Assessing Port Governance, Devolution and Terminal Performance in Nigeria

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D. E. Onwuegbuchunam

2018-02-01

Full Text Available Concerns about performance and efficiency in port terminals led many national governments to embark on port reforms. The Federal government of Nigeria, for example, adopted the Landlord port model which brought about concessioning of port terminals to private operators. Despite high investments in terminal facilities by the private terminal operators, there are still complaints about level of service offered to port users. This paper applied key performance indicator metrics and parameters of queuing model in assessing performance of Nigeria’s concessioned port terminals. Data for the study were obtained from terminal level records of cargo and ship handling activities for years 2000 to 2015. Major findings indicate that cargo and vessel throughputs improved after the reforms in the six ports examined. However, much variability was observed in trends in ships’ turnround times across all ports after the concession policy implementation. Additional results from the queuing model analysis suggest that the high ships turnround times observed in some ports are associated to delays in ship operation at the berths. The paper recommends that policy interventions be focused on ship operations at the berths as a step in improving service level in the port terminals.

Use of CFD in development of intake ports for diesel engines

International Nuclear Information System (INIS)

Alcenius, T.

2002-01-01

The design of intake ports for diesel engines is difficult due to the many competing requirements of the cylinder head design. When the concept design is completed, the typical course for verification and optimization of the port is through steady state flow testing. In the past, optimization of the port was considered a 'black art' as the final shape of the port and its performance was tied directly to the experience of the port development engineer. As CFD has been increasingly used to analyze various aspects of engine performance, an obvious area to explore is its use to predict steady state port flow performance prior to fabrication of any test hardware. A study was carried out to evaluate the usefulness of CFD in predicting steady state flow bench results and to provide insight into the fluid mechanics of the port flow to assist in the flow bench development. Port flow testing was carried out on a baseline diesel engine port for a range of valve lifts from zero to just above the maximum valve lift. This experimental test data was used to calculate flow coefficients and swirl ratios (an indicator of mean air motion in the cylinder). Subsequently, CFD models were generated that replicated the flow bench set-up. Three valve lifts across the valve lift range were chosen for the comparison. Results of the analysis were used to calculate flow coefficients and swirl ratios. Computed results were then compared to the experiments to determine their accuracy and a detailed review of the CFD results was conducted to understand the flow in the port. Modifications were made to the port from recommendations made based on the CFD results. The ports were then retested to determine the effectiveness of the recommendations. Finally, the results are discussed as to their meaning and usefulness for design programs. (author)

Detailed Design and Fabrication Method of the ITER Vacuum Vessel Ports

International Nuclear Information System (INIS)

Hee-Jae Ahn; Kwon, T.H.; Hong, Y.S.

2006-01-01

The engineering design of the ITER vacuum vessel (VV) has been progressed by the ITER International Team (IT) with the cooperation of several participant teams (PT). The VV and ports are the components allocated to Korea for the construction of the ITER. Hyundai Heavy Industries has been involved in the structural analysis, detailed design and development of the fabrication method of the upper and lower ports within the framework of the ITER transitional arrangements (ITA). The design of the port structures has been investigated to validate and to improve the conceptual designs of the ITER IT and other PT. The special emphasis was laid on the flange joint between the port extension and the in-port plug to develop the design of the upper port. The modified design with a pure friction type flange with forty-eight pieces of bolts instead of the tangential key is recommended. Furthermore, the alternative flange designs developed by the ITER IT have been analyzed in detail to simplify the lip seal maintenance into the port flange. The structural analyses of the lower RH port have been also performed to verify the capacity for supporting the VV. The maximum stress exceeds the allowable value at the reinforcing block and basement. More elaborate local models have been developed to mitigate the stress concentration and to modify the component design. The fabrication method and the sequence of the detailed fabrication for the ports are developed focusing on the cost reduction as well as the simplification. A typical port structure includes a port stub, a stub extension and a port extension with a connecting duct. The fabrication sequence consists of surface treatment, cutting, forming, cleaning, welding, machining, and non-destructive inspection and test. Tolerance study has been performed to avoid the mismatch of each fabricated component and to obtain the suitable tolerances in the assembly at the shop and site. This study is based on the experience in the fabrication of

Traumatic brain injury pharmacological treatment: recommendations

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Renato Anghinah

Full Text Available ABSTRACT This article presents the recommendations on the pharmacological treatment employed in traumatic brain injury (TBI at the outpatient clinic of the Cognitive Rehabilitation after TBI Service of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. A systematic assessment of the consensus reached in other countries, and of articles on TBI available in the PUBMED and LILACS medical databases, was carried out. We offer recommendations of pharmacological treatments in patients after TBI with different symptoms.

A Decision Fusion Framework for Treatment Recommendation Systems.

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Mei, Jing; Liu, Haifeng; Li, Xiang; Xie, Guotong; Yu, Yiqin

2015-01-01

Treatment recommendation is a nontrivial task--it requires not only domain knowledge from evidence-based medicine, but also data insights from descriptive, predictive and prescriptive analysis. A single treatment recommendation system is usually trained or modeled with a limited (size or quality) source. This paper proposes a decision fusion framework, combining both knowledge-driven and data-driven decision engines for treatment recommendation. End users (e.g. using the clinician workstation or mobile apps) could have a comprehensive view of various engines' opinions, as well as the final decision after fusion. For implementation, we leverage several well-known fusion algorithms, such as decision templates and meta classifiers (of logistic and SVM, etc.). Using an outcome-driven evaluation metric, we compare the fusion engine with base engines, and our experimental results show that decision fusion is a promising way towards a more valuable treatment recommendation.

Three ports versus four ports laparoscopic cholecystectomy

International Nuclear Information System (INIS)

Shah, S.F.; Waqar, S.; Chaudry, M.A.; Hameed, S.

2017-01-01

To compare three ports laparoscopic cholecystectomy and four ports laparoscopic cholecystectomy in terms of complications, time taken to complete the procedure, hospital stay and cost effectiveness in local perspective. Methodology: This randomized control trial included 60 patients who underwent elective laparoscopic cholecystectomy at Department of Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan from January 2013 to June 2013. These patients were randomized on computer generated table of random numbers into group A and Group B. In Group A patients four ports were passed to perform laparoscopic cholecystectomy and in Group B patients three ports were passed to perform the procedure. Results: The mean age in both groups was 44 years (range 18-72). Three ports laparoscopic cholecystectomy (43 min) took less time to complete than four ports laparoscopic cholecystectomy (51 min). Patients in three ports laparoscopic cholecystectomy experienced less pain as compared to four ports group. The total additional analgesia requirement in 24 hours calculated in milligrams was less in three port laparoscopic cholecystectomy group as compared four port laparoscopic cholecystectomy group. The mean hospital stay in three port laparoscopic cholecystectomy group is 25 hours while the mean hospital stay in the four port laparoscopic cholecystectomy group is 28 hours. Conclusion: Three ports laparoscopic cholecystectomy is safe and effective procedure and it did not compromise the patient safety. (author)

Is single port enough in minimally surgery for pneumothorax?

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Ocakcioglu, Ilhan; Alpay, Levent; Demir, Mine; Kiral, Hakan; Akyil, Mustafa; Dogruyol, Talha; Tezel, Cagatay; Baysungur, Volkan; Yalcinkaya, Irfan

2016-01-01

Video-assisted thoracoscopic surgery is a widespread used procedure for treatment of primary spontaneous pneumothorax patients. In this study, the adaptation of single-port video-assisted thoracoscopic surgery approach to primary spontaneous pneumothorax patients necessitating surgical treatment, with its pros and cons over the traditional two- or three-port approaches are examined. Between January 2011 and August 2013, 146 primary spontaneous pneumothorax patients suitable for surgical treatment are evaluated prospectively. Indications for surgery included prolonged air leak, recurrent pneumothorax, or abnormal findings on radiological examinations. Visual analog scale and patient satisfaction scale score were utilized. Forty triple-port, 69 double-port, and 37 single-port operations were performed. Mean age of 146 (126 male, 20 female) patients was 27.1 ± 16.4 (range 15-42). Mean operation duration was 63.59 ± 26 min; 61.7 for single, 64.2 for double, and 63.8 min for triple-port approaches. Total drainage was lower in the single-port group than the multi-port groups (P = 0.001). No conversion to open thoracotomy or 30-day hospital mortality was seen in our group. No recurrence was seen in single-port group on follow-up period. Visual analog scale scores on postoperative 24th, 48th, and 72nd hours were 3.42 ± 0.94, 2.46 ± 0.81, 1.96 ± 0.59 in the single-port group; significantly lower than the other groups (P = 0.011, P = 0.014, and P = 0.042, respectively). Patient satisfaction scale scores of patients in the single-port group on 24th and 48th hours were 1.90 ± 0.71 and 2.36 ± 0.62, respectively, indicating a significantly better score than the other two groups (P = 0.038 and P = 0.046). This study confirms the competency of single-port procedure in first-line surgical treatment of primary spontaneous pneumothorax.

The Development of the Regional Sea Port Infrastructure on the Basis of Dry Port

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Aleksandr Nelevich Rakhmangulov

2016-09-01

Full Text Available This article contributes to the solution of the relevant problem of the seaport infrastructure development for the purpose of increasing the cargo turnover in the regions of seaport location as well as to improve the quality of freight traffic on the basis of the creation of container hinterlands — dry ports. The options of dry ports as the potentially effective solution to increase the cargo turnover of existing seaports, improve the timeliness of freight transportation and overcome the environmental problems of the regions of seaport location are shown. This work analyzes the transport infrastructure of the region, the cargo turnover of major Russian sea and dry ports as well as the experience of creating dry ports in the Russian Federation and abroad. The authors propose the system of parameters for dry ports, which are recommended for the assessment of seaport infrastructure development scenarios on the stage of strategic planning. The authors have developed the approach of optimal values determination of the main parameters of dry ports by simulation modeling method. The features of construction and research of the simulation models of system “seaport — dry port” in programming software AnyLogic are considered. The results of modeling experiments with a developed simulation model are provided. This model is aimed to assess the maximum estimated capacity of the existing seaport in the conditions of the increasing irregularity of cargo traffic, and also to determine the optimum parameters of the constructed «dry port». The obtained dependencies as a result of modeling experiments prove the adequacy of the selected main parameters of dry ports for the effective evaluation of the scenarios of the strengthening of carrying and estimated capacity of existing seaports on the stage of strategic planning. The article shows that the methodology of this research can be used by the investors and public authorities as grounds for a decision on

Long-term catheterization: current approaches in the diagnosis and treatment of port-related infections

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Bustos C

2014-02-01

Full Text Available Cesar Bustos,1 Aitziber Aguinaga,1 Francisco Carmona-Torre,2 Jose Luis Del Pozo1,3 1Department of Clinical Microbiology, 2Department of Internal Medicine, 3Division of Infectious Diseases, Clinica Universidad de Navarra, Pamplona, Spain Abstract: Since the first description in 1982, totally implanted venous access ports have progressively improved patients' quality of life and medical assistance when a medical condition requires the use of long-term venous access. Currently, they are part of the standard medical care for oncohematologic patients. However, apart from mechanical and thrombotic complications, there are also complications associated with biofilm development inside the catheters. These biofilms increase the cost of medical assistance and extend hospitalization. The most frequently involved micro-organisms in these infections are gram-positive cocci. Many efforts have been made to understand biofilm formation within the lumen catheters, and to resolve catheter-related infection once it has been established. Apart from systemic antibiotic treatment, the use of local catheter treatment (ie, antibiotic lock technique is widely employed. Many different antimicrobial options have been tested, with different outcomes, in clinical and in in vitro assays. The stability of antibiotic concentration in the lock solution once instilled inside the catheter lumen remains unresolved. To prevent infection, it is mandatory to perform hand hygiene before catheter insertion and manipulation, and to disinfect catheter hubs, connectors, and injection ports before accessing the catheter. At present, there are still unresolved questions regarding the best antimicrobial agent for catheter-related bloodstream infection treatment and the duration of concentration stability of the antibiotic solution within the lumen of the port. Keywords: catheter-related infection, bacteremia, biofilm

Single-port (OctoPort) assisted extracorporeal ovarian cystectomy for the treatment of large ovarian cysts: compare to conventional laparoscopy and laparotomy.

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Chong, Gun Oh; Hong, Dae Gy; Lee, Yoon Soon

2015-01-01

To evaluate single-port assisted extracorporeal cystectomy for treatment of large ovarian cysts and to compare its surgical outcomes, complications, and cystic content spillage rates with those of conventional laparoscopy and laparotomy. Retrospective study (Canadian Task Force classification II-2). University teaching hospital. Twenty-five patients who underwent single-port assisted extracorporeal cystectomy (group 1), 33 patients who underwent conventional laparoscopy (group 2), and 25 patients who underwent laparotomy (group 3). Surgical outcomes, complications, and spillage rates in group 1 were compared with those in groups 2 and 3. Patients characteristics and tumor histologic findings were similar in the 3 groups. The mean (SD) largest diameter of ovarian cysts was 11.4 (4.2) cm in group 1, 9.7 (2.3) cm in group 2, and 12.0 (3.4) cm in group 3. Operative time in groups 1 and 2 was similar at 69.3 (26.3) minutes vs 73.1 (36.3) minutes (p = .66); however, operative time in group 1 was shorter than in group 3, at 69.3 (26.3) minutes vs 87.5 (26.6) minutes (p =.02). Blood loss in group 1 was significantly lower than in groups 2 and 3, at 16.0 (19.4) mL vs 36.1 (20.7) mL (p < .001) and 16.0 (19.4) mL vs 42.2 (39.7) mL (p = .005). The spillage rate in group 1 was profoundly lower than in group 2, at 8.0% vs 69.7% (p < .001). Single-port assisted extracorporeal cystectomy offers an alternative to conventional laparoscopy and laparotomy for management of large ovarian cysts, with comparable surgical outcomes. Furthermore, cyst content spillage rate in single-port assisted extracorporeal cystectomy was remarkably lower than that in conventional laparoscopy. Copyright © 2015. Published by Elsevier Inc.

SU-F-T-409: Modelling of the Magnetic Port in Temporary Breast Tissue Expanders for a Treatment Planning System

International Nuclear Information System (INIS)

Yoon, J; Heins, D; Zhang, R

2016-01-01

Purpose: To model the magnetic port in the temporary breast tissue expanders and to improve accuracy of dose calculation in Pinnacle, a commercial treatment planning system (TPS). Methods: A magnetic port in the tissue expander was modeled with a radiological measurement-basis; we have determined the dimension and the density of the model by film images and ion chamber measurement under the magnetic port, respectively. The model was then evaluated for various field sizes and photon energies by comparing depth dose values calculated by TPS (using our new model) and ion chamber measurement in a water tank. Also, the model was further evaluated by using a simplified anthropomorphic phantom with realistic geometry by placing thermoluminescent dosimeters (TLD)s around the magnetic port. Dose perturbations in a real patient’s treatment plan from the new model and a current clinical model, which is based on the subjective contouring created by the dosimetrist, were also compared. Results: Dose calculations based on our model showed less than 1% difference from ion chamber measurements for various field sizes and energies under the magnetic port when the magnetic port was placed parallel to the phantom surface. When it was placed perpendicular to the phantom surface, the maximum difference was 3.5%, while average differences were less than 3.1% for all cases. For the simplified anthropomorphic phantom, the calculated point doses agreed with TLD measurements within 5.2%. By comparing with the current model which is being used in clinic by TPS, it was found that current clinical model overestimates the effect from the magnetic port. Conclusion: Our new model showed good agreement with measurement for all cases. It could potentially improve the accuracy of dose delivery to the breast cancer patients.

Fewer-than-four ports versus four ports for laparoscopic cholecystectomy.

Science.gov (United States)

Gurusamy, Kurinchi Selvan; Vaughan, Jessica; Rossi, Michele; Davidson, Brian R

2014-02-20

cholecystectomy as the experimental intervention. Only one trial including 70 participants had low risk of bias. Fewer-than-four-ports laparoscopic cholecystectomy could be completed successfully in more than 90% of participants in most trials. The remaining participants were mostly converted to four-port laparoscopic cholecystectomy but some participants had to undergo open cholecystectomy.There was no mortality in either group in the seven trials that reported mortality (318 participants in fewer-than-four-ports laparoscopic cholecystectomy group and 316 participants in four-port laparoscopic cholecystectomy group). The proportion of participants with serious adverse events was low in both treatment groups and the estimated RR was compatible with a reduction and substantial increased risk with the fewer-than-four-ports group (6/318 (1.9%)) and four-port laparoscopic cholecystectomy group (0/316 (0%)) (RR 3.93; 95% CI 0.86 to 18.04; 7 trials; 634 participants; very low quality evidence). The estimated difference in the quality of life (measured between 10 and 30 days) was imprecise (standardised mean difference (SMD) 0.18; 95% CI -0.05 to 0.42; 4 trials; 510 participants; very low quality evidence), as was the proportion of participants in whom the laparoscopic cholecystectomy had to be converted to open cholecystectomy between the groups (fewer-than-four ports 3/289 (adjusted proportion 1.2%) versus four port: 5/292 (1.7%); RR 0.68; 95% CI 0.19 to 2.35; 5 trials; 581 participants; very low quality evidence). The fewer-than-four-ports laparoscopic cholecystectomy took 14 minutes longer to complete (MD 14.44 minutes; 95% CI 5.95 to 22.93; 9 trials; 855 participants; very low quality evidence). There was no clear difference in hospital stay between the groups (MD -0.01 days; 95% CI -0.28 to 0.26; 6 trials; 731 participants) or in the proportion of participants discharged as day surgery (RR 0.92; 95% CI 0.70 to 1.22; 1 trial; 50 participants; very low quality evidence) between the

Ocular injuries among industrial welders in Port Harcourt, Nigeria

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Fiebai B

2011-09-01

Full Text Available B Fiebai, EA AwoyesukuDepartment of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, NigeriaBackground: The purpose of this study was to determine the prevalence and pattern of ocular injuries among industrial welders and rate the use of protective eyewear at work among industrial welders in Port Harcourt. Information from this study will provide a database for effective policy formation on prevention of occupational eye injuries in Port Harcourt Rivers State.Methods: A cross-sectional survey of ocular injuries and use of protective eyewear among industrial welders in the Port Harcourt local government area of Rivers State, Nigeria, was carried out over a three-month period. Five hundred welders were selected by simple random sampling. Information was obtained using an interviewer-administered questionnaire. All welders were examined in their workshops.Results: Flying metal chips were the chief source of ocular injury, as reported by 199 (68.15% of those who gave a history of work-related eye injury, while arc rays accounted for the remaining 93 (31.85%. There was a high level of awareness of the risk of sustaining an eye injury from welding (n = 490, 98%, but only 46 (15.3% of the welders were using protective eyewear at the time of injury.Conclusion: To minimize ocular injury and promote eye health amongst industrial welders, safety intervention programs, such as awareness campaigns, setting up of targeted programs by the relevant government agencies, and encouragement of locally produced eye protectors is recommended. The involvement of occupational medical practitioners is also strongly recommended.Keywords: industrial welders, ocular injury, Port Harcourt, preventable blindness, protective eye devices

Ports Primer: 3.2 Port Governance

Science.gov (United States)

State and local governments are important players in port governance and in oversight of transportation projects that may affect ports. Private corporations may also play a role if they lease or own a terminal at a port.

Treatment of port-wine stains with flash lamp pumped pulsed dye laser on Indian skin: A six year study

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Chandroth Ponnambath Thajudheen

2014-01-01

Full Text Available Context: Port-wine stain (PWS is one of the commonly encountered congenital cutaneous vascular lesions, with an equal sex distribution. Pulsed dye lasers (PDL have revolutionized the treatment of both congential and acquired cutaneous vascular lesions. The pulsed dye lasers owing to its superior efficacy and safety profile have become the gold standard for the management of port-wine stains. Aims: To evaluate the efficacy and side effects of pulsed dye laser for the management of Port-wine stain on Indian skin. Materials and Methods: Seventy five patients of Fitzpatrick skin types IV&V with PWS underwent multiple treatments with PDL (V beam-Candela over a period of six years at monthly intervals. Laser parameters were wavelength 595nm, spot sizes 7-10mm, fluence 6-12 j/cm2, pulse duration 0.45-10ms, along with cryogen cooling. Serial photographs were taken before and after every session. Clinical improvement scores of comparable photographs using a quartile grading (o=80% were judged independently by two dermatologists after the series of treatment. Minimum number of treatments was 6 and maximum 17.They were followed up at six monthly intervals to observe re darkening of PWS. Results: No patient showed total clearance.Grade3 improvement was observed in 70 % of children and 50% of adults after 8-10 sessions. Children showed better and faster response than adults. Thirty percent of patients developed post inflammatory hyper pigmentation which resolved over a period of six to eight weeks. Two patients had superficial scarring due to stacking of pulses. None of the patients showed re darkening of PWS till now. Conclusion: Pulsed dye laser is an effective and safe treatment for port-wine stain in Indian skin.

The Aggregate Planning For Trucking Operation in Cikarang Dry Port

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Dwi Puspita Sari Utami

2015-06-01

Full Text Available Abstract. Cikarang Dry Port currently is the only dry port in Indonesia. This Dry Port has a role to connect or extend the Sea Port to the industrial areas located far from Sea Port. Thus, it creates a value added and also reduce costs. One of the operations done in Cikarang Dry Port is trucking operation. This research aims to examine the planning of 2014 trucking activity in Cikarang Dry Port to determine the right number of the truck that will be best occupied to manage all demands. The analysis begins with demand forecasting by using a moving average method of 12 months or one year period in 2013 which will be used as main information to develop the plans. There are three plans developed in this research. Based on the three plans, Plan A with minimum trucking plan with subcontracting is the most profitable which gives the highest profitability of Rp. 374,984,625. Recommendation for this research is using the current minimum number of 39 trucks rent with additional subcontracting when the demand is exceeding the capacity, thus, Cikarang Dry Port can occupy all demands and gain more profits. Keywords: Aggregate Planning; Scheduling; Trucking Operation; Moving Average; Cikarang Dry Port

The Aggregate Planning For Trucking Operation in Cikarang Dry Port

Directory of Open Access Journals (Sweden)

Dwi Puspita Sari Utami

2015-07-01

Full Text Available Abstract. Cikarang Dry Port currently is the only dry port in Indonesia. This Dry Port has a role to connect or extend the Sea Port to the industrial areas located far from Sea Port. Thus, it creates a value added and also reduce costs. One of the operations done in Cikarang Dry Port is trucking operation. This research aims to examine the planning of 2014 trucking activity in Cikarang Dry Port to determine the right number of the truck that will be best occupied to manage all demands. The analysis begins with demand forecasting by using a moving average method of 12 months or one year period in 2013 which will be used as main information to develop the plans. There are three plans developed in this research. Based on the three plans, Plan A with minimum trucking plan with subcontracting is the most profitable which gives the highest profitability of Rp. 374,984,625. Recommendation for this research is using the current minimum number of 39 trucks rent with additional subcontracting when the demand is exceeding the capacity, thus, Cikarang Dry Port can occupy all demands and gain more profits.Keywords: Aggregate Planning; Scheduling; Trucking Operation; Moving Average; Cikarang Dry Port

Cooperation Performance Evaluation between Seaport and Dry Port; Case of Qingdao Port and Xi'an Port

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Jian Li

2014-12-01

Full Text Available Along with the drastic competition among ports, the strive for the vast economic hinterland and the supply of goods have become strategic problems for port operators. At the same time, port enterprises are paying more and more attention to the construction of dry ports. This article establishes the port cooperation performance evaluation index based on the balanced score card method and uses the grey relational degree method to evaluate the cooperation performance between seaports and dry ports. Finally using Qingdao port and Xi'an port as an example, and Zhengzhou port and Lanzhou port as benchmarks, the application of this evaluation method is introduced in detail. The conclusion reveals that cooperation between Qingdao port and Xi'an port has deficiencies in customer satisfaction, financial cooperation and non-market tools. Alongside this, the author proposes related issues about information management in the supply chain, competition position and the scope of hinterland. This article, combined with the related theory of supply chain and performance evaluation, puts forward a set of relatively complete cooperation performance evaluations between seaports and dry ports, which provide scientific theory support for better cooperation.

Utility of the Canadian Treatment Optimization Recommendations (TOR) in MS care.

Science.gov (United States)

Grand'Maison, François; Bhan, Virender; Freedman, Mark S; Myles, Mary L; Patry, David G; Selchen, Daniel H; Moriarty, Patrick; Traboulsee, Anthony L

2013-07-01

Criteria for Treatment Optimization Recommendations (TOR) for patients with multiple sclerosis (MS) identify suboptimal response to disease-modifying treatment (DMT). The Canadian TOR (CanTOR) were used to indicate recommendations for treatment switches or treatment maintenance based on relapse, disease progression and magnetic resonance imaging (MRI) criteria in patients. We assessed concordance between the TOR and clinicians' decisions regarding treatment response and identified prevalence of patients with MS receiving DMT meeting medium/high levels of concern according to TOR. Prospective baseline and end-of-study assessments of patients with relapsing-remitting MS (RRMS) or clinically isolated syndrome were conducted in this open-label, 12-month, Phase IV, observational Canadian study. Data were reported for 184 patients (female 72%, mean age 39 years) of which 96% had RRMS. The TOR criteria identified 19 (10.3%) patients with suboptimal response to treatment. Twelve patients had ≥1 high level of concern. Two patients had ≥2 medium levels of concern. Concordance between TOR and clinician decision in maintaining treatment was 95.3%. Where treatment change was recommended by the TOR, concordance was 29.4%. Clinicians identified the TOR as the principal reason for changing treatment in 50.0% of cases where the TOR identified suboptimal response. The TOR were considered useful by 70.6% of clinicians when treatment optimization was recommended and by 55.3% when maintaining treatment was recommended. The TOR criteria can identify suboptimal response in this patient cohort. Concordance between TOR and clinician decision was high when maintaining treatment was recommended. Usefulness of the TOR was most apparent when treatment optimization was recommended.

The Global View on Port State Control

NARCIS (Netherlands)

S. Knapp (Sabine); Ph.H.B.F. Franses (Philip Hans)

2006-01-01

textabstractThis report is the second part of a PhD project entitled "The Econometrics of Maritime Safety – Recommendations to Enhance Safety at Sea" which is based on 183,000 port state control inspections and 11,700 casualties from various data sources. Its overall objective is to provide

A case of acquired port wine stain: an association with repeated sunburn?

Science.gov (United States)

Seremet, Sila; Benar, Elif B; Afsar, Fatma Sule; Calli, Aylin; Ulusarac, Ozlem

2016-10-01

Unlike congenital port wine stain (PWS), an acquired PWS is a rare vascular lesion that develops later in life. Although solar damage is associated with acquired PWS, there is no reported case of acquired PWS after sunburn in the literature. We report a case of a 54-year-old man diagnosed with acquired PWS possibly caused by repeated sunburn. We recommended laser treatment to our patient; however, the patient did not chose to receive any treatment. Our case demonstrates a possible rare occurrence of an acquired PWS after sunburn with larger lesions and more diffuse distribution. For this reason, our case differs from other acquired PWS cases. © 2016 The International Society of Dermatology.

A Simplified Technique of Percutaneous Hepatic Artery Port-Catheter Insertion for the Treatment of Advanced Hepatocellular Carcinoma with Portal Vein Invasion

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Choi, Sun Young [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Kim, Ah Hyun; Lee, Do Yun; Lee, Kwang Hun; Won, Jong Yun [Yonsei University College of Medicine, Severance Hospital, Seoul (Korea, Republic of); Kim, Kyung Ah [Inje University Ilsan Paik Hospital, Ilsan (Korea, Republic of)

2010-12-15

We assessed the outcomes of a simplified technique for the percutaneous placement of a hepatic artery port-catheter system for chemotherapy infusion in advanced hepatocellular carcinoma with portal vein invasion. From February 2003 to February 2008, percutaneous hepatic artery port-catheter insertion was performed in 122 patients who had hepatocellular carcinoma with portal vein invasion. The arterial access route was the common femoral artery. The tip of the catheter was wedged into the right gastroepiploic artery without an additional fixation device. A side hole was positioned at the distal common hepatic artery to allow the delivery of chemotherapeutic agents into the hepatic arteries. Coil embolization was performed only to redistribute to the hepatic arteries or to prevent the inadvertent delivery of chemotherapeutic agents into extrahepatic arteries. The port chamber was created at either the supra-inguinal or infra-inguinal region. Technical success was achieved in all patients. Proper positioning of the side hole was checked before each scheduled chemotherapy session by port angiography. Catheter-related complications occurred in 19 patients (16%). Revision was achieved in 15 of 18 patients (83%). This simplified method demonstrates excellent technical feasibility, an acceptable range of complications, and is hence recommended for the management of advanced hepatocellular carcinoma with portal vein thrombosis

COMPARATIVE ANALYSIS OF LEADING PORTS OF LATVIA: COMPETITIVENESS OF LIEPAJA PORT

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Diāna Līduma

2015-06-01

Full Text Available There are 10 operating ports in Latvia and 3 of them – Liepaja, Ventspils and Riga ports are regarded as the leading commercial ports. Role of port operation in the economics of region and country is essential from the point of view of employment and entrepreneurship. This is based with data on investment of operation of Latvian ports in GDP, on average it is assessed to be 5-7% annually. In the context of employment, Liepaja Port gives work to 6.9% of human resources of the city. However, concern about the competitiveness of Liepaja Port influenced by the proximity of more developed competitive ports, technical possibilities of the port and dynamics of freight turnover has occurred in recent years. Therewith in framework of this article in the context of such criteria as location of ports and their technical parameters, volumes of freight, specialization and costs of ports, the operation of leading ports of Latvia is intercompared and analyzed by clarifying whether Liepaja Port is competitive among other ports of Latvia. Opinions of port experts on perspectives of port development and statistical data of ports from 2011-2013 are analyzed within the framework of the article. The aim of the research is to clarify the comparative advantages of ports of Latvia. The research revealed that the provision of competitiveness of Liepaja Port is to be related with application of the available free territories, advantages of location in relation to the Scandinavian market, and the necessity to develop the cooperation among ports of Latvia to offer joint freight acquisition, distributions and unified logistics solution and strengthen the position of ports in the circumstances of international competition.

Laser Treatment of Port Wine Stains

Science.gov (United States)

Majaron, Boris; Nelson, J. Stuart

Port wine stain (PWS), also called nevus flammeus, is a congenital, cutaneous vascular malformation involving post-capillary venules which produce a light pink to red to dark-red-violet discoloration of human skin [1]. PWS occurs in an estimated 3 children per 1000 live births, affecting males and females and all racial groups equally [2]. There appears to be no hereditary predilection for PWS within families. There are no known risk factors or ways to prevent PWS.

Treatment Recommendation Actions, Contingencies, and Responses: An Introduction.

Science.gov (United States)

Stivers, Tanya; Barnes, Rebecca K

2017-08-21

In the era of patient participation in health care decision making, we know surprisingly little about the ways in which treatment recommendations are made, the contexts that shape their formulation, and the consequences of these formulations. In this article, we introduce a systematic collective investigation of how recommendations for medications are responded to and made in primary versus secondary care, in the US versus the UK, and in contexts where the medication was over the counter versus by prescription. This article provides an overview of the coding system that was used in this project including describing what constitutes a recommendation, the primary action types clinicians use for recommendations, and the types of responses provided by patients to recommendations.

Two-port access versus four-port access laparoscopic ovarian cystectomy.

Science.gov (United States)

Choi, Won-Kyu; Kim, Jang-Kew; Yang, Jung-Bo; Ko, Young-Bok; Nam, Sang-Lyun; Lee, Ki-Hwan

2014-09-01

This study was conducted to compare the surgical outcomes between two-port access and four-port access laparoscopic ovarian cystectomy. Four hundred and eighty nine patients who had received two-port access laparoscopic ovarian cystectomy (n=175) and four-port access laparoscopic ovarian cystectomy (n=314) in Chungnam National University Hospital from January 2009 to August 2012 were analyzed retrospectively. The data were compared between the bilaterality of the cysts and cyst diameter of less than 6 cm and 6 cm or more. There were no significant differences in patient's age, parity, body weight, body mass index and history of previous surgery between the two-port and four-port access laparoscopy group. Bilaterality of ovarian cysts was more in fourport access laparoscopy group (13.7% vs. 32.5%, P=0.000). There were no significant differences in operation time, hemoglobin change, hospital stay, adhesiolysis, transfusion, and insertion of hemo-vac between the two-port and four-port access laparoscopy group for size matched compare. However additional analgesics were more in four-port access laparoscopy group for unilateral ovarian cystectomy. Two-port access laparoscopic surgery was feasible and safe for unilateral and bilateral ovarian cystectomy compare with four-port access laparoscopic surgery.

Single-port laparoscopic partial splenectomy: a case report.

Science.gov (United States)

Hong, Tae Ho; Lee, Sang Kuon; You, Young Kyoung; Kim, Jun Gi

2010-10-01

With the better understanding of the importance of the spleen as a primary organ of the human immune system, there has been an increased interest in performing the partial splenectomy for a number of indications such as nonparasitic cysts, benign tumors, staging of lymphomas, etc. Moreover, laparoscopic partial splenectomy has been gaining more interest as the recommended approach for benign splenic disorders to preserve the splenic function with very low recurrence rates. Meanwhile, many surgeons have attempted to reduce the number and size of the ports in laparoscopic surgery with the aim of inducing less parietal trauma and fewer scars. One of these efforts is single-port laparoscopic surgery, which is a rapidly evolving field all over the world. Here, we describe a feasible method of single-port laparoscopic partial splenectomy for treating a benign splenic cyst that was located in the upper medial aspect of the spleen.

Green Port / Eco Port Project - Applications and Procedures in Turkey

Science.gov (United States)

Akgul, Burak

2017-12-01

As being the heartlands of international trade, sea ports are the junction points of land and sea routes. The growth of global trade has led to the development of number and capacity as well as the service quality of ports. The policies and procedures applied during construction, operation and development of ports under development with environmental considerations scope has evolved in accordance with the needs of global trends. Although maritime transportation provides the most ecofriendly transportation method, the reduction of potential environmental threats and continuous improvement of ports and their vicinity is paramount from environmental concerns with regards to the international environmental standards. In the context of the study, national and international legal regulations governing the control of the environmental impacts of the activity groups causing pollution in Turkey based sea ports were viewed. In addition, the models applied during the measurement and documentation of environmental impacts were investigated. The most important aspects in terms of the effectiveness of the environmental management models are legal regulations. However, the standards applied at the ports without any legal obligation, such as EcoPorts applications, ISO 14001 standard, and the EMAS (Eco-Management and Audit Scheme) were sought in the scope of the study. The boundaries of the study were determined as the EU based Environmental Management Systems and the Green Port/Eco Port Project which is being administered by the Turkish Ministry of Transport, Maritime and Communication. “Marport”, which is Turkey’s first certified Green Port / Eco Port is designated as the experimental study site. In addition, the provisions in the ports of ESPO member countries are approached in order to compare the effectiveness and applicability of Green Port / Eco Port Project.

Flat-port connectors

KAUST Repository

Alrashed, Mohammed

2017-05-26

Disclosed are various embodiments for connectors used with electronic devices, such as input and/or output ports to connect peripheral equipment or accessories. More specifically, various flat-port are provided that can be used in place of standard connectors including, but not limited to, audio jacks and Universal Serial Bus (USB) ports. The flat-port connectors are an alternate connection design to replace the traditional receptacle port (female-port), making the device more sealed creation more dust and water resistant. It is unique in the way of using the outer surfaces of the device for the electrical connection between the ports. Flat-port design can allow the manufacture of extremely thin devices by eliminating the side ports slots that take a lot of space and contribute to the increase thickness of the device. The flat-port receptacle improves the overall appearance of the device and makes it more resistant to dust and water.

Intra-arterial port implantation for intra-arterial chemotherapy : comparison between PIPS(Percutaneously Implantable Port System) and port system

International Nuclear Information System (INIS)

Yoon, Sang Jin; Shim, Hyung Jin; Jung, Hun Young; Choi, Yong Ho; Kim, Yang Soo; Song, In Sup; Kwak, Byung Kook

1999-01-01

To compare the techniques and complications of intra-arterial port implantation for intra-arterial chemotherapy between PIPS and the port system. For intra-arterial port implantation, 27 cases in 27 patients were retrospectively evaluated using PIPS(PIPS-200, William Cook Europe, Denmark) while for 21 cases in 19 patients a pediatric venous port system(Port-A-Cath, 5.8F, SIMS Deltec, U. S. A.) was used. All intra-arterial port implantation was performed percuteneously in an angiographic ward. Hepatocellular carcinoma was diagnosed in 18 patients and hepatic metastasis in 16. Peripheral cholangiocarcinoma, and pancreatic gastric, ovarian, renal cell and colon carcinoma were included. We compared the techniques and complications between PIPS and the port system. The follow up period ranged from 23 to 494(mean, 163) days in PIPS and from 12 to 431(mean, 150) days in the port system. In all cases, intra-arterial port implantations were technically successful. Port catheter tips were located in the common hepatic artery(n=8), proper hepatic artery(n=7), right hepatic artery(n=5), gastroduodenal artery(n=2), left hepatic artery(n=1), pancreaticoduodenal artery(n=1), inferior mesenteric artery(n=1), lumbar artery(n=1), and renal artery(n=1) in PIPS, and in the proper hepatic artery(n=6), gastroduodenal artery(n=6), common hepatic artery(n=3), right hepatic artery(n=4), inferior mesenteric artery(n=1), and internal iliac artery(n=1) in the port system. Port chambers were buried in infrainguinal subcutaneous tissue. Using PIPS, complications developed in seven cases(25.9%) and of these, four (57.1%) were catheter or chamber related. In the port system, catheter or chamber related complications developed in four cases(19.0%). Because PIPS and the port system have relative merits and demetrits, successful intra-arterial port implantation is possible if equipment is properly selected

Port Stakeholder Summit: Advancing More Sustainable Ports (April 2014)

Science.gov (United States)

EPA's National Port Stakeholders Summit, Advancing More Sustainable Ports, focused on actions to protect air quality while reducing climate risk and supporting economic growth, making ports more environmentally sustainable.

Ports Initiative

Science.gov (United States)

EPA's Ports Initiative works in collaboration with the port industry, communities, and government to improve environmental performance and increase economic prosperity. This effort helps people near ports breath cleaner air and live better lives.

ECSPECT prospective multicentre registry for single-port laparoscopic colorectal procedures

DEFF Research Database (Denmark)

Weiss, Helmut; Zorron, R; Vestweber, K-H

2017-01-01

BACKGROUND: The international multicentre registry ECSPECT (European Consensus of Single Port Expertise in Colorectal Treatment) was established to evaluate the general feasibility and safety of single-port colorectal surgery with regard to preoperative risk assessment. METHODS: Consecutive...... patients undergoing single-port colorectal surgery were enrolled from 11 European centres between March 2010 and March 2014. Data were analysed to assess patient-, technique- and procedure-dependent parameters. A validated sex-adjusted risk chart was developed for prediction of single-port colorectal...

Comparison Between Conditions of Major Roads Within and Outside the Port of Durban

Directory of Open Access Journals (Sweden)

O. M. Kunene

2013-02-01

Full Text Available Over the past years road traffic has increased at the Port of Durban. Due to the lack of maintenance, this has resulted in road deterioration. Roads are considered as the most important transport mode at the Port of Durban. It is an important mean for facilitating economic growth of local, regional and national industries. For the Port to maintain global competitiveness with the current trend of globalization, it has to be ensured that the roads are well maintained. The purpose of the paper is to provide an overview of road condition within and outside the Port. Verification and assessment of the condition of the existing eight major roads was conducted. Comparisons between the condition of the eight major roads within and outside the Port were highlighted. Conclusions and recommendations were also drawn based on the findings.

Revisiting port pricing : a proposal for seven port pricing principles

NARCIS (Netherlands)

Van Den Berg, R.; De Langen, P.W.; Van Zuijlen, P.C.J.

2017-01-01

A review of seven large landlord port authorities around the world reveals a notable diversity of pricing structures. While port authorities increasingly act as commercial undertakings, port pricing often seems to be not driven by commercial considerations. In this paper, we argue that ports can be

Influence of Port Policy on the Development of Croatian Container Ports

Directory of Open Access Journals (Sweden)

Čedomir Dundović

2002-03-01

Full Text Available It is important to consider the port development throughoutthe world from the aspect of economical, transport and portpolicy and their mutual impact on commerce and efficiency ofports. By examining such relations in the context of developmentof the Croatian container ports, it is possible to define reasonsfor lagging behind of Croatian ports compared to theworld movements.The main reason for the negative trend of development ofCroatian container ports lies in the non-existence of adequatemeasures of transport, maritime and port policy. Analysis ofstatistics over the past decade and comparison of structure andvolume of the general cargo traffic in the Rijeka port and theneighbouring ports in the area of North Adriatic are both showingsignificant size discrepancy and uncompetitiveness of theCroatian port. Disturbances that have brought to such a situationresult from inadequate port policy and non-harmonisedactivities between various modes of transport.In order to overcome such situation, the authors suggest determiningof clear tasks, goals and measures of the port policythat have to be undertaken so that the Croatian policy could becompatible with the main aspects, development tendencies andmeasures of theE U port policy.

Towards Sustainable ASEAN Port Development: Challenges and Opportunities for Vietnamese Ports

Directory of Open Access Journals (Sweden)

Saeyeon Roh

2016-06-01

Full Text Available Sustainability agendas are challenging port authorities around the world to find ways of operating and managing their ports efficiently and effectively in terms of economic, social, as well as environmental development. In this respect, governments in ASEAN countries have been implementing various green activities seeking to reduce the environmental impact of shipping and related activities. In this connection, most studies in the existing literature mainly focus on the environmental aspects of sustainable development and have not clearly explained what sustainable port development exactly entails. Furthermore, most of these studies emphasized on the impact of port development and overlooked what factors influence sustainable port development. To address these gaps, this research aim to explore the main factors shaping sustainable port development. This was conducted through a comprehensive review of related literature as well as confirmatory in-depth interviews with port authorities. As a result, findings from this research would help identify key elements of sustainable port development from port authorities’ perspective. The challenges, opportunities and managerial implications for Vietnamese ports are also discussed accordingly.

Radiologically-placed venous ports in children under venous anesthesia

International Nuclear Information System (INIS)

Jang, Joo Yeon; Jeon, Ung Bae; Choo, Ki Seok; Hwang, Jae Yeon; Kim, Yong Woo; Lee, Yun Jin; Nam, Sang Ool; Lim, Young Tak

2015-01-01

To evaluate the efficacy and safety of radiologic venous port placement in children under venous anesthesia. Between April 2009 and July 2011, 44 ports were implanted in 41 children (24 boys, 17 girls). The age of patients ranged from 9 months to 19 years (mean, 6.5 years) and their body weights ranged from 6.8 kg to 56.3 kg (mean, 23.2 kg). Right internal jugular vein access was used in 42 ports, right subclavian vein in 1, and left subclavian in 1. Durability and complications of port implantation were reviewed. The technical success rate was 100%. The catheter life was 10-661 days (mean 246 days). Two patients died during the follow-up period, 21 and 6 ports were removed at the end of treatment or as a result of complications, respectively. One port was removed and replaced by a Hickmann catheter. Three ports were explanted due to port-related sepsis, one due to a catheter kink, and two for unexplained fever or insertion site pain. The overall port-related infection was 3 cases (6.8%, 0.28/1000 catheter days). Venous port placement by interventional radiologists in children under intravenous sedation is relatively safe, with a high rate of technical success and low rate of complications.

Radiologically-placed venous ports in children under venous anesthesia

Energy Technology Data Exchange (ETDEWEB)

Jang, Joo Yeon; Jeon, Ung Bae; Choo, Ki Seok; Hwang, Jae Yeon; Kim, Yong Woo; Lee, Yun Jin; Nam, Sang Ool; Lim, Young Tak [Pusan National University School of Medicine, Yangsan (Korea, Republic of)

2015-02-15

To evaluate the efficacy and safety of radiologic venous port placement in children under venous anesthesia. Between April 2009 and July 2011, 44 ports were implanted in 41 children (24 boys, 17 girls). The age of patients ranged from 9 months to 19 years (mean, 6.5 years) and their body weights ranged from 6.8 kg to 56.3 kg (mean, 23.2 kg). Right internal jugular vein access was used in 42 ports, right subclavian vein in 1, and left subclavian in 1. Durability and complications of port implantation were reviewed. The technical success rate was 100%. The catheter life was 10-661 days (mean 246 days). Two patients died during the follow-up period, 21 and 6 ports were removed at the end of treatment or as a result of complications, respectively. One port was removed and replaced by a Hickmann catheter. Three ports were explanted due to port-related sepsis, one due to a catheter kink, and two for unexplained fever or insertion site pain. The overall port-related infection was 3 cases (6.8%, 0.28/1000 catheter days). Venous port placement by interventional radiologists in children under intravenous sedation is relatively safe, with a high rate of technical success and low rate of complications.

Variation in Recommendation for Surgical Treatment for Compressive Neuropathy

NARCIS (Netherlands)

Hageman, Michiel G. H.; Becker, Stephanie J. E.; Bot, Arjan G. J.; Guitton, Thierry; Ring, David; Wahegaonkar, Abhijeet L.; Garcia, Aida E.; Schefer, Alan; Castillo, Alberto Perez; Terrono, Andrew L.; Gurman, Andrew W.; Apard, T.; Watkins, Barry; Ilyas, Asif; Hearon, Bernard F.; Wills, Brian P. D.; Wintman, Bruce I.; Swigart, Carrie; Spath, Catherine; Dario, Cesar; Miranda, Oliveira; Goldfarb, Charles A.; Cassidy, Charles; Metzger, Charles; Eaton, Charles; Wilson, Chris; Walsh, Christopher J.; Wilson, Christopher J.; Jones, Christopher M.; Young, Colby; Bottke, Craig A.; Osei, Daniel A.; Kirkpatrick, D. Kay; Tate, David; Polatsch, Daniel; Nelson, David L.; Kalainov, David M.; Lamey, David M.; Hanel, Doug; Ostrowski, David M.; Miller, David R.; McKee, Desirae M.; Shin, Eon K.; Ruchelsman, David; Bonatz, Ekkehard; Hofmeister, Eric P.; Fischer, Evan S.; Kaplan, F. Thomas D.; Fernandes, C. H.; Forigua, Jamie E.; Cayon Cayon, Fidel Ernesto; Raia, Frank J.; Walter, Frank L.; Frykman, Gary K.; Pess, Gary M.; Kuzma, Gary R.; Huemer, Georg M.; Byrd, Gregory Dee; Balfour, George W.; Caro, Gladys Cecilia Zambrano; Hernandez, German Ricardo; DeSilva, Gregory; Bamberger, H. Brent; Grunwald, H. W.; MccUtchan, Hal; Solomon, Harrison; Kimball, Hervey L.; Stuart, J. E. B.; Lin, Ines C.; Choueka, Jack; Reid, James G.; Boler, James M.; Pomerance, Jay; Johnson, Jeff W.; Yao, Jeffrey; Calandruccio, Jim; Green, Jennifer B.; Wolf, Jennifer Moriatis; Frankenhoff, Jessica A.; Oakey, Jerome W.; Fischer, Jochen; Howlett, John; Jiuliano, John; Erickson, John M.; McAuliffe, John; Evans, John P.; Taras, John; Boretto, Jorge G.; Isaacs, Jonathan; Di Giovanni, Jose Fernando; Nolla, Jose; Abzug, Joshua M.; Adams, Julie; Chivers, Karel; Prommersberger, Karl-Josef; Malone, Kevin J.; Lee, Kendrick; Halperin, Lawrence S.; Weiss, Lawrence; Benson, Leon; Lane, Lewis B.; Paz, Lior; Lattanza, Lisa; Palmer, M. Jason; Catalano, Louis; Richard, Marc J.; Rizzo, Marco; Boyer, Martin; Calcagni, Maurizio; Wood, Megan M.; Baskies, Michael; Grafe, Michael W.; Behrman, Michael; Jones, Michael; Quinn, Michael; Nancollas, Michael; Kessler, Michael W.; Pirela-Cruz, Miguel A.; Patel, Milan M.; Felipe, Naquira Escobar Luis; Harness, Neil G.; Akabudike, Ngozi M.; Horangic, Nicholas J.; Semenkin, Oleg M.; Leung, Nicky L.; McCulloch, Patrick T.; Owens, Patrick W.; Martineau, Paul A.; Bettinger, Paul; Guidera, Paul; Hoepfner, Peter E.; Sitaram, Prasad; DeNoble, Peter H.; Jebson, Peter; Coogan, Philip; Dantuluri, Phani; Gaston, R. Glenn; Nyszkiewicz, Ralf; Costanzo, Ralph M.; de Bedout, Ramon; Hauck, Randy; Fricker, Renato M.; GIlbert, Richard S.; Hutchison, Richard L.; Barth, Richard W.; Papandrea, Rick; Szabo, Robert M.; Gray, Robert R. L.; Nathan, Ross; Spruijt, Sander; Shatford, Russell; Klinefelter, Ryan; Sodha, Samir; Calfee, Ryan P.; Kakar, Sanjeev; Kaplan, Saul; Duncan, Scott F.; Mitchell, Scott; Dodds, Seth; Jacoby, Sidney M.; Kennedy, Stephen A.; Marczyk, Stanley Casimir; Dailey, Stephen W.; Kronlage, Steve; Alter, Steven; Beldner, Steven; McCabe, Steven J.; Hilliard, Stuart M.; Fischer, Thomas J.; Baxamusa, Taizoon; Taleb, C.; Varecka, Thomas F.; Wyrick, Theresa; Havenhill, Timothy G.; Siff, Todd; Knoll, Victoria D.; Patel, Vipul P.; Batson, W. Arnnold; Hammert, Warren C.; van Wyk, William J.

2013-01-01

Purpose It is our impression that there is substantial, unexplained variation in hand surgeon recommendations for treatment of peripheral mononeuropathy. We tested the null hypothesis that specific patient and provider factors do not influence recommendations for surgery. Methods Using a web-based

Port-Wine Stains

Science.gov (United States)

... Safe Videos for Educators Search English Español Port-Wine Stains KidsHealth / For Parents / Port-Wine Stains What's ... Manchas de vino de oporto What Are Port-Wine Stains? A port-wine stain is a type ...

PORT (Programme of Recognition and Therapy): the first Polish recognition and treatment programme for patients with an at-risk mental state.

Science.gov (United States)

Kotlicka-Antczak, Magdalena; Pawełczyk, Tomasz; Rabe-Jabłońska, Jolanta; Pawełczyk, Agnieszka

2015-08-01

To present the activities of the first early intervention centre in Poland and the Programme of Recognition and Therapy (PORT) run by the centre. An overview of the admission process, diagnostic procedures and therapeutic interventions offered to individuals with an at-risk mental state. The PORT programme, developed in 2010, included 81 individuals, aged 15-29 years so far. The diagnostic procedures consists of evaluation of symptoms with the use of the Comprehensive Assessment of At-Risk Mental State (CAARMS), assessment of premorbid and current personality traits and the evaluation of cognitive functions. Therapeutic interventions include cognitive behavioural therapy, diet supplementation with omega-3 fatty acids and pharmacological treatment. Overall rate of conversion into psychosis within the years 2010-2103 was 18.5%. The programme has also been a source of research in the field of early psychosis. The PORT programme enables young people with an ARMS an easy access to the specialized service offering treatment tailored to their specific needs. © 2014 Wiley Publishing Asia Pty Ltd.

What patient characteristics make clinicians recommend brief treatment?

NARCIS (Netherlands)

Schaefer, B. A.; Koeter, M. W. J.; Wouters, L.; Emmelkamp, P. M. G.; Schene, A. H.

2003-01-01

Objective: Assessing self-rated items that might have an impact on clinicians recommending brief treatment (BT) over unlimited or long-term treatment (ULT). Method: On the basis of patient self-report data we compared patients referred by clinicians to BT (n =71) with those referred to ULT (n =145).

Ecotoxicological evaluation of industrial port of Venice (Italy) sediment samples after a decontamination treatment

International Nuclear Information System (INIS)

Libralato, Giovanni; Losso, Chiara; Arizzi Novelli, Alessandra; Citron, Marta; Della Sala, Stefano; Zanotto, Emanuele; Cepak, Franka; Volpi Ghirardini, Annamaria

2008-01-01

This work assesses the ecotoxicological effects of polluted sediment after a decontamination treatment process using a new sediment washing technique. Sediment samples were collected from four sites in Marghera Port industrial channels (Venice, Italy). Ecotoxicological evaluations were performed with Vibrio fischeri and Crassostrea gigas bioassays. Whole sediment and elutriate were deemed as the most suitable environmental matrices for this study. Toxicity scores developed in the Lagoon of Venice for V. fischeri on whole sediment and for C. gigas on elutriate were considered for the final ranking of samples. Ecotoxicological results showed that the treated sediment samples presented both acute and sub-chronic toxicities, which were mainly attributed to the presence of some remaining chemicals such as metals and polyaromatic hydrocarbons. The acute toxicity ranged from low to medium, while the sub-chronic one from absent to very high, suggesting that treated sediments could not be reused in direct contact with seawater. - A sediment washing technique was assessed for port contaminated sediment remediation and reuse, indicating its reduced efficiency and the need for further improvements

Ecotoxicological evaluation of industrial port of Venice (Italy) sediment samples after a decontamination treatment

Energy Technology Data Exchange (ETDEWEB)

Libralato, Giovanni [Environmental Sciences Department, Venice University Ca Foscari, Campo della Celestia 2737/b, I-30122 Venice (Italy)], E-mail: giovanni.libralato@unive.it; Losso, Chiara; Arizzi Novelli, Alessandra [Environmental Sciences Department, Venice University Ca Foscari, Campo della Celestia 2737/b, I-30122 Venice (Italy); Citron, Marta; Della Sala, Stefano; Zanotto, Emanuele [Environmental Department, Venice Port Authority, Zattere 1401, I-30123, Venice (Italy); Cepak, Franka [Institute of Public Health, Vojkovo nabrezje 4a, 6000 Koper (Slovenia); Volpi Ghirardini, Annamaria [Environmental Sciences Department, Venice University Ca Foscari, Campo della Celestia 2737/b, I-30122 Venice (Italy)

2008-12-15

This work assesses the ecotoxicological effects of polluted sediment after a decontamination treatment process using a new sediment washing technique. Sediment samples were collected from four sites in Marghera Port industrial channels (Venice, Italy). Ecotoxicological evaluations were performed with Vibrio fischeri and Crassostrea gigas bioassays. Whole sediment and elutriate were deemed as the most suitable environmental matrices for this study. Toxicity scores developed in the Lagoon of Venice for V. fischeri on whole sediment and for C. gigas on elutriate were considered for the final ranking of samples. Ecotoxicological results showed that the treated sediment samples presented both acute and sub-chronic toxicities, which were mainly attributed to the presence of some remaining chemicals such as metals and polyaromatic hydrocarbons. The acute toxicity ranged from low to medium, while the sub-chronic one from absent to very high, suggesting that treated sediments could not be reused in direct contact with seawater. - A sediment washing technique was assessed for port contaminated sediment remediation and reuse, indicating its reduced efficiency and the need for further improvements.

76 FR 47529 - Port Access Route Study: In the Waters of Montauk Channel and Block Island Sound

Science.gov (United States)

2011-08-05

... DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 167 [Docket No. USCG-2005-21650] Port...: The Coast Guard announces the availability of Preliminary Study Recommendations of a Port Access Route... help reduce the risk of marine casualties and increase vessel traffic management efficiency in the...

Strategic port development

DEFF Research Database (Denmark)

Olesen, Peter Bjerg; Dukovska-Popovska, Iskra; Hvolby, Hans-Henrik

2014-01-01

While large global ports are recognised as playing a central role in many supply chains as logistic gateways, smaller regional ports have been more stagnant and have not reached the same level of development as the larger ports. The research literature in relation to port development is also...

Effect of the timing of treatment of port-wine stains with the flash-lamp-pumped pulsed-dye laser

NARCIS (Netherlands)

van der Horst, C. M.; Koster, P. H.; de Borgie, C. A.; Bossuyt, P. M.; van Gemert, M. J.

1998-01-01

BACKGROUND: Port-wine stains can be treated with a flash-lamp-pumped pulsed-dye laser, but it is uncertain whether this treatment is more effective if administered early in life, when the skin is thinner and the lesion is smaller. METHODS: We prospectively studied 100 patients with a previously

Treatment of severe psoriasis in children: recommendations of an Italian expert group.

Science.gov (United States)

Fortina, Anna Belloni; Bardazzi, Federico; Berti, Samantha; Carnevale, Claudia; Di Lernia, Vito; El Hachem, Maya; Neri, Iria; Gelmetti, Carlo Mario; Lora, Viviana; Mazzatenta, Carlo; Milioto, Mirella; Moretta, Gaia; Patrizi, Annalisa; Peris, Ketty; Villani, Alberto

2017-10-01

This article provides comprehensive recommendations for the systemic treatment of severe pediatric psoriasis based on evidence obtained from a systematic review of the literature and the consensus opinion of expert dermatologists and pediatricians. For each systemic treatment, the grade of recommendation (A, B, C) based on the treatment's approval by the European Medicines Agency for childhood psoriasis and the experts' opinions is discussed. The grade of recommendation for narrow-band-ultraviolet B phototherapy, cyclosporine, and retinoids is C, while that for methotrexate is C/B. The use of adalimumab, etanercept, and ustekinumab has a grade A recommendation. No conventional systemic treatments are approved for pediatric psoriasis. Adalimumab is approved by the European Medicines Agency as a first-line treatment for severe chronic plaque psoriasis in children (≥ 4 years old) and adolescents. Etanercept and ustekinumab are approved as second-line therapy in children ≥ 6 and ≥ 12 years, respectively. A treatment algorithm as well as practical tools (i.e., tabular summaries of differential diagnoses, treatment mechanism of actions, dosing regimens, control parameters) are provided to assist in therapeutic reasoning and decision-making for individual patients. These treatment recommendations are endorsed by major Italian Pediatric and Dermatology Societies. What is Known: • Guidelines for the treatment of severe pediatric psoriasis are lacking and most traditional systemic treatments are not approved for use in young patients. Although there has been decades of experience with some of the traditional agents such as phototherapy, acitretin, and cyclosporine in children, there are no RCTs on their pediatric use while RCTs investigating new biologic agents have been performed. What is New: • In this manuscript, an Italian multidisciplinary team of experts focused on treatment recommendations for severe forms of psoriasis in children based on an up

Port of Rotterdam

NARCIS (Netherlands)

Veenstra, A.W.

2014-01-01

The port of Rotterdam is one of the largest ports in the World and has great significance for the Dutch and European economy. Newly appointed TU/e professor Albert Veenstra explains if and how the Port of Rotterdam is affected by the economic crisis. With other European ports closing in, what can

Engineering issues on the diagnostic port integration in ITER upper port 18

Energy Technology Data Exchange (ETDEWEB)

Pak, Sunil, E-mail: paksunil@nfri.re.kr [National Fusion Research Institute, Gwahak-ro, Yuseong-gu, Daejeon (Korea, Republic of); Bertalot, Luciano [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-lez-Durance (France); Cheon, Mun Seong [National Fusion Research Institute, Gwahak-ro, Yuseong-gu, Daejeon (Korea, Republic of); Giacomin, Thibaud [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-lez-Durance (France); Heemskerk, Cock J.M.; Koning, Jarich F. [Heemskerk Innovative Technology, Merelhof 2, 2172 HZ Sassenheim (Netherlands); Lee, Hyeon Gon [National Fusion Research Institute, Gwahak-ro, Yuseong-gu, Daejeon (Korea, Republic of); Nemtcev, Grigorii [Institution “PROJECT CENTER ITER”, Akademika Kurchatova sq., Moscow (Russian Federation); Ronden, Dennis M.S. [FOM Institute DIFFER, P.O. Box 1207, 3430 BE Nieuwegein (Netherlands); Seon, Chang Rae [National Fusion Research Institute, Gwahak-ro, Yuseong-gu, Daejeon (Korea, Republic of); Udintsev, Victor; Yukhnov, Nikolay [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-lez-Durance (France); Zvonkov, Alexander [Institution “PROJECT CENTER ITER”, Akademika Kurchatova sq., Moscow (Russian Federation)

2016-11-01

Highlights: • Diagnostic port integration in the upper port 18 of ITER is presented in order to house the three diagnostic systems. • Issue on the neutron shielding in the upper port 18 is addressed and the shut-down dose rate in the interspace is summarized. • The maintenance strategy in the upper port 18 is described. - Abstract: The upper port #18 (UP18) in ITER hosts three diagnostic systems: the neutron activation system, the Vacuum Ultra-Violet spectrometer system, and the vertical neutron camera. These diagnostics are integrated into three infrastructures in the port: the upper port plug, interspace support structure and port cell support structure. The port integration in UP18 is at the preliminary design stage and the current design of the infrastructure as well as the diagnostic integration is described here. The engineering issues related to neutron shielding and maintenance are addressed and the design approach is suggested.

Prophylaxis and treatment of HIV-1 infection in pregnancy - Swedish Recommendations 2017.

Science.gov (United States)

Navér, Lars; Albert, Jan; Carlander, Christina; Flamholc, Leo; Gisslén, Magnus; Karlström, Olof; Svedhem-Johansson, Veronica; Sönnerborg, Anders; Westling, Katarina; Yilmaz, Aylin; Pettersson, Karin

2018-01-24

Prophylaxis and treatment with antiretroviral drugs have resulted in a very low rate of mother-to-child transmission (MTCT) of HIV during recent years. Registration of new antiretroviral drugs, modification of clinical praxis, updated general treatment guidelines and increasing knowledge about MTCT have necessitated regular revisions of the recommendations for 'Prophylaxis and treatment of HIV-1 infection in pregnancy'. The Swedish Reference Group for Antiviral Therapy (RAV) has updated the recommendations from 2013 at an expert meeting 19 September 2017. In the new text, current treatment guidelines for non-pregnant are considered. The most important revisions are that: (1) Caesarean section and infant prophylaxis with three drugs are recommended when maternal HIV RNA >150 copies/mL (previously >50 copies/mL). The treatment target of undetectable HIV RNA remains unchanged <50 copies/mL; (2) Obstetric management and mode of delivery at premature rupture of the membranes and rupture of the membranes at full term follow the same procedures as in HIV negative women; (3) Vaginal delivery is recommended to a well-treated woman with HIV RNA <150 copies/mL regardless of gestational age, if no obstetric contraindications are present; (4) Treatment during pregnancy should begin as soon as possible and should continue after delivery; (5) Ongoing well-functioning HIV treatment at pregnancy start should usually be retained; (6) Recommended drugs and drug combinations have been updated.

Port-wine vascular malformations and glaucoma risk in Sturge-Weber syndrome.

Science.gov (United States)

Sharan, Sapna; Swamy, Brighu; Taranath, Deepa Ajay; Jamieson, Robyn; Yu, Tao; Wargon, Orli; Grigg, John R

2009-08-01

Treatment of the capillary vascular malformation (port-wine stain) in Sturge-Weber syndrome with the use of a laser is helpful cosmetically. However, concerns have been raised that laser obliteration of port-wine stains may result in ocular hypertension. The aim of this study was to review clinical features and management of ocular complications of SWS and assess the effects of dermatological laser treatment on the incidence of glaucoma or ocular hypertension. This retrospective cohort study was conducted in an institutional setting. All patients had involvement of the face. Patients who underwent skin laser to the port-wine vascular malformation were analyzed further. Ocular involvement, glaucoma, and skin laser treatment and the relationship to ocular hypertension/glaucoma were observed. Forty-one Sturge-Weber syndrome patients with port-wine vascular malformation were analyzed. Glaucoma was observed in 24 patients (58.5%) at mean age of 2.9 years (range, 0.0-16.5). Of these, 18 (75.0%) were treated with medical therapy, and 10 (41.7%) required trabeculectomy, with 2 of these requiring Seton implant. Of the 41 patients, 28 (68.3%) underwent laser to face/forehead. Mean age of laser commencement was 5 years (range, 0.4-16.5). Thirteen did not undergo laser treatment. Fourteen of the 28 and 10 of the 13 developed ocular hypertension/glaucoma. This retrospective review did not find evidence to suggest that laser treatment of port-wine vascular malformations causes glaucoma or that it can worsen a preexisting ocular hypertension or glaucoma. Statistical analysis was inconclusive.

Environmental Factors' Consideration at Industrial Transportation Organization in the «Seaport - Dry port» System

Science.gov (United States)

Muravev, Dmitri; Rakhmangulov, Aleksandr

2016-11-01

Currently, container shipping development is directly associated with an increase of warehouse areas for containers' storage. One of the most successful types of container terminal is an intermodal terminal called a dry port. Main pollution sources during the organization of intermodal transport are considered. A system of dry port parameters, which are recommended for the evaluation of different scenarios for a seaport infrastructure development at the stage of its strategic planning, is proposed in this paper. The authors have developed a method for determining the optimal values of the main dry port parameters by simulation modeling in the programming software Any- Logic. Dependencies thatwere obtained as a result of modeling experiments prove the adequacy of main selected dry port parameters for the effective scenarios' evaluation of throughput and handling capacity at existing seaports at the stage of strategic planning and a rational dry port location, allowed ensuring the improvement of the ecological situation in a port city.

The omni-relevance of surgery: how medical specialization shapes orthopedic surgeons' treatment recommendations.

Science.gov (United States)

Hudak, Pamela L; Clark, Shannon J; Raymond, Geoffrey

2013-01-01

This article examines treatment recommendations in orthopedic surgery consultations and shows how surgery is treated as "omni-relevant" within this activity, providing a context within which the broad range of treatment recommendations proposed by surgeons is offered. Using conversation analysis to analyse audiotaped encounters between orthopedic surgeons and patients, we highlight how surgeons treat surgery as having a special, privileged status relative to other treatment options by (1) invoking surgery (whether or not it is actually being recommended) and (2) presenting surgery as the "last best resort" (in relation to which other treatment options are calibrated, described and considered). This privileged status surfaces in the design and delivery of recommendations as a clear asymmetry: Recommendations for surgery are proposed early, in relatively simple and unmitigated form. In contrast, recommendations not for surgery tend to be delayed and involve significantly more interactional work in their delivery. Possible implications of these findings, including how surgeons' structuring of recommendations may shape patient expectations (whether for surgery or some alternative), and potentially influence the distribution of orthopedic surgery procedures arising from these consultations, are considered.

A comparison of field-only electronic portal imaging hard copies with double exposure port films in radiation therapy treatment setup confirmation to determine its clinical application in a radiotherapy center

International Nuclear Information System (INIS)

Hatherly, Kay; Smylie, Josephine; Rodger, Alan

1999-01-01

Purpose: To determine in which treatment sites field-only hard copy electronic portal images (EPI) captured during a treatment exposure could replace traditional double exposed port films in a busy radiation oncology department. Methods and Materials: The three linear accelerators in the William Buckland Radiotherapy Centre (WBRC) at the Alfred Hospital in Melbourne are each equipped with an electronic portal imaging device (EPID). These devices can be used daily on all patients where the treatment fields are within the size constraint of the cassette, for example, less than 25 x 25 cm. Port films using radiographic film in hard cassettes were previously considered the standard method of field placement verification. After the radiation therapists were trained in all program aspects of capturing, enhancing, and producing hard copies of EPIs, a study was developed to evaluate the possibility of replacing port films with EPI hard copies within the established departmental procedures. Comparison of EPI hard copy with the simulator film and the port film of the same field was carried out by the radiation oncologist specialists. Seventy-eight comparison sets were generated and grouped into seven anatomical regions for evaluation by the radiation oncologist specialist responsible for each particular region. The outcome decision was the preferred imaging option. Where no preference was stated, EPI became the modality of choice, as it increased the efficiency of work practice. Results: The results indicate that field-only EPI can be considered to be at least as clinically useful for treatment verification in the following sites: breast, chest, hip, spine, and large pelvic fields. Port films using a standard, double exposure technique were considered necessary for partial brain fields, small pelvis fields, extremities, and radical head and neck fields. Conclusion: The quality of field-only images captured using an EPID has been favorably assessed to be equivalent to, or an

The Re-Conceptualization of the Port Supply Chain as a Smart Port Service System: The Case of the Port of Salerno

Directory of Open Access Journals (Sweden)

Antonio Botti

2017-04-01

Full Text Available This paper proposes a re-conceptualization of the port supply chain as a smart service system, in accordance with the theory of service science. Starting from a short literature review about the port supply chain approach and service science, a new comprehensive framework is provided to better understand seaport dynamics and the creation of competitive port supply chains. The methodology used is the case study approach. The Authors examined the Port of Salerno (Italy and re-conceptualized it as a smart port service system. The originality of the work lies in the application of service science as a lens to re-conceptualize the port supply chain, that allows the implementation of a logistic framework. Both theoretical and practical implications are provided to enrich the literature about port supply chains and to support port operators.

Ocular injuries among industrial welders in Port Harcourt, Nigeria

Science.gov (United States)

Fiebai, B; Awoyesuku, EA

2011-01-01

Background The purpose of this study was to determine the prevalence and pattern of ocular injuries among industrial welders and rate the use of protective eyewear at work among industrial welders in Port Harcourt. Information from this study will provide a database for effective policy formation on prevention of occupational eye injuries in Port Harcourt Rivers State. Methods A cross-sectional survey of ocular injuries and use of protective eyewear among industrial welders in the Port Harcourt local government area of Rivers State, Nigeria, was carried out over a three-month period. Five hundred welders were selected by simple random sampling. Information was obtained using an interviewer-administered questionnaire. All welders were examined in their workshops. Results Flying metal chips were the chief source of ocular injury, as reported by 199 (68.15%) of those who gave a history of work-related eye injury, while arc rays accounted for the remaining 93 (31.85%). There was a high level of awareness of the risk of sustaining an eye injury from welding (n = 490, 98%), but only 46 (15.3%) of the welders were using protective eyewear at the time of injury. Conclusion To minimize ocular injury and promote eye health amongst industrial welders, safety intervention programs, such as awareness campaigns, setting up of targeted programs by the relevant government agencies, and encouragement of locally produced eye protectors is recommended. The involvement of occupational medical practitioners is also strongly recommended. PMID:21966197

Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring

DEFF Research Database (Denmark)

Kappos, Ludwig; Bates, David; Edan, Gilles

2011-01-01

Natalizumab, a highly specific α4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very......, based on additional long-term follow-up of clinical studies and post-marketing observations, including appropriate patient selection and management recommendations.......Natalizumab, a highly specific α4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very...... active disease. The expected benefits of natalizumab treatment have to be weighed against risks, especially the rare but serious adverse event of progressive multifocal leukoencephalopathy. In this Review, we revisit and update previous recommendations on natalizumab for treatment of patients with RRMS...

E-Services and Positioning of Passenger Ports in the Context of Cruise Tourism Promotion

Directory of Open Access Journals (Sweden)

Andriela Vitić-Ćetković

2014-02-01

Full Text Available The paper positions the passenger sea ports in the context of cruise tourism on the basis of e-services they offer. The e-services of eleven passenger ports are categorized and then quantitatively evaluated by binary and ranking approaches. In general, the port e-services might be categorized according to their functionality as navigational, ship and passenger-related ones, logistics, business, marketing, entertainment, security, safety, environmental, etc. These services can be bidirectional informational and/or transactional. In this paper, only those port e-services related directly to the passengers’ needs, within the frame of cruise tourism, are taken into consideration and categorized as core, or as value-added ones, and as informational and/or transactional ones. Then, each of them is assigned an appropriate binary value (0/1, depending on whether the considered passenger port offers the related e-service or not. These values are employed in the evaluation of the analyzed passenger port e-services offered, and as a base for their positioning. The appropriate weights coefficients, obtained by ranking (Saaty method, were used in the process of the considered port final positioning on the cruise tourism e-market. Some additional analyses and recommendations in the direction of further positioning and promotion of the port of Kotor (Montenegro, as rising cruise tourism port (destination, are given as well.

Socio-Economic Factors Affecting the Marketing of Garri in Port ...

African Journals Online (AJOL)

Socio-Economic Factors Affecting the Marketing of Garri in Port Harcourt City of ... recommended ways of improving the marketing system of garri in the study area. ... socio economic characteristic of the traders, purchases and sales transaction, ... 78% had basic education which help them in keeping proper record and in ...

Modeling of the metallic port in breast tissue expanders for photon radiotherapy.

Science.gov (United States)

Yoon, Jihyung; Xie, Yibo; Heins, David; Zhang, Rui

2018-03-30

The purpose of this study was to model the metallic port in breast tissue expanders and to improve the accuracy of dose calculations in a commercial photon treatment planning system (TPS). The density of the model was determined by comparing TPS calculations and ion chamber (IC) measurements. The model was further validated and compared with two widely used clinical models by using a simplified anthropomorphic phantom and thermoluminescent dosimeters (TLD) measurements. Dose perturbations and target coverage for a single postmastectomy radiotherapy (PMRT) patient were also evaluated. The dimensions of the metallic port model were determined to be 1.75 cm in diameter and 5 mm in thickness. The density of the port was adjusted to be 7.5 g/cm 3 which minimized the differences between IC measurements and TPS calculations. Using the simplified anthropomorphic phantom, we found the TPS calculated point doses based on the new model were in agreement with TLD measurements within 5.0% and were more accurate than doses calculated based on the clinical models. Based on the photon treatment plans for a real patient, we found that the metallic port has a negligible dosimetric impact on chest wall, while the port introduced significant dose shadow in skin area. The current clinical port models either overestimate or underestimate the attenuation from the metallic port, and the dose perturbation depends on the plan and the model in a complex way. TPS calculations based on our model of the metallic port showed good agreement with measurements for all cases. This new model could improve the accuracy of dose calculations for PMRT patients who have temporary tissue expanders implanted during radiotherapy and could potentially reduce the risk of complications after the treatment. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Extracorporeal treatment for barbiturate poisoning: recommendations from the EXTRIP Workgroup.

Science.gov (United States)

Mactier, Robert; Laliberté, Martin; Mardini, Joelle; Ghannoum, Marc; Lavergne, Valery; Gosselin, Sophie; Hoffman, Robert S; Nolin, Thomas D

2014-09-01

The EXTRIP (Extracorporeal Treatments in Poisoning) Workgroup conducted a systematic review of barbiturate poisoning using a standardized evidence-based process to provide recommendations on the use of extracorporeal treatment (ECTR) in patients with barbiturate poisoning. The authors reviewed all articles, extracted data, summarized key findings, and proposed structured voting statements following a predetermined format. A 2-round modified Delphi method was used to reach a consensus on voting statements, and the RAND/UCLA Appropriateness Method was used to quantify disagreement. 617 articles met the search inclusion criteria. Data for 538 patients were abstracted and evaluated. Only case reports, case series, and nonrandomized observational studies were identified, yielding a low quality of evidence for all recommendations. Using established criteria, the workgroup deemed that long-acting barbiturates are dialyzable and short-acting barbiturates are moderately dialyzable. Four key recommendations were made. (1) The use of ECTR should be restricted to cases of severe long-acting barbiturate poisoning. (2) The indications for ECTR in this setting are the presence of prolonged coma, respiratory depression necessitating mechanical ventilation, shock, persistent toxicity, or increasing or persistently elevated serum barbiturate concentrations despite treatment with multiple-dose activated charcoal. (3) Intermittent hemodialysis is the preferred mode of ECTR, and multiple-dose activated charcoal treatment should be continued during ECTR. (4) Cessation of ECTR is indicated when clinical improvement is apparent. This report provides detailed descriptions of the rationale for all recommendations. In summary, patients with long-acting barbiturate poisoning should be treated with ECTR provided at least one of the specific criteria in the first recommendation is present. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Two Ports Laparoscopic Inguinal Hernia Repair in Children

OpenAIRE

Ibrahim, Medhat M.

2015-01-01

Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac. Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation...

Extracorporeal Treatment for Lithium Poisoning: Systematic Review and Recommendations from the EXTRIP Workgroup

Science.gov (United States)

Decker, Brian S.; Goldfarb, David S.; Dargan, Paul I.; Friesen, Marjorie; Gosselin, Sophie; Hoffman, Robert S.; Lavergne, Valéry; Nolin, Thomas D.

2015-01-01

The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical and toxicokinetic data were extracted and summarized following a predetermined format. The entire workgroup voted through a two-round modified Delphi method to reach a consensus on voting statements. A RAND/UCLA Appropriateness Method was used to quantify disagreement, and anonymous votes were compiled and discussed in person. A second vote was conducted to determine the final workgroup recommendations. In total, 166 articles met inclusion criteria, which were mostly case reports, yielding a very low quality of evidence for all recommendations. A total of 418 patients were reviewed, 228 of which allowed extraction of patient-level data. The workgroup concluded that lithium is dialyzable (Level of evidence=A) and made the following recommendations: Extracorporeal treatment is recommended in severe lithium poisoning (1D). Extracorporeal treatment is recommended if kidney function is impaired and the [Li+] is >4.0 mEq/L, or in the presence of a decreased level of consciousness, seizures, or life-threatening dysrhythmias irrespective of the [Li+] (1D). Extracorporeal treatment is suggested if the [Li+] is >5.0 mEq/L, significant confusion is present, or the expected time to reduce the [Li+] to 36 hours (2D). Extracorporeal treatment should be continued until clinical improvement is apparent or [Li+] is treatments should be continued for a minimum of 6 hours if the [Li+] is not readily measurable (1D). Hemodialysis is the preferred extracorporeal treatment (1D), but continuous RRT is an acceptable alternative (1D). The workgroup supported the use of extracorporeal treatment in severe lithium poisoning. Clinical decisions on when to use extracorporeal treatment should take into account the

Severe isolated tricuspid insufficiency due to tricuspid papillary muscle rupture after a fall from a horse: treatment with port access minimally invasive cardiac surgery.

Science.gov (United States)

Öz, Kürsad; Mayeran, Yousef; Van Praet, Frank; Codens, Jose; Vanerman, Hugo

2014-04-01

We report on the successful treatment of tricuspid valve insufficiency due to blunt chest injury using port-access minimally invasive cardiac surgery. The optimal surgical treatment of traumatic valvular insufficiency is discussed, including a brief review of the relevant literature.

Flat-port connectors

KAUST Repository

Alrashed, Mohammed

2017-01-01

and water resistant. It is unique in the way of using the outer surfaces of the device for the electrical connection between the ports. Flat-port design can allow the manufacture of extremely thin devices by eliminating the side ports slots that take a lot

Integrated circuit test-port architecture and method and apparatus of test-port generation

Science.gov (United States)

Teifel, John

2016-04-12

A method and apparatus are provided for generating RTL code for a test-port interface of an integrated circuit. In an embodiment, a test-port table is provided as input data. A computer automatically parses the test-port table into data structures and analyzes it to determine input, output, local, and output-enable port names. The computer generates address-detect and test-enable logic constructed from combinational functions. The computer generates one-hot multiplexer logic for at least some of the output ports. The one-hot multiplexer logic for each port is generated so as to enable the port to toggle between data signals and test signals. The computer then completes the generation of the RTL code.

Ultrasonographic determination of the thyroid volume in 7- 10 years old children of Bushehr port 2007

Directory of Open Access Journals (Sweden)

Farzad Morad Haseli

2009-02-01

Full Text Available Background: Determination of thyroid volume using ultrasound has been recommended for monitoring public control of iodine deficiency programs in areas with mild iodine deficiency or with no iodine deficiency, instead of physical examination, in order to estimate the prevalence rate of goiter. The aim of this study was to determine the reference ranges of thyroid volume in Bushehr port. Methods: Thyroid volume of 1247 primary schoolchildren aged 7-10 years who were selected by probability proportionate to size method from rural and urban areas of Bushehr port was determined using ultrasonography. Medians and percentiles of thyroid volumes for age and body surface area were calculated for both genders. Results: The 97th percentiles of thyroid volume of Bushehr port schoolchildren according to age and sex were all lower than the corresponding sex-specific normative WHO reference values. Goiter prevalence was 1.68% according to WHO thyroid volume references for age in the studied population. The goiter prevalence according to age and body surface area-specific new normative WHO reference values were 7.13 and 7.17%, respectively. Conclusion: The 97th percentile for thyroid volume, calculated by ultrasonography in Bushehr port schoolchildren, were lower than the international WHO newly recommended reference values in all ages. Therefore, determination of a native reference value for estimating the prevalence rate of thyroid is highly recommended. According to ultrasonographically determined goiter prevalence, Bushehr is an iodine sufficient area.

Sea freight - Antwerp Port

Directory of Open Access Journals (Sweden)

NEACSU Nicoleta Andreea

2017-01-01

Full Text Available Shipping plays a vital role in achieving the movement of goods, both in terms of quantity and efficiency. This paper presents the role and advantages of shipping in the global economy and analyzes the development and Antwerp Port activity. Currently, the second most important trading port in Europe and 14th in the ranking of most important ports that handle containers worldwide, the Port of Antwerp, Belgium is a port in the heart of Europe, accessible to large sized vessels. 200 years of constructing infrastructure and logistics around the central location, as well as pressure from Rotterdam, that had an impact on the competitiveness of the port of Antwerp, all this led the port to occupy a leading position in the top rankings.

Determinants of Port Performance - Case Study of 4 Main Ports in Indonesia (2005-2015

Directory of Open Access Journals (Sweden)

Atika Aqmarina

2018-03-01

Full Text Available Port plays significant role in supporting economic growth of a country. This study aims to analyze the determinant of port performance in Indonesia. In this research, the ports selected are four main ports in Indonesia which are Port of Belawan, Port of Tanjung Priok, Port of Tanjung Perak, and Makassar. These ports are designed as the hub ports in the national sea transport system of the country. The study used pooled OLS as the methodology to analyze the determinant. The result of this studies shows that total traffic is not influenced by operating surplus per ton, whereas the rest of variables such as turnaround time, idle time, berth of occupancy rate, rate of return, number of employee and cargo equipment have significant results and significantly influenced the total traffic.

ITER lower port systems integration

Energy Technology Data Exchange (ETDEWEB)

Levesy, B., E-mail: bruno.levesy@iter.org [ITER Organization, CS 90 046, 13067 St Paul Lez Durance Cedex (France); Baker, D.; Boussier, B.; Bryan, S.; Cordier, J.J.; Dremel, M.; Dell' Orco, G.; Daly, E.; Doshi, B.; Jeannoutot, T.; Friconneau, J.P.; Gliss, C.; Le Barbier, R.; Lachevre, F.; Loughlin, M.; Martin, A.; Martins, J.P.; Maruyama, S.; Palmer, J.; Reichle, R. [ITER Organization, CS 90 046, 13067 St Paul Lez Durance Cedex (France)

2011-10-15

The lower port systems are installed inside the vacuum vessel lower ports and in the adjacent port cells. The vacuum vessel ports and penetrations are allocated as follow: -4 ports dedicated to remote handling of the divertor cassettes, contain diagnostics racks and divertor cooling pipes. -5 ports connecting the main vessel to the torus cryopumps, contain divertor cooling pipes, pellet and gas injection pipes and vertical stabilization coil feeders. -3 penetrations connecting torus cryopumps are connected to the vacuum vessel by branch pipes. -Specific penetrations for divertor cooling lines, in-vessel viewing and glow discharge systems. The general layout of the port systems has been revised recently to improve the cryopump (8 t weight, 1.8 m diameter and 2.5 m long) maintenance scheme with remote handling tools and integrate the in-vessel vertical stabilization coil feeders. The port allocation, the pumping ports design, and interfaces in-between ports and cryostat and in-between cryopumps and cryostat have been up-dated. The integration inside the 18 port cells (11 m x 4 m each) has been reviewed to avoid clashes in between systems and to fix the openings in the port cell concrete walls. The new layout integrates safety and neutron-shielding requirements as well as remote handling and maintenance compatibility for the different systems. The paper presents the up-dated integration of the lower port systems inside the ports and the port cells. Interfaces of the port systems with the vacuum vessel, the cryostat and the port cells are described.

Extracorporeal Treatment for Lithium Poisoning: Systematic Review and Recommendations from the EXTRIP Workgroup.

Science.gov (United States)

Decker, Brian S; Goldfarb, David S; Dargan, Paul I; Friesen, Marjorie; Gosselin, Sophie; Hoffman, Robert S; Lavergne, Valéry; Nolin, Thomas D; Ghannoum, Marc

2015-05-07

The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical and toxicokinetic data were extracted and summarized following a predetermined format. The entire workgroup voted through a two-round modified Delphi method to reach a consensus on voting statements. A RAND/UCLA Appropriateness Method was used to quantify disagreement, and anonymous votes were compiled and discussed in person. A second vote was conducted to determine the final workgroup recommendations. In total, 166 articles met inclusion criteria, which were mostly case reports, yielding a very low quality of evidence for all recommendations. A total of 418 patients were reviewed, 228 of which allowed extraction of patient-level data. The workgroup concluded that lithium is dialyzable (Level of evidence=A) and made the following recommendations: Extracorporeal treatment is recommended in severe lithium poisoning (1D). Extracorporeal treatment is recommended if kidney function is impaired and the [Li(+)] is >4.0 mEq/L, or in the presence of a decreased level of consciousness, seizures, or life-threatening dysrhythmias irrespective of the [Li(+)] (1D). Extracorporeal treatment is suggested if the [Li(+)] is >5.0 mEq/L, significant confusion is present, or the expected time to reduce the [Li(+)] to 36 hours (2D). Extracorporeal treatment should be continued until clinical improvement is apparent or [Li(+)] is lithium poisoning. Clinical decisions on when to use extracorporeal treatment should take into account the [Li(+)], kidney function, pattern of lithium toxicity, patient's clinical status, and availability of extracorporeal treatments. Copyright © 2015 by the American Society of Nephrology.

Treatment recommendations for DSM-5-defined mixed features.

Science.gov (United States)

Rosenblat, Joshua D; McIntyre, Roger S

2017-04-01

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) mixed features specifier provides a less restrictive definition of mixed mood states, compared to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), including mood episodes that manifest with subthreshold symptoms of the opposite mood state. A limited number of studies have assessed the efficacy of treatments specifically for DSM-5-defined mixed features in mood disorders. As such, there is currently an inadequate amount of data to appropriately inform evidence-based treatment guidelines of DSM-5 defined mixed features. However, given the high prevalence and morbidity of mixed features, treatment recommendations based on the currently available evidence along with expert opinion may be of benefit. This article serves to provide these interim treatment recommendations while humbly acknowledging the limited amount of evidence currently available. Second-generation antipsychotics (SGAs) appear to have the greatest promise in the treatment of bipolar disorder (BD) with mixed features. Conventional mood stabilizing agents (ie, lithium and divalproex) may also be of benefit; however, they have been inadequately studied. In the treatment of major depressive disorder (MDD) with mixed features, the comparable efficacy of antidepressants versus other treatments, such as SGAs, remains unknown. As such, antidepressants remain first-line treatment of MDD with or without mixed features; however, there are significant safety concerns associated with antidepressant monotherapy when mixed features are present, which merits increased monitoring. Lurasidone is the only SGA monotherapy that has been shown to be efficacious specifically in the treatment of MDD with mixed features. Further research is needed to accurately determine the efficacy, safety, and tolerability of treatments specifically for mood episodes with mixed features to adequately inform

Principal Ports

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Principal Ports are defined by port limits or US Army Corps of Engineers (USACE) projects, these exclude non-USACE projects not authorized for publication. The...

Recommended Ventilation Strategies for Energy-Efficient Production Homes

Energy Technology Data Exchange (ETDEWEB)

Roberson, J.; Brown, R.; Koomey, J.; Warner, J.; Greenberg, S.

1998-12-01

This report evaluates residential ventilation systems for the U.S. Environmental Protection Agency's (EPA's) ENERGY STAR{reg_sign} Homes program and recommends mechanical ventilation strategies for new, low-infiltration, energy-efficient, single-family, ENERGY STAR production (site-built tract) homes in four climates: cold, mixed (cold and hot), hot humid, and hot arid. Our group in the Energy Analysis Department at Lawrence Berkeley National Lab compared residential ventilation strategies in four climates according to three criteria: total annualized costs (the sum of annualized capital cost and annual operating cost), predominant indoor pressure induced by the ventilation system, and distribution of ventilation air within the home. The mechanical ventilation systems modeled deliver 0.35 air changes per hour continuously, regardless of actual infiltration or occupant window-opening behavior. Based on the assumptions and analysis described in this report, we recommend independently ducted multi-port supply ventilation in all climates except cold because this strategy provides the safety and health benefits of positive indoor pressure as well as the ability to dehumidify and filter ventilation air. In cold climates, we recommend that multi-port supply ventilation be balanced by a single-port exhaust ventilation fan, and that builders offer balanced heat-recovery ventilation to buyers as an optional upgrade. For builders who continue to install forced-air integrated supply ventilation, we recommend ensuring ducts are airtight or in conditioned space, installing a control that automatically operates the forced-air fan 15-20 minutes during each hour that the fan does not operate for heating or cooling, and offering ICM forced-air fans to home buyers as an upgrade.

An assessment of residential exposure to environmental noise at a shipping port.

Science.gov (United States)

Murphy, Enda; King, Eoin A

2014-02-01

The World Health Organisation has recently acknowledged that contrary to the trend for other environmental stressors, noise exposure is increasing in Europe. However, little research has been conducted on environmental noise exposure to handling activity at shipping ports. This paper reports on research examining the extent of noise exposure for residents within the vicinity of Dublin Port, Ireland using the nation's largest port terminal as a proxy for port noise. In order to assess the level of exposure in the area, long-term measurements were undertaken at the most exposed residential façade for a period of 45days to determine the extent of night-time exposure that was above levels recommended by the World Health Organisation. The indicators L90, Leq and LMax were used to determine exposure levels. The results show that exposure is above night-time guideline limits set down by the WHO, above Irish levels for the assessment of noise mitigation and highlight the extent to which port noise can be a significant environmental stressor. The research also investigated the extent of low-frequency noise (which is associated with greater health issues) from night-time port handling activity and found a significant low-frequency component indicating the negative health issues that might arise from port noise exposure more generally. We also undertook semi-structured interviews with residents to qualitatively assess the self-reported impact of prolonged night-time noise exposure for local residents. Copyright © 2013 Elsevier Ltd. All rights reserved.

Management of Port Operations

OpenAIRE

Gheorghe BASANU; Georgiana NUKINA

2011-01-01

The Management of port operation requires the proper and efficient use of port facility, equipment for cargo handling, berth facilities, waterways and roads. It also entails the use of effective communications system, storage facilities, and dockworkers. The whole activities mentioned above form the bulk of port operations. The aspiration of port operator is to get cargo through the gateway of ports as fast as possible on to other modes of transport (rail or road) with a minimal cost to them ...

Recommendations on Chronic Constipation (Including Constipation Associated with Irritable Bowel Syndrome Treatment

Directory of Open Access Journals (Sweden)

Pierre Paré

2007-01-01

Full Text Available While chronic constipation (CC has a high prevalence in primary care, there are no existing treatment recommendations to guide health care professionals. To address this, a consensus group of 10 gastroenterologists was formed to develop treatment recommendations. Although constipation may occur as a result of organic disease, the present paper addresses only the management of primary CC or constipation associated with irritable bowel syndrome. The final consensus group was assembled and the recommendations were created following the exact process outlined by the Canadian Association of Gastroenterology for the following areas: epidemiology, quality of life and threshold for treatment; definitions and diagnostic criteria; lifestyle changes; bulking agents and stool softeners; osmotic agents; prokinetics; stimulant laxatives; suppositories; enemas; other drugs; biofeedback and behavioural approaches; surgery; and probiotics. A treatment algorithm was developed by the group for CC and constipation associated with irritable bowel syndrome. Where possible, an evidence-based approach and expert opinions were used to develop the statements in areas with insufficient evidence. The nature of the underlying pathophysiology for constipation is often unclear, and it can be tricky for physicians to decide on an appropriate treatment strategy for the individual patient. The myriad of treatment options available to Canadian physicians can be confusing; thus, the main aim of the recommendations and treatment algorithm is to optimize the approach in clinical care based on available evidence.

The Windows serial port programming handbook

CERN Document Server

Bai, Ying

2004-01-01

The fundamentals of serial port communications. Serial port programming in ANSI C and Assembly languages for MS-DOS. Serial ports interface developed in VC++ 6.0. Serial port programming in Visual Basic. Serial port programming in LabVIEW. Serial port programming in MATLAB. Serial port programming in Smalltalk. Serial port programming in Java.

Maintaining and Researching Port Safety: A Case Study of the Port of Kaohsiung

OpenAIRE

Tseng, Po-Hsing.; Pilcher, Nick.

2017-01-01

Maintaining port safety in full conformity with IMO standards is a requisite for every port and country. To do this, understanding the challenges and human factors involved is key. To date, much research has shed valuable light on these factors and considered how to address them. One aspect that is often noted is that both maintaining port safety and researching port safety presents numerous challenges. This paper considers both these aspects in the context of a case study of port safety in K...

Shipping emissions in ports

OpenAIRE

Merk, Olaf

2014-01-01

Shipping emissions in ports are substantial, accounting for 18 million tonnes of CO2 emissions, 0.4 million tonnes of NOx, 0.2 million of SOx and 0.03 million tonnes of PM10 in 2011. Around 85% of emissions come from containerships and tankers. Containerships have short port stays, but high emissions during these stays. Most of CO2 emissions in ports from shipping are in Asia and Europe (58%), but this share is low compared to their share of port calls (70%). European ports have much less emi...

19 CFR 101.3 - Customs service ports and ports of entry.

Science.gov (United States)

2010-04-01

... and Service Ports. Many of the ports listed were created by the President's message of March 3, 1913....S.C. 1). Subsequent orders of the President or of the Secretary of the Treasury which affected these... Port of the Delaware River and Bay described in T.D. 96-4. Perth Amboy New Mexico Albuquerque Including...

Extracorporeal treatment for thallium poisoning: recommendations from the EXTRIP Workgroup.

Science.gov (United States)

Ghannoum, Marc; Nolin, Thomas D; Goldfarb, David S; Roberts, Darren M; Mactier, Robert; Mowry, James B; Dargan, Paul I; Maclaren, Robert; Hoegberg, Lotte C; Laliberté, Martin; Calello, Diane; Kielstein, Jan T; Anseeuw, Kurt; Winchester, James F; Burdmann, Emmanuel A; Bunchman, Timothy E; Li, Yi; Juurlink, David N; Lavergne, Valery; Megarbane, Bruno; Gosselin, Sophie; Liu, Kathleen D; Hoffman, Robert S

2012-10-01

The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl). After an extensive search, the co-chairs reviewed the articles, extracted the data, summarized findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and RAND/UCLA Appropriateness Method to quantify disagreement. Blinded votes were compiled, returned, and discussed during a conference call. A second vote determined the final recommendations. Forty-five articles met inclusion criteria. Only case reports and case series were identified, yielding a very low quality of evidence for all recommendations. Data on 74 patients, including 11 who died, were abstracted. The workgroup concluded that Tl is slightly dialyzable and made the following recommendations: ECTR is recommended in severe Tl poisoning (1D). ECTR is indicated if Tl exposure is highly suspected on the basis of history or clinical features (2D) or if the serum Tl concentration is >1.0 mg/L (2D). ECTR should be initiated as soon as possible, ideally within 24-48 hours of Tl exposure (1D), and be continued until the serum Tl concentration is poisoning.

Development of a novel controllable, multidirectional, reusable metallic port with a wide working space.

Science.gov (United States)

Hosaka, Seiji; Ohdaira, Takeshi; Umemoto, Satoshi; Hashizume, Makoto; Kawamoto, Shunji

2013-12-01

Endoscopic surgery is currently a standard procedure in many countries. Furthermore, conventional four-port laparoscopic cholecystectomy is developing into a single-port procedure. However, in many developing countries, disposable medical products are expensive and adequate medical waste disposable facilities are absent. Advanced medical treatments such as laparoscopic or single-port surgeries are not readily available in many areas of developing countries, and there are often no other sterilization methods besides autoclaving. Moreover, existing reusable metallic ports are impractical and are thus not widely used. We developed a novel controllable, multidirectional single-port device that can be autoclaved, and with a wide working space, which was employed in five patients. In all patients, laparoscopic cholecystectomy was accomplished without complications. Our device facilitates single-port surgery in areas of the world with limited sterilization methods and offers a novel alternative to conventional tools for creating a smaller incision, decrease postoperative pain, and improve cosmesis. This novel device can also lower the cost of medical treatment and offers a promising tool for major surgeries requiring a wide working space.

Adolescents’ Pain Coping Profiles: Expectations for Treatment, Functional Outcomes and Adherence to Psychological Treatment Recommendations

Directory of Open Access Journals (Sweden)

Robyn Lewis Claar

2011-01-01

Full Text Available OBJECTIVES: To explore how adolescents’ pain coping profiles relate to their expectations regarding psychological treatment recommendations, and to examine patients’ functioning and engagement in psychological treatment three months following a multidisciplinary pain clinic evaluation.

Evaluation of the Necessity of Port Fixation in Central Venous Port Implantation

Energy Technology Data Exchange (ETDEWEB)

Kim, Sang Su; Kim, Hyung Pil [Inje University Pusan Paik Hospital, Busan (Korea, Republic of); Bae, Jae Ik; Won, Je Hwan [Ajou University School of Medicine, Suwon (Korea, Republic of)

2010-06-15

The technical success and complications were especially focused on and evaluated the need for fixation of a port under fluoroscopic guidance placement of the totally implantable central venous access ports for long term central venous access. Two hundred eighty nine consecutive patients (170 men, 119 women, mean age: 52-year-old) who underwent venous port implantation for the administration of chemotherapy were followed over a 1-month period. The procedures were performed in the angiographic suite by an interventional radiologist and all access was through the right jugular vein, except for the patients who had undergone a right mastectomy. The procedures were performed in the following order: 1) venous puncture, 2) making a pocket, 3) catheter tunneling, 4) port insertion, 5) catheter sizing, and 6) insertion. A port which was connected to the tunneled catheter was inserted into the minimally sized subcutaneous pocket with the aid of a small retractor. A follow-up was performed with medical records and chest radiographs. The follow-up period for evaluating the venous port ranged from 59 to 329 days (mean: 175 days) The procedures performed to gain right jugular vein access were successful without difficulty in all cases. The 18 patients that underwent procedures to gain left jugular vein access encountered some difficulty upon insertion of a catheter into the SVC due to encountering the tortuous left brachiocephalic vein. No complications occurred during and immediately after the procedure. In one case the port chamber rotated within the subcutaneous pocket; however, no catheter migration or malfunction occurred. If port insertion was followed by catheter insertion, the port chamber can be tightly implanted in the minimally sized pocket. This would avoid the need for fixation of the catheter to the port chamber leading into the pocket

Practical recommendations for radium-223 treatment of metastatic castration-resistant prostate cancer

International Nuclear Information System (INIS)

Du, Yong; Carrio, Ignasi; De Vincentis, Giuseppe; Fanti, Stefano; Ilhan, Harun; Mommsen, Caroline; Nitzsche, Egbert; Sundram, Francis; Vogel, Wouter; Oyen, Wim; Lewington, Val

2017-01-01

Radium Ra 223 dichloride (radium-223, Xofigo registered) is the first targeted alpha therapy for patients with castration-resistant prostate cancer and symptomatic bone metastases. Radium-223 provides a new treatment option for this setting, but also necessitates a new treatment management approach. We provide straightforward and practical recommendations for European nuclear medicine centres to optimize radium-223 service provision. An independent research consultancy agency observed radium-223 procedures and conducted interviews with all key staff members involved in radium-223 treatment delivery in 11 nuclear medicine centres across six countries (Germany, Italy, the Netherlands, Spain, Switzerland and the UK) experienced in administering radium-223. The findings were collated and discussed at a meeting of experts from these centres, during which key consensus recommendations were defined. The recommendations cover centre organization and preparation; patient referral; radium-223 ordering, preparation and disposal; radium-223 treatment delivery/administration; and patient experience. Guidance includes structured coordination and communication within centres and multidisciplinary teams, focusing on sharing best practice to provide high-quality, patient-centred care throughout the treatment pathway. These expert recommendations are intended to complement existing management guidelines. Sharing best practice and experience will help nuclear medicine centres to optimize radium-223 service provision and improve patient care. (orig.)

Practical recommendations for radium-223 treatment of metastatic castration-resistant prostate cancer

Energy Technology Data Exchange (ETDEWEB)

Du, Yong [The Royal Marsden NHS Foundation Trust, Department of Nuclear Medicine and PET/CT, London (United Kingdom); Carrio, Ignasi [Hospital Sant Pau, Barcelona (Spain); De Vincentis, Giuseppe [Policlinico Umberto I University Hospital Rome, Rome (Italy); Fanti, Stefano [University Hospital Bologna, Bologna (Italy); Ilhan, Harun [Ludwig-Maximilians-University Hospital, Munich (Germany); Mommsen, Caroline [Praxis fuer diagnostische und therapeutische Nuklearmedizin Berlin, Berlin (Germany); Nitzsche, Egbert [Canton Hospital Aarau, Aarau (Switzerland); Sundram, Francis [University Hospital Southampton NHS Foundation Trust, Southampton (United Kingdom); Vogel, Wouter [The Netherlands Cancer Institute, Amsterdam (Netherlands); Oyen, Wim [The Royal Marsden NHS Foundation Trust, Department of Nuclear Medicine and PET/CT, London (United Kingdom); The Institute of Cancer Research, London (United Kingdom); Lewington, Val [Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom)

2017-09-15

Radium Ra 223 dichloride (radium-223, Xofigo registered) is the first targeted alpha therapy for patients with castration-resistant prostate cancer and symptomatic bone metastases. Radium-223 provides a new treatment option for this setting, but also necessitates a new treatment management approach. We provide straightforward and practical recommendations for European nuclear medicine centres to optimize radium-223 service provision. An independent research consultancy agency observed radium-223 procedures and conducted interviews with all key staff members involved in radium-223 treatment delivery in 11 nuclear medicine centres across six countries (Germany, Italy, the Netherlands, Spain, Switzerland and the UK) experienced in administering radium-223. The findings were collated and discussed at a meeting of experts from these centres, during which key consensus recommendations were defined. The recommendations cover centre organization and preparation; patient referral; radium-223 ordering, preparation and disposal; radium-223 treatment delivery/administration; and patient experience. Guidance includes structured coordination and communication within centres and multidisciplinary teams, focusing on sharing best practice to provide high-quality, patient-centred care throughout the treatment pathway. These expert recommendations are intended to complement existing management guidelines. Sharing best practice and experience will help nuclear medicine centres to optimize radium-223 service provision and improve patient care. (orig.)

Intake port

Science.gov (United States)

Mendler, Edward Charles

2005-02-01

The volumetric efficiency and power of internal combustion engines is improved with an intake port having an intake nozzle, a venturi, and a surge chamber. The venturi is located almost halfway upstream the intake port between the intake valves and the intake plenum enabling the venturi throat diameter to be exceptionally small for providing an exceptionally high ram velocity and an exceptionally long and in turn high efficiency diffuser flowing into the surge chamber. The intake port includes an exceptionally large surge chamber volume for blow down of the intake air into the working cylinder of the engine.

Research on the Impact of Ownership Structure to Operation Performance of the Chinese Listed Port Companies

Directory of Open Access Journals (Sweden)

Bao Jiang

2015-06-01

Full Text Available The ownership structure which has a huge impact on company operation performance is the foundation of corporate governance structure choice. At present, the number of China's listed port companies is the largest in the world; however, they have a very complex ownership structure. This study discusses the impact of ownership structure on the operation performance of the Chinese ports. This empirical research applies factor analysis to evaluate the operation performance of listed port companies, and then adopts linear regression analysis based on the evaluation results to explore the impact of ownership structure to operation performance. Finally, it proposes recommendations for optimizing the ownership structure of listed port companies, in order to promote a better and faster development of China's port industry. The empirical results show that for most of the listed port companies, the largest shareholder is in the absolute controlling position, and the gap between the largest shareholder and the second largest shareholder is very large, which means the ownership concentration is relatively high. Meanwhile, the top five shareholders equity ratio squared is in negative correlation with operation performance.

Shutdown dose rates at ITER equatorial ports considering radiation cross-talk from torus cryopump lower port

Energy Technology Data Exchange (ETDEWEB)

Juárez, Rafael, E-mail: rjuarez@ind.uned.es [Departamento de Ingeniería Energética, ETSII-UNED, Calle Juan del Rosal 12, Madrid 28040 (Spain); Pampin, Raul [F4E, Torres Diagonal Litoral B3, Josep Pla 2, Barcelona 08019 (Spain); Levesy, Bruno [ITER Organization, 13115 Route de Vinon sur Verdon, St Paul Lez Durance (France); Moro, Fabio [ENEA, Via Enrico Fermi 45, Frascati, Rome (Italy); Suarez, Alejandro [ITER Organization, 13115 Route de Vinon sur Verdon, St Paul Lez Durance (France); Sanz, Javier [Departamento de Ingeniería Energética, ETSII-UNED, Calle Juan del Rosal 12, Madrid 28040 (Spain)

2015-11-15

Shutdown dose rates for planned maintenance purposes is an active research field in ITER. In this work the radiation (neutron and gamma) cross-talk between ports in the most conservative case foreseen in ITER is investigated: the presence of a torus cryopump lower port, mostly empty for pumping efficiency reasons. There will be six of those ports: #4, #6, #10, #12, #16 and #18. The equatorial ports placed above them will receive a significant amount of additional radiation affecting the shutdown dose rates during in situ maintenance activities inside the cryostat, and particularly in the port interspace area. In this study a general situation to all the equatorial ports placed above torus cryopump lower ports is considered: a generic diagnostics equatorial port placed above the torus cryopump lower port (LP#4). In terms of shutdown dose rates at equatorial port interspace after 10{sup 6} s of cooling time, 405 μSv/h has been obtained, of which 160 μSv/h (40%) are exclusively due to radiation cross-talk from a torus cryopump lower port. Equatorial port activation due to only “local neutrons” contributes 166 μSv/h at port interspace, showing that radiation cross-talk from such a lower port is a phenomenon comparable in magnitude to the neutron leakage though the equatorial port plug.

Microbiological Study in Coastal Water of Port Dickson, Malaysia

International Nuclear Information System (INIS)

Ainon Hamzah; Saiful Hazwa Kipli; Siti Rahil Ismail; Rawlins Una; Sukiman Sarmani

2011-01-01

The microbial composition in coastal water of the Port Dickson beach in Negeri Sembilan, Malaysia was analyzed using several microbial indicators for the purpose of selecting the best indicator for marine water pollution. The indicators studied were total coliform (TC), fecal coliform (FC), fecal streptococci (FS) and coliphage. Five locations were selected along the Port Dickson beaches and samplings were carried out in 1998 and 2001. The results showed an increase in the number of total coliform (TC), fecal coliform (FC) and fecal streptococci (FS) between these two sampling by 98.12 %, 86.12 % and 99 %, respectively. The numbers of TC, FC and FS exceeded the recommended limit for recreational seawater based on U.S. EPA 1986 standard. There was a positive correlation between TC, FC and FS and negative to coliphages. (author)

Treatment of uncertainties in the existence of free berths with risk analysis techniques. Establishment of policies in port of Cadiz (SPAIN)

Energy Technology Data Exchange (ETDEWEB)

Awad Nuñez, S.; Camarero Orive, A.; Romero Sanchez-Brunete, M.; Camarero Orive, A.; Gonzalez Cancelas, N.

2016-07-01

This research discusses the challenges involved in the treatment of uncertainties in the existence of free berths during the arrival of cruise ships at seaports. Pursuing this goal, a three-step methodology is adopted: 1) Identifying risk sources and critical risk variables and how they are related; 2) Fitting the Probability Distribution Functions that best represent the behaviour of each critical risk variable; and 3) Simulating the probability of a ship having to wait because there are no free berths using a technique that combines statistical concepts (random sampling) with the ability of computers to generate pseudo-random numbers and automate estimations of the values of the set of critical risk variables. The innovative use of risk analysis techniques in this field allows the establishment of policies to improve the planning and management of port infrastructure, for example, deciding when it is necessary to work to increase the number of berths. As a case of study, we applied this methodology to study whether the enlargement of the wharf in the port of Cadiz (Spain) is necessary right now considering the number of cruise ships that have arrived at the port in the past three years, their date and hour of arrival, their length and draught, the duration of their stay in port and their waiting time before being able to enter the port. This action would require moving logistics activities to a new terminal, but would bring to the city the opportunity to rethink the seafront, introducing new cruiser links with the city centre and developing a better seaport-city integration. (Author)

Laparoscopic versus open surgery for the treatment of colorectal cancer: a literature review and recommendations from the Comité de l’évolution des pratiques en oncologie

Science.gov (United States)

Morneau, Mélanie; Boulanger, Jim; Charlebois, Patrick; Latulippe, Jean-François; Lougnarath, Rasmy; Thibault, Claude; Gervais, Normand

2013-01-01

Background Adoption of the laparoscopic approach for colorectal cancer treatment has been slow owing to initial case study results suggesting high recurrence rates at port sites. The use of laparoscopic surgery for colorectal cancer still raises a number of concerns, particularly with the technique’s complexity, learning curve and longer duration. After exploring the scientific literature comparing open and laparoscopic surgery for the treatment of colorectal cancer with respect to oncologic efficacy and short-term outcomes, the Comité de l’évolution des pratiques en oncologie (CEPO) made recommendations for surgical practice in Quebec. Methods Scientific literature published from January 1995 to April 2012 was reviewed. Phase III clinical trials and meta-analyses were included. Results Sixteen randomized trials and 10 meta-analyses were retrieved. Analysis of the literature confirmed that for curative treatment of colorectal cancer, laparoscopy is not inferior to open surgery with respect to survival and recurrence rates. Moreover, laparoscopic surgery provides short-term advantages, including a shorter hospital stay, reduced analgesic use and faster recovery of intestinal function. However, this approach does require a longer operative time. Conclusion Considering the evidence, the CEPO recommends that laparoscopic resection be considered an option for the curative treatment of colon and rectal cancer; that decisions regarding surgical approach take into consideration surgeon experience, tumour stage, potential contraindications and patient expectations; and that laparoscopic resection for rectal cancer be performed only by appropriately trained surgeons who perform a sufficient volume annually to maintain competence. PMID:24067514

Generic Diagnostic Port Integration for the Equatorial Port Plug of ITER

International Nuclear Information System (INIS)

Doceul, L.; Chappuis, Ph.; Portafaix, Ch.; Guillaume, T.; Bruyere, Ch.; Walker, Ch.; Ingesson, Ch.; Ciattaglia, E.; Salasca, S.; Eric, T.

2006-01-01

ITER requires an extensive set of diagnostic systems to provide several key functions such as protection of the device, input to plasma control systems and evaluation of the plasma performance. Most of these diagnostics system are to be integrated in port plugs, which are water cooled stainless steel structures (approximately: 50 t, 2 m x 2 m x 4 m) inserted into the vacuum-vessel ports. The port plug must perform basic functions such as providing neutron and gamma shielding, supporting the first wall armour and shielding blanket material, closing the vacuum vessel ports, supporting the diagnostic equipment (within the primary vacuum, on the primary vacuum boundary and in the port interspace). CEA (Commissariat l'Energie Atomique) has contributed to the engineering activities on the port plugs and has more particularly focused on the design and diagnostic integration in the representative equatorial port plug EQ01. The specific CEA contributions were to perform the general engineering, structural and thermal analysis. These detailed analysis have highlighted some design issues which were worked out through different solutions. This paper will contain the description of the engineering activities performed such as: - The conceptual design of the EQ01 and the associated diagnostics, such as the visible and infrared optical diagnostic, - The static mechanical calculations, taking into account the electromagnetic loads occurring during fast transient plasma events, - The dynamic calculation constituted of modal and transient analysis under the same electromagnetic loads to estimate the dynamic amplification factor due to the resonance phenomenon, - The thermal assessment under the neutronic load of the water-cooled stainless steel structure, - The seismic response of the port plug inside the vacuum vessel, taking into account the ground spectra and soil conditions in the Cadarache site. (author)

Getting Port Governance Right

DEFF Research Database (Denmark)

de Langen, Peter; Saragiotis, Periklis

2018-01-01

This chapter discusses the relevance of ports for economic development and next identifies port governance as a critical determinant of a well-functioning port industry. While in the past decades privately owned terminal operating companies have emerged and contributed to more efficient supply ch...

Reduced-port robotic total mesorectal resection for rectal cancer using a single-port access: a technical note.

Science.gov (United States)

Bae, Sung Uk; Jeong, Woon Kyung; Baek, Seong Kyu

2017-12-01

Single-port laparoscopic surgery has some advantages, including improved cosmetic outcomes and minimized parietal trauma. However, pure single-port laparoscopic rectal cancer surgery is challenging because of the difficulties in creating triangulation and applying the laparoscopic staplers with sufficient distal margins in the narrow pelvic cavity. Recently, a reduced-port robotic operation with a robotic single-port access plus one wristed robotic arm for colon cancer was introduced to overcome the limitations of single-port laparoscopic rectal surgery. Single-port laparoscopic surgery has some advantages, including improved cosmetic outcomes and minimized parietal trauma. However, the pure single-port laparoscopic rectal cancer operation is challenging. Recently, a reduced-port robotic operation with a robotic single-port access plus one wristed robotic arm for colon cancer was introduced to overcome the limitations of single-port laparoscopic rectal surgery. We performed a single-port plus an additional port robotic operation using a robotic single-port access through the umbilical incision, and the wristed robotic instruments were inserted through an additional robotic port in the right lower quadrant. The total operative and docking times were 310 min and 25 min, respectively. The total number of lymph nodes harvested was 12, and the proximal and distal resection margins were 11.1 and 2 cm, respectively. The patient was discharged on postoperative day 12 uneventfully. Based on a representative case, reduced-port robotic total mesorectal excision for rectal cancer using the single-port access appears to be feasible and safe. This approach could overcome the limitations of single-port laparoscopic rectal surgery.

[Catheter fracture and pulmonary embolization of the distal fragment: a rare complication of the totally implantable venous access port].

Science.gov (United States)

Rebahi, H; El Adib, A G; Mouaffak, Y; El Hattaoui, M; Chaara, A; Sadek, H; Khouchani, M; Mahmal, L; Younous, S

2015-01-01

Totally implantable venous access port plays a crucial role in the treatment of patients in oncology. However, its use can result sporadically in catheter fracture with catheter tip embolization into pulmonary arteries. We report this unusual but potentially serious complication in four patients. In these patients, the port had been inserted percutaneously into the subclavian vein using the infra-clavicular approach. This side effect occurred late in three patients. In all patients, the catheter fracture was asymptomatic or pauci-symptomatic and was caused by the pinch-off syndrome. The retrieval of the embolized fragments was successfully performed by transcatheter procedure in the cardiac catheterisation laboratory. We reviewed the literature and the newest guidelines and recommendations to detail the clinico-radiological features, the possible causes of this complication and discussed means to recognize, manage and prevent it. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

European evidence-based recommendations for diagnosis and treatment of paediatric antiphospholipid syndrome: the SHARE initiative.

Science.gov (United States)

Groot, Noortje; de Graeff, Nienke; Avcin, Tadej; Bader-Meunier, Brigitte; Dolezalova, Pavla; Feldman, Brian; Kenet, Gili; Koné-Paut, Isabelle; Lahdenne, Pekka; Marks, Stephen D; McCann, Liza; Pilkington, Clarissa A; Ravelli, Angelo; van Royen-Kerkhof, Annet; Uziel, Yosef; Vastert, Sebastiaan J; Wulffraat, Nico M; Ozen, Seza; Brogan, Paul; Kamphuis, Sylvia; Beresford, Michael W

2017-10-01

Antiphospholipid syndrome (APS) is rare in children, and evidence-based guidelines are sparse. Consequently, management is mostly based on observational studies and physician's experience, and treatment regimens differ widely. The Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) initiative was launched to develop diagnostic and management regimens for children and young adults with rheumatic diseases. Here, we developed evidence-based recommendations for diagnosis and treatment of paediatric APS. Evidence-based recommendations were developed using the European League Against Rheumatism standard operating procedure. Following a detailed systematic review of the literature, a committee of paediatric rheumatologists and representation of paediatric haematology with expertise in paediatric APS developed recommendations. The literature review yielded 1473 articles, of which 15 were valid and relevant. In total, four recommendations for diagnosis and eight for treatment of paediatric APS (including paediatric Catastrophic Antiphospholipid Syndrome) were accepted. Additionally, two recommendations for children born to mothers with APS were accepted. It was agreed that new classification criteria for paediatric APS are necessary, and APS in association with childhood-onset systemic lupus erythematosus should be identified by performing antiphospholipid antibody screening. Treatment recommendations included prevention of thrombotic events, and treatment recommendations for venous and/or arterial thrombotic events. Notably, due to the paucity of studies on paediatric APS, level of evidence and strength of the recommendations is relatively low. The SHARE initiative provides international, evidence-based recommendations for diagnosis and treatment for paediatric APS, facilitating improvement and uniformity of care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use

Strong Motion Instrumentation of Seismically-Strengthened Port Structures in California by CSMIP

Science.gov (United States)

Huang, M.J.; Shakal, A.F.

2009-01-01

The California Strong Motion Instrumentation Program (CSMIP) has instrumented five port structures. Instrumentation of two more port structures is underway and another one is in planning. Two of the port structures have been seismically strengthened. The primary goals of the strong motion instrumentation are to obtain strong earthquake shaking data for verifying seismic analysis procedures and strengthening schemes, and for post-earthquake evaluations of port structures. The wharves instrumented by CSMIP were recommended by the Strong Motion Instrumentation Advisory Committee, a committee of the California Seismic Safety Commission. Extensive instrumentation of a wharf is difficult and would be impossible without the cooperation of the owners and the involvement of the design engineers. The instrumentation plan for a wharf is developed through study of the retrofit plans of the wharf, and the strong-motion sensors are installed at locations where specific instrumentation objectives can be achieved and access is possible. Some sensor locations have to be planned during design; otherwise they are not possible to install after construction. This paper summarizes the two seismically-strengthened wharves and discusses the instrumentation schemes and objectives. ?? 2009 ASCE.

Safety and Effectiveness of Percutaneously Inserted Peritoneal Ports Compared to Surgically Inserted Ports in a Retrospective Study of 87 Patients with Ovarian Carcinoma over a 10-Year Period

International Nuclear Information System (INIS)

Woodley-Cook, Joel; Tarulli, Emidio; Tan, Kong T.; Rajan, Dheeraj K.; Simons, Martin E.

2016-01-01

PurposePlacement of peritoneal ports has become a favorable technique for direct chemotherapy infusion in treating peritoneal metastases from ovarian cancer. We aim to outline an approach to the percutaneous insertion of peritoneal ports and to characterize success and complication rates compared to surgically inserted ports.Materials and MethodsRetrospective analysis was collected from 87 patients who had peritoneal port insertion (28 inserted surgically and 59 percutaneously) for treatment of peritoneal metastases from ovarian cancer from July 2004 to July 2014. Complications were classified according to the SIR Clinical Practice Guidelines as major or minor.ResultsTechnical success rates for surgically and percutaneously inserted ports were 100 and 96.7 %, respectively (p = 0.44), with the two percutaneous failures successful at a later date. There were no major complications in either group. Minor complication rates for surgically versus percutaneously inserted ports were 46.4 versus 22.0 %, respectively (p = 0.02). The infection rate for surgically inserted versus percutaneously inserted ports was 14.3 and 0 %, respectively (p = 0.002). The relative risk of developing a complication from percutaneous peritoneal port insertion without ascites was 3.4 (p = 0.04). For percutaneously inserted ports, the mean in-room procedure time was 81 ± 1.3 min and mean fluoroscopy time was 5.0 ± 4.5 min.ConclusionPercutaneously inserted peritoneal ports are a safe alternative to surgically inserted ports, demonstrating similar technical success and lower complication rates.

Safety and Effectiveness of Percutaneously Inserted Peritoneal Ports Compared to Surgically Inserted Ports in a Retrospective Study of 87 Patients with Ovarian Carcinoma over a 10-Year Period

Energy Technology Data Exchange (ETDEWEB)

Woodley-Cook, Joel, E-mail: jwoodleycook@gmail.com [The Scarborough Hospital, Vascular and Interventional Radiology, Department of Diagnostic Imaging (Canada); Tarulli, Emidio; Tan, Kong T.; Rajan, Dheeraj K.; Simons, Martin E. [University of Toronto, Vascular and Interventional Radiology, Department of Medical Imaging, University Health Network (Canada)

2016-11-15

PurposePlacement of peritoneal ports has become a favorable technique for direct chemotherapy infusion in treating peritoneal metastases from ovarian cancer. We aim to outline an approach to the percutaneous insertion of peritoneal ports and to characterize success and complication rates compared to surgically inserted ports.Materials and MethodsRetrospective analysis was collected from 87 patients who had peritoneal port insertion (28 inserted surgically and 59 percutaneously) for treatment of peritoneal metastases from ovarian cancer from July 2004 to July 2014. Complications were classified according to the SIR Clinical Practice Guidelines as major or minor.ResultsTechnical success rates for surgically and percutaneously inserted ports were 100 and 96.7 %, respectively (p = 0.44), with the two percutaneous failures successful at a later date. There were no major complications in either group. Minor complication rates for surgically versus percutaneously inserted ports were 46.4 versus 22.0 %, respectively (p = 0.02). The infection rate for surgically inserted versus percutaneously inserted ports was 14.3 and 0 %, respectively (p = 0.002). The relative risk of developing a complication from percutaneous peritoneal port insertion without ascites was 3.4 (p = 0.04). For percutaneously inserted ports, the mean in-room procedure time was 81 ± 1.3 min and mean fluoroscopy time was 5.0 ± 4.5 min.ConclusionPercutaneously inserted peritoneal ports are a safe alternative to surgically inserted ports, demonstrating similar technical success and lower complication rates.

Application of Game Theory and Uncertainty Theory in Port Competition between Hong Kong Port and Shenzhen Port

Directory of Open Access Journals (Sweden)

Thi Minh Hoang Do

2015-06-01

Full Text Available This paper unveils the strong competition in container cargo between Hong Kong Port which has been emerging as an international maritime center since the 1970s and Shenzhen Port which has recently gained remarkable achievements in the Pearl River Delta region. Among various competing strategies, the study focuses on the long-term one in which two ports will decide to compete by investing in capacity. The purpose of this research is to examine their decision making process and to suggest future strategic actions in the current situation. Within its scope, only economic profit brought back from the investment is considered. For this reason, an uncertain payoff two-person game model is developed where an uncertain factor of demand is involved. In applying Uncertainty theory (Liu, 2013, the two methods to solve the game are introduced, including uncertain statistics and the expected Nash Equilibrium strategy. The results obtained from this research generate meaningful suggestions for future competition plan for the two selected ports, which conclude that Shenzhen is the dominant port in this long-term strategy. Compared to existing works on the same topic, the paper shows its distinctiveness by studying the latest competitive situation with regard to the uncertain demand in the game model.

Inland Ports in the Republic of Croatia: Approvals for Port Activities instead of Concessions

Directory of Open Access Journals (Sweden)

Goran Vojković

2008-11-01

Full Text Available According to the 1998 Act on Inland Ports, the right to performall port activities within inland ports of the Republic ofCroatia is given on the basis of concession, obtained throughbidding. It has been noticed in practice that modem businessprocesses and traffic flows are more dynamic than before whenclassic concession relations were created. Also, types andamounts of cargo are changing every couple of years, which isfollowed by quick adjustments, instead of working according torigid and long-term defined decisions and concession contracts.Furthermore, the practice has shown for some activitiesthat the number of port providers (such as ship suppliers,port-agency and freight forwarders should not be limited. Thismeans that the system of a limited number of port providers isimportant only for the activities that require location within aport, as the port area is physically limited. Therefore, the newAct on Navigation and Inland Ports from 2007, whose framehas been completed by sub-law acts during 2008, has replacedthe complex concession system for performing activities in inlandports by a more liberal approval system. On the basis ofthese, higher dynamics of work of port providers is enabled aswell as easier adjustment to market conditions. Furthermore,the main limitation factor that determines the number of portusers becomes the available physical space within a port, whichprovides undisturbed competition, along with larger offer ofport services that do not require that space. It is also importantto point out that the new Act specifically includes distributionand cargo logistics, also processing and improvement of goodsas well as industrial activities including production that enablecomplete economic utilization of port capacities into the existingport activities, thus significantly changing the role of the portitself as a logistic centre.

Multiple-port valve

International Nuclear Information System (INIS)

Doody, T.J.

1978-01-01

A multiple-port valve assembly is designed to direct flow from a primary conduit into any one of a plurality of secondary conduits as well as to direct a reverse flow. The valve includes two mating hemispherical sockets that rotatably receive a spherical valve plug. The valve plug is attached to the primary conduit and includes diverging passageways from that conduit to a plurality of ports. Each of the ports is alignable with one or more of a plurality of secondary conduits fitting into one of the hemispherical sockets. The other hemispherical socket includes a slot for the primary conduit such that the conduit's motion along that slot with rotation of the spherical plug about various axes will position the valve-plug ports in respect to the secondary conduits

360 PORT MDA - A Strategy to Improve Port Security

Science.gov (United States)

2006-09-01

Participating Agencies (After: Executive Briefing..........................27 Table 6. Designated Joint Operations Center Participants (From: SAFE...Investigations CGIP Coast Guard Intelligence Program CHOC Charleston Harbor Operations Center CIO Command Intelligence Officer CMT Combating Maritime... EXECUTIVE SUMMARY Ports are critical to our economy and national security. Key hubs in the international trade network, U.S. ports accounted for more than

Examples of Savannah River water dilution between the Savannah River Plant and the Beaufort-Jasper and Port Wentworth water-treatment plants

International Nuclear Information System (INIS)

Hayes, D.W.

1983-01-01

A substantial dilution of the river water occurs between the Savannah River Plant (SRP) and the two treatment plants. This dilution results from inflow of surface and groundwater and from direct rainfall. The amount of dilution was estimated to be approximately 20% and 54% down to the Port Wentworth and Beaufort-Jasper plants, respectively

Port Stakeholder Summit - April 2014

Science.gov (United States)

EPA's National Port Stakeholders Summit, Advancing More Sustainable Ports, focused on actions to protect air quality while reducing climate risk and supporting economic growth, making ports more environmentally sustainable.

An Analysis of Port Service Quality and Customer Satisfaction: The Case of Korean Container Ports

Directory of Open Access Journals (Sweden)

Gi Tae Yeo

2015-12-01

Full Text Available Ports play a critical role in the economy of many countries and regions. Failure or unreliability of port services can significantly influence port customers—shipping lines and cargo owners—and result in their dissatisfaction. However, what constitutes port service quality (PSQ and its influence on the satisfaction of port customers has not been well investigated in the literature. Therefore, this study investigates the concept of PSQ and its influence on customer satisfaction in the case of Korean container ports. Following a literature review, a conceptual model of PSQ and its influence on customer satisfaction is proposed. The model was validated through a survey of 313 members of the Korean Port Logistics Association (KPLA. Partial least squares structural equation modeling (PLS-SEM was conducted to confirm the PSQ dimensions and to examine their relationship with customer satisfaction using SmartPLS 3.2.1 software. PSQ is found to be a five-factor construct, and its management, and image and social responsibility factors have significant positive effects on customer satisfaction. In addition to its academic contribution, this study also contributes to management practices because port managers can use the PSQ scale to measure their customers’ satisfaction and justify investments in the quality management of port services.

Concerning background from calorimeter ports

International Nuclear Information System (INIS)

Digiacomo, N.J.

1985-01-01

Any detector system viewing a port or slit in a calorimeter wall will see, in addition to the primary particles of interest, a background of charged and neutral particles and photons generated by scattering from the port walls and by leakage from incompletely contained primary particle showers in the calorimeter near the port. The signal to noise ratio attainable outside the port is a complex function of the primary source spectrum, the calorimeter and port design and, of course, the nature and acceptance of the detector system that views the port. Rather than making general statements about the overall suitability (or lack thereof) of calorimeter ports, we offer here a specific example based on the external spectrometer and slit of the NA34 experiment. This combination of slit and spectrometer is designed for fixed-target work, so that the primary particle momentum spectrum contains higher momentum particles than expected in a heavy ion colliding beam environment. The results are, nevertheless, quite relevant for the collider case

Results of an integration study of a diagnostics port plug in ITER

International Nuclear Information System (INIS)

Salasca, Sophie; Cantone, Bruno; Grosman, André; Esposito, Basilio; Moro, Fabio; Morocco, Daniele; Villari, Rosaria; Angelone, Maurizio; Rincon, Esther; Hidalgo, Carlos; Nagy, Daniel; Kocsis, Gabor; Varela, Paulo; Porempovics, Gabor; Perrollaz, Guillaume; Patel, Kunal; Krivchenkov, Yuri; Walsh, Michael

2013-01-01

Highlights: ► An extensive study on the integration of diagnostics in a port plug of ITER has been performed. ► It has shown that the diagnostic performances could not be reached if their number was not decreased. ► A design of Diagnostic Shield Modules has been validated through mechanical and thermal analyses. ► These analyses have confirmed that the highest loads are concentrated in the vicinity of the plasma. -- Abstract: Diagnostics in ITER are mandatory to characterize the parameters of plasma and study its interactions with plasma-facing components. Diagnostics components in the vicinity of the plasma are supported by metallic structures called port plugs. At the tokamak mid-plane, these components are installed in port plugs through intermediate structures called drawers. Apart from hosting the diagnostics, the port plugs act as shielding against neutrons and gammas, in order to limit the nuclear loads in crucial components (such as diagnostics and superconducting coils) as well as the dose levels in the controlled zones of the tokamak. The radiation shielding function of the port plugs is ensured through an optimized mixture of heavy metallic materials and water, forming shielding blocks surrounding the diagnostics and called Diagnostic Shield Modules (DSMs). These DSMs constitute the rear part of the drawers (the front part being composed of the Diagnostic First Wall). This paper presents the main results of a study performed in Europe on the integration of a particular diagnostics port plug, the Equatorial Port Plug 1 (EPP1). The paper first provides the results of the EPP1 diagnostics integration analysis. In a second step it focuses on the design of the EPP1 DSMs and summarizes the major results of a thorough set of analyses aiming at studying the DSMs behaviour under different loads, suggesting recommendations to improve their current design

Visualization of differences across port state control regimes by means of correspondence analysis

NARCIS (Netherlands)

S. Knapp (Sabine); M. van de Velden (Michel)

2007-01-01

textabstractThis article is based on a combined dataset of 183,819 port state control (PSC) inspections from various port state control regimes around the world. In theory, there should be no differences in treatments of inspections to determine if a vessel is substandard or not no matter where the

Non-Price Competition in the Port Sector: A Case Study of Ports in Turkey

OpenAIRE

Soner Esmer; Hong-Oanh Nguyen, Ph.D.; Yapa Mahinda Bandara, Ph.D.; Kazim Yeni, Ph.D.

2016-01-01

Although the port sector has been facing increasing competition, there is limited research on how ports compete using non-price competition strategies. There are a few studies on non-price competition in the port sector. However they mainly focus on the marketing aspect. This paper seeks to fill this gap in the literature, especially from a combined marketing-economic perspective. Especially the paper's main objective is to identify the determinants of non-price competition in the port sector...

Recommended treatment for urinary tract infection in pregnancy.

Science.gov (United States)

Vercaigne, L M; Zhanel, G G

1994-02-01

To establish and recommend a therapeutic regimen for the treatment of urinary tract infection (UTI) in pregnancy based on the published studies. An English-language literature search employing MEDLINE, Index Medicus, and bibliographic reviews of the references obtained were searched (key terms: urinary tract infection, UTI, pregnancy, bacteriuria). All identified human studies dealing with bacteriuria or UTI in pregnancy were analyzed. Limited data are available regarding the appropriate antibiotic management of UTI in pregnancy. Single-dose cure rates with amoxicillin are approximately 80 percent. Trimethoprim/sulfamethoxazole provides cure rates of greater than 80 percent. Cephalosporins and nitrofurantoin produce variable results. We recommend separating pregnant subjects with UTI into two groups. Those with asymptomatic bacteriuria can be treated with a single dose of an antimicrobial to which the organism is susceptible. For those with symptomatic UTI, we recommend amoxicillin 500 mg tid for three days. Urine cultures should be repeated seven days following therapy to assess cure or failure. Well-designed studies need to be performed, comparing single-dose and three-day therapy for UTI in pregnancy.

American Society of Radiation Oncology Recommendations for Documenting Intensity-Modulated Radiation Therapy Treatments

International Nuclear Information System (INIS)

Holmes, Timothy; Das, Rupak; Low, Daniel; Yin Fangfang; Balter, James; Palta, Jatinder; Eifel, Patricia

2009-01-01

Despite the widespread use of intensity-modulated radiation therapy (IMRT) for approximately a decade, a lack of adequate guidelines for documenting these treatments persists. Proper IMRT treatment documentation is necessary for accurate reconstruction of prior treatments when a patient presents with a marginal recurrence. This is especially crucial when the follow-up care is managed at a second treatment facility not involved in the initial IMRT treatment. To address this issue, an American Society for Radiation Oncology (ASTRO) workgroup within the American ASTRO Radiation Physics Committee was formed at the request of the ASTRO Research Council to develop a set of recommendations for documenting IMRT treatments. This document provides a set of comprehensive recommendations for documenting IMRT treatments, as well as image-guidance procedures, with example forms provided.

Dynamism Patterns of Western Mediterranean Cruise Ports and the Coopetition Relationships Between Major Cruise Ports

Directory of Open Access Journals (Sweden)

Esteve-Perez Jeronimo

2018-03-01

Full Text Available The Mediterranean Sea has seen an increase of ports hosting cruise ships during the first fifteen years of the 21st century. The increase in cruise ship presence in Mediterranean ports is associated with the dynamism of cruise traffic in recent years, with an average annual growth of 7.45% for cruise passengers worldwide during the period of 1990-2015. Cruise traffic is a maritime business that is primarily composed of two elements, maritime affairs and tourism. This article focuses on the maritime component. With the growth of the cruise industry, cruise lines have been forced to seek new ports to meet demand in an attempt to create differentiated products based on the ports that compose the itinerary. The itinerary system of cruise traffic makes the cruise ports depend on one another to design an itinerary. This feature results in both complex geographic relationships in the design of a cruise itinerary and complex competitive/cooperative relationships between ports. The aim of this article is to present the hierarchic picture of a sample of 29 cruise ports in the Western Mediterranean region during the period of 2000-2015. To achieve this goal, a port size classification is proposed and a shift-share analysis at the inter- and intra-group size level is applied. Moreover, concentration measures are used to determine the changes in the levels of market concentration. Furthermore, a dynamic model is proposed to determine the competitive or cooperative relationships between cruise ports. The proposed model is applied to the largest ports with data from the 2001-2015 period.

Substantial variability in postoperative treatment, and convalescence recommendations following vaginal repair. A nationwide questionnaire study

DEFF Research Database (Denmark)

Ottesen, Marianne; Møller, Charlotte; Kehlet, H

2001-01-01

BACKGROUND: Postoperative care and convalescence recommendations following vaginal surgery are generally not evidence based. The aim of this study was to describe pre and postoperative treatment, and advice and restrictions for the convalescence period, given by Danish hospital-employed gynecolog......BACKGROUND: Postoperative care and convalescence recommendations following vaginal surgery are generally not evidence based. The aim of this study was to describe pre and postoperative treatment, and advice and restrictions for the convalescence period, given by Danish hospital......-employed gynecologists, and gynecologists in private practice, to patients undergoing vaginal repair. METHOD: In 1999 all Danish gynecologists (n=433) received a tested questionnaire about postoperative treatment and convalescence recommendations following vaginal repair. Non-responders received one reminder. OUTCOME...... anterior repair, and 2 days (range, 1-7) following posterior repair. The recommended sick leave was median 6 weeks (range, 2-12) for patients with work with heavy lifts. There were substantial differences in recommendations. Recommended lifting restrictions were median 3 kg (range, 0-20) for median 4 weeks...

[Concordance between hospital prescriptions and recommendations in the treatment of mania].

Science.gov (United States)

Laforgue, Edouard-Jules; Bulteau, Samuel; Cholet, Jennyfer; Victorri-Vigneau, Caroline; Guitteny, Marie; Mauduit, Nicolas; Vanelle, Jean-Marie; Sauvaget, Anne

2017-06-01

There are differences between recommendations and practice in the pharmacological treatment of acute mania. The objective was to assess conformity of the anti-manic prescription between national recommendations (Haute Autorité de santé [French health authority, HAS] and "résumé des caractéristiques du produit" [product characteristics, RCP]) and clinical practice. We observed the drug prescriptions of in-patients for a manic episode. The main outcome measure was the concordance rate with the recommendations of the drugs prescriptions at the 48th hour. The secondary outcome repeated the same process with the hospital discharge statement of switches, associations, the presence of symptomatic and antidepressant treatments. Sixty-six episodes were included, 40 patients (60%) had a prescription complies with RCP recommendations H48 and 46 patients (70%) to HAS. These rates fall at hospital discharge. Off-label prescriptions, drug combinations and choices of not listed molecules are the most common reasons for non-conformity. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

Case Studies: Improving Environmental Performance and Economic Prosperity at Ports and in Near-Port Communities

Science.gov (United States)

Case Study links for improving environmental performance and economic prosperity at ports and in near-port communities. Case studies on equipment upgrades, jobs and benefits, land use and transportation, port-community engagement, and citizen science.

Mobile Clinical Decision Support System for Acid-base Balance Diagnosis and Treatment Recommendation.

Science.gov (United States)

Mandzuka, Mensur; Begic, Edin; Boskovic, Dusanka; Begic, Zijo; Masic, Izet

2017-06-01

This paper presents mobile application implementing a decision support system for acid-base disorder diagnosis and treatment recommendation. The application was developed using the official integrated development environment for the Android platform (to maximize availability and minimize investments in specialized hardware) called Android Studio. The application identifies disorder, based on the blood gas analysis, evaluates whether the disorder has been compensated, and based on additional input related to electrolyte imbalance, provides recommendations for treatment. The application is a tool in the hands of the user, which provides assistance during acid-base disorders treatment. The application will assist the physician in clinical practice and is focused on the treatment in intensive care.

Vectorization, parallelization and porting of nuclear codes (porting). Progress report fiscal 1999

Energy Technology Data Exchange (ETDEWEB)

Kawasaki, Nobuo; Nemoto, Toshiyuki; Kawai, Wataru; Ishizuki, Shigeru [Fujitsu Ltd., Tokyo (Japan); Ogasawara, Shinobu; Kume, Etsuo; Adachi, Masaaki [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Yatake, Yo-ichi [Hitachi Ltd., Tokyo (Japan)

2001-01-01

Several computer codes in the nuclear field have been vectorized, parallelized and transported on the FUJITSU VPP500 system, the AP3000 system, the SX-4 system and the Paragon system at Center for Promotion of Computational Science and Engineering in Japan Atomic Energy Research Institute. We dealt with 18 codes in fiscal 1999. These results are reported in 3 parts, i.e., the vectorization and the parallelization part on vector processors, the parallelization port on scalar processors and the porting part. In this report, we describe the porting. In this porting part, the porting of Assisted Model Building with Energy Refinement code version 5 (AMBER5), general purpose Monte Carlo codes far neutron and photon transport calculations based on continuous energy and multigroup methods (MVP/GMVP), automatic editing system for MCNP library code (autonj), neutron damage calculations for materials irradiations and neutron damage calculations for compounds code (SPECTER/SPECOMP), severe accident analysis code (MELCOR) and COolant Boiling in Rod Arrays, Two-Fluid code (COBRA-TF) on the VPP500 system and/or the AP3000 system are described. (author)

The Flexible Port

NARCIS (Netherlands)

Taneja, P.

2013-01-01

Ports are beset with many uncertainties about their futures. They are confronted with new demands in terms of functions and scales, new external constraints, and changed expectations. The inability to adequately meet these demands can mean costly adaptations for a port, or loss of cargo and

Principal Ports and Facilities

Data.gov (United States)

California Natural Resource Agency — The Principal Port file contains USACE port codes, geographic locations (longitude, latitude), names, and commodity tonnage summaries (total tons, domestic, foreign,...

Principal Ports and Facilities

Data.gov (United States)

California Department of Resources — The Principal Port file contains USACE port codes, geographic locations (longitude, latitude), names, and commodity tonnage summaries (total tons, domestic, foreign,...

Treatment Recommendations for Locally Advanced, Non-Small-Cell Lung Cancer: The Influence of Physician and Patient Factors

International Nuclear Information System (INIS)

Lee, Irwin H.; Hayman, James A.; Landrum, Mary Beth; Tepper, Joel; Tao, May Lin; Goodman, Karyn A.; Keating, Nancy L.

2009-01-01

Purpose: To determine the impact of patient age, comorbidity, and physician factors on treatment recommendations for locally advanced, unresectable non-small-cell lung cancer (NSCLC). Methods and Materials: We surveyed radiation oncologists regarding their recommendations for treatment (chemoradiation, radiation alone, chemotherapy alone, or no therapy) for hypothetical patients with Stage IIIB NSCLC who varied by age (55 vs. 80 years) and comorbid illness (none, moderate, or severe chronic obstructive pulmonary disease [COPD]). Multinomial logistic regression was used to assess the impact of physician and practice characteristics on radiation oncologists' treatment recommendations for three scenarios with the least agreement. Results: Of 214 radiation oncologists, nearly all (99%) recommended chemoradiation for a healthy 55 year old. However, there was substantial variability in recommendations for a 55 year old with severe COPD, an 80-year-old with moderate COPD, and an 80-year-old with severe COPD. Physicians seeing a lower volume of lung cancer patients were statistically less likely to recommend radiotherapy for younger or older patients with severe COPD (both p < 0.05), but the impact was modest. Conclusions: Nearly all radiation oncologists report following the evidence-based recommendation of chemoradiation for young, otherwise healthy patients with locally advanced, unresectable NSCLC, but there is substantial variability in treatment recommendations for older or sicker patients, probably related to the lack of clinical trial data for such patients. The physician and practice characteristics we examined only weakly affected treatment recommendations. Additional clinical trial data are necessary to guide recommendations for treatment of elderly patients and patients with poor pulmonary function to optimize their management.

Vacuum vessel port structures for ITER-FEAT

International Nuclear Information System (INIS)

Utin, Yu.; Ioki, K.; Komarov, V.; Krylov, V.; Kuzmin, E.; Labusov, I.; Miki, N.; Onozuka, M.; Rozov, V.; Sannazzaro, G.; Tesini, A.; Yamada, M.; Barthel, Th.

2001-01-01

The equatorial and the upper port structures are the most loaded among those of the ITER-FEAT vacuum vessel (VV). For all of these ports, the VV closure plate and the in-port components are integrated into the port plug. The plugs/port structures are affected by plasma events and must withstand high mechanical loads. Based on typical port plugs, this paper presents the conceptual design of the port structures (with emphasis on the supporting system), and the results of analyses performed

Vacuum vessel port structures for ITER-FEAT

Energy Technology Data Exchange (ETDEWEB)

Utin, Yu.; Ioki, K.; Komarov, V.; Krylov, V.; Kuzmin, E.; Labusov, I.; Miki, N.; Onozuka, M.; Rozov, V.; Sannazzaro, G.; Tesini, A.; Yamada, M.; Barthel, Th

2001-11-01

The equatorial and the upper port structures are the most loaded among those of the ITER-FEAT vacuum vessel (VV). For all of these ports, the VV closure plate and the in-port components are integrated into the port plug. The plugs/port structures are affected by plasma events and must withstand high mechanical loads. Based on typical port plugs, this paper presents the conceptual design of the port structures (with emphasis on the supporting system), and the results of analyses performed.

COSIMA-ES-PORT

DEFF Research Database (Denmark)

Barfod, Michael Bruhn; Leleur, Steen

2007-01-01

This article describes the results of the research project – WP3 East-west, Interreg IIIB – concerning the de¬velop¬ment of a new composite decision model, COSIMA-ES-PORT, for the assessment of three pre-feasibility studies situated at the Port of Esbjerg: a road project, a railway project...... and a multimodal terminal. The three studies indicates that a new road connection to the Port of Esbjerg is a very profitable project due to large travel time savings, whereas a new railway connection is not economically viable. However, a new multimodal terminal is also a very profitable project. The COSIMA...

Non-Price Competition in the Port Sector: A Case Study of Ports in Turkey

Directory of Open Access Journals (Sweden)

Soner Esmer

2016-03-01

Full Text Available Although the port sector has been facing increasing competition, there is limited research on how ports compete using non-price competition strategies. There are a few studies on non-price competition in the port sector. However they mainly focus on the marketing aspect. This paper seeks to fill this gap in the literature, especially from a combined marketing-economic perspective. Especially the paper's main objective is to identify the determinants of non-price competition in the port sector and evaluate their effect on various aspects of non-price competition. We start with a general conceptual framework to explain how competition in the sector can be affected by various factors and then propose an analytical framework on non-price competition. The analytical model is then used to support the design of a survey questionnaire. Next, hypothesis tests are conducted using exploratory factor analysis (EFA and structural equation modeling (SEM and data collected from a survey of Turkish ports. Based on the analysis results, the implications for port management and future research are also discussed.

Management of Artisanal Fishing Port: a Case Study on Labuhanhaji Fishing Port, South Aceh Regency, Aceh Province

OpenAIRE

NurJannah, Betri; ', Syaifuddin; Zain, Jonny

2014-01-01

A series survey activity was carried out for evaluating management function atlabuanhaji fishing port, South Aceh regency. This research was emphasis on planning, organizing, action and controlling at management pattern of labuhanhaji fishing port. The facilities of fishing port data and daily activities description of staff at labuhanhaji fishing port was used as additional information and consideration in management of labuhanhaji fishing port. Lack of good management was impact on staff an...

Port Harcourt Medical Journal - Vol 3, No 3 (2009)

African Journals Online (AJOL)

Simple vision screening in lower primary school children in Port Harcourt city · EMAIL ... An evaluation of the appropirateness of the home treatment given by caregivers ... relative risk of metabolic syndrome components in Nigerians: The adult ...

Two Ports Laparoscopic Inguinal Hernia Repair in Children

Directory of Open Access Journals (Sweden)

Medhat M. Ibrahim

2015-01-01

Full Text Available Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac. Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation to other modalities of repair was the aim of this work. 90 children including 75 males and 15 females underwent surgery. Hernia in 55 cases was right-sided and in 15 left-sided. Two patients had recurrent hernia following open hernia repair. 70 (77.7% cases were suffering unilateral hernia and 20 (22.2% patients had bilateral hernia. Out of the 20 cases 5 cases were diagnosed by laparoscope (25%. The patients’ median age was 18 months. The mean operative time for unilateral repairs was 15 to 20 minutes and bilateral was 21 to 30 minutes. There was no conversion. The complications were as follows: one case was recurrent right inguinal hernia and the second was stitch sinus. Discussion. The results confirm the safety and efficacy of two ports laparoscopic hernia repair in congenital inguinal hernia in relation to other modalities of treatment.

Maximizing port and transportation system productivity by exploring alternative port operation strategies.

Science.gov (United States)

2011-06-01

Seaports are a critical transportation component that supports the nations economy. Many U.S. : ports are now experiencing significant truck congestion at the gate, which decreases the productivity of : ports and truck fleets (e.g. truck wait time...

A review of dry ports

OpenAIRE

Violeta Roso; Kent Lumsden

2010-01-01

The objective of this article is to present the previous research on the dry port concept and to review the world's existing dry ports, that is freight terminals that use the term ‘dry port’ in their name. Therefore, the purpose of this article is to clarify the concept by showing potential discrepancies or agreements between theory and practice. Starting from a literature review on the dry port concept, this article presents a review of existing dry ports in the world. A number of qualitativ...

Mechanical characteristics of plastic base Ports and impact on flushing efficacy.

Science.gov (United States)

Guiffant, Gérard; Flaud, Patrice; Royon, Laurent; Burnet, Espérie; Merckx, Jacques

2017-01-01

Three types of totally implantable venous access devices, Ports, are currently in use: titanium, plastic (polyoxymethylene, POM), and mixed (titanium base with a POM shell). Physics theory suggests that the interaction between a non-coring needle (NCN, made of stainless steel) and a plastic base would lead to the stronger material (steel) altering the more malleable material (plastic). To investigate whether needle impacts can alter a plastic base's surface, thus potentially reducing flushing efficacy. A Port made of POM was punctured 200 times with a 19-gauge NCN. Following the existing guidelines, the needle tip pricked the base with each puncture. The Port's base was then examined using a two-dimensional optical instrument, and a bi-dimensional numerical simulation using COMSOL ® was performed to investigate potential surface irregularities and their impact on fluid flow. Each needle impact created a hole (mean depth, 0.12 mm) with a small bump beside it (mean height, 0.02 mm) the Reynolds number Re k ≈10. A numerical simulation of the one hole/bump set showed that the flushing efficacy was 60% that of flushing along a flat surface. In clinical practice, the number of times a Port is punctured depends on patient and treatment characteristics, but each needle impact on the plastic base may increase the risk of decreased flushing effectiveness. Therefore, the more a plastic Port is accessed, the greater the risk of microorganisms, blood products, and medication accumulation. Multiple needle impacts created an irregular surface on the Port's base, which decreased flushing efficacy. Clinical investigation is needed to determine whether plastic base Ports are associated with an increased risk of Port infection and occlusion compared to titanium base Ports.

Recommendations to avoid gross errors of dose in radiotherapeutic treatments

International Nuclear Information System (INIS)

Souza, Cleber Nogueira de; Monti, Carlos Roberto; Sibata, Claudio Hissao

2001-01-01

Human mistakes are an important source of errors in radiotherapy and may occur at every step of the radiotherapy planning and treatment. To reduce this level of uncertainties, several specialized organizations have recommended a comprehensive quality assurance program. In Brazil, the requirement for these programs has been strongly stressed, and most radiotherapy services have pursued this goal regarding radiation units and dosimetry equipment, as well as the verification of the calculations of the patient's dose and the revision of the plan charts. As a contribution to the improvement of quality control, we present some recommendations to avoid failure of treatment due to error in the delivered dose, such as redundant check of the manual or computer calculations, weekly check of the total dose for each patient, and prevention of inadvertent access to any safety system of the equipment by any staff member that is only supposed to operate the machine. Moreover, the use of a computerized treatment record and verification system should be considered in order to eliminate errors due to incorrect selection of the treatment parameters, in a daily basis. We report four radioactive incidents with patient injuries occurred throughout the world and some gross errors of dose. (author)

Analyzing Growth Opportunity of Port from the Resource-based Perspective The Case of Port of Tanjung Pelepas Malaysia

Directory of Open Access Journals (Sweden)

Muhammad Subhan

2008-09-01

Full Text Available Capturing growth opportunity has become a major integral activity of any port to sustain growth and competitive advantage. One of the famous strategies in leveraging sustainable growth and competitive advantage is the resource-based theory application into port strategic management, viewing resources of the port (internal and external and its capabilities as the sources for achieving competitive advantage. In this study, we attempt to identify, exploit, and analyze growth opportunity of a Malaysian port from the perspective of the theory. We analyze the port’s resources in terms of values, uniqueness, inimitability, durability, and substitutability. The result is then compared with its rival ports in the region. This study recognizes that the port has successfully identified and exploited its resources for capturing growth opportunity and competing with other ports in the region. We perceive that the port will sustain its growth and competitive advantage as a major port in the region based on its current performance and rivalry circumstances. This study signifies that the higher the level to which resource-based theory of competitive advantage is applied, the higher and longer the growth and competitive advantage will be achieved by the port.

[Treatment with psychotropic agents in patients with dementia and delirium : Gap between guideline recommendations and treatment practice].

Science.gov (United States)

Hewer, Walter; Thomas, Christine

2017-02-01

Psychiatric symptoms in dementia and delirium are associated with a substantially reduced quality of life of patients and their families and often challenging for professionals. Pharmacoepidemiological surveys have shown that, in particular, patients living in nursing homes receive prescriptions of psychotropic agents in significant higher frequency than recommended by current guidelines. This article focuses on a critical appraisal of this gap from the point of view of German healthcare services. Narrative review with special reference to the German dementia guideline from 2016 and recently published practice guidelines for delirium in old age in German and English language. The indications for use of psychotropic agents, especially antipsychotics, are defined narrowly in the German dementia guideline. According to this guideline for several psychopathological symptoms evidence based recommendations cannot be given, currently. For delirium several practice guidelines related to different treatment settings have been published recently. Comparable to the German dementia guideline they recommend general medical interventions and nonpharmacological treatment as first line measures and the use of psychotropic agents only under certain conditions. These guidelines differ to some extent regarding the strength of recommendation for psychopharmacological treatment. The guidelines discussed here advocate well-founded a cautious prescription of psychotropic agents in patients with dementia and delirium. This contrasts to everyday practice which is characterized by significantly higher prescription rates. This gap may explained partially by a lack of evidence-based recommendations regarding certain psychopathological symptoms. Most notably, however, epidemiological data disclose an unacceptable rate of hazardous overtreatment with psychotropic agents, especially in long-term care of persons with dementia. In this situation counteractive measures by consequent implementation

The voice of Holland: Dutch public and patient's opinion favours single-port laparoscopy.

Science.gov (United States)

Fransen, Sofie Af; Broeders, Epm; Stassen, Lps; Bouvy, Nd

2014-07-01

Single-port laparoscopy is prospected as the future of minimal invasive surgery. It is hypothesised to cause less post operative pain, with a shorter hospitalisation period and improved cosmetic results. Population- and patient-based opinion is important for the adaptation of new techniques. This study aimed to assess the opinion and perception of a healthy population and a patient population on single-port laparoscopy compared with conventional laparoscopy. An anonymous 33-item questionnaire, describing conventional and single-port laparoscopy, was given to 101 patients and 104 healthy volunteers. The survey participants (median age 44 years; range 17-82 years) were asked questions about their personal situation and their expectations and perceptions of the two different surgical techniques; conventional multi-port laparoscopy and single-port laparoscopy. A total of 72% of the participants had never heard of single-port laparoscopy before. The most important concern in both groups was the risk of surgical complications. When complication risks remain similar, 80% prefers single-port laparoscopy to conventional laparoscopy. When the risk of complications increases from 1% to 10%, 43% of all participants prefer single-port laparoscopy. A total of 70% of the participants are prepared to receive treatment in another hospital if single-port surgery is not performed in their hometown hospital. The preference for single-port approach was higher in the female population. Although cure and safety remain the main concerns, the population and patients group have a favourable perception of single-port surgery. The impact of public opinion and patient perception towards innovative techniques is undeniable. If the safety of the two different procedures is similar, this study shows a positive attitude of both participant groups in favour of single-port laparoscopy. However, solid scientific proof for the safety and feasibility of this new surgical technique needs to be obtained

Port Authority Best Practices

Science.gov (United States)

Best practices for port authorities include near-port community collaboration, anti-idling policies, expanding off-peak hours, development of EMS, developing an emissions inventory, education, electric power and substituting trucking for rail or barge.

US Ports of Entry

Data.gov (United States)

Department of Homeland Security — HSIP Non-Crossing Ports-of-Entry A Port of Entry is any designated place at which a CBP officer is authorized to accept entries of merchandise to collect duties, and...

Starting manufacturing phase of ITER upper ports

Energy Technology Data Exchange (ETDEWEB)

Utin, Yuri, E-mail: yuri.utin@iter.org [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Alekseev, Alexander; Sborchia, Carlo; Choi, Changho; Albin, Vincent; Barabash, Vladimir; Davis, James [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Fabritsiev, Sergey [NTC Sintez, Efremov Inst., 189631 Metallostroy, St. Petersburg (Russian Federation); Giraud, Benoit; Guirao, Julio [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Koenig, Werner [MAN Diesel & Turbo SE, Werftstrasse 17, Deggendorf (Germany); Kedrov, Igor; Kuzmin, Evgeny [NTC Sintez, Efremov Inst., 189631 Metallostroy, St. Petersburg (Russian Federation); Levesy, Bruno; Martinez, Jean-Marc [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Prebeck, Markus [MAN Diesel & Turbo SE, Werftstrasse 17, Deggendorf (Germany); Privalova, Elena [NTC Sintez, Efremov Inst., 189631 Metallostroy, St. Petersburg (Russian Federation); Ranzinger, Franz [MAN Diesel & Turbo SE, Werftstrasse 17, Deggendorf (Germany); Savrukhin, Petr [Russian Federation ITER Domestic Agency, Kurchatov sq.1, 123182 Moscow (Russian Federation); Schiller, Thomas [MAN Diesel & Turbo SE, Werftstrasse 17, Deggendorf (Germany); and others

2015-10-15

Highlights: • The port plugs are attached to the ports with high-strength fasteners. • Tightening of the fasteners via inductive heating was tested. • A concept for the port/plug sealing with metal-type gaskets has progressed. • Manufacturing design of the Upper Ports is in progress. • A full-scale mock-up of double-wall part of the port stub extension is in manufacturing process – acceptable final tolerances are expected. - Abstract: The ITER Vacuum Vessel (VV) features upper, equatorial and lower ports. The upper and regular equatorial ports are occupied by the port plugs. Although the port design has been overall completed in the past, the design of some remaining interfaces was still in progress: in particular, the Sealing Flange package, which includes the high-vacuum seals and the plug fasteners. As the ITER construction phase has started, the procurement of the VV ports has been launched. The VV upper ports will be procured by the Russian Federation Domestic Agency. The main suppliers were selected and the manufacturing design of the first parts is in full progress now. Since the VV is classified at nuclear level N2, the design and manufacture of its components are to be compliant with the French RCC-MR code and regulations for nuclear pressure equipment in France. These regulations make a strong impact to the port design and manufacturing process.

Starting manufacturing phase of ITER upper ports

International Nuclear Information System (INIS)

Utin, Yuri; Alekseev, Alexander; Sborchia, Carlo; Choi, Changho; Albin, Vincent; Barabash, Vladimir; Davis, James; Fabritsiev, Sergey; Giraud, Benoit; Guirao, Julio; Koenig, Werner; Kedrov, Igor; Kuzmin, Evgeny; Levesy, Bruno; Martinez, Jean-Marc; Prebeck, Markus; Privalova, Elena; Ranzinger, Franz; Savrukhin, Petr; Schiller, Thomas

2015-01-01

Highlights: • The port plugs are attached to the ports with high-strength fasteners. • Tightening of the fasteners via inductive heating was tested. • A concept for the port/plug sealing with metal-type gaskets has progressed. • Manufacturing design of the Upper Ports is in progress. • A full-scale mock-up of double-wall part of the port stub extension is in manufacturing process – acceptable final tolerances are expected. - Abstract: The ITER Vacuum Vessel (VV) features upper, equatorial and lower ports. The upper and regular equatorial ports are occupied by the port plugs. Although the port design has been overall completed in the past, the design of some remaining interfaces was still in progress: in particular, the Sealing Flange package, which includes the high-vacuum seals and the plug fasteners. As the ITER construction phase has started, the procurement of the VV ports has been launched. The VV upper ports will be procured by the Russian Federation Domestic Agency. The main suppliers were selected and the manufacturing design of the first parts is in full progress now. Since the VV is classified at nuclear level N2, the design and manufacture of its components are to be compliant with the French RCC-MR code and regulations for nuclear pressure equipment in France. These regulations make a strong impact to the port design and manufacturing process.

Evidence-based review, grade of recommendation, and suggested treatment recommendations for melasma

Directory of Open Access Journals (Sweden)

Nilendu Sarma

2017-01-01

Full Text Available Treatment of melasma is known to be less satisfactory, often incomplete, and relapse is frequent. Although many treatment options are available, they are either known to be unsafe on long-term use or their long-term safety profile is unknown. Patients often use various drugs, even topical steroid-based preparation without any medical supervision for long period of time, making the skin unsuitable for many of the drugs available. Thus, there has been gross disparity among the treating physician about what drugs and what regimen are best suitable for various categories of melasma patients and in different situations. With this background, numerous newer drugs, mostly combinations of some proprietary molecules or even unknown plant extracts, have flooded the market for the management of melasma. Information on efficacy or safety of these products are almost unknown. Studies on Asian people, especially Indian population, are far less commonly available. Therapeutic guideline for use on Indian patients with melasma is almost missing. Extrapolation of data from Caucasian people for use on Asian people may not be scientifically justifiable because Caucasian and Asian people are known to have inherent difference in their response as well as tolerance to the drugs used for melasma. With this background, we have extensively evaluated, following a strict, scientifically designed protocol, all the available studies on melasma management till May 2016 and prepared this document on level of evidence, grade of recommendation and suggested therapeutic guideline for melasma as per the method proposed by Oxford Centre of Evidence-Based Medicine. Various ethical, social, logical, regional, and economic issues in the context of Indian and similar populations were given due importance while preparing the suggested therapeutic recommendation.

Logistics Road map for Smart SeaPorts

Directory of Open Access Journals (Sweden)

Khaled Gaber EL Sakty

2016-12-01

Full Text Available In the digital world, a smart concept became an essential feature for port organizations to serve as intelligent hubs in the world transport networks.  Smart ports are the trend for the future long-term strategies. Henceforth, ports aims at contributing to sustainable growth by establishing the appropriate conditions for the adoption of new management energy models based on low environmental impact and triggering innovation of both technologies and processes. The scope of this paper is to examine three main issues of smart ports; smart port arctic logistics roadmap, smart port challenges and obstacles in arctic port areas, and the criteria and Key Performance Indicators guiding the assessment of ports against this concept. The main purpose is to develop a smart arctic logistics road map for the future.

Dry Port Development: A Systematic Review

Directory of Open Access Journals (Sweden)

Fatimazahra BENTALEB

2015-12-01

Full Text Available Studies on dry ports as nodes in multimodal transport have been expanded to decrease the mounting congestion on seaports. The principal objective of this study is to inspect how dry port researches have been conducted from different perspective. This paper tries to recap the existing researches that aimed to study dry port concept via a systematic review, to present a general overview of the researches on our relevant region and propose a classification for these researches. This paper present a systematic review of dry port that looks to illustrate the progress of researches on this area between 1986 and 2015, collecting researches on dry port concept and analyzing the main characteristics of the dry port development and their contribution to the multimodal transport. The results indicated that most dry port studies considerate the strategic level and concentrate in the Asian continent. Studies regarding other decision levels and continents have to be developed in further researches. Although the existing studies make a contribution in dry port concept, they allow gaps in terms of operational and tactical decision levels considering their limited geographical region.

DeepSurv: personalized treatment recommender system using a Cox proportional hazards deep neural network.

Science.gov (United States)

Katzman, Jared L; Shaham, Uri; Cloninger, Alexander; Bates, Jonathan; Jiang, Tingting; Kluger, Yuval

2018-02-26

Medical practitioners use survival models to explore and understand the relationships between patients' covariates (e.g. clinical and genetic features) and the effectiveness of various treatment options. Standard survival models like the linear Cox proportional hazards model require extensive feature engineering or prior medical knowledge to model treatment interaction at an individual level. While nonlinear survival methods, such as neural networks and survival forests, can inherently model these high-level interaction terms, they have yet to be shown as effective treatment recommender systems. We introduce DeepSurv, a Cox proportional hazards deep neural network and state-of-the-art survival method for modeling interactions between a patient's covariates and treatment effectiveness in order to provide personalized treatment recommendations. We perform a number of experiments training DeepSurv on simulated and real survival data. We demonstrate that DeepSurv performs as well as or better than other state-of-the-art survival models and validate that DeepSurv successfully models increasingly complex relationships between a patient's covariates and their risk of failure. We then show how DeepSurv models the relationship between a patient's features and effectiveness of different treatment options to show how DeepSurv can be used to provide individual treatment recommendations. Finally, we train DeepSurv on real clinical studies to demonstrate how it's personalized treatment recommendations would increase the survival time of a set of patients. The predictive and modeling capabilities of DeepSurv will enable medical researchers to use deep neural networks as a tool in their exploration, understanding, and prediction of the effects of a patient's characteristics on their risk of failure.

Social Media Usage Patterns in Port Industry: Implications for Port Promotion and Public Relations

Directory of Open Access Journals (Sweden)

Aylin ÇALIŞKAN

2018-03-01

Full Text Available While social media has been penetrating the daily lives of individuals, the businesses have started to develop new strategical approaches for using social media tools, since they understand the importance of this new area. This study aims to take a step on the gap about social media marketing in the port industry. The focused sample is container ports located in Turkey, but to gain more meaningful insights, a comparison is also made with the ports of Los Angeles, Rotterdam, and Antwerp. The post set on Facebook, which covers the 8 months’ period, was analyzed through a social media analytics software, and the most attractive topics and engagement levels were determined. It was found that the most attractive posts of ports with high engagement levels do not include any statement, image, or video about port service, infrastructure and superstructure, investments, or success stories. At the end of the study, suggestions are developed by supporting with real cases for ports’ social media management.

Principles of subcutaneous port placement.

Science.gov (United States)

Gonda, Shaun J; Li, Ruizong

2011-12-01

The introduction of totally implantable subcutaneous devices in the early 1980s provided patients with secure, reliable venous access and also gave them the ability to move more freely and have a more normal lifestyle with these devices in place. The most common totally implantable device used today is the subcutaneous port. These ports consist of an injection port connected to a catheter. Ports provide a number of advantages compared with other venous catheters; the most important is the reduced risk of infection. These devices have significantly lower rates of infection than nontunneled and tunneled catheters. Additional advantages include less frequent irrigation and minimal home care, and they are less prone to environmental or cutaneous contamination when not being accessed. This article will focus on the placement of these ports. Copyright © 2011 Elsevier Inc. All rights reserved.

HomePort

DEFF Research Database (Denmark)

Le Guilly, Thibaut; Olsen, Petur; Ravn, Anders Peter

2013-01-01

Ambient Intelligence systems use many sensors and actuators, with a diversity of networks, protocols and technologies which makes it impossible to access the devices in a common manner. This paper presents the HomePort software, which provides an open source RESTful interface to heterogeneous...... sensor networks, allowing a simple unified access to virtually any kind of protocol using well known standards. HomePort includes means to provide event notification, as well as a tracing mechanism. The software is implemented and we report on initial experiments and provide an evaluation that shows...

Consensus Recommendations for Radiation Therapy Contouring and Treatment of Vulvar Carcinoma

Energy Technology Data Exchange (ETDEWEB)

Gaffney, David K., E-mail: david.gaffney@hci.utah.edu [Department of Radiation Oncology, Huntsman Cancer Hospital, Salt Lake City, Utah (United States); King, Bronwyn [Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre and Epworth Radiation Oncology, Melbourne, Victoria (Australia); Viswanathan, Akila N. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); Barkati, Maroie [Department of Radiation Oncology, Centre hospitalier de l' universite de Montreal, Montreal, Quebec (Canada); Beriwal, Sushil [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Eifel, Patricia [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Erickson, Beth [Department of Radiation Oncology, Proedtert and Medical College Clinical Cancer Center, Milwaukee, Wisconsin (United States); Fyles, Anthony [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Goulart, Jennifer [Department of Radiation Oncology, British Columbia Cancer Agency, Victoria, British Columbia (Canada); Harkenrider, Matthew [Department of Radiation Oncology, Stritch School of Medicine, Loyola University, Maywood, Illinois (United States); Jhingran, Anuja; Klopp, Ann [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Koh, Wui-Jin [Department of Radiation Oncology, University of Washington, Seattle, Washington (United States); Lim, Karen [Liverpool Cancer Therapy Centre, Radiation Oncology Unit, Sydney, New South Wales (Australia); Petersen, Ivy [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Portelance, Lorraine [Radiation Oncology Department, Miller School of Medicine, University of Miami, Miami, Florida (United States); and others

2016-07-15

Purpose: The purpose of this study was to develop a radiation therapy (RT) contouring atlas and recommendations for women with postoperative and locally advanced vulvar carcinoma. Methods and Materials: An international committee of 35 expert gynecologic radiation oncologists completed a survey of the treatment of vulvar carcinoma. An initial set of recommendations for contouring was discussed and generated by consensus. Two cases, 1 locally advanced and 1 postoperative, were contoured by 14 physicians. Contours were compared and analyzed using an expectation-maximization algorithm for simultaneous truth and performance level estimation (STAPLE), and a 95% confidence interval contour was developed. The level of agreement among contours was assessed using a kappa statistic. STAPLE contours underwent full committee editing to generate the final atlas consensus contours. Results: Analysis of the 14 contours showed substantial agreement, with kappa statistics of 0.69 and 0.64 for cases 1 and 2, respectively. There was high specificity for both cases (≥99%) and only moderate sensitivity of 71.3% and 64.9% for cases 1 and 2, respectively. Expert review and discussion generated consensus recommendations for contouring target volumes and treatment for postoperative and locally advanced vulvar cancer. Conclusions: These consensus recommendations for contouring and treatment of vulvar cancer identified areas of complexity and controversy. Given the lack of clinical research evidence in vulvar cancer radiation therapy, the committee advocates a conservative and consistent approach using standardized recommendations.

Consensus Recommendations for Radiation Therapy Contouring and Treatment of Vulvar Carcinoma

International Nuclear Information System (INIS)

Gaffney, David K.; King, Bronwyn; Viswanathan, Akila N.; Barkati, Maroie; Beriwal, Sushil; Eifel, Patricia; Erickson, Beth; Fyles, Anthony; Goulart, Jennifer; Harkenrider, Matthew; Jhingran, Anuja; Klopp, Ann; Koh, Wui-Jin; Lim, Karen; Petersen, Ivy; Portelance, Lorraine

2016-01-01

Purpose: The purpose of this study was to develop a radiation therapy (RT) contouring atlas and recommendations for women with postoperative and locally advanced vulvar carcinoma. Methods and Materials: An international committee of 35 expert gynecologic radiation oncologists completed a survey of the treatment of vulvar carcinoma. An initial set of recommendations for contouring was discussed and generated by consensus. Two cases, 1 locally advanced and 1 postoperative, were contoured by 14 physicians. Contours were compared and analyzed using an expectation-maximization algorithm for simultaneous truth and performance level estimation (STAPLE), and a 95% confidence interval contour was developed. The level of agreement among contours was assessed using a kappa statistic. STAPLE contours underwent full committee editing to generate the final atlas consensus contours. Results: Analysis of the 14 contours showed substantial agreement, with kappa statistics of 0.69 and 0.64 for cases 1 and 2, respectively. There was high specificity for both cases (≥99%) and only moderate sensitivity of 71.3% and 64.9% for cases 1 and 2, respectively. Expert review and discussion generated consensus recommendations for contouring target volumes and treatment for postoperative and locally advanced vulvar cancer. Conclusions: These consensus recommendations for contouring and treatment of vulvar cancer identified areas of complexity and controversy. Given the lack of clinical research evidence in vulvar cancer radiation therapy, the committee advocates a conservative and consistent approach using standardized recommendations.

Adaptive Port Planning under Disruptive Trends with focus on the case of The Port of Kuala Tanjung, Indonesia

OpenAIRE

Prakoso Andre; Taneja Poonam; Velinga Tiedo

2018-01-01

As a national strategic project, the Port of Kuala Tanjung draws significant attention at national and international level. Considering the semi-greenfield nature of the port, the diverse set of stakeholders, and the prevailing disruptive trends in the world port business, a robust first-phase port layout is required to kick-start the project and guarantee the overall sustainability of the port development. The objective of this research is to identify any uncertain or disruptive trends, both...

Hypertension detection and control in Port Harcourt: knowledge gap ...

African Journals Online (AJOL)

... on continuing medical education on hypertension in Port Harcourt, Nigeria was conducted in June 2013. Post test was also administered. Participants were drawn from both private and public medical practice. The questionnaire contained demographic data and knowledge of diagnosis and treatment of hypertension.

Port entry arrangements

International Nuclear Information System (INIS)

Chicken, J.C.; King, M.A.

1978-01-01

The objective of the paper is to describe the safety scheme port authorities should establish to deal with any contingency that may result from the visit of a nuclear powered ship. The safety scheme should be devised to cover both normal operation and any accident conditions that could arise while the ship is in port. The paper is divided into three parts. The three parts being: background information, general instructions, and emergency procedures. The background information will describe the nature of the hazards a port authority has to be prepared to deal with, and the philosophical basis for a berthing policy. In the part dealing with general instructions the objective of the safety scheme will be described. Also this part will describe the composition of the Port Safety Panel, allocation of responsibilities, passage and berthing arrangements, general safety precautions, records required, and rescue arrangements. In the part dealing with emergency procedures the role of: the Ship's Master, Harbour Authorities, Local Police, and local Health Services are discussed. As an Appendix to the paper a copy of the safety scheme that has been devised for visits of nuclear merchant ships to Southampton is given

Recommendations of the Brazilian Society of Rheumatology for the diagnosis and treatment of chikungunya fever. Part 2 - Treatment

Directory of Open Access Journals (Sweden)

Claudia Diniz Lopes Marques

Full Text Available Abstract Chikungunya fever has become an important public health problem in countries where epidemics occur because half of the cases progress to chronic, persistent and debilitating arthritis. Literature data on specific therapies at the various phases of arthropathy caused by chikungunya virus (CHIKV infection are limited, lacking quality randomized trials assessing the efficacies of different therapies. There are a few studies on the treatment of musculoskeletal manifestations of chikungunya fever, but these studies have important methodological limitations. The data currently available preclude conclusions favorable or contrary to specific therapies, or an adequate comparison between the different drugs used. The objective of this study was to develop recommendations for the treatment of chikungunya fever in Brazil. A literature review was performed via evidence-based selection of articles in the databases Medline, SciELO, PubMed and Embase and conference proceedings abstracts, in addition to expert opinions to support decision-making in defining recommendations. The Delphi method was used to define the degrees of agreement in 2 face-to-face meetings and several online voting rounds. This study is part 2 of the Recommendations of the Brazilian Society of Rheumatology (Sociedade Brasileira de Reumatologia - SBR for the Diagnosis and Treatment of chikungunya fever and specifically addresses treatment.

Assesment of port governance in Brazil: a managerial perspective on the port of Santos

OpenAIRE

Almeida, José Eduardo Costa de

2015-01-01

The role of maritime transportation within international trade was drastically revamped during the inception of the globalization process, which enhanced the contribution of ports in world economy as main logistics gateways for global production and trade. As a result, the relationship between ports and governments has changed. Devolution ideologies that had been applied in other industries decades ago were now being considered by governments for the port industry. Many central governments so...

[Clinical retrospective control study of single-port laparoendoscopic and multi-port laparoscopic ovarian cystectomy].

Science.gov (United States)

Liu, X; Wen, M K; Liu, H Y; Sun, D W; Lang, J H; Fan, Q B; Shi, H H

2017-10-25

Objective: To investigate clinical outcomes of laparoendoscopic single-site ovarian cystectomy compared with traditional multi-port laparoscopic ovarian cystectomy. Methods: Data of 81 patients with ovarian cystectomy from January 2016 to May 2017, the single-site group ( n= 40) and the multi-port group ( n= 41) in Peking Union Medical College Hospital were retrospectively collected. The outcomes of single-site and multi-port groups were analyzed and compared, including: postoperative fever, operation time, blood loss, hemoglobin change, surgical complications, postoperative pain score, postoperative analgesic requirements, body image scale and cosmetic score, length of hospital stay, postoperative total cost. Results: No complication was found in two groups. No difference was found in postoperative fever, blood loss, hemoglobin change, postoperative pain score, length of hospital stay, and total cost between the two groups (all P> 0.05). Operation time was (50±20) minutes in single-site group, and (40±15) minutes in multi-port group; postoperative analgesic requirements was 28%(11/40) in single-site group, and 7%(4/41) in multi-port group; cosmetic score was 22.6±2.6 in single-site group, and 17.3±2.6 in multi-port group; body image scale was 5.7±1.2 in single-site group, and 6.2±1.2 in multi-port group; these four clinical parameters were statistical differences (all P< 0.05). Conculsion: Laparoendoscopic single-site ovarian cystectomy is feasible and safe, although it could't relieve the postoperative pian, it do offer a higher cosmetic satisfaction.

Container Traffic In European Ports

Directory of Open Access Journals (Sweden)

Elen Twrdy

2004-03-01

Full Text Available Over the last fifteen years the European transport markethas witnessed a growth of container traffic which today reachesapproximately 50 million TEU per year. From 1997 to 2002,container traffic in the northern European ports increased from14 to 20.6 million TEU per year, in the ports of the westernMedite"anean from 6 to 10 million TEU per year, and in thenorthern Adriatic ports from 0. 69 to 0. 74 million TEU per year.The ports of the northern Adriatic are located in three states(Slovenia, Croatia and Italy with different statuses in relationto the common European market. In addition, different developmentlevels of these states are reflected in different levels ofinternational commercial exchange, the development of the existinginfrastructure and plans for the construction of new infrastructures.However, all three countries share a common goaltoincrease their competitiveness in comparison with the westemEuropean ports.

System аnalysis concession maritime trade ports

Directory of Open Access Journals (Sweden)

Y.V. Shmatock

2015-03-01

Full Text Available The article proves the significance of maritime commercial ports as strategic for the country. The urgency of port concessions to improve transport infrastructure. The definition of ports in terms of system analysis and determination of management port. Outlined the sequence of system analysis concessions maritime trade ports in the table. Selection of qualified managers is based on the concession tender under prescribed conditions. These criteria should be considered when determining the concessionaire. These stages of the concession tender. Meeting the needs of the economy, international trade, public inquiries into transportation of goods is not possible without the efficient operation of maritime trade ports. Only complex technological modernization of maritime trade ports will enable them to take leadership positions. Tree depicted objectives effectively manage commercial sea port. Therefore, initiation of concessions needs to implement measures to achieve the talented and skillful result.

Oluvil Port Development Project

DEFF Research Database (Denmark)

Frigaard, Peter; Margheritini, Lucia

Oluvil Port Development Project is the first development of a large port infrastructure in the entire eastern coastline of Sri Lanka. The project is supported by the Danish Foreign Ministry. Feasibility studies and detailed design studies were carried out by Lanka Hydraulic Institute Ltd during...... the years 1995 to 2003. The design was reviewed by COWI a/s. Construction of the port was started in 2008. MT Højgaard a/s acted as contractor. The outer breakwaters were constructed as first part of the project. During and after completion of the breakwaters a serious beach erosion and sand accumulation...... has been observed. Severe erosion is seen north of the harbour and some accumulation of sand is seen south of the harbour. On a sandy coastline like the one in Oluvil such erosion problems as observed are very typical. The report: Oluvil Port Development Project: Studies on Beach Erosion written...

COMPETITION BETWEEN CONTAINER PORTS IN THE NORTHERN ADRIATIC

OpenAIRE

Elen Twrdy; Milan Batista

2014-01-01

World trade has changed in the last decade such that container traffic flows are oriented towards more parts of the European continent. The European container port system is not a homogeneous set of ports; instead it consists of several big ports (e.g., Rotterdam, Hamburg, Algeciras...) and a large number of medium and small ports. Northern Adriatic (NA) ports, namely Rijeka, Koper, Trieste, Venice and Ravenna, are small ports. Each of these ports have different development plans but in varyi...

Treatment of fibromyalgia syndrome: recommendations of recent evidence-based interdisciplinary guidelines with special emphasis on complementary and alternative therapies.

Science.gov (United States)

Ablin, Jacob; Fitzcharles, Mary-Ann; Buskila, Dan; Shir, Yoram; Sommer, Claudia; Häuser, Winfried

2013-01-01

Objective. Current evidence indicates that there is no single ideal treatment for fibromyalgia syndrome (FMS). First choice treatment options remain debatable, especially concerning the importance of complementary and alternative medicine (CAM) treatments. Methods. Three evidence-based interdisciplinary guidelines on FMS in Canada, Germany, and Israel were compared for their first choice and CAM-recommendations. Results. All three guidelines emphasized a patient-tailored approach according to the key symptoms. Aerobic exercise, cognitive behavioral therapy, and multicomponent therapy were first choice treatments. The guidelines differed in the grade of recommendation for drug treatment. Anticonvulsants (gabapentin, pregabalin) and serotonin noradrenaline reuptake inhibitors (duloxetine, milnacipran) were strongly recommended by the Canadian and the Israeli guidelines. These drugs received only a weak recommendation by the German guideline. In consideration of CAM-treatments, acupuncture, hypnosis/guided imagery, and Tai Chi were recommended by the German and Israeli guidelines. The Canadian guidelines did not recommend any CAM therapy. Discussion. Recent evidence-based interdisciplinary guidelines concur on the importance of treatment tailored to the individual patient and further emphasize the need of self-management strategies (exercise, and psychological techniques).

Do guidelines recommending pharmacogenetic testing of psychiatric patients affect treatment costs and the use of healthcare services?

DEFF Research Database (Denmark)

Herbild, Louise; Bech, Mickael; Gyrd-Hansen, Dorte

2011-01-01

To identify the effects of local recommendations of pharmacogenetic testing in psychiatry with respect to treatment costs.......To identify the effects of local recommendations of pharmacogenetic testing in psychiatry with respect to treatment costs....

50 CFR 24.12 - Designated ports.

Science.gov (United States)

2010-10-01

...) The U.S. Department of Agriculture ports at Hilo, Hawaii, and Chicago, Illinois, are designated ports..., Florida Atlanta, Georgia Savannah, Georgia Agana, Guam Hilo, Hawaii Honolulu, Hawaii Wailuku, Maui, Hawaii... Orlando, Florida Honolulu, Hawaii New Orleans, Louisiana Hoboken, New Jersey (Port of New York) Jamaica...

Perancangan Miniatur Traffic Light Dengan Mempergunakan Pengendali Port Paralel

OpenAIRE

Eka Wahyudi; Desi Permanasari

2012-01-01

Port paralel tentunya sudah tidak asing lagi dalam dunia komputer. Hal tersebut disebabkan karena port paralel merupakan sarana komunikasi yang terdapat pada Personal Computer (PC). Dengan memanfaatkan port tersebut, saat ini komputer juga dapat dipergunakan untuk keperluan pengontrolan/pengendalian rangkaian listrik dengan memanfaatkan port paralel (port printer). Port paralel memiliki kecepatan transfer data yang lebih cepat apabila dibandingkan dengan port serial, maka dari itu port parale...

Ecotoxicological evaluation of industrial port of Venice (Italy) sediment samples after a decontamination treatment.

Science.gov (United States)

Libralato, Giovanni; Losso, Chiara; Arizzi Novelli, Alessandra; Citron, Marta; Della Sala, Stefano; Zanotto, Emanuele; Cepak, Franka; Volpi Ghirardini, Annamaria

2008-12-01

This work assesses the ecotoxicological effects of polluted sediment after a decontamination treatment process using a new sediment washing technique. Sediment samples were collected from four sites in Marghera Port industrial channels (Venice, Italy). Ecotoxicological evaluations were performed with Vibrio fischeri and Crassostrea gigas bioassays. Whole sediment and elutriate were deemed as the most suitable environmental matrices for this study. Toxicity scores developed in the Lagoon of Venice for V. fischeri on whole sediment and for C. gigas on elutriate were considered for the final ranking of samples. Ecotoxicological results showed that the treated sediment samples presented both acute and sub-chronic toxicities, which were mainly attributed to the presence of some remaining chemicals such as metals and polyaromatic hydrocarbons. The acute toxicity ranged from low to medium, while the sub-chronic one from absent to very high, suggesting that treated sediments could not be reused in direct contact with seawater.

Brazilian society of hepatology recommendations for the diagnosis and treatment of hepatocellular carcinoma

Directory of Open Access Journals (Sweden)

Flair J Carrilho

Full Text Available ABSTRACT Hepatocellular carcinoma is a malignancy of global importance and is associated with a high rate of mortality. Recent advances in the diagnosis and treatment of this disease make it imperative to update the recommendations on the management of the disease. In order to draw evidence-based recommendations concering the diagnosis and management of hepatocellular carcinoma, the Brazilian Society of Hepatology has sponsored a single-topic meeting in João Pessoa (PB. All the invited pannelists were asked to make a systematic review of the literature and to present topics related to the risk factors for its development, methods of screening, radiological diagnosis, staging systems, curative and palliative treatments and hepatocellular carcinoma in noncirrhotic liver. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of those recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present paper is the final version of the reviewed manuscript containing the recommendations of the Brazilian Society of Hepatology.

Hub Status and Indexation of Container Ports

Directory of Open Access Journals (Sweden)

Yong-An Park

2015-06-01

This study develops two sub-indexes of port classification and capacity, and combines cases of these two sub-indexes into various types in order to find a proper port hub index. The paper demonstrates how different types of port hub index are useful measurements for evaluating outputs and inputs of container ports. In a case analysis we show that the indexes of period variables and lagged variables have more explanatory power with regard to changes of port throughputs and high correlation with inputs.

DEA Window Analysis for Measuring Port Efficiencies in Serbia

Directory of Open Access Journals (Sweden)

Danijela Pjevčević

2012-01-01

Full Text Available The aim of the paper is to apply Data Envelopment Analysis (DEA method in measuring and analyzing the efficiencies of ports on the river Danube. DEA window analysis is used to determine the efficiency of ports and to observe the possibility of changes in the port efficiency over time. A study is conducted to evaluate the efficiencies of ports on the territory of Serbia in order to identify the sources of inefficiencies and formulate proposals for improving the services of those ports and their operations through a four-year window analysis with port efficiency trends and average efficiencies. The progress is made in the measurement of port efficiency in relation to port productive activities - total area of warehouses, quay length, number of cranes and port throughput, for the Serbian river ports. Keywords: river ports, total area of warehouses, quay length, number of cranes, port throughput, port efficiency, DEA window analysis

Multi-functional use of port areas

NARCIS (Netherlands)

Ros, R.; Taneja, P.; Vellinga, T.

2012-01-01

The core business of a port is handling vessels and cargo. In addition a landlord Port Authority invests in development of port areas. However, in view of the new trends such as stakeholders interests related to environment and sustainability, it is can be wise to reexamine the business portfolio

Notch filters for port-Hamiltonian systems

NARCIS (Netherlands)

Dirksz, D.A.; Scherpen, J.M.A.; van der Schaft, A.J.; Steinbuch, M.

2012-01-01

In this paper a standard notch filter is modeled in the port-Hamiltonian framework. By having such a port-Hamiltonian description it is proven that the notch filter is a passive system. The notch filter can then be interconnected with another (nonlinear) port-Hamiltonian system, while preserving the

Port-contact systems in bilateral telemanipulation

NARCIS (Netherlands)

Secchi, C; Stramigioli, Stefano; Fantuzzi, C.

2007-01-01

In this paper we develop one of the first control applications of the recently proposed port-contact framework. We show how it is possible to model and control a bilateral telemanipulation system using port-contact systems and we develop a port-contact impedance controller that allows to impose a

Increasing consumer demand for tobacco treatments: Ten design recommendations for clinicians and healthcare systems.

Science.gov (United States)

Woods, Susan Swartz; Jaén, Carlos Roberto

2010-03-01

Health professionals play an important role in addressing patient tobacco use in clinical settings. While there is clear evidence that identifying tobacco use and assisting smokers in quitting affects outcomes, challenges to improve routine, clinician-delivered tobacco intervention persist. The Consumer Demand Initiative has identified simple design principles to increase consumers' use of proven tobacco treatments. Applying these design strategies to activities across the healthcare system, we articulate ten recommendations that can be implemented in the context of most clinical systems where most clinicians work. The recommendations are: (1) reframe the definition of success, (2) portray proven treatments as the best care, (3) redesign the 5A's of tobacco intervention, (4) be ready to deliver the right treatment at the right time, (5) move tobacco from the social history to the problem list, (6) use words as therapy and language that makes sense, (7) fit tobacco treatment into clinical team workflows, (8) embed tobacco treatment into health information technology, (9) make every encounter an opportunity to intervene, and (10) end social disparities for tobacco users. Clinical systems need to change to improve tobacco treatment implementation. The consumer- and clinician-centered recommendations provide a roadmap that focuses on increasing clinician performance through greater understanding of the clinician's role in helping tobacco users, highlighting the value of evidence-based tobacco treatments, employing shared decision-making skills, and integrating routine tobacco treatment into clinical system routines. Published by Elsevier Inc.

Vaginoscopy in Ewes Utilizing a Laparoscopic Surgical Port Device

Directory of Open Access Journals (Sweden)

Jeremiah Easley

2017-01-01

Full Text Available Vaginoscopy allows for diagnostic evaluation and treatment of the vaginal vault. A laparoscopic surgical port device and rigid telescope were utilized for serial vaginoscopy in 8 healthy anesthetized ewes. Vaginoscopy examinations were performed in each ewe at days 1, 14, and 28. This technique was well-tolerated and facilitated carbon dioxide vaginal inflation, complete vaginal examination, identification of the cervix, and targeted biopsy collection. No complications were encountered during or following the vaginoscopy procedures. The laparoscopic port device was well-suited to the ewe vulvar size. This technique could be applied to clinical evaluation in ewes for the purposes of examination, biopsy, culture, foreign body removal, and minor surgical procedures.

Treatment of Fibromyalgia Syndrome: Recommendations of Recent Evidence-Based Interdisciplinary Guidelines with Special Emphasis on Complementary and Alternative Therapies

Directory of Open Access Journals (Sweden)

Jacob Ablin

2013-01-01

Full Text Available Objective. Current evidence indicates that there is no single ideal treatment for fibromyalgia syndrome (FMS. First choice treatment options remain debatable, especially concerning the importance of complementary and alternative medicine (CAM treatments. Methods. Three evidence-based interdisciplinary guidelines on FMS in Canada, Germany, and Israel were compared for their first choice and CAM-recommendations. Results. All three guidelines emphasized a patient-tailored approach according to the key symptoms. Aerobic exercise, cognitive behavioral therapy, and multicomponent therapy were first choice treatments. The guidelines differed in the grade of recommendation for drug treatment. Anticonvulsants (gabapentin, pregabalin and serotonin noradrenaline reuptake inhibitors (duloxetine, milnacipran were strongly recommended by the Canadian and the Israeli guidelines. These drugs received only a weak recommendation by the German guideline. In consideration of CAM-treatments, acupuncture, hypnosis/guided imagery, and Tai Chi were recommended by the German and Israeli guidelines. The Canadian guidelines did not recommend any CAM therapy. Discussion. Recent evidence-based interdisciplinary guidelines concur on the importance of treatment tailored to the individual patient and further emphasize the need of self-management strategies (exercise, and psychological techniques.

Port Harcourt Medical Journal

African Journals Online (AJOL)

Port Harcourt Medical Journal's objectives are to disseminate medical information from the College of Health Sciences, University of Port Harcourt and the rest of the national and international medical community; act as a medium for the articulation of research and findings from same as well as proceedings of medical ...

Perancangan Miniatur Traffic Light Dengan Mempergunakan Pengendali Port Paralel

Directory of Open Access Journals (Sweden)

Eka Wahyudi

2012-05-01

Full Text Available Port paralel tentunya sudah tidak asing lagi dalam dunia komputer. Hal tersebut disebabkan karena port paralel merupakan sarana komunikasi yang terdapat pada Personal Computer (PC. Dengan memanfaatkan port tersebut, saat ini komputer juga dapat dipergunakan untuk keperluan pengontrolan/pengendalian rangkaian listrik dengan memanfaatkan port paralel (port printer. Port paralel memiliki kecepatan transfer data yang lebih cepat apabila dibandingkan dengan port serial, maka dari itu port paralel lebih banyak dipergunakan untuk pengendalian nyala lampu (LED. Dengan memanfaatkan bantuan software Saraf Listrik versi 1.01, maka port paralel dapat menjadi alternatif baru untuk pengendalian traffic light.

Italian consensus on Eular 2003 recommendations for the treatment of knee osteoarthritis

Directory of Open Access Journals (Sweden)

P. Patrignani

2011-09-01

Full Text Available The recommendations for the management of osteoarthritis (OA of the knee firstly proposed by the EULAR in 2000, have been updated in 2003. One of the most important objectives of the expert charged to provide these recommendations was their dissemination. Thus, the information generated may be used by each individual country to produce their own set of management guidelines and algorithms for treatment in primary care. The Italian Society of Rheumatology (SIR and the Italian League against Rheumatism (LIMAR have organised a Consensus on the EULAR recommendations 2003 with the aim to analyse their acceptability and the applicability according to our own experience and local situations in the Italy. The results of this Consensus have demonstrated that a large majority of the EULAR recommendations are endorsed by the Italian experts. Furthermore, the final document of the Italian Consensus clearly indicated the need that the specialists involved in the management of knee OA strongly encourage the dissemination of the EULAR 2003 recommendations also in Italy.

Port Card Module

International Nuclear Information System (INIS)

Utes, M.

1994-01-01

The Port Card will be one link in the data acquisition system for the D0 Silicon Vertex Detector. This system consists of the following parts, starting at the detector: Silicon strip detectors are mounted in a spaceframe and wire-bonded to custom bare-die integrated circuits (SVX-II chips) that digitize the charge collected by the strips. The 128-channel chips are mounted on a High-Density Interconnect (HDI) that consists of a small flex circuit that routes control signals and eight data bits for each of three to ten chips onto a common data bus. A cable then routes this bus approximately thirty feet out from the detector to the Port Card. The Port Card houses a commercial chipset that serializes the data in real time and converts the signal into laser light impulses that are then transmitted through a multi-mode optical fiber about 150 feet to a Silicon Acquisition and Readout board (SAR). Here, the data is transformed back to parallel electrical signals that are stored in one of several banks of FIFO memories. The FIFOs place their data onto the VME backplane to a VME Buffer Driver (VBD) which stores the event data in buffers for eventual readout over a thirty-two signal ribbon cable to the Level Two Computers and subsequent tape storage. Control and sequencing of the whole operation starts with the Silicon Acquisition/Readout Controller (SARC) working in tandem with the D0 Clock System. The SARC resides in the same VME crate as the SARs, and transforms signals from the Trigger System into control codes distributed to the various Port Cards via optical fibers operating at 53 Mb/s. It is through these control codes that data taking operations such as data-acquisition, digitization, readout, and various resets can be carried out. The Port Card receives the control codes and manipulates the SVX-II chips in the proper way to effect proper data taking. There will be a total of about 700,000 channels, which translates into about 5580 SVX-II chips, 66 to 100 Port Cards

TRENDS IN CONTEMPORARY PORT SERVICES MARKETS

Directory of Open Access Journals (Sweden)

Hanna Klimek

2014-12-01

Full Text Available This article describes the issues associated with functioning of contemporary seaport services markets. The growth of international supply chains, technical progress and the integration processes in shipping, growth of containerization, increasing competition in the seaport services markets and environmental protection regulations make it necessary for port service providers to adapt to the changing expectations and requirements of their customers, both shippers and, especially maritime, carriers. Thus, the activities they undertake are associated with making investments to ensure an adequate capacity to handle cargo, passengers and means of transport, required quality of service, but also with appropriate organization of port supply centres and lead to an improvement of their competitiveness. Both the factors associated with the external and internal environment of seaports affect the changes in the relationship between the supply and demand on port services markets. Contemporary port services markets are characterized by certain phenomena which can be a sign of their adaptation and development. The aim of this article is to present the essence of the port services market and its relationship with the environment, which subject to rapid and significant changes, creates new conditions for the operation of port supply centres and the entire port services market.

US Army Corps of Engineers Ports, Geographic WGS84, BTS (2006) [usace_port_BTS_2006

Data.gov (United States)

Louisiana Geographic Information Center — Contains physical information on commercial facilities at the principal U.S. Coastal, Great Lakes and Inland Ports. The data consists of listings of port area's...

Combination of PDT and topical angiogenic inhibitor for treatment of port wine stain (PWS) birthmarks: a novel approach

Science.gov (United States)

Yuan, Kaihua; Huang, Qiaobing; Huang, Zheng

2009-06-01

Port wine stain (PWS) birthmarks are a congenital cutaneous vascular malformation involving ecstatic post-capillary venules. Current standard treatment for PWS is the pulsed dye laser (PDL). Vascular-targeted photodynamic therapy (PDT) has been used for the treatment of PWS in China since the early 1990's. Both can achieve a certain degree of color blanching in various types of PWS lesions. However, the majority of PWS lesions require multiple treatments. Some PWS lesions can recur or become darker after successful treatment. Recently, it has been proposed that this phenomenon might be initiated by neoangiogenesis that can be caused by treatment via wound healing response. The combined use of photothermolysis and a topical application of an angiogenic inhibitor such as Imiquimod and Rapamycin, were evaluated in several pilot studies. It is well-known that PDT can induce various host immune responses VEGF overexpression. Recent clinical data also show that improved clinical outcomes are obtained through the combination of ocular PDT and anti-VEGF therapy. This article will discuss rationales and implications of using such a combination modality and highlight recent progress based on our clinical experience and published data.

The Challenges of Malaysian Dry Ports Development

Directory of Open Access Journals (Sweden)

Jagan Jeevan

2015-03-01

Full Text Available This paper examines the functions and challenges of dry ports development in Malaysia through 11 face-to-face interviews with dry port stakeholders. The findings reveal that Malaysian dry ports are developed to accelerate national and international business, to activate intermodalism in the nation, to promote regional economic development and to enhance seaport competitiveness. Malaysian dry ports perform the function of transport and logistics, information processing, seaports and value-added services. Challenges facing Malaysian dry ports include insufficient railway tracks, unorganized container planning on the rail deck, highly dependent on single mode of transportation, poor recognition from the seaport community, and competition from localized seaports. This paper further indicates strategies for coping with these challenges and identifies future opportunities for Malaysian dry ports development.

Substantial variability in postoperative treatment, and convalescence recommendations following vaginal repair. A nationwide questionnaire study

DEFF Research Database (Denmark)

Ottesen, Marianne; Møller, Charlotte; Kehlet, H

2001-01-01

-employed gynecologists, and gynecologists in private practice, to patients undergoing vaginal repair. METHOD: In 1999 all Danish gynecologists (n=433) received a tested questionnaire about postoperative treatment and convalescence recommendations following vaginal repair. Non-responders received one reminder. OUTCOME...... MEASURES: Pre and postoperative treatment, and expected hospital stay. Furthermore, lifting restrictions, sick leave, and convalescence before resumption of defined activities. RESULTS: The overall response rate was 82%. The expected postoperative hospital stay was median 3 days (range, 1-7) following...... anterior repair, and 2 days (range, 1-7) following posterior repair. The recommended sick leave was median 6 weeks (range, 2-12) for patients with work with heavy lifts. There were substantial differences in recommendations. Recommended lifting restrictions were median 3 kg (range, 0-20) for median 4 weeks...

Benchmark dynamics in the environmental performance of ports.

Science.gov (United States)

Puig, Martí; Michail, Antonis; Wooldridge, Chris; Darbra, Rosa Mari

2017-08-15

This paper analyses the 2016 environmental benchmark performance of the port sector, based on a wide representation of EcoPorts members. This is the fifth time that this study has been conducted as an initiative of the European Sea Ports Organisation (ESPO). The data and results are derived from the Self-Diagnosis Method (SDM), a concise checklist against which port managers can self-assess the environmental management of their port in relation to the performance of the EcoPorts membership. The SDM tool was developed in the framework of the ECOPORTS project (2002-2005) and it is managed by ESPO. A total number of 91 ports from 20 different European Maritime States contributed to this evaluation. The main results are that air quality remains as the top environmental priority of the respondent ports, followed by energy consumption and noise. In terms of environmental management, the study confirms that key components are commonly implemented in the majority of European ports. 94% of contributing ports have a designated environmental manager, 92% own an environmental policy and 82% implement an environmental monitoring program. Waste is identified as the most monitored issue in ports (80%), followed by energy consumption (73%) and water quality (70%). Copyright © 2017 Elsevier Ltd. All rights reserved.

The Vitiligo Working Group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo.

Science.gov (United States)

Mohammad, Tasneem F; Al-Jamal, Mohammed; Hamzavi, Iltefat H; Harris, John E; Leone, Giovanni; Cabrera, Raúl; Lim, Henry W; Pandya, Amit G; Esmat, Samia M

2017-05-01

Treatment of vitiligo with narrowband ultraviolet B light (NBUVB) is an important component of the current standard of care. However, there are no consistent guidelines regarding the dosing and administration of NBUVB in vitiligo, reflected by varied treatment practices around the world. To create phototherapy recommendations to facilitate clinical management and identify areas requiring future research. The Vitiligo Working Group (VWG) Phototherapy Committee addressed 19 questions regarding the administration of phototherapy over 3 conference calls. Members of the Photomedicine Society and a group of phototherapy experts were surveyed regarding their phototherapy practices. Based on comparison and analysis of survey results, expert opinion, and discussion held during conference calls, expert recommendations for the administration of NBUVB phototherapy in vitiligo were created. There were several areas that required further research before final recommendations could be made. In addition, no standardized methodology was used during literature review and to assess the strength of evidence during the development of these recommendations. This set of expert recommendations by the VWG is based on the prescribing practices of phototherapy experts from around the world to create a unified, broadly applicable set of recommendations on the use of NBUVB in vitiligo. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

[Single-port laparoscopic cholecystectomy: advantages and disadvantages].

Science.gov (United States)

Alekberzade, A V; Lipnitsky, E M; Krylov, N N; Sundukov, I V; Badalov, D A

2016-01-01

To analyze the outcomes of single-port laparoscopic cholecystectomy. Early and long-term postoperative period has been analyzed in 240 patients who underwent laparoscopic cholecystectomy (LCE) including 120 cases of single-port technique and 120 cases of four-port technique. Both groups were compared in surgical time, pain syndrome severity (visual analog scale), need for analgesics, postoperative complications, hospital-stay, daily activity recovery and return to physical work, patients' satisfaction of surgical results and their aesthetic effect. It was revealed that single-port LCE is associated with lower severity of postoperative pain, quick recovery of daily activity and return to physical work, high satisfaction of surgical results and their aesthetic effect compared with four-port LCE. Disadvantages of single-port LCE include longer duration of surgery, high incidence of postoperative umbilical hernia. However hernia was predominantly observed during the period of surgical technique development. Further studies to standardize, evaluate the safety and benefits of single-port LCE are necessary.

Subclavian Vein Versus Arm Vein for Totally Implantable Central Venous Port for Patients with Head and Neck Cancer: A Retrospective Comparative Analysis

International Nuclear Information System (INIS)

Akahane, Akio; Sone, Miyuki; Ehara, Shigeru; Kato, Kenichi; Tanaka, Ryoichi; Nakasato, Tatsuhiko

2011-01-01

Purpose: This study was designed to compare central venous ports (CVP) from two different routes of venous access―the subclavian vein and arm vein―in terms of safety for patients with head and neck cancer (HNC). Methods: Patients with HNC who underwent image-guided implantations of CVPs were retrospectively evaluated. All CVPs were implanted under local anesthesia. Primary outcome measurements were rates and types of adverse events (AEs). Secondary outcomes included technical success and rate and reason of CVP removal. Results: A total of 162 patients (subclavian port group, 47; arm port group, 115) were included in this study. Technical success was achieved in all patients. The median follow-up period was 94 (range, 1–891) days. Two patients in the subclavian port group experienced periprocedural complications. Postprocedural AEs were observed in 8.5 and 22.6% of the subclavian port and arm port group patients, respectively (P = 0.044). Phlebitis and system occlusions were observed only in the arm port group. The rate of infection was not significantly different between the two groups. The CVP was removed in 34 and 39.1% of the subclavian port and arm port patients, respectively. Conclusions: Both subclavian and arm CVPs are feasible in patients with HNC. AEs were more frequent in the arm port group; thus, the arm port is not recommended as the first choice for patients with HNC. However, further experience is needed to improve the placement technique and the maintenance of CVPs and a prospective analysis is warranted.

The Practice of Guangzhou Port Planning Environmental Impact Assessment

Science.gov (United States)

Wang, Ning; Zhao, Junjie; Shou, Youping; Qiao, Jianzhe; Dong, Shipei; Zhang, Lu

2018-01-01

In this paper, the effects of the implementation of Guangzhou port plan were analyzed from hydrological condition, water environment and ecological environment. Regional water environmental carrying capacity was analyzed. Guangzhou port is a main port in the coast of China, it is an important port of foreign trade in south China, it is an important port for energy supplies and raw materials in Guangdong province [1]. With the shipping channel condition improvement and the construction of large specialized container port area, Guangzhou port will gradually become trunk line port of container transport in south China.

The radiation analyses of ITER lower ports

International Nuclear Information System (INIS)

Petrizzi, L.; Brolatti, G.; Martin, A.; Loughlin, M.; Moro, F.; Villari, R.

2010-01-01

The ITER Vacuum Vessel has upper, equatorial, and lower ports used for equipment installation, diagnostics, heating and current drive systems, cryo-vacuum pumping, and access inside the vessel for maintenance. At the level of the divertor, the nine lower ports for remote handling, cryo-vacuum pumping and diagnostic are inclined downwards and toroidally located each every 40 o . The cryopump port has additionally a branch to allocate a second cryopump. The ports, as openings in the Vacuum Vessel, permit radiation streaming out of the vessel which affects the heating in the components in the outer regions of the machine inside and outside the ports. Safety concerns are also raised with respect to the dose after shutdown at the cryostat behind the ports: in such zones the radiation dose level must be kept below the regulatory limit to allow personnel access for maintenance purposes. Neutronic analyses have been required to qualify the ITER project related to the lower ports. A 3-D model was used to take into account full details of the ports and the lower machine surroundings. MCNP version 5 1.40 has been used with the FENDL 2.1 nuclear data library. The ITER 40 o model distributed by the ITER Organization was developed in the lower part to include the relevant details. The results of a first analysis, focused on cryopump system only, were recently published. In this paper more complete data on the cryopump port and analysis for the remote handling port and the diagnostic rack are presented; the results of both analyses give a complete map of the radiation loads in the outer divertor ports. Nuclear heating, dpa, tritium production, and dose rates after shutdown are provided and the implications for the design are discussed.

Influence of the temperature and oxygen exposure in red Port wine: A kinetic approach.

Science.gov (United States)

Oliveira, Carla Maria; Barros, António S; Silva Ferreira, António César; Silva, Artur M S

2015-09-01

Although phenolics are recognized to be related with health benefits by limiting lipid oxidation, in wine, they are the primary substrates for oxidation resulting in the quinone by-products with the participation of transition metal ions. Nevertheless, high quality Port wines require a period of aging in either bottle or barrels. During this time, a modification of sensory properties of wines such as the decrease of astringency or the stabilization of color is recognized to phenolic compounds, mainly attributed to anthocyanins and derived pigments. The present work aims to illustrate the oxidation of red Port wine based on its phenolic composition by the effect of both thermal and oxygen exposures. A kinetic approach toanthocyanins degradation was also achieved. For this purpose a forced red Port wine aging protocol was performed at four different storage temperatures, respectively, 20, 30, 35 and 40°C, and two adjusted oxygen saturation levels, no oxygen addition (treatment I), and oxygen addition (treatment II). Three hydroxycinnamic esters, three hydroxycinnamic acids, three hydroxybenzoic acids, two flavan-3-ols, and six anthocyanins were quantitated weekly during 63days, along with oxygen consumption. The most relevant phenolic oxidation markers were anthocyanins and catechin-type flavonoids, which had the highest decreases during the thermal and oxidative red Port wine process. Both temperature and oxygen treatments affected the rate of phenolic degradation. In addition, temperature seems to influence mostly the phenolics kinetic degradation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Lost in translation? How adults living with Cystic Fibrosis understand treatment recommendations from their healthcare providers, and the impact on adherence to therapy.

Science.gov (United States)

Pakhale, S; Baron, J; Armstrong, M; Tasca, G; Gaudet, E; Aaron, S D; Cameron, W; Balfour, L

2016-08-01

This study builds on the limited research documenting Cystic Fibrosis (CF) patients' understanding of treatment recommendations and how this may impact adherence to therapy. We surveyed adults with CF and their healthcare professional (HCP) to capture treatment recommendations provided by the HCP, and patients' knowledge, and frequency of performance, of these recommendations. We classified CF participants' understanding of treatment recommendations (correct/incorrect) as compared to the actual recommendations made by the HCP. We computed CF participants' adherence in relation to HCP treatment recommendations and to their own understanding of treatment recommendations (adherent/non-adherent). Complete HCP and patient data were available for 42 participants. The recommended treatment frequency was correctly understood by 0%-87.8% of CF participants. Adherence to HCP treatment recommendations ranged from 0 to 68.3% (mean 45.4%±21.5), and rates were low (<33%) for acapella, percussion/postural drainage, tobramycin nebulization and insulin. Participants' adherence was greater when calculated in relation to participants' understanding of treatment recommendations (62.4%±25.1) than when calculated in relation to actual HCP treatment recommendations (45.4%±21.5%) (p=0.009). Adults with CF misunderstand treatment recommendations; this likely affects treatment adherence. Interventions to ensure HCPs use effective communication strategies are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Testing and Analysis of Sensor Ports

Science.gov (United States)

Zhang, M.; Frendi, A.; Thompson, W.; Casiano, M. J.

2016-01-01

This Technical Publication summarizes the work focused on the testing and analysis of sensor ports. The tasks under this contract were divided into three areas: (1) Development of an Analytical Model, (2) Conducting a Set of Experiments, and (3) Obtaining Computational Solutions. Results from the experiment using both short and long sensor ports were obtained using harmonic, random, and frequency sweep plane acoustic waves. An amplification factor of the pressure signal between the port inlet and the back of the port is obtained and compared to models. Comparisons of model and experimental results showed very good agreement.

Ship waste quantities prediction model for the port of Belgrade

Directory of Open Access Journals (Sweden)

VLADANKA PRESBURGER ULNIKOVIĆ

2011-06-01

Full Text Available This study focuses on the issues related to the waste management in river ports in general and especially in the port of Belgrade. Data on solid waste, waste oils, oily waters, gray water and black water have been collected for a period of five years. The methodology of data collection is presented. Trends of data were analyzed and the regression model was used to predict the waste quantities in the Belgrade port. This data could be utilized as a basis for the calculation of the equipment capacity for waste selective collection, treatment and storage. The results presented in this study establish the need for an orga¬nized management system for this type of waste which can be achieved either by constructing and providing new specialized terminal or by providing mobile floating facilities and other plants in the Port of Belgrade for these kinds of ser¬vices. In addition to the above, the legislative and organizational strategy of waste management has been explored to complete the study because the im¬pact of good waste management on environment and prevention of environ¬mental accidents would be highly beneficial. This study demonstrated that ad¬dressing these issues should be considered at international as well as national level.

Formation of the mechanism of realisation of the logistics strategy of river ports

Directory of Open Access Journals (Sweden)

Tymoshchuk Olena M.

2013-03-01

Full Text Available The article identifies the role of river ports in the logistical chain of supplies of the transportation system of Ukraine. It envisages to use the developed logistics strategy for creation of river logistics centres on the basis of river ports with a high level of logistical attractiveness, which would become organisers of cargo delivery at a certain stage of movement of goods and a connecting logistical link at the junction of transport elements of the system (systems of managing the process of transportation, information support, selection of optimal technological schemes of cargo treatment in the port and optimal interaction of adjacent types of transport, methods of management (organisational, economic, technical and technological, and legal, logistical principles and technologies, which would allow achievement of effective realisation of the logistics strategy of a river port. The article offers to create a separate commercial structure – information logistics centre, which would ensure information support of the logistical movement of goods and optimal managerial decision making.

Single-port versus conventional multiport access prophylactic laparoscopic bilateral salpingo-oophorectomy in high-risk patients for ovarian cancer: a comparison of surgical outcomes.

Science.gov (United States)

Angioni, Stefano; Pontis, Alessandro; Sedda, Federica; Zampetoglou, Theodoros; Cela, Vito; Mereu, Liliana; Litta, Pietro

2015-01-01

Bilateral salpingo-oophorectomy (BSO) in carriers of BRCA1 and BRCA2 mutations is widely recommended as part of a risk-reduction strategy for ovarian or breast cancer due to an underlying genetic predisposition. BSO is also performed as a therapeutic intervention for patients with hormone-positive premenopausal breast cancer. BSO may be performed via a minimally invasive approach with the use of three to four 5 mm and/or 12 mm ports inserted through a skin incision. To further reduce the morbidity associated with the placement of multiple port sites and to improve cosmetic outcomes, single-port laparoscopy has been developed with a single access point from the umbilicus. The purpose of this study was to evaluate the surgical outcomes associated with reducing the risks of salpingo-oophorectomy performed in a single port, while comparing multiport laparoscopy in women with a high risk for ovarian cancer. Single-port laparoscopy-BSO is feasible and safe, with favorable surgical and cosmetic outcomes when compared to conventional laparoscopy.

Evidence supporting contemporary post-operative radiation therapy (PORT) using linear accelerators in N2 lung cancer.

Science.gov (United States)

Patel, Suchit H; Ma, Yan; Wernicke, A Gabriella; Nori, Dattatreyudu; Chao, K S C; Parashar, Bhupesh

2014-05-01

Post-operative radiotherapy (PORT) treatment for lung cancer declined since a meta-analysis failed to show benefit in patients with N2 disease. Because several included studies employed outmoded radiation planning and delivery techniques, we sought to determine whether PORT with modern technology benefits patients with N2 disease. We conducted searches of the published literature. For inclusion, studies must have included patients with stage III-N2 lung cancer treated with PORT using only linear accelerators, used a control group that did not receive PORT, and reported outcome data for overall survival (OS). Prospective and retrospective analyses were included. Exclusion criteria were the use of cobalt devices or orthovoltage radiation. Data were evaluated with random-effects models. Three prospective and eight retrospective studies were included. The PORT and no-PORT groups included 1368 and 1360 patients, respectively. The PORT group had significantly improved OS over the no-PORT group (hazard ratio [HR] = 0.77, 95% confidence interval [CI] 0.62-0.96, P = 0.020). Locoregional recurrence-free survival (LRFS) in 10 studies for which data was available was also improved in the PORT group (HR = 0.51, CI 0.41-0.65, P PORT was associated with significantly lower risk of death and locoregional recurrence in patients with N2 lung cancer. Our study was limited by lack of access to individual patient data, which would have enabled more detailed analyses. Regardless, data thus far suggest PORT may be associated with a survival benefit. Given a lack of large-scale prospective data, clinical trials evaluating PORT with modern technology are warranted. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Extracorporeal treatment for carbamazepine poisoning: Systematic review and recommendations from the EXTRIP workgroup

Science.gov (United States)

Ghannoum, Marc; Yates, Christopher; Galvao, Tais F.; Sowinski, Kevin M.; Vo, Thi Hai Vân; Coogan, Andrew; Gosselin, Sophie; Lavergne, Valery; Nolin, Thomas D.; Hoffman, Robert S.

2014-01-01

Abstract Context. The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was created to provide evidence and consensus-based recommendations on the use of extracorporeal treatments (ECTRs) in poisoning. Objectives. To perform a systematic review and provide clinical recommendations for ECTR in carbamazepine poisoning. Methods. After a systematic literature search, the subgroup extracted the data and summarized the findings following a pre-determined format. The entire workgroup voted via a two-round modified Delphi method to reach a consensus on voting statements, using a RAND/UCLA Appropriateness Method to quantify disagreement. Anonymous votes were compiled, returned, and discussed in person. A second vote determined the final recommendations. Results. Seventy-four articles met inclusion criteria. Articles included case reports, case series, descriptive cohorts, pharmacokinetic studies, and in-vitro studies; two poor-quality observational studies were identified, yielding a very low quality of evidence for all recommendations. Data on 173 patients, including 6 fatalities, were reviewed. The workgroup concluded that carbamazepine is moderately dialyzable and made the following recommendations: ECTR is suggested in severe carbamazepine poisoning (2D). ECTR is recommended if multiple seizures occur and are refractory to treatment (1D), or if life-threatening dysrhythmias occur (1D). ECTR is suggested if prolonged coma or respiratory depression requiring mechanical ventilation are present (2D) or if significant toxicity persists, particularly when carbamazepine concentrations rise or remain elevated, despite using multiple-dose activated charcoal (MDAC) and supportive measures (2D). ECTR should be continued until clinical improvement is apparent (1D) or the serum carbamazepine concentration is below 10 mg/L (42 the μ in μmol/L looks weird.) (2D). Intermittent hemodialysis is the preferred ECTR (1D), but both intermittent hemoperfusion (1D) or continuous

Adaptive Port Planning under Disruptive Trends with focus on the case of the Port of Kuala Tanjung, Indonesia

NARCIS (Netherlands)

Taneja, P.; Velinga, Tiedo

2018-01-01

As a national strategic project, the Port of Kuala Tanjung draws significant attention at national and international level. Considering the semi-greenfield nature of the port, the diverse set of stakeholders, and the prevailing disruptive trends in the world port business, a robust first-phase

Hemoporfin Photodynamic Therapy for Port-Wine Stain: A Randomized Controlled Trial.

Directory of Open Access Journals (Sweden)

Yi Zhao

Full Text Available Photodynamic therapy (PDT has shown potentially beneficial results in treating port-wine stain, but its benefit-risk profile remains undefined. This study aimed to evaluate the efficacy and safety of PDT conducted with hemoporfin and a 532 nm continuous wave laser to treat port-wine stain clinically.This randomized clinical trial was conducted in eight hospitals in China. Participants were adolescent and adult patients (age range: 14-65 years old with port-wine stain. During stage 1 (day 1 to week 8 all patients were randomized at a 3:1 ratio to treatment (532 nm laser irradiation (96-120 J/cm2 with hemoporfin (5mg/kg; PDT-hemoporfin, n = 330 or placebo groups (irradiation with placebo (PDT-placebo, n = 110; during stage 2 (week 8 to 16 patients in both groups were offered treatment. Clinician-evaluators, who were blind to the study, classified each case on the following four-level scale according to assessment of before and after standardized pictures of the lesion area: no improvement: <20%; some improvement: 20-59%; great improvement: 60-89%; or nearly completely resolved: ≥90%. The primary efficacy endpoint was proportion of patients achieving at least some improvement at week 8. The secondary efficacy endpoints were proportion of patients achieving nearly completely resolved or at least great improvement at week 8, proportion of patients achieving early completely resolved, at least great improvement, or at least some improvement at week 16, and the corresponding satisfaction of the investigators and the patients (designated as 'excellent', 'good', 'moderate', or 'ineffective' at weeks 8 and 16.Compared to the PDT-placebo group, the PDT-hemoporfin group showed a significantly higher proportion of patients that achieved at least some improvement (89.7% [n = 295; 95% CI, 85.9%-92.5%] vs. 24.5% [n = 27; 95% CI, 17.4%-33.3%] at week 8 (P < 0.0001 and higher improvements for all secondary efficacy endpoints. Treatment reactions occurred in 99

Treatment of Childhood and Adolescent Obesity: An Integrative Review of Recent Recommendations from Five Expert Groups

Science.gov (United States)

Kirschenbaum, Daniel S.; Gierut, Kristen

2013-01-01

Objective: To compare and contrast 5 sets of expert recommendations about the treatment of childhood and adolescent obesity. Method: We reviewed 5 sets of recent expert recommendations: 2007 health care organizations' four stage model, 2007 Canadian clinical practice guidelines, 2008 Endocrine Society recommendations, 2009 seven step model, and…

Cyber security in ports: Business as usual

OpenAIRE

Moerel, Lokke; Dezeure, Freddy

2017-01-01

Our paper summarizes the risks and provides concrete and pragmatic proposals to increase substantially the cyber maturity and resilience in the ports by organizing training and awareness raising, fostering cooperation and information exchange both between the stakeholders in the ports and across the ports and integrating the cyber risk into the physical security risk management processes and structures already in place within the ports. This also involves a higher degree of oversight by the P...

Slewing Port Jib Cranes

Directory of Open Access Journals (Sweden)

Boris Visočnik

2002-09-01

Full Text Available The paper presents slewing port cra11es with a luffing jib.The advantages of slewing port jib cranes are high lifting capacities,high speeds of re-loading and excellent mobility since theyare capable of load lifting, travelling, luffing and slewing. Thepaper gives a detailed description of their characteristics suchas the highest reached load-canying capacities, speeds of motionand accelerations. It also presents the crane assembly,driving mechanisms, loads and load cases, transport by shipsand testing of lifting capacity. As a practical example the paperpresents the slewing port jib crane with the capacity of25!15!5 tat a 27/37/40 m radius made by the Slovenian companyMetalna Maribor for the shipyard 3. Maj, Rijeka, Croatia.

Treatment Recommendations for Single-Unit Crowns: Findings from The National Dental Practice-Based Research Network

Science.gov (United States)

McCracken, Michael S.; Louis, David R.; Litaker, Mark S.; Minyé, Helena M.; Mungia, Rahma; Gordan, Valeria V.; Marshall, Don G.; Gilbert, Gregg H.

2016-01-01

Background Objectives were to: (1) quantify practitioner variation in likelihood to recommend a crown; and (2) test whether certain dentist, practice, and clinical factors are significantly associated with this likelihood. Methods Dentists in the National Dental Practice-Based Research Network completed a questionnaire about indications for single-unit crowns. In four clinical scenarios, practitioners ranked their likelihood of recommending a single-unit crown. These responses were used to calculate a dentist-specific “Crown Factor” (CF; range 0–12). A higher score implies a higher likelihood to recommend a crown. Certain characteristics were tested for statistically significant associations with the CF. Results 1,777 of 2,132 eligible dentists responded (83%). Practitioners were most likely to recommend crowns for teeth that were fractured, cracked, endodontically-treated, or had a broken restoration. Practitioners overwhelmingly recommended crowns for posterior teeth treated endodontically (94%). Practice owners, Southwest practitioners, and practitioners with a balanced work load were more likely to recommend crowns, as were practitioners who use optical scanners for digital impressions. Conclusions There is substantial variation in the likelihood of recommending a crown. While consensus exists in some areas (posterior endodontic treatment), variation dominates in others (size of an existing restoration). Recommendations varied by type of practice, network region, practice busyness, patient insurance status, and use of optical scanners. Practical Implications Recommendations for crowns may be influenced by factors unrelated to tooth and patient variables. A concern for tooth fracture -- whether from endodontic treatment, fractured teeth, or large restorations -- prompted many clinicians to recommend crowns. PMID:27492046

Research on variable swirl intake port for high-speed multivalve DI diesel engine. Effects of port configuration on flow characteristics and swirl generation capacity; 4 ben kogata kosoku DI diesel engine no kahen swirl kyuki port ni kansuru kenkyu. Kyuki port haichi ga ryudo tokusei to swirl seino ni oyobosu eikyo

Energy Technology Data Exchange (ETDEWEB)

Kawashima, J; Ogawa, H; Tsuru, Y [Nissan Motor Co. Ltd., Tokyo (Japan)

1997-10-01

In our previous papers, the variable swirl intake port system which can control a wide swirl ratio range (from 4 to 10) was described. This system consisted of two separate intake ports, one of them has a flow control valve for changing the swirl ratio. In this type of variable swirl system, some variations of port combination, port shape, and position can be designed. In this paper, the intake flow characteristics of various port combinations were analyzed on the basis of a steady-state air flow test and 3-dimensional computations. The results indicate that the total performance of the twin ports can be estimated from that of a single port in any kind of port combination. Some difference in flow patterns were found in a variety of port combinations even if each swirl ratio is similar. The selected port combinations in our previous study are good for a wide swirl control range. 11 refs., 9 figs., 1 tab.

The Maritime Environment - International Conference and Exhibition on Ballast Water, Waste Water and Sewage Treatment on Ships and in Ports Held in Bremerhaven, Germany on 12-14 September 2001. Conference Proceedings

National Research Council Canada - National Science Library

2001-01-01

The Maritime International Conference on Ballast Water, Waste Water and Sewage Treatment on Ships and in Ports held in Bremerhaven, Germany on 12-14 September 2001 was cosponsored by Deerberg-Systems...

Two-port robotic hysterectomy: a novel approach.

Science.gov (United States)

Moawad, Gaby N; Tyan, Paul; Khalil, Elias D Abi

2018-03-24

The objective of the study was to demonstrate a novel technique for two-port robotic hysterectomy with a particular focus on the challenging portions of the procedure. The study is designed as a technical video, showing step-by-step a two-port robotic hysterectomy approach (Canadian Task Force classification level III). IRB approval was not required for this study. The benefits of minimally invasive surgery for gynecological pathology have been clearly documented in multiple studies. Patients had fewer medical and surgical complications postoperatively, better cosmesis and quality of life. Most gynecological surgeons require 3-5 ports for the standard gynecological procedure. Even though the minimally invasive multiport system provides an excellent safety profile, multiple incisions are associated with a greater risk for morbidity including infection, pain, and hernia. In the past decade, various new methods have emerged to minimize the number of ports used in gynecological surgery. The interventions employed were a two-port robotic hysterectomy, using a camera port plus one robotic arm, with a focus on salpingectomy and cuff closure. We describe a transvaginal and a transabdominal approach for salpingectomy and a novel method for cuff closure. The transvaginal and transabdominal techniques for salpingectomy for two-port robotic-assisted hysterectomy provide excellent tension and exposure for a safe procedure without the need for an extra port. We also describe a transvaginal technique to place the vaginal cuff on tension during closure. With the necessary set of skills on a carefully chosen patient, two-port robotic-assisted total laparoscopic hysterectomy is a feasible procedure.

Double Pass 595?nm pulsed dye laser at a 6 minute interval for the treatment of port-wine stains is not more effective than single pass

NARCIS (Netherlands)

Peters, M. A. D.; van Drooge, A. M.; Wolkerstorfer, A.; van Gemert, M. J. C.; van der Veen, J. P. W.; Bos, J. D.; Beek, J. F.

2012-01-01

Background Pulsed dye laser (PDL) is the first choice for treatment of port wine stains (PWS). However, outcome is highly variable and only a few patients achieve complete clearance. The objective of the study was to compare efficacy and safety of single pass PDL with double pass PDL at a 6 minute

[Subcutaneous implantation type central venous port management in patients with malignant tumors effect of different antiseptic agents on central venous port-related infection].

Science.gov (United States)

Sato, Junya; Kumagai, Masumi; Kato, Kenichi; Akahane, Akio; Suzuki, Michiko; Kashiwaba, Masahiro; Sone, Miyuki; Kudo, Kenzo

2014-08-01

Subcutaneous implantation type central venous ports(CV ports)are used in chemotherapy. Here, we prospectively examined the frequency of CV port-related infections when the disinfectant was changed from 10% povidone iodine to 1% chlorhexidine ethanol or 70% ethanol. The subjects were patients with malignant tumors, who had newly been implanted with CV ports. We examined CV port-related infections at 1 week after CV port implantation and every 2 weeks thereafter, following sterilization upon insertion of a Huber needle to the CV port. CV port evulsion due to CV port-related infection was noted in 3 patients(4.8%)in whom 15%chlorhexidine ethanol was used(n=62)and in 2 patients(3.3%)in whom 70% ethanol was used(n=60). Infection rates per 1,000 days of CV port use were 1.48% and 1.01%, respectively. Thus, the outcomes of sterilization using 1% chlorhexidine ethanol and 70% ethanol did not differ significantly from those on using 10% povidone iodine for sterilization, based on preliminary results at our institution(3 of 59 patients[5.1%]had port evulsion due to CV port-related infection and the infection rate per 1,000 days of CV port use was 1.47%, Akahane et al, 2012). Chlorhexidine ethanol and ethanol are very convenient to use because they dry quickly and do not need discoloration. Accordingly, chlorhexidine ethanol and ethanol might be useful in CV port management.

Recommendations for standardized diagnostics, treatment and following care in tumor diseases. Geriatric patient with tumor disease

International Nuclear Information System (INIS)

Hagmueller, E.; Neises, M.; Queisser, W.; Richter, H.; Schneider, G.

2001-01-01

The recommendations for the treatment of geriatric patients with tumor disease, presented in the paper, cover: surgery; chemotherapy; radiotherapy and immunotherapy. Radiotherapy is recommended for skin tumors, pain treatment in the bone metastases (40 - 50 Gy), system diseases (with reduction of the usual size of the irradiated area), small size tumors etc. It is considered as an appropriate method (excluding wide fields) for geriatric outpatients

International recommendations on the diagnosis and treatment of patients with acquired hemophilia A

Science.gov (United States)

Huth-Kühne, Angela; Baudo, Francesco; Collins, Peter; Ingerslev, Jørgen; Kessler, Craig M.; Lévesque, Hervé; Castellano, Maria Eva Mingot; Shima, Midori; St-Louis, Jean

2009-01-01

Acquired hemophilia A (AHA) is a rare bleeding disorder characterized by autoantibodies directed against circulating coagulation factor (F) VIII. Typically, patients with no prior history of a bleeding disorder present with spontaneous bleeding and an isolated prolonged aPTT. AHA may, however, present without any bleeding symptoms, therefore an isolated prolonged aPTT should always be investigated further irrespective of the clinical findings. Control of acute bleeding is the first priority, and we recommend first-line therapy with bypassing agents such as recombinant activated FVII or activated prothrombin complex concentrate. Once the diagnosis has been achieved, immediate autoantibody eradication to reduce subsequent bleeding risk should be performed. We recommend initial treatment with corticosteroids or combination therapy with corticosteroids and cyclophosphamide and suggest second-line therapy with rituximab if first-line therapy fails or is contraindicated. In contrast to congenital hemophilia, no comparative studies exist to support treatment recommendations for patients with AHA, therefore treatment guidance must rely on the expertise and clinical experience of specialists in the field. The aim of this document is to provide a set of international practice guidelines based on our collective clinical experience in treating patients with AHA and contribute to improved care for this patient group. PMID:19336751

Systems theory of interconnected port contact systems

NARCIS (Netherlands)

Eberard, D.; Maschke, B.M.; Schaft, A.J. van der

2005-01-01

Port-based network modeling of a large class of complex physical systems leads to dynamical systems known as port-Hamiltonian systems. The key ingredient of any port-Hamiltonian system is a power-conserving interconnection structure (mathematically formalized by the geometric notion of a Dirac

Ports and Terminals : Planning and Functional Design

NARCIS (Netherlands)

Groenveld, R.; Velsink, H.

1993-01-01

1. Maritime transport, means and commodities 3. Principles of integrated port planning 4. Planning and design of a port's water areas 5. Port terminals - introduction 6. Conventional general cargo terminals 7. Container terminals 8. Oil & liquid gas terminals 9. Dry bulk cargo terminals 10. Fishery

Conservative systems with ports on contact manifolds

NARCIS (Netherlands)

Eberard, D.; Maschke, B.M.; van der Schaft, Arjan; Piztek, P.

In this paper we propose an extension of port Hamiltonian systems, called conservative systems with ports, which encompass systems arising from the Irreversible Thermodynamics. Firstly we lift a port Hamiltonian system from its state space manifold to the thermodynamic phase space to a contact

Single port VATS: recent developments in Asia.

Science.gov (United States)

Yu, Peter S Y; Capili, Freddie; Ng, Calvin S H

2016-03-01

Single port video-assisted thoracic surgery (VATS) is the most recent evolution in minimally invasive thoracic surgery. With increasing global popularity, the single port VATS approach has been adopted by experienced thoracic surgeons in many Asian countries. From initial experience of single port VATS lobectomy to the more complex sleeve resection procedures now forming part of daily practice in some Asia institutes, the region has been the proving ground for single port VATS approaches' feasibility and safety. In addition, certain technical refinements in single port VATS lung resection and lymph node dissection have also sprung from Asia. Novel equipment designed to facilitate single port VATS allowing further reduce access trauma are being realized by the partnership between surgeons and the industries. Advanced thoracoscopes and staplers that are narrower and more maneuverable are particularly important in the smaller habitus of patients from Asia. These and similar new generation equipment are being applied to single port VATS in novel ways. As dedicated thoracic surgeons in the region continue to striving for excellence, innovative ideas in single incision access including subxiphoid and embryonic natural-orifice transluminal endoscopic surgery (e-NOTES) have been explored. Adjunct techniques and technology used in association with single port VATS such as non-intubated surgery, hybrid operating room image guidance and electromagnetic navigational bronchoscopy are all in rapid development in Asia.

Dual-port distal gastrectomy for the early gastric cancer

OpenAIRE

Kashiwagi, Hiroyuki; Kumagai, Kenta; Monma, Eiji; Nozue, Mutsumi

2014-01-01

Background Although recent trends in laparoscopic procedures have been toward minimizing the number of incisions, four or five ports are normally required to complete laparoscopic gastrectomy because of the complexity of this procedure. Multi-channel ports, such as the SILS port (Covidien, JAPAN), are now available and are crucial for performing single-incision laparoscopic surgery (SILS) or reduced port surgery (RPS). We carried out reduced port distal gastrectomy (RPDG) using a dual-port me...

Varying effects of recommended treatments for heart failure with reduced ejection fraction

DEFF Research Database (Denmark)

Thomsen, Marius Mark; Lewinter, Christian; Køber, Lars

2016-01-01

The aim of this paper is to evaluate the treatment effects of recommended drugs and devices on key clinical outcomes for patients with heart failure with reduced ejection fraction (HFREF). Randomized controlled trials (RCTs) listed in the 2012 HF guideline from the European Society of Cardiology...... as well as the 2013 HF guideline from the American College of Cardiology Foundation and American Heart Association were evaluated for use in the meta-analysis. RCTs written in English evaluating recommended drugs and devices for the treatment of patients with HFREF were included. Meta-analyses, based...... on the outcomes of all-cause mortality and hospitalization because of HF, were performed with relative risk ratio as the effect size. In the identified 47 RCTs, patients were on average 63 years old and 22% were female. Drugs targeting the renin-angiotensin-aldosterone system, beta-blockers, cardiac...

Effect of Prostate Magnetic Resonance Imaging/Ultrasound Fusion-guided Biopsy on Radiation Treatment Recommendations

Energy Technology Data Exchange (ETDEWEB)

Reed, Aaron; Valle, Luca F.; Shankavaram, Uma; Krauze, Andra; Kaushal, Aradhana; Schott, Erica; Cooley-Zgela, Theresa [Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Wood, Bradford [Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland (United States); Pinto, Peter [Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Choyke, Peter; Turkbey, Baris [Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Citrin, Deborah E., E-mail: citrind@mail.nih.gov [Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States)

2017-04-01

Purpose: Targeted magnetic resonance imaging (MRI)/ultrasound fusion prostate biopsy (MRI-Bx) has recently been compared with the standard of care extended sextant ultrasound-guided prostate biopsy (SOC-Bx), with the former associated with an increased rate of detection of clinically significant prostate cancer. The present study sought to determine the influence of MRI-Bx on radiation therapy and androgen deprivation therapy (ADT) recommendations. Methods and Materials: All patients who had received radiation treatment and had undergone SOC-Bx and MRI-Bx at our institution were included. Using the clinical T stage, pretreatment prostate-specific antigen, and Gleason score, patients were categorized into National Comprehensive Cancer Network risk groups and radiation treatment or ADT recommendations assigned. Intensification of the recommended treatment after multiparametric MRI, SOC-Bx, and MRI-Bx was evaluated. Results: From January 2008 to January 2016, 73 patients received radiation therapy at our institution after undergoing a simultaneous SOC-Bx and MRI-Bx (n=47 with previous SOC-Bx). Repeat SOC-Bx and MRI-Bx resulted in frequent upgrading compared with previous SOC-Bx (Gleason score 7, 6.7% vs 44.6%; P<.001; Gleason score 8-10, 2.1% vs 38%; P<.001). MRI-Bx increased the proportion of patients classified as very high risk from 24.7% to 41.1% (P=.027). Compared with SOC-Bx alone, including the MRI-Bx findings resulted in a greater percentage of pathologically positive cores (mean 37% vs 44%). Incorporation of multiparametric MRI and MRI-Bx results increased the recommended use and duration of ADT (duration increased in 28 of 73 patients and ADT was added for 8 of 73 patients). Conclusions: In patients referred for radiation treatment, MRI-Bx resulted in an increase in the percentage of positive cores, Gleason score, and risk grouping. The benefit of treatment intensification in accordance with the MRI-Bx findings is unknown.

Analysis of laparoscopic port site complications: A descriptive study.

Science.gov (United States)

Karthik, Somu; Augustine, Alfred Joseph; Shibumon, Mundunadackal Madhavan; Pai, Manohar Varadaraya

2013-04-01

The rate of port site complications following conventional laparoscopic surgery is about 21 per 100,000 cases. It has shown a proportional rise with increase in the size of the port site incision and trocar. Although rare, complications that occur at the port site include infection, bleeding, and port site hernia. To determine the morbidity associated with ports at the site of their insertion in laparoscopic surgery and to identify risk factors for complications. Prospective descriptive study. In the present descriptive study, a total of 570 patients who underwent laparoscopic surgeries for various ailments between August 2009 and July 2011 at our institute were observed for port site complications prospectively and the complications were reviewed. Descriptive statistical analysis was carried out in the present study. The statistical software, namely, SPSS 15.0 was used for the analysis of the data. Of the 570 patients undergoing laparoscopic surgery, 17 (3%) had developed complications specifically related to the port site during a minimum follow-up of three months; port site infection (PSI) was the most frequent (n = 10, 1.8%), followed by port site bleeding (n = 4, 0.7%), omentum-related complications (n = 2; 0.35%), and port site metastasis (n = 1, 0.175%). Laparoscopic surgeries are associated with minimal port site complications. Complications are related to the increased number of ports. Umbilical port involvement is the commonest. Most complications are manageable with minimal morbidity, and can be further minimized with meticulous surgical technique during entry and exit.

Curve identification for high friction surface treatment (HFST) installation recommendation : final report.

Science.gov (United States)

2016-09-01

The objectives of this study are to develop and deploy a means for cost-effectively extracting curve information using the widely available GPS and GIS data to support high friction surface treatment (HFST) installation recommendations (i.e., start a...

Challenges and Strategies of Abidjan Port-Hinterland Connectivity

Directory of Open Access Journals (Sweden)

Gamassa Pascal Kany Prud’ome

2017-01-01

Full Text Available Abidjan port-hinterland is composed of three countries which include Ivory Coast, Mali and Burkina Faso. The fast economic growth of the above countries resulted to a greater demand for the foreign goods from their population, causing a congestion problem at Abidjan port. Because of this problem, the connectivity movement between the port and its hinterland has considerably slowed down. In this article a qualitative methodology is used to analyse the Abidjan port-hinterland connectivity. The constant delays of the train services, the road congestion and the lack of coordination and communication between Abidjan port and its hinterland customers are the main presented challenges. The results of this research demonstrate that the poor quality roads and railways and the lack of a new dry port in Ivory Coast greatly affects the fluidity of the Abidjan port-hinterland connectivity. This article suggests some strategies on how to solve the current challenges and will be helpful in deciding on how the Abidjan port should be developed better and improve its connectivity with its hinterland.

Prospective analysis of the port-wine stain patient population in the Netherlands in light of novel treatment modalities.

Science.gov (United States)

van Raath, M Ingmar; Bambach, Caroline A; Dijksman, Lea M; Wolkerstorfer, Albert; Heger, Michal

2018-04-01

Pulsed dye laser is the gold standard for port-wine stain (PWS) treatment. However, pulsed dye lasers achieve suboptimal clinical results in a majority of patients. Patient demand for novel therapies and willingness to participate in clinical studies is currently unknown, yet, imperative for steering R&D activity. The objective of this study was to evaluate these two factors in relation to PWS patient demographics. A questionnaire was used to assess patient and PWS characteristics, treatment history, efficacy, and satisfaction, stress level, willingness to travel and pay for an effective treatment, participation in clinical studies, and amenability to intravenous drug administration. Descriptive statistics and correlation analysis were performed. Of the respondents (N = 108), 65% would participate in clinical studies and 49% would accept intravenous drugs. For an effective treatment, 58% was prepared to pay over €2,000 and 48% would travel more than 6 h. Travel time was inversely correlated with age, clearance rate, and satisfaction. Facial PWS patients had undergone more treatments, were less satisfied, and less willing to participate in studies or accept intravenous drugs. Stress levels were higher in females. There is considerable demand for new PWS therapies, and a substantial proportion of patients are willing to participate in clinical studies.

Extracorporeal treatment for theophylline poisoning: systematic review and recommendations from the EXTRIP workgroup.

Science.gov (United States)

Ghannoum, Marc; Wiegand, Timothy J; Liu, Kathleen D; Calello, Diane P; Godin, Melanie; Lavergne, Valery; Gosselin, Sophie; Nolin, Thomas D; Hoffman, Robert S

2015-05-01

The Extracorporeal Treatments in Poisoning workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments (ECTRs) in poisoning. Here, the workgroup presents its systematic review and recommendations for theophylline. After a systematic review of the literature, a subgroup reviewed articles, extracted data, summarized findings, and proposed structured voting statements following a pre-determined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and the RAND/UCLA Appropriateness Method was used to quantify disagreement. Anonymous votes were compiled, returned, and discussed. A second vote determined the final recommendations. 141 articles were included: 6 in vitro studies, 4 animal studies, 101 case reports/case series, 7 descriptive cohorts, 4 observational studies, and 19 pharmacokinetic studies, yielding a low-to-very-low quality of evidence for all recommendations. Data on 143 patients were reviewed, including 10 deaths. The workgroup concluded that theophylline is dialyzable (level of evidence = A) and made the following recommendations: ECTR is recommended in severe theophylline poisoning (1C). Specific recommendations for ECTR include a theophylline concentration [theophylline] > 100 mg/L (555 μmol/L) in acute exposure (1C), the presence of seizures (1D), life-threatening dysrhythmias (1D) or shock (1D), a rising [theophylline] despite optimal therapy (1D), and clinical deterioration despite optimal care (1D). In chronic poisoning, ECTR is suggested if [theophylline] > 60 mg/L (333 μmol/L) (2D) or if the [theophylline] > 50 mg/L (278 μmol/L) and the patient is either less than 6 months of age or older than 60 years of age (2D). ECTR is also suggested if gastrointestinal decontamination cannot be administered (2D). ECTR should be continued until clinical improvement is apparent or the [theophylline] is poisoning is amenable to ECTRs. The workgroup recommended

Upper Gastro-Intestinal Endoscopy in Port Harcourt, Nigeria: An Audit

African Journals Online (AJOL)

Background: Accurate diagnosis of disease conditions using laboratory, imaging or endoscopic investigation is essential for appropriate treatment. There is paucity of data on upper GI endoscopy in Port-Harcourt. This audit of our early experience is intended to provide data on the pattern of endoscopy findings which is ...

The impact of an emerging port on the carbon dioxide emissions of inland container transport: An empirical study of Taipei port

International Nuclear Information System (INIS)

Liao, C.-H.; Tseng, P.-H.; Cullinane, Kevin; Lu, C.-S.

2010-01-01

This study analyzes the changes in carbon dioxide (CO 2 ) emissions resulting from the movement of containers from established ports through the emerging port of Taipei in Northern Taiwan. An activity-based emissions model is used to estimate the CO 2 emissions of container transport under four scenarios where there are switches of market share from existing ports to the emerging port. The results show that there are greater reductions in CO 2 when transhipment routes are changed from the ports of Kaohsiung, Taichung and Keelung to the emerging port of Taipei. The paper concludes that the analytical approach adopted in the paper can help decision-makers understand potential CO 2 emissions reduction strategies in the route selection of inland container transportation and such consideration should provide a broader and more meaningful basis for the socio-economic evaluation of port investment projects.

Process and overview of diagnostics integration in ITER ports

International Nuclear Information System (INIS)

Drevon, J.M.; Walsh, M.; Andrew, P.; Barnsley, R.; Bertalot, L.; Bock, M. de; Bora, D.; Bouhamou, R.; Direz, M.F.; Encheva, A.; Fang, T.; Feder, R.; Giacomin, T.; Hellermann, M. von; Jakhar, S.; Johnson, D.; Kaschuk, Y.; Kusama, Y.; Lee, H.G.; Levesy, B.

2013-01-01

Highlights: ► An overview of the Port Integration hardware for tenant system hosting inside ITER diagnostics ports is given. ► The main challenges for diagnostic port integration engineering are presented. ► The actions taken for a common modular approach and a coordinated design are detailed. -- Abstract: ITER will have a set of 45 diagnostics to ensure controlled operation. Many of them are integrated in the ITER ports. This paper addresses the integration process of the diagnostic systems and the approach taken to enable coordinated progress. An overview of the Port Integration hardware introduces the various structures needed for hosting tenant systems inside ITER diagnostics ports. The responsibilities of the different parties involved (ITER Organization and the Domestic Agencies) are outlined. The main challenges for diagnostic port integration engineering are summarized. The plan for a common approach to design and manufacture of the supporting structures, in particular the Port Plug is detailed. A coordinated design including common components and a common approach for neutronic analyses is proposed. One particular port, the equatorial port 11, is used to illustrate the approach

Higher complication risk of totally implantable venous access port systems in patients with advanced cancer - a single institution retrospective analysis.

Science.gov (United States)

Chang, Yi-Fang; Lo, An-Chi; Tsai, Chung-Hsin; Lee, Pei-Yi; Sun, Shen; Chang, Te-Hsin; Chen, Chien-Chuan; Chang, Yuan-Shin; Chen, Jen-Ruei

2013-02-01

Totally implantable port systems are generally recommended for prolonged central venous access in diverse settings, but their risk of complications remains unclear for patients with advanced cancer. The aim of this study was to assess the risk of port system failure in patients with advanced cancer. We conducted a retrospective cohort study in a comprehensive cancer centre. A detailed chart review was conducted among 566 patients with 573 ports inserted during January-June, 2009 (average 345.3 catheter-days). Cox regression analysis was applied to evaluate factors during insertion and early maintenance that could lead to premature removal of the port systems due to infection or occlusion. Port system-related infection was significantly associated with receiving palliative care immediately after implantation (hazard ratio, HR = 7.3, 95% confidence interval, 95% CI = 1.2-46.0), after adjusting for probable confounders. Primary cancer site also impacted the occurrence of device-related infection. Receiving oncologic/palliative care (HR = 3.0, P = 0.064), advanced cancer stage (HR = 6.5, P = 0.077) and body surface area above 1.71 m(2) (HR = 3.4, P = 0.029) increased the risk of port system occlusion. Our study indicates that totally implantable port systems yield a higher risk of complications in terminally ill patients. Further investigation should be carefully conducted to compare outcomes of various central venous access devices in patients with advanced cancer and to develop preventive strategies against catheter failure.

Ports, policies and interventions in ports in Portugal - 20th Century

OpenAIRE

Dias, Emílio Brògueira; Alves, Jorge Fernandes

2010-01-01

Ce texte, inspiré des données issues des travaux des deux auteurs, aborde, de manière synthétique, les grandes lignes des transformations portuaires au Portugal, à travers un panorama des différents ports et de leur évolution. Cet exposé se focalise sur les exemples les plus significatifs que sont les ports de Leixões, Aveiro, Lisbonne, Setubal et Sines. This text, based on the data used in previous works by the authors, seeks to assess briefly, the main lines of transformations in Portuga...

Adherence to CDC Recommendations for the Treatment of Uncomplicated Gonorrhea - STD Surveillance Network, United States, 2016.

Science.gov (United States)

Weston, Emily J; Workowski, Kimberly; Torrone, Elizabeth; Weinstock, Hillard; Stenger, Mark R

2018-04-27

Gonorrhea, the sexually transmitted disease (STD) caused by Neisseria gonorrhoeae, is the second most common notifiable disease in the United States after chlamydia; 468,514 cases were reported to state and local health departments in 2016, an increase of 18.5% from 2015 (1). N. gonorrhoeae has progressively developed resistance to most antimicrobials used to treat the infection (2). As a result, CDC recommends two antimicrobials (250 mg of ceftriaxone [IM] plus 1 g of azithromycin [PO]) for treating uncomplicated gonorrhea to improve treatment efficacy and, potentially, to slow the emergence and spread of antimicrobial resistance. To monitor adherence to the current CDC-recommended regimen for uncomplicated gonorrhea, CDC reviewed enhanced data collected on a random sample of reported cases of gonorrhea in seven jurisdictions participating in the STD Surveillance Network (SSuN) and estimated the proportion of patients who received the CDC-recommended regimen for uncomplicated gonorrhea, by patient characteristics and diagnosing facility type. In 2016, the majority of reported patients with gonorrhea (81%) received the recommended regimen. There were no differences in the proportion of patients receiving the recommended regimen by age or race/ethnicity; however, patients diagnosed with gonorrhea in STD (91%) or family planning/reproductive health (94%) clinics were more likely to receive this regimen than were patients diagnosed in other provider settings (80%). These data document high provider adherence to CDC gonorrhea treatment recommendations in specialty STD clinics, indicating high quality of care provided in those settings. Local and state health departments should monitor adherence with recommendations in their jurisdictions and consider implementing interventions to improve provider and patient compliance with gonorrhea treatment recommendations where indicated.

Wounds caused by contact with muzzle-lift relief ports (Mag-Na-Port).

Science.gov (United States)

Rogers, D R; Shem, R J

1992-12-01

Fan-shaped stippled burns were produced on the skin when a revolver whose barrel had been modified by the Mag-Na-Port process was fired twice with the side of the muzzle in contact. A grazing wound was produced by one bullet, and an oblique entry was produced by the other. The characteristics of Mag-Na-Port wounds and test shots are described, and these are compared with test shots from two other higher power revolvers.

Port performance evaluation tool based on microsimulation model

Directory of Open Access Journals (Sweden)

Tsavalista Burhani Jzolanda

2017-01-01

Full Text Available As port performance is becoming correlative to national competitiveness, the issue of port performance evaluation has significantly raised. Port performances can simply be indicated by port service levels to the ship (e.g., throughput, waiting for berthing etc., as well as the utilization level of equipment and facilities within a certain period. The performances evaluation then can be used as a tool to develop related policies for improving the port’s performance to be more effective and efficient. However, the evaluation is frequently conducted based on deterministic approach, which hardly captures the nature variations of port parameters. Therefore, this paper presents a stochastic microsimulation model for investigating the impacts of port parameter variations to the port performances. The variations are derived from actual data in order to provide more realistic results. The model is further developed using MATLAB and Simulink based on the queuing theory.

From tankers to tissues : tracking the degradation and fate of oil discharges in Port Valdez, Alaska

International Nuclear Information System (INIS)

Payne, J.R.; Braddock, J.F.; Bailey, J.; Ka'aihue, L.; Kuckertz, T.H.; Short, J.W.; Driskell, W.B.

2005-01-01

An average of 9 million gallons per day of oil-contaminated ballast water off loaded from tankers are treated at the Alyeska Pipeline Service Company Ballast Water Treatment Facility at the terminus of the Trans-Alaska Pipeline in Port Valdez, Alaska. This paper focuses on the results of 2 Prince William Sound Regional Citizens' Advisory Council monitoring programs which detail changes in the chemical composition of treated ballast water as it moves from tankers through the facility and subsequently traces the effluent hydrocarbons into the receiving environment of Port Valdez. The treatment facility involves gravity separation tanks, dissolved air flotation cells and biological treatment tanks. Effluent containing traces of volatile aromatics, including benzene, toluene, ethylbenzene and xylenes, low levels of oil, saturated hydrocarbons and polycyclic aromatic hydrocarbons is being continuously discharged to Port Valdez. Because of the extremely large average flow rate, low concentrations in the effluent can add up to a significant mass discharge. Samples from the facility were collected on 3 occasions. In March 2004, a limited pilot series of composite samples were collected from the effluent and the effluent to Port Valdez from a sampling port in the Fan/Meter Building. Second-round samples were collected from a wider suite of locations. A BIORATE assay study was completed during September 2004 and January 2005 field programs to measure degradation rates. The largest hydrocarbon pollution sources detected in samples from Port Valdez stations are correlated with an oil spill mishap at the terminal in 1994 and a sheen event in 1997. Apart from these events, concentrations from petrogenic sources are usually near or below the detection limits of the analytic methods used. However, on a routine basis, oil signals attributed to the facility effluent are detectable in mussel tissues at both Alyeska Marine Terminal and Gold Creek stations, and in sediments at Alyeska

Implantable port devices in paediatric oncology patients: A clinical experience from a tertiary care hospital

International Nuclear Information System (INIS)

Dogar, S.A.; Khan, M.A.M.

2013-01-01

Objective: To assess the frequency of infection of portacath in children having malignant tumours and undergoing chemotherapy, and to assess the association of the infection with already known risk factors. Methods: The retrospective review was conducted at Aga Khan University Hospital, Karachi, and involved patient data related to the period between January 2005 to December 2010. A questionnaire was designed to collect the required data. A total of 67 children were included having portacath inserted for chemotherapy. Children in which portacath was inserted under local anaesthesia in Radiology department, reinserted or inserted because of a reason other than childhood malignancy were excluded. SPSS 19 was used for statistical analysis. Results: Of the total, 46 (67%) patients were males and a majority of the total (n=31; 46%) was between 6-10 years of age. Besides, 42 (63%) patients had leukaemia, 7(11%) had lymphoma and 18(26%) had various solid tumours. Six (8.95%) ports were removed due to infection. There was significant difference between infection and non-infection groups with respect to absolute neutrophilic count levels (p <0.001). Positive association was found between low absolute neutrophilic count level (<500) and the occurrence of port infection. Conclusions: Port infection rate is higher in children with low absolute neutrophilic count. The issue needs to be addressed and one may have to alter the timings of port insertion. It is recommended to insert port when absolute neutrophilic count is normal. To further evaluate the subject, a multicentre trial must be conducted. (author)

[A new port catheter system of aluminum oxide ceramics].

Science.gov (United States)

Haindl, H; Schmoll, E; Willmann, G

1995-03-01

Implantable port catheter systems are becoming increasingly important, as they often permit out-patient treatment for many indications that would otherwise require hospitalization. Moreover, they also increase the safety/reliability of infusion therapy in critical inpatients. For a variety of reasons, the materials used so far, i.e. steel, titanium and various plastics have not been completely satisfactory. The main disadvantage of metallic systems is the formation of artefacts in tomographic images, while the shortcomings of plastics are mechanical, e.g. chip formation and early membrane failure. Against this background, a port catheter system made of alumina ceramic, which is largely free of the disadvantages of the other materials, was developed. The expected advantages in terms of complication rate and radiological artefacts, were fully confirmed by the evaluation of 160 monitored patients.

Analysis of laparoscopic port site complications: A descriptive study

Directory of Open Access Journals (Sweden)

Somu Karthik

2013-01-01

Full Text Available Context: The rate of port site complications following conventional laparoscopic surgery is about 21 per 100,000 cases. It has shown a proportional rise with increase in the size of the port site incision and trocar. Although rare, complications that occur at the port site include infection, bleeding, and port site hernia. Aims: To determine the morbidity associated with ports at the site of their insertion in laparoscopic surgery and to identify risk factors for complications. Settings and Design: Prospective descriptive study. Materials and Methods: In the present descriptive study, a total of 570 patients who underwent laparoscopic surgeries for various ailments between August 2009 and July 2011 at our institute were observed for port site complications prospectively and the complications were reviewed. Statistical Analysis Used: Descriptive statistical analysis was carried out in the present study. The statistical software, namely, SPSS 15.0 was used for the analysis of the data. Results: Of the 570 patients undergoing laparoscopic surgery, 17 (3% had developed complications specifically related to the port site during a minimum follow-up of three months; port site infection (PSI was the most frequent (n = 10, 1.8%, followed by port site bleeding (n = 4, 0.7%, omentum-related complications (n = 2; 0.35%, and port site metastasis (n = 1, 0.175%. Conclusions: Laparoscopic surgeries are associated with minimal port site complications. Complications are related to the increased number of ports. Umbilical port involvement is the commonest. Most complications are manageable with minimal morbidity, and can be further minimized with meticulous surgical technique during entry and exit.

Analysis of laparoscopic port site complications: A descriptive study

Science.gov (United States)

Karthik, Somu; Augustine, Alfred Joseph; Shibumon, Mundunadackal Madhavan; Pai, Manohar Varadaraya

2013-01-01

CONTEXT: The rate of port site complications following conventional laparoscopic surgery is about 21 per 100,000 cases. It has shown a proportional rise with increase in the size of the port site incision and trocar. Although rare, complications that occur at the port site include infection, bleeding, and port site hernia. AIMS: To determine the morbidity associated with ports at the site of their insertion in laparoscopic surgery and to identify risk factors for complications. SETTINGS AND DESIGN: Prospective descriptive study. MATERIALS AND METHODS: In the present descriptive study, a total of 570 patients who underwent laparoscopic surgeries for various ailments between August 2009 and July 2011 at our institute were observed for port site complications prospectively and the complications were reviewed. STATISTICAL ANALYSIS USED: Descriptive statistical analysis was carried out in the present study. The statistical software, namely, SPSS 15.0 was used for the analysis of the data. RESULTS: Of the 570 patients undergoing laparoscopic surgery, 17 (3%) had developed complications specifically related to the port site during a minimum follow-up of three months; port site infection (PSI) was the most frequent (n = 10, 1.8%), followed by port site bleeding (n = 4, 0.7%), omentum-related complications (n = 2; 0.35%), and port site metastasis (n = 1, 0.175%). CONCLUSIONS: Laparoscopic surgeries are associated with minimal port site complications. Complications are related to the increased number of ports. Umbilical port involvement is the commonest. Most complications are manageable with minimal morbidity, and can be further minimized with meticulous surgical technique during entry and exit. PMID:23741110

Vectorization, parallelization and porting of nuclear codes (porting). Progress report fiscal 1998

International Nuclear Information System (INIS)

Nemoto, Toshiyuki; Kawai, Wataru; Ishizuki, Shigeru; Kawasaki, Nobuo; Kume, Etsuo; Adachi, Masaaki; Ogasawara, Shinobu

2000-03-01

Several computer codes in the nuclear field have been vectorized, parallelized and transported on the FUJITSU VPP500 system, the AP3000 system and the Paragon system at Center for Promotion of Computational Science and Engineering in Japan Atomic Energy Research Institute. We dealt with 12 codes in fiscal 1998. These results are reported in 3 parts, i.e., the vectorization and parallelization on vector processors part, the parallelization on scalar processors part and the porting part. In this report, we describe the porting. In this porting part, the porting of Monte Carlo N-Particle Transport code MCNP4B2 and Reactor Safety Analysis code RELAP5 on the AP3000 are described. In the vectorization and parallelization on vector processors part, the vectorization of General Tokamak Circuit Simulation Program code GTCSP, the vectorization and parallelization of Molecular Dynamics Ntv Simulation code MSP2, Eddy Current Analysis code EDDYCAL, Thermal Analysis Code for Test of Passive Cooling System by HENDEL T2 code THANPACST2 and MHD Equilibrium code SELENEJ on the VPP500 are described. In the parallelization on scalar processors part, the parallelization of Monte Carlo N-Particle Transport code MCNP4B2, Plasma Hydrodynamics code using Cubic Interpolated propagation Method PHCIP and Vectorized Monte Carlo code (continuous energy model/multi-group model) MVP/GMVP on the Paragon are described. (author)

Compliance with dental treatment recommendations by rural paediatric patients after a live-video teledentistry consultation: A preliminary report.

Science.gov (United States)

McLaren, Sean W; Kopycka-Kedzierawski, Dorota T

2016-04-01

The purpose of this research was to assess the compliance rate with recommended dental treatment by rural paediatric dental patients after a live-video teledentistry consultation. A retrospective dental chart review was completed for 251 rural paediatric patients from the Finger Lakes region of New York State who had an initial teledentistry appointment with a paediatric dentist located remotely at the Eastman Institute for Oral Health in Rochester, NY. The recommended treatment modalities were tabulated and comprehensive dental treatment completion rates were obtained. The recommended treatment modality options of: treatment in the paediatric dental clinic; treatment using nitrous oxide anxiolysis; treatment with oral sedation; treatment in the operating room with general anaesthesia; or teleconsultation were identified for the 251 patients. Compliance rates for completed dental treatment based on initial teleconsultation recommendations were: 100% for treatment in the paediatric dental clinic; 56% for nitrous oxide patients; 87% for oral sedation; 93% for operating room; and 90% for teleconsultations. The differences in the compliance rates for all treatment modalities were not statistically significant (Fisher's exact test, p > 0.05). Compliance rates for completed comprehensive dental treatment for this rural population of paediatric dental patients were quite high, ranging from 56% to 100%, and tended to be higher when treatment was completed in fewer visits. Live-video teledentistry consultations conducted among rural paediatric patients and a paediatric dentist in the specialty clinic were feasible options for increasing dental treatment compliance rates when treating complex paediatric dental cases. © The Author(s) 2015.

Single port laparoscopic ileocaecal resection for Crohn's disease: a multicentre comparison with multi-port laparoscopy

NARCIS (Netherlands)

Carvello, M.; de Groof, E. J.; de Buck van Overstraeten, A.; Sacchi, M.; Wolthuis, A. M.; Buskens, C. J.; D'Hoore, A.; Bemelman, W. A.; Spinelli, A.

2018-01-01

AimSingle port (SP) ileocaecal resection (ICR) is an established technique but there are no large studies comparing SP and multi-port (MP) laparoscopic surgery in Crohn's disease (CD). The aim of this study was to compare postoperative pain scores and analgesia requirements after SP and MP

Mechanical characteristics of plastic base Ports and impact on flushing efficacy

Directory of Open Access Journals (Sweden)

Guiffant G

2017-01-01

Full Text Available Gérard Guiffant,1 Patrice Flaud,1 Laurent Royon,1 Espérie Burnet,2 Jacques Merckx1–3 1University Paris Diderot, Biofluidic Group, UMR CNRS, 2Pulmonary Department and Adult Cystic Fibrosis Centre, Cochin Hospital, 3University Teaching Hospital, Necker-Enfants Malades, Paris, France Background: Three types of totally implantable venous access devices, Ports, are currently in use: titanium, plastic (polyoxymethylene, POM, and mixed (titanium base with a POM shell. Physics theory suggests that the interaction between a non-coring needle (NCN, made of stainless steel and a plastic base would lead to the stronger material (steel altering the more malleable material (plastic. Objectives: To investigate whether needle impacts can alter a plastic base’s surface, thus potentially reducing flushing efficacy. Study design and methods: A Port made of POM was punctured 200 times with a 19-gauge NCN. Following the existing guidelines, the needle tip pricked the base with each puncture. The Port’s base was then examined using a two-dimensional optical instrument, and a bi-dimensional numerical simulation using COMSOL® was performed to investigate potential surface irregularities and their impact on fluid flow. Results: Each needle impact created a hole (mean depth, 0.12 mm with a small bump beside it (mean height, 0.02 mm the Reynolds number Rek≈10. A numerical simulation of the one hole/bump set showed that the flushing efficacy was 60% that of flushing along a flat surface. Discussion: In clinical practice, the number of times a Port is punctured depends on patient and treatment characteristics, but each needle impact on the plastic base may increase the risk of decreased flushing effectiveness. Therefore, the more a plastic Port is accessed, the greater the risk of microorganisms, blood products, and medication accumulation. Conclusions: Multiple needle impacts created an irregular surface on the Port’s base, which decreased flushing efficacy

Port Sunlight, essai architectural et social

OpenAIRE

Machet, Laurence

2017-01-01

The purpose of this article is to examine the city of Port Sunlight, its history, design and originality. Created by William Lever in 1888 in order to house his newly-built soap factory, Port Sunlight is part of the numerous “factory villages” built in the wake of the industrial revolution according to philanthropic and utilitarian principles. But this article intends to show that Port Sunlight differs from other factory towns. Its careful design, elaborate architecture and public facilities ...

Development of a Breast Cancer Treatment Program in Port-au-Prince, Haiti: Experiences From the Field

Science.gov (United States)

Libby, Rachel; Patberg, Elizabeth; Gabriel, Dieudina; Al-Quran, Samer; Kasher, Matthew; Heldermon, Coy; Daily, Karen; Auguste, Joseph R.; Suprien, Valery C.; Hurley, Judith

2016-01-01

Purpose The nonprofit Project Medishare launched a breast cancer treatment program in Port-au-Prince in July 2013 to address the demand for breast cancer care in Haiti. We outline the development of the program, highlight specific challenges, and discuss key considerations for others working in global oncology. Methods We reflected on our experiences in the key areas of developing partnerships, building laboratory capacity, conducting medical training, using treatment algorithms, and ensuring access to safe, low-cost chemotherapy drugs. We also critically reviewed our costs and quality measures. Results The program has treated a total of 139 patients with breast cancer with strong adherence to treatment regimens in 85% of patients. In 273 chemotherapy administrations, no serious exposure or adverse safety events were reported by staff. The mortality rate for 94 patients for whom we have complete data was 24% with a median survival time of 53 months. Our outcome data were likely influenced by stage at presentation, with more than half of patients presenting more than 12 months after first noticing a tumor. Future efforts will therefore focus on continuing to improve the level of care, while working with local partners to spread awareness, increase screening, and get more women into care earlier in the course of their disease. Conclusion Our experiences may inform others working to implement protocol-based cancer treatment programs in resource-poor settings and can provide valuable lessons learned for future global oncology efforts. PMID:28717677

Port-Orford-Cedar Root Disease

Science.gov (United States)

Lewis F. Roth; Robert D. Jr. Harvey; John T. Kliejunas

1987-01-01

The most serious disease of Port-Orford-cedar (Chamaecyparis lawsoniana (A. Murr.) Parl.) is a root disease caused by the fungus Phytophthