countermeasures against incident related traffic congestion in the city. It was found out that the effects of incidents were different for the different zones, types of incidents and the periods the incident occurred. In addition to the incident duration and the number of vehicles affected, the impact of incidents also depended on availability of alternative routes, number of lanes on the road, discipline of the driver in manoeuvring at incident location and traffic control at the scene.

  17. Kansas Department of Transportation column expert : ultimate shear capacity of circular columns using the simplified modified compression field theory.

    Science.gov (United States)

    2015-09-01

    The importance of the analysis of circular columns to accurately predict their ultimate confined : capacity under shear-flexure-axial force interaction domain is recognized in light of the extreme load event : imposed by the current American Associat...

  18. Classification of radioactive waste and determination of waste specifications as well as conditions of acceptance for ultimate storage

    International Nuclear Information System (INIS)

    Merz, E.

    1983-04-01

    The determination of waste specification and conditions of acceptance must follow a certain scheme, the basics of which will be presented. First the types of waste and the ultimate storage facilities will be characterized. The various categories of waste will be listed in a universally valid system, and the preliminary conditioning options will be determined. Based on the results of safety analysis taking into account the whole system - geological circumstances, ultimate store mines, types and forms of waste - specifications for the various ultimate store products are to be derived following iterative methods. Suggestions though not of a binding nature and probably subject to eventual revisions in part will be presented. To ensure the safety goals, i.e. the exclusion of radioactivity from the human biosphere, appropriate quality control is required concerning the production and the acceptance at the ultimate store. The guiding principles to be heeded will be discussed in brief. (orig./HP) [de

  19. Nonlinearity management and diffraction management for the ...

    Indian Academy of Sciences (India)

    Variational equations and partial differential equation have been simulated numerically. Analytical and numerical studies have shown that nonlinearity management and diffraction management stabilize the pulse against decay or collapse providing undisturbed propagation even for larger energies of the incident beam.

  20. Validation of the ULSAP Closed-Form Method for Ultimate Strength Analysis of Cross-Stiffened Panels

    OpenAIRE

    Dippold, Samuel Mark

    2005-01-01

    This thesis presents the results of 67 ABAQUS elasto-plastic Riks ultimate strength analyses of cross-stiffened panels. These panels cover a wide range of typical geometries. Uniaxial compression is applied to the panels, and in some cases combined with lateral pressure. For eight of the panels full-scale experimental results are available, and these verified the accuracy of the ABAQUS results. The 67 ABAQUS results were then compared to the ultimate strength predictions from the computer...

  1. A unified approach for determining the ultimate strength of RC members subjected to combined axial force, bending, shear and torsion

    OpenAIRE

    Wang, Pu; Huang, Zhen

    2017-01-01

    This paper uses experimental investigation and theoretical derivation to study the unified failure mechanism and ultimate capacity model of reinforced concrete (RC) members under combined axial, bending, shear and torsion loading. Fifteen RC members are tested under different combinations of compressive axial force, bending, shear and torsion using experimental equipment designed by the authors. The failure mechanism and ultimate strength data for the four groups of tested RC members under di...

  2. Medication incidents reported to an online incident reporting system.

    LENUS (Irish Health Repository)

    Alrwisan, Adel

    2011-01-15

    AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

  3. PEP-X: An Ultimate Storage Ring Based on Fourth-Order Geometric Achromats

    Energy Technology Data Exchange (ETDEWEB)

    Cai, Yunhai; Bane, Karl; Hettel, Robert; Nosochkov, Yuri; Wang, Min-Huey; /SLAC

    2012-04-06

    We have designed an 'ultimate' storage ring for the PEP-X light source that achieves the diffraction limited emittances (at 1.5 {angstrom}) of 12 pm-rad in both horizontal and vertical planes with a 4.5-GeV beam. These emittances include the contribution of intrabeam scattering at a nominal current of 200 mA in 3300 bunches. This quality beam in conjunction with a conventional 4-m undulator in a straight section can generate synchrotron radiation having a spectral brightness above 10{sup 22} [photons/s/mm{sup 2}/mrad{sup 2}/0.1% BW] at a 10 keV photon energy. The high coherence at the diffraction limit makes PEP-X competitive with 4th generation light sources based on an energy recovery linac. In addition, the beam lifetime is several hours and the dynamic aperture is large enough to allow off-axis injection. The alignment and stability tolerances, though challenging, are achievable. A ring with all these properties is only possible because of several major advances in mitigating the effects of nonlinear resonances.

  4. New design equations for estimation of ultimate bearing capacity of shallow foundations resting on rock masses

    Directory of Open Access Journals (Sweden)

    Amir H. Alavi

    2016-01-01

    Full Text Available Rock masses are commonly used as the underlying layer of important structures such as bridges, dams and transportation constructions. The success of a foundation design for such structures mainly depends on the accuracy of estimating the bearing capacity of rock beneath them. Several traditional numerical approaches are proposed for the estimation of the bearing capacity of foundations resting on rock masses to avoid performing elaborate and expensive experimental studies. Despite this fact, there still exists a serious need to develop more robust predictive models. This paper proposes new nonlinear prediction models for the ultimate bearing capacity of shallow foundations resting on non-fractured rock masses using a novel evolutionary computational approach, called linear genetic programming. A comprehensive set of rock socket, centrifuge rock socket, plate load and large-scaled footing load test results is used to develop the models. In order to verify the validity of the models, the sensitivity analysis is conducted and discussed. The results indicate that the proposed models accurately characterize the bearing capacity of shallow foundations. The correlation coefficients between the experimental and predicted bearing capacity values are equal to 0.95 and 0.96 for the best LGP models. Moreover, the derived models reach a notably better prediction performance than the traditional equations.

  5. A new approach to the modeling of ultimate heat sink cooling ponds

    International Nuclear Information System (INIS)

    Policastro, A.J.; Wastag, M.; Paul, J.; Carhart, R.A.

    1996-01-01

    Ultimate heat sink (UHS) cooling pond thermal performance is analyzed by a new method in which zero, one, and three-dimensional models are used in combination. A typical UHS pond has an irregular shape covering 20 hectares at an average depth of 4 m with a heavy thermal load of 40 MWt (megawatts thermal) per hectare. The resulting flow field can be one, two or three dimensional. A three-dimensional numerical model (Paul 1983) is modified and used to determine the effective dimensionality of the pond under accident conditions. The model's surface heat transfer formulas and its predictions of thermal hydraulics are verified using laboratory and field data. The Paul model shows that, unlike normal cooling ponds, a typical UHS pond is vertically-mixed with only a longitudinal temperature variation. Buoyancy-driven circulations, strong discharge-to-intake flow, and rapid surface heat removal break down the usual vertical stratification. Predictions of the one-dimensional MITEMP model are shown to agree with Paul model predictions for a typical UHS pond at the Catawba Nuclear Power Plant

  6. Measurement of ultimate tensile strength and Young modulus in LYSO scintillating crystals

    Energy Technology Data Exchange (ETDEWEB)

    Scalise, Lorenzo, E-mail: l.scalise@univpm.it [Dipartimento di Meccanica, Universita Politecnica delle Marche, Via Brecce Bianche, 60131 Ancona (Italy); Rinaldi, Daniele [Dipartimento di Fisica e Ingegneria dei Materiali e del Territorio, Universita Politecnica delle Marche, Via Brecce Bianche, 60131 Ancona (Italy); Istituto Nazionale di Fisica Nucleare, Section of Perugia (Italy); Davi, Fabrizio [Dipartimento di Architettura Costruzioni e Strutture, Universita Politecnica delle Marche, Via Brecce Bianche, 60131 Ancona (Italy); Paone, Nicola [Dipartimento di Meccanica, Universita Politecnica delle Marche, Via Brecce Bianche, 60131 Ancona (Italy)

    2011-10-21

    Scintillating crystals are employed in high energy physics, in medical imaging, diagnostic and security. Two mechanical properties of lutetium-yttrium oxyorthosilicate cerium-doped Lu{sub 2(1-x)}Y{sub 2x}SiO{sub 5}:Ce with x=0.1 (LYSO) crystals have been measured: the ultimate tensile stress ({sigma}{sub UTS}) and the Young elastic modulus (E). Measurements are made by means of a 4-points loading device and the experimental results account for an elastic-brittle stress-strain relation, which depends heavily on the specimen preparation and the material defects. {sigma}{sub UTS} along the [0 1 0] tensile direction ranges within 68.14 and 115.61 MPa, which, in the lowest case, is more than twice with respect to those measured for PbWO{sub 4} (PWO), exhibiting a marked difference between the annealed and the not-annealed samples. The mean elastic modulus (E), along the same direction, is E=1.80x10{sup 11} ({+-}2.15x10{sup 10}) N/m{sup 2}, with lower dispersion respect to UTS data. This type of analysis and study can be included into quality control procedures of crystals, based on samples taken out of production; such procedures can be established for industrial processing of crystals aimed to the high energy physics (calorimeters) and medical imaging (PET, etc.) applications.

  7. Emotional contagion in soccer penalty shootouts: celebration of individual success is associated with ultimate team success.

    Science.gov (United States)

    Moll, Tjerk; Jordet, Geir; Pepping, Gert-Jan

    2010-07-01

    We examined the association between celebratory responses after successful soccer penalty kicks and the outcome of a penalty shootout. Individually displayed post-shot behaviours in penalty shootouts held in World Cups and European Championships (N = 151) were rated on the presence of universally distinct and recognizable behaviours associated with positive emotions. Using chi-square analyses we investigated which behaviours were associated with winning the shootout, when the relative standing between the teams was equal. Players who engaged in certain celebratory post-shot behaviours were more likely to be in the team that ultimately won the penalty shootout. In particular, celebrations including both arms were associated with winning the shootout. It was more likely that the next kick taken by an opponent was missed after a player displayed these behaviours after a goal than when he did not. The findings are interpreted in terms of emotional contagion - that is, the transference of emotions from individuals onto teammates and opponents. It is suggested that the individual expression of post-performance emotions serves a direct purpose in enhancing future team performance and that emotional contagion is an important process in the context of elite sport performance.

  8. Backup and Ultimate Heat Sinks in CANDU Reactors For Prolonged SBO Accidents

    Energy Technology Data Exchange (ETDEWEB)

    Nitheanandan, T.; Brown, M. J. [Atomic Energy of Canada Limited, Ontario (Canada)

    2013-10-15

    In a pressurized heavy water reactor, following loss of the primary coolant, severe core damage would begin with the depletion of the liquid moderator, exposing the top row of internally-voided fuel channels to steam cooling conditions on the inside and outside. The uncovered fuel channels would heat up, deform and disassemble into core debris. Large inventories of water passively reduce the rate of progression of the accident, prolonging the time for complete loss of engineered heat sinks. The efficacy of available backup and ultimate heat sinks, available in a CANDU 6 reactor, in mitigating the consequences of a prolonged station blackout scenario was analysed using the MAAP4-CANDU code. The analysis indicated that the steam generator secondary side water inventory is the most effective heat sink during the accident. Additional heat sinks such as the primary coolant, moderator, calandria vault water and end shield water are also able to remove decay heat; however, a gradually increasing mismatch between heat generation and heat removal occurs over the course of the postulated event. This mismatch is equivalent to an additional water inventory estimated to be 350,000 kg at the time of calandria vessel failure. In the Enhanced CANDU 6 reactor ∼2,040,000 kg of water in the reserve water tank is available for prolonged emergencies requiring heat sinks.

  9. The ultimate technology: the end of technology and the task of nature.

    Science.gov (United States)

    Riis, Søren

    2013-01-01

    One of the most influential philosophers of the 20th century, Martin Heidegger (1889-1976), died prior to the remarkable cloning of the sheep Dolly and before Dr. Venter started his experiments on creating synthetic life, and he never explicitly discussed living technologies. However, by reinterpreting his notion of "modern technology," this article shows how it is possible to philosophically assess living technologies and to recognize ways in which Heidegger anticipated this phenomenon with his notion of cybernetics. The interpretation elucidates the fundamental process of technology becoming living and simultaneously presents living technology as the ultimate technology. The thesis of this article is that living technology is not just one more technology; rather, it is the perfection of technology as understood by Aristotle. Aristotle's thinking is in this way a key example of a profound reassessment of nature and technology. Aristotle clearly separates these two domains of being in his definition, but in doing so, he also connects them to one another in a highly influential way. Following this line of thought, the article finally offers an original perspective involving renewed respect for the perpetual self-unfolding nature of living technology.

  10. The Ultimate Question of Origins: God and the Beginning of the Universe

    Science.gov (United States)

    Craig, William Lane

    1999-12-01

    Both cosmology and philosophy trace their roots to the wonder felt by the ancient Greeks as they contemplated the universe. The ultimate question remains why the universe exists rather than nothing. This question led Leibniz to postulate the existence of a metaphysically necessary being, which he identified as God. Leibniz's critics, however, disputed this identification, claiming that the space-time universe itself may be the metaphysically necessary being. The discovery during this century that the universe began to exist, however, calls into question the universe's status as metaphysically necessary, since any necessary being must be eternal in its existence. Although various cosmogonic models claiming to avert the beginning of the universe predicted by the standard model have been and continue to be offered, no model involving an eternal universe has proved as plausible as the standard model. Unless we are to assert that the universe simply sprang into being uncaused out of nothing, we are thus led to Leibniz's conclusion. Several objections to inferring a supernatural cause of the origin of the universe are considered and found to be unsound.

  11. An Experimental Investigation on the Ultimate Strength of Partially Infilled: Braced Steel Frames

    Science.gov (United States)

    Dubey, Shailendra Kumar Damodar; Kute, Sunil Y.

    2017-12-01

    Infilled walls are usually, considered as non-structural elements. However, these walls are effective in carrying lateral loads. In this regard, an experimental investigation was planned and conducted to study the effect of braced and partially infilled steel frames with cement mortar and concrete in comparison to the bare frames. All these frames were tested up to collapse and subjected only to horizontal loads to obtain an effective and possible solution for soft storey which are generally not infilled. In comparison to bare steel frames, partially infilled frames have an increase of lateral load capacity by 45-60%. Central bracing is more effective than that of the corner bracing. For the same load partially infilled frames have significantly less deflection than that of the bare frames. A reduced load factor is suggested for the design of soft storey columns with the partial infills. A mathematical model has been proposed to calculate the theoretical ultimate load for the braced, cement mortar and concrete partial infilled frames.

  12. Measurement of ultimate tensile strength and Young modulus in LYSO scintillating crystals

    Science.gov (United States)

    Scalise, Lorenzo; Rinaldi, Daniele; Davì, Fabrizio; Paone, Nicola

    2011-10-01

    Scintillating crystals are employed in high energy physics, in medical imaging, diagnostic and security. Two mechanical properties of lutetium-yttrium oxyorthosilicate cerium-doped Lu 2(1- x) Y 2 xSiO 5:Ce with x=0.1 (LYSO) crystals have been measured: the ultimate tensile stress ( σUTS) and the Young elastic modulus ( E). Measurements are made by means of a 4-points loading device and the experimental results account for an elastic-brittle stress-strain relation, which depends heavily on the specimen preparation and the material defects. σUTS along the [0 1 0] tensile direction ranges within 68.14 and 115.61 MPa, which, in the lowest case, is more than twice with respect to those measured for PbWO 4 (PWO), exhibiting a marked difference between the annealed and the not-annealed samples. The mean elastic modulus ( E), along the same direction, is E=1.80×10 11 (±2.15×10 10) N/m 2, with lower dispersion respect to UTS data. This type of analysis and study can be included into quality control procedures of crystals, based on samples taken out of production; such procedures can be established for industrial processing of crystals aimed to the high energy physics (calorimeters) and medical imaging (PET, etc.) applications.

  13. COLLECTIVE VORTEX BEHAVIORS: DIVERSITY, PROXIMATE, AND ULTIMATE CAUSES OF CIRCULAR ANIMAL GROUP MOVEMENTS.

    Science.gov (United States)

    Delcourt, Johann; Bode, Nikolai W F; Denoël, Mathieu

    2016-03-01

    Ant mill, caterpillar circle, bat doughnut, amphibian vortex, duck swirl, and fish torus are different names for rotating circular animal formations, where individuals turn around a common center. These "collective vortex behaviors" occur at different group sizes from pairs to several million individuals and have been reported in a large number of organisms, from bacteria to vertebrates, including humans. However, to date, no comprehensive review and synthesis of the literature on vortex behaviors has been conducted. Here, we review the state of the art of the proximate and ultimate causes of vortex behaviors. The ubiquity of this behavioral phenomenon could suggest common causes or fundamental underlying principles across contexts. However, we find that a variety of proximate mechanisms give rise to vortex behaviors. We highlight the potential benefits of collective vortex behaviors to individuals involved in them. For example, in some species, vortices increase feeding efficiency and could give protection against predators. It has also been argued that vortices could improve collective decision-making and information transfer. We highlight gaps in our understanding of these ubiquitous behavioral phenomena and discuss future directions for research in vortex studies.

  14. The ultimate signal-to-noise ratio in realistic body models.

    Science.gov (United States)

    Guérin, Bastien; Villena, Jorge F; Polimeridis, Athanasios G; Adalsteinsson, Elfar; Daniel, Luca; White, Jacob K; Wald, Lawrence L

    2017-11-01

    We compute the ultimate signal-to-noise ratio (uSNR) and G-factor (uGF) in a realistic head model from 0.5 to 21 Tesla. We excite the head model and a uniform sphere with a large number of electric and magnetic dipoles placed at 3 cm from the object. The resulting electromagnetic fields are computed using an ultrafast volume integral solver, which are used as basis functions for the uSNR and uGF computations. Our generalized uSNR calculation shows good convergence in the sphere and the head and is in close agreement with the dyadic Green's function approach in the uniform sphere. In both models, the uSNR versus B 0 trend was linear at shallow depths and supralinear at deeper locations. At equivalent positions, the rate of increase of the uSNR with B 0 was greater in the sphere than in the head model. The uGFs were lower in the realistic head than in the sphere for acceleration in the anterior-posterior direction, but similar for the left-right direction. The uSNR and uGFs are computable in nonuniform body models and provide fundamental performance limits for human imaging with close-fitting MRI array coils. Magn Reson Med 78:1969-1980, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  15. Genotyping by sequencing (GBS, an ultimate marker-assisted selection (MAS tool to accelerate plant breeding

    Directory of Open Access Journals (Sweden)

    Jiangfeng eHe

    2014-09-01

    Full Text Available Marker-assisted selection (MAS refers to the use of molecular markers to assist phenotypic selections in crop improvement. Several types of molecular markers, such as single nucleotide polymorphism (SNP, have been identified and effectively used in plant breeding. The application of next-generation sequencing (NGS technologies has led to remarkable advances in whole genome sequencing, which provides ultra-throughput sequences to revolutionize plant genotyping and breeding. To further broaden NGS usages to large crop genomes such as maize and wheat, genotyping by sequencing (GBS has been developed and applied in sequencing multiplexed samples that combine molecular marker discovery and genotyping. GBS is a novel application of NGS protocols for discovering and genotyping SNPs in crop genomes and populations. The GBS approach includes the digestion of genomic DNA with restriction enzymes followed by the ligation of barcode adapter, PCR amplification and sequencing of the amplified DNA pool on a single lane of flow cells. Bioinformatic pipelines are needed to analyze and interpret GBS datasets. As an ultimate MAS tool and a cost-effective technique, GBS has been successfully used in implementing genome-wide association study (GWAS, genomic diversity study, genetic linkage analysis, molecular marker discovery and genomic selection (GS under a large scale of plant breeding programs.

  16. Thermal performance experiments on ultimate heat sinks, spray ponds, and cooling ponds

    International Nuclear Information System (INIS)

    Hadlock, R.K.

    1976-12-01

    A program of measurement on a Battelle-Northwest (BNW) spray pond has been completed to prove an integrated instrumentation system for application in future field experiments. The measurement programs in the field will produce data of relevance to the design and understanding of performance for ultimate heat sinks as components of emergency core cooling systems. In the absence of active emergency cooling systems, the data will be obtained on analog systems--prime candidates among these are the naturally-occurring hot ponds at Yellowstone National Park and man-made hot cooling ponds at Savannah River National Laboratory as well as spray ponds at various industrial facilities. The proof experiment has provided data that not only illustrate the effectiveness of the instrumentation system but also display interesting site-specific heat transfer processes. The data to be obtained in the field will also be site specific but must be of generic applicability in modeling for design and performance purposes. The integrated instrumentation system will evolve, through modest modifications and substantial supplementation, to provide the requisite data for the more demanding situation of work in and about hot water

  17. Test research and analysis for ultimate capacity of Qinshan NPP PCCV

    International Nuclear Information System (INIS)

    Zufeng, X.

    1994-01-01

    This paper introduces design and research for containment of Qinshan NPP which is the first PWR in CHINA designed and constructed by ourselves. The PCCV design is basically in conformity to ASME code. To verify the structural integrity capacity of Qinshan NPP containment, we fulfilled SIT and ILRT successfully in June, 1991. The special attention of the paper is focused on the ultimate capacity of the PCCV under severe accidents and earthquake. A study comprised of five different independent parts has been performed for the development of containment model test and corresponding nonlinear analysis. There are two prestressed concrete containment models with equipment hatch. One is 1/15 scale with steel liner tested on shake table and then moved out loaded with atmospheric pressure. The other is 1/10 scale without steel liner loaded with water pressure until destruction. From different methods including model test and nonlinear analysis, all obtained unanimous conclusion. The capacity under internal pressure and earthquake is reliable. The safety margin is enough. Consequently, in the second phase of Qinshan NPP and other PWR NPP under design, PCCV should be a better selection in China since it's more economic, rational and safe. (author)

  18. Incidence of constipation in stroke patients

    Science.gov (United States)

    Li, Jianxiang; Yuan, Mengguo; Liu, Yunfang; Zhao, Yang; Wang, Jingqing; Guo, Weifeng

    2017-01-01

    Abstract There is growing awareness of a link between the gut and cardiovascular disease. Constipation is common among individuals who have had a stroke, and it negatively affects social functioning and quality of life. However, no systematic study on the incidence of constipation in stroke patients has been reported. We selected studies included in Medline, Embase, Cochrane database, and Web of Science. Studies were included if they reported the incidence in stroke patients. Two authors selected the studies, extracted the data independently, and assessed these. Subgroup analyses were conducted according to the stroke subtype and stage of stroke. After detailed evaluations, 8 studies (n  =  1385 participants) were found that contained data that were suitable for meta-analytic synthesis. A forest plot showed that the incidence of constipation was 48% (95% confidence interval [CI]  =  33%–63%). In the analysis of the type of stroke subgroup, the incidence of constipation in patients who had had a hemorrhagic stroke (66% [95% CI  =  40–91%]) was higher than that in patients who had experienced an ischemic stroke (51% [95% CI  =  27%–75%]). The incidence in the acute stage (45% [95% CI  =  36%–54%]) was lower than that in the rehabilitation stage (48% [95% CI  =  23%–73%]). Constipation after a stroke event occurs frequently. This finding may raise awareness about bowel complications to allow correct evaluation and proper management. PMID:28640117

  19. Incident users of antipsychotics

    DEFF Research Database (Denmark)

    Baandrup, Lone; Kruse, Marie

    2016-01-01

    PURPOSE: In Denmark, as well as in many other countries, consumption of antipsychotics is on the rise, partly due to increasing off-label use. The aim of this study was to analyze and quantify the extent of off-label use and polypharmacy in incident users of antipsychotic medication, and to examine...... initial antipsychotic prescribing patterns and associated use of mental health care services. METHOD: Population-based cohort study linking the following Danish national registers: the Central Psychiatric Research Register, the Register of Medicinal Product Statistics, and Statistics Denmark. RESULTS...

  20. Occupational Risks Associated with Solid Waste Management in the Informal Sector of Gweru, Zimbabwe

    Science.gov (United States)

    Jerie, Steven

    2016-01-01

    This study identifies and analyses the occupational risks associated with solid waste management practices in the informal enterprises of Gweru. Many concerns have been raised about the potential harm from waste to the environment and the general public, but the risks and consequent costs of occupational hazards in waste management have received little attention in the rush to adopt or adapt technologies such as composting. A multimethods research design that triangulates qualitative and quantitative research paradigms is employed in this study. The quantitative design involves physical characterisation of solid waste through material component separation and measurements as well as a questionnaire survey that investigates the risks associated with waste management. The qualitative component includes interviews, open-ended questionnaires, and field observations. Occupational risks occur at every stage in the waste management process, from the point where workers handle waste in the enterprises for collection or recycling to the point of ultimate disposal. Key findings from the study revealed that solid waste management practices are dominated by manual handling tasks hence the higher incidents of muscular-skeletal disorders. Other safety and health hazards associated with waste management in the informal enterprises of Gweru include incidents of diarrhoea, viral hepatitis, and higher incidents of obstructive and restrictive disorders. PMID:27418935

  1. Occupational Risks Associated with Solid Waste Management in the Informal Sector of Gweru, Zimbabwe.

    Science.gov (United States)

    Jerie, Steven

    2016-01-01

    This study identifies and analyses the occupational risks associated with solid waste management practices in the informal enterprises of Gweru. Many concerns have been raised about the potential harm from waste to the environment and the general public, but the risks and consequent costs of occupational hazards in waste management have received little attention in the rush to adopt or adapt technologies such as composting. A multimethods research design that triangulates qualitative and quantitative research paradigms is employed in this study. The quantitative design involves physical characterisation of solid waste through material component separation and measurements as well as a questionnaire survey that investigates the risks associated with waste management. The qualitative component includes interviews, open-ended questionnaires, and field observations. Occupational risks occur at every stage in the waste management process, from the point where workers handle waste in the enterprises for collection or recycling to the point of ultimate disposal. Key findings from the study revealed that solid waste management practices are dominated by manual handling tasks hence the higher incidents of muscular-skeletal disorders. Other safety and health hazards associated with waste management in the informal enterprises of Gweru include incidents of diarrhoea, viral hepatitis, and higher incidents of obstructive and restrictive disorders.

  2. Management

    OpenAIRE

    Daft, Richard L.; Kendrick, Martyn; Vershinina, Natalia

    2010-01-01

    The market-leading textbook for principles of management courses reaches a new level with Richard L. Daft being joined by Martyn Kendrick and Natalia Vershinina (both Leicester Business School) to provide an unparalleled resource for students in Europe, the Middle East and Africa (EMEA). After listening to the requirements of lecturers, the authors have maintained the same comprehensive coverage and structure of the original work but carefully threaded in new EMEA and wider global examples an...

  3. Common Causes of Pesticide Incidents

    Science.gov (United States)

    There are many types of pesticide incidents. EPA staff analyze pesticide incident reports involving people (including children and farm workers), pets, domestic animals, wildlife including bees and other pollinators, and the environment.

  4. The effect of search channel elimination on purchase incidence, order size and channel choice

    NARCIS (Netherlands)

    Konus, U.; Neslin, S.A.; Verhoef, P.C.

    This study investigates the impact of eliminating a search channel on purchase incidence, order size, channel choice and, ultimately, sales and profits. We analyze customer panel data from a large retailer over a five-year period. The retailer conducted a randomized field test in which the firm

  5. Increasing incidence of pyogenic spondylodiscitis

    DEFF Research Database (Denmark)

    Kehrer, Michala; Pedersen, Court; Jensen, Thøger G

    2014-01-01

    Smaller studies indicate that the incidence of pyogenic spondylodiscitis is increasing, possible related to a growing elderly population. Data supporting this is sparse, and we therefore studied patient characteristics and changes in spondylodiscitis incidence 1995-2008.......Smaller studies indicate that the incidence of pyogenic spondylodiscitis is increasing, possible related to a growing elderly population. Data supporting this is sparse, and we therefore studied patient characteristics and changes in spondylodiscitis incidence 1995-2008....

  6. Responding to a biological incident

    Energy Technology Data Exchange (ETDEWEB)

    Campagna, P.R. [U.S. Environmental Response Team, Office of Superfund Remediation and Technology Innovation, Edison, NJ (United States)

    2005-07-01

    The U.S. Environmental Protection Agency's Environmental Response Team (ERT) was established in October 1978 to provide technical assistance to a variety of governmental agencies in the area of environmental emergency issues such as chemical spills, uncontrolled hazardous waste site and terrorist incidents. This paper describes responses to a biological incident that occurred on July 29 2004, when the United States Department of Agriculture (USDA) received an anonymous e-mail identifying 3 containers on board the M/V Rio Puelo, one of which was said to contain a harmful biological substance. The containers were part of a 5 container shipment of Argentinian lemons bound for Canada. The vessel had a total of 2204 containers, of which 260 were loaded at the same port as the lemons. The containers were to be off-loaded at the Port of Newark and transported via truck to Canada. The federal On-Scene Coordinator (OSC) was responsible for managing this incident, as well as assessing the creditability of the threat. In accordance with federal authorities under the Public Water Safety Act, the Captain of the Port of New York ordered the vessel to anchor off shore. A tactical security operations team was dispatched to assess vessel security. It was determined that none of the crew, who had been exposed to the potential agent 10 days earlier, had shown any symptoms of biological warfare agents. A multi-agency unified command was set up, consisting of state, federal and local agencies. Various options were evaluated, including treatment of the containers on board due to the possibility of a dispersal device which could cause wide-spread contamination; the off loading and disposal of the cargo into the sea; and off loading of containers on shore with subsequent treatment. The following safety precautions were taken: cooling units were shut off 48 hours before sailing; the vents were sealed and closed; and the drains were plugged. At the port, trained dogs were used, and

  7. Trends in incidence, survival, and management of uveal melanoma: a population-based study of 7,516 patients from the Surveillance, Epidemiology, and End Results database (1973–2012

    Directory of Open Access Journals (Sweden)

    Mahendraraj K

    2016-10-01

    Full Text Available Krishnaraj Mahendraraj,1 Christine SM Lau,1,2 Injoon Lee,2 Ronald S Chamberlain1–3 1Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA; 2St George’s University School of Medicine, Grenada, West Indies; 3Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA Introduction: Uveal melanoma (UM is the most common primary intraocular malignancy, despite comprising <5% of all melanomas. To date, relatively few case series of UM have been published. Moreover, the factors influencing survival remain largely unknown. This study sought to analyze the impact of demographics, histology, clinical presentation, and treatments on the clinical outcomes of UM in a large modern nationwide patient cohort.Methods: Demographics and clinical data were abstracted on 277,120 histologically confirmed melanoma patients from the Surveillance, Epidemiology, and End Results database between 1973 and 2012.Results: A total of 7,516 cases of UM represented 3.2% of all recorded cases of melanoma. The mean age-adjusted incidence was 5.1 per million (95% CI 4.2–6.1 and was higher in males (5.9, CI =4.4–7.6 compared to females (4.5, CI =3.3–5.8, P<0.001. UM occurred most commonly in the sixth decade of life (61.4±15 and among Caucasians (94.7%. A total of 52.3% of cases were reported in the Western US (35.7% in California. The initial diagnoses in 65.2% of cases were by histopathology, followed by clinical diagnosis (18.8% and radiographic imaging (16.0%. The percentage of UM cases managed by surgery alone decreased by 69.4% between the 1973–1977 and 2006–2012 time periods, concomitant with a 62% increase in primary radiotherapy, P<0.001. The UM mean overall and cancer-specific 5-year relative survival rates were 79.8%±5.8% and 76%±5.3%, respectively. The mean 5-year cancer-specific survival rate (76% remained stable during the study period between 1973 and 2012. The mean survival for patients treated with

  8. Consequences of EEG electrode position error on ultimate beamformer source reconstruction performance.

    Science.gov (United States)

    Dalal, Sarang S; Rampp, Stefan; Willomitzer, Florian; Ettl, Svenja

    2014-01-01

    Inaccuracy of EEG electrode coordinates forms an error term in forward model generation and ultimate source reconstruction performance. This error arises from the combination of both intrinsic measurement noise of the digitization apparatus and manual coregistration error when selecting corresponding points on anatomical MRI volumes. A common assumption is that such an error would lead only to displacement of localized sources. Here, we measured electrode positions on a 3D-printed full-scale replica head, using three different techniques: a fringe projection 3D scanner, a novel "Flying Triangulation" 3D sensor, and a traditional electromagnetic digitizer. Using highly accurate fringe projection data as ground truth, the Flying Triangulation sensor had a mean error of 1.5 mm while the electromagnetic digitizer had a mean error of 6.8 mm. Then, again using the fringe projection as ground truth, individual EEG simulations were generated, with source locations across the brain space and a range of sensor noise levels. The simulated datasets were then processed using a beamformer in conjunction with the electrode coordinates registered with the Flying Triangulation and electromagnetic digitizer methods. The beamformer's output SNR was severely degraded with the digitizer-based positions but less severely with the Flying Triangulation coordinates. Therefore, the seemingly innocuous error in electrode registration may result in substantial degradation of beamformer performance, with output SNR penalties up to several decibels. In the case of low-SNR signals such as deeper brain structures or gamma band sources, this implies that sensor coregistration accuracy could make the difference between successful detection of such activity or complete failure to resolve the source.

  9. The Ultimate Pile Bearing Capacity from Conventional and Spectral Analysis of Surface Wave (SASW) Measurements

    Science.gov (United States)

    Faizah Bawadi, Nor; Anuar, Shamilah; Rahim, Mustaqqim A.; Mansor, A. Faizal

    2018-03-01

    A conventional and seismic method for determining the ultimate pile bearing capacity was proposed and compared. The Spectral Analysis of Surface Wave (SASW) method is one of the non-destructive seismic techniques that do not require drilling and sampling of soils, was used in the determination of shear wave velocity (Vs) and damping (D) profile of soil. The soil strength was found to be directly proportional to the Vs and its value has been successfully applied to obtain shallow bearing capacity empirically. A method is proposed in this study to determine the pile bearing capacity using Vs and D measurements for the design of pile and also as an alternative method to verify the bearing capacity from the other conventional methods of evaluation. The objectives of this study are to determine Vs and D profile through frequency response data from SASW measurements and to compare pile bearing capacities obtained from the method carried out and conventional methods. All SASW test arrays were conducted near the borehole and location of conventional pile load tests. In obtaining skin and end bearing pile resistance, the Hardin and Drnevich equation has been used with reference strains obtained from the method proposed by Abbiss. Back analysis results of pile bearing capacities from SASW were found to be 18981 kN and 4947 kN compared to 18014 kN and 4633 kN of IPLT with differences of 5% and 6% for Damansara and Kuala Lumpur test sites, respectively. The results of this study indicate that the seismic method proposed in this study has the potential to be used in estimating the pile bearing capacity.

  10. The in vitro digestibility of beef varies with its inherent ultimate pH.

    Science.gov (United States)

    Farouk, Mustafa M; Wu, Guojie; Frost, Deborah A; Clerens, Stefan; Knowles, Scott O

    2014-11-01

    Animal carcasses and cuts of meat are usually differentiated and valued according to size and compositional attributes. An underappreciated variable of red meat is its inherent ultimate pH (pHu) value, which affects organoleptic and processing characteristics. This study tests the hypothesis that high pHu aged meat would be more digestible than low pHu unaged (fresh) meat. Longissimus dorsi muscles collected from 59 bull carcasses had pHu values of 5.6-6.9. These were aged for 21 days at -1.5 °C, then raw and cooked (72 °C) samples were enzymatically digested at 37 °C with pepsin (pH 1.9 for 90 min) followed by pancreatin (pH 8.0 for an additional 120 min) to simulate conditions in the stomach and small intestine, respectively. Meat proteins and peptides in the digests were separated by 1D SDS PAGE. Regardless of pHu, ageing or cooking, most sarcoplasmic and myofibrillar proteins were rapidly digested by pepsin, with concomitant release of products identified by LC-MS/MS as mainly myosin-1, -2 and -7, α-actinin-2 or -3 and tropomyosin beta and alpha chains. These products were resistant to further digestion for the entire 210 min duration of the incubation. In terms of rate and extent of digestibility of these resistant products, high pHu > low pHu (P unaged (P meat samples increased with increasing pHu (P meat was highly digestible but could be further differentiated on the basis of its pHu and the ease of digestibility of proteins. Specific carcasses or cuts could be targeted to consumer groups in order to provide benefits and add value.

  11. The U.S. Gas Flooding Experience: CO2 Injection Strategies and Impact on Ultimate Recovery

    Energy Technology Data Exchange (ETDEWEB)

    Nunez-Lopez, Vanessa [The University of Texas at Austin; Hosseini, Seyyed; Gil-Egui, Ramon

    2017-09-29

    The Permian Basin in West Texas and southwestern New Mexico has seen 45 years of oil reserve growth through CO2 enhanced oil recovery (CO2 EOR). More than 60 CO2 EOR projects are currently active in the region’s limestone, sandstone and dolomite reservoirs. Water alternating gas (WAG) has been the development strategy of choice in the Permian for several technical and economic reasons. More recently, the technology started to get implemented in the much more porous and permeable clastic depositional systems of the onshore U.S. Gulf Coast. Continued CO2 injection (CGI), as opposed to WAG, was selected as the injection strategy to develop Gulf Coast oil fields, where CO2 injection volumes are significantly larger (up to 6 times larger) than those of the Permian. We conducted a compositional simulation based study with the objective of comparing the CO2 utilization ratios (volume of CO2 injected to produce a barrel of oil) of 4 conventional and novel CO2 injection strategies: (1) continuous gas injection (CGI), (2) water alternating gas (WAG), (3) water curtain injection (WCI), and (4) WAG and WCI combination. These injection scenarios were simulated using the GEM module from the Computer Modeling Group (CMG). GEM is an advanced general equation-of-state compositional simulator, which includes equation of state, CO2 miscible flood, CO2/brine interactions, and complex phase behavior. The simulator is set up to model three fluid phases including water, oil, and gas. Our study demonstrates how the selected field development strategy has a significant impact on the ultimate recovery of CO2-EOR projects, with GCI injection providing maximum oil recovery in absolute volume terms, but with WAG offering a more balanced technical-economical approach.

  12. Effect of Incorporation of Antifungal Agents on the Ultimate Tensile Strength of Temporary Soft Denture Liners.

    Science.gov (United States)

    Neppelenbroek, Karin Hermana; Lima, Jozely Francisca Mello; Hotta, Juliana; Galitesi, Lucas Lulo; Almeida, Ana Lucia Pompéia Fraga; Urban, Vanessa Migliorini

    2018-02-01

    To investigate the ultimate tensile strength of temporary soft denture liners modified by minimum inhibitory concentrations (MICs) of antifungal agents for Candida albicans biofilm (SC5314) determined in previous microbiological research. Dumbbell-shaped specimens (n = 7) with a central cross-sectional area of 6 × 3 × 33 mm were produced by Softone and Trusoft, without (control) or with incorporation of drugs in powder form at MICs for C. albicans biofilm (per g of material powder): nystatin (0.032 g), chlorhexidine diacetate (0.064 g), ketoconazole (0.128 g), miconazole (0.256 g), and itraconazole (0.256 g). After plasticization, specimens were immersed in distilled water at 37°C for 24 hours, 7 or 14 days, and then tested in tension in a universal testing machine at 40 mm/min. Data of tensile strength (MPa) and elongation percentage (%) were submitted to 3-way ANOVA and Tukey's test (α = 0.05). At the end of 14 days, the tensile strength for both materials was significantly lower in the groups modified by miconazole and itraconazole compared to the other groups (p 0.05). After 7 and 14 days in water, miconazole and itraconazole added into both materials resulted in significantly lower elongation percentages compared to the other antifungal agents and control (p 0.05). The addition of the nystatin, chlorhexidine, and ketoconazole at MICs for C. albicans biofilm resulted in no harmful effects on the tensile strength and elongation percentage of the temporary soft denture liner materials up to 14 days. © 2017 by the American College of Prosthodontists.

  13. The establishment of MELCOR/SNAP model of Chinshan nuclear power plant for Ultimate Response Guideline

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, Wen-Sheng, E-mail: wshsu@ess.nthu.edu.tw [Nuclear Science and Technology Development Center, Institute of Nuclear Engineering and Science, National Tsing Hua University, Nuclear and New Energy Education and Research Foundation, No. 101, Section 2, Kuang Fu Rd., HsinChu 30013, Taiwan, ROC (China); Chiang, Yu, E-mail: s101013702@m101.nthu.edu.tw [Nuclear Science and Technology Development Center, Institute of Nuclear Engineering and Science, National Tsing Hua University, Nuclear and New Energy Education and Research Foundation, No. 101, Section 2, Kuang Fu Rd., HsinChu 30013, Taiwan, ROC (China); Wang, Jong-Rong, E-mail: jongrongwang@gmail.com [Nuclear Science and Technology Development Center, Institute of Nuclear Engineering and Science, National Tsing Hua University, Nuclear and New Energy Education and Research Foundation, No. 101, Section 2, Kuang Fu Rd., HsinChu 30013, Taiwan, ROC (China); Wang, Ting-Yi, E-mail: minired1119@gmail.com [Nuclear Science and Technology Development Center, Institute of Nuclear Engineering and Science, National Tsing Hua University, Nuclear and New Energy Education and Research Foundation, No. 101, Section 2, Kuang Fu Rd., HsinChu 30013, Taiwan, ROC (China); Wang, Te-Chuan, E-mail: tcwang@iner.gov.tw [Institute of Nuclear Energy Research Atomic Energy Council, R.O.C., 1000, Wenhua Road Jiaan Village, Longtan Township, Taoyuan County 32546, Taiwan (China); Teng, Jyh-Tong, E-mail: jyhtong@cycu.edu.tw [Department of Mechanical Engineering, Chung Yuan Christian University, 200, Chung Pei Rd, Chung Li 32023, Taiwan, ROC (China); Chen, Shao-Wen, E-mail: chensw@mx.nthu.edu.tw [Nuclear Science and Technology Development Center, Institute of Nuclear Engineering and Science, National Tsing Hua University, Nuclear and New Energy Education and Research Foundation, No. 101, Section 2, Kuang Fu Rd., HsinChu 30013, Taiwan, ROC (China); and others

    2017-01-15

    Highlights: • The establishment of a MELCOR/SNAP model of Chinshan (BWR/4). • MELCOR/SNAP model was used to estimate the effectiveness of URG for Chinshan. • The MELCOR results were compared to MAAP, TRACE and PCTRAN. • URG is a new method to prevent a Fukushima-like accident. • The low raw water (150 GPM) can make the cladding temperature below 1088.7 K. - Abstract: After Fukushima Daiichi disaster, the safety analysis of severe accidents became one of the safety concerns in Taiwan. The Emergency Operating Procedure (EOP) cannot cope with a multiple system failure situation under a severe accident since it is a “Symptom-basis” procedure. To deal with that, Taiwan Power Company built up a new strategy for Fukushima-like accident called Ultimate Response Guideline (URG). It is a simple strategy with three main conditions: loss of regular motor driven injection system, loss of all AC power and tsunami/earthquake warning. If two of three happen, the operating procedure will change from EOP to URG and start the main works by following the strategy. There are three main works in URG: controlled-depressurization, line up low pressure injection water and prepare containment venting. In this study, MELCOR2.1 was used to calculate the cases of URG and checked the goal of the strategy that prevents the accident or not. There were three steps in this research. First, a model of Chinshan nuclear power plant (NPP) was built. Second, one was the case with URG and the other was not by using the above MELCOR model. The results were compared to MAAP5.0, TRACE and PCTRAN. Finally, some sensitivity studies of depressurization and water injection rate were done.

  14. Consequences of EEG electrode position error on ultimate beamformer source reconstruction performance

    Directory of Open Access Journals (Sweden)

    Sarang S Dalal

    2014-03-01

    Full Text Available Inaccuracy of EEG electrode coordinates forms an error term in forward model generation and ultimate source reconstruction performance. This error arises from the combination of both intrinsic measurement noise of the digitization apparatus and manual coregistration error when selecting corresponding points on anatomical MRI volumes. A common assumption is that such an error would lead only to displacement of localized sources. Here, we measured electrode positions on a 3D-printed full-scale replica head, using three different techniques: a fringe projection 3D scanner, a novel Flying Triangulation 3D sensor, and a traditional electromagnetic digitizer. Using highly accurate fringe projection data as ground truth, the Flying Triangulation sensor had a mean error of 1.5 mm while the electromagnetic digitizer had a mean error of 6.8 mm. Then, again using the fringe projection as ground truth, individual EEG simulations were generated, with source locations across the brain space and a range of sensor noise levels. The simulated datasets were then processed using a beamformer in conjunction with the electrode coordinates registered with the Flying Triangulation and electromagnetic digitizer methods. The beamformer’s output SNR was severely degraded with the digitizer-based positions but less severely with the Flying Triangulation coordinates. Therefore, the seemingly innocuous error in electrode registration may result in substantial degradation of beamformer performance, with output SNR penalties up to several decibels. In the case of low-SNR signals such as deeper brain structures or gamma band sources, this implies that sensor coregistration accuracy could make the difference between successful detection of such activity or complete failure to resolve the source.

  15. Different Ultimate Factors Define Timing of Breeding in Two Related Species.

    Directory of Open Access Journals (Sweden)

    Veli-Matti Pakanen

    Full Text Available Correct reproductive timing is crucial for fitness. Breeding phenology even in similar species can differ due to different selective pressures on the timing of reproduction. These selection pressures define species' responses to warming springs. The temporal match-mismatch hypothesis suggests that timing of breeding in animals is selected to match with food availability (synchrony. Alternatively, time-dependent breeding success (the date hypothesis can result from other seasonally deteriorating ecological conditions such as intra- or interspecific competition or predation. We studied the effects of two ultimate factors on the timing of breeding, synchrony and other time-dependent factors (time-dependence, in sympatric populations of two related forest-dwelling passerine species, the great tit (Parus major and the willow tit (Poecile montanus by modelling recruitment with long-term capture-recapture data. We hypothesized that these two factors have different relevance for fitness in these species. We found that local recruitment in both species showed quadratic relationships with both time-dependence and synchrony. However, the importance of these factors was markedly different between the studied species. Caterpillar food played a predominant role in predicting the timing of breeding of the great tit. In contrast, for the willow tit time-dependence modelled as timing in relation to conspecifics was more important for local recruitment than synchrony. High caterpillar biomass experienced during the pre- and post-fledging periods increased local recruitment of both species. These contrasting results confirm that these species experience different selective pressures upon the timing of breeding, and hence responses to climate change may differ. Detailed information about life-history strategies is required to understand the effects of climate change, even in closely related taxa. The temporal match-mismatch hypothesis should be extended to consider

  16. The Federal Emergency Management Agency's National Incident Management System

    Science.gov (United States)

    The NIMS provides an integrated framework defining the roles and responsibilities of federal, state and local first responders, developed with responders from different jurisdictions and disciplines, to better work together during emergency events.

  17. Qualitative analysis of factors leading to clinical incidents.

    Science.gov (United States)

    Smith, Matthew D; Birch, Julian D; Renshaw, Mark; Ottewill, Melanie

    2013-01-01

    The purpose of this paper is to evaluate the common themes leading or contributing to clinical incidents in a UK teaching hospital. A root-cause analysis was conducted on patient safety incidents. Commonly occurring root causes and contributing factors were collected and correlated with incident timing and severity. In total, 65 root-cause analyses were reviewed, highlighting 202 factors implicated in the clinical incidents and 69 categories were identified. The 14 most commonly occurring causes (encountered in four incidents or more) were examined as a key-root or contributory cause. Incident timing was also analysed; common factors were encountered more frequently during out-hours--occurring as contributory rather than a key-root cause. In total, 14 commonly occurring factors were identified to direct interventions that could prevent many clinical incidents. From these, an "Organisational Safety Checklist" was developed to involve departmental level clinicians to monitor practice. This study demonstrates that comprehensively investigating incidents highlights common factors that can be addressed at a local level. Resilience against clinical incidents is low during out-of-hours periods, where factors such as lower staffing levels and poor service provision allows problems to escalate and become clinical incidents, which adds to the literature regarding out-of-hours care provision and should prove useful to those organising hospital services at departmental and management levels.

  18. Grazing incidence beam expander

    Energy Technology Data Exchange (ETDEWEB)

    Akkapeddi, P.R.; Glenn, P.; Fuschetto, A.; Appert, Q.; Viswanathan, V.K.

    1985-01-01

    A Grazing Incidence Beam Expander (GIBE) telescope is being designed and fabricated to be used as an equivalent end mirror in a long laser resonator cavity. The design requirements for this GIBE flow down from a generic Free Electron Laser (FEL) resonator. The nature of the FEL gain volume (a thin, pencil-like, on-axis region) dictates that the output beam be very small. Such a thin beam with the high power levels characteristic of FELs would have to travel perhaps hundreds of meters or more before expanding enough to allow reflection from cooled mirrors. A GIBE, on the other hand, would allow placing these optics closer to the gain region and thus reduces the cavity lengths substantially. Results are presented relating to optical and mechanical design, alignment sensitivity analysis, radius of curvature analysis, laser cavity stability analysis of a linear stable concentric laser cavity with a GIBE. Fabrication details of the GIBE are also given.

  19. Safety culture and learning from incidents: the role of incident reporting and causal analyses

    International Nuclear Information System (INIS)

    Wilpert, B.

    1994-01-01

    Nuclear industry more than any other industrial branch has developed and used predictive risk analysis as a method of feedforward control of safety and reliability. Systematic evaluation of operating experience, statistical documentation of component failures, systematic documentation and analysis of incidents are important complementary elements of feedback control: we are dealing here with adjustment and learning from experience, in particular from past incidents. Using preliminary findings from ongoing research at the Research Center Systems Safety at the Berlin University of Technology the contribution discusses preconditions for an effective use of lessons to be learnt from closely matched incident reporting and in depth analyses of causal chains leading to incidents. Such conditions are especially standardized documentation, reporting and analyzing methods of incidents; structured information flows and feedback loops; abstaining from culpability search; mutual trust of employees and management; willingness of all concerned to continually evaluate and optimize the established learning system. Thus, incident related reporting and causal analyses contribute to safety culture, which is seen to emerge from tightly coupled organizational measures and respective change in attitudes and behaviour. (author) 2 figs., 7 refs

  20. Proximate and Ultimate Compositional Changes in Corn Stover during Torrefaction using Thermogravimetric Analyzer and Microwaves

    Energy Technology Data Exchange (ETDEWEB)

    Jaya Shankar Tumuluru

    2012-07-01

    regular and microwaves and their effect on proximate and ultimate composition. Studies indicated that microwave torrefaction is a good way to torrefy the biomass in short periods of time. A maximum calorific value of 21 MJ/kg is achievable at 6 min residence time compared to 15 min using the dry torrefaction technique. Increasing the residence time increased the carbon content where a maximum carbon content of 52.20 % was achievable at lower residence time. The loss of volatiles is comparatively lower compared to dry torrefaction technique. Moisture content of microwave torrefied samples was in between 2-2.5 % (w.b).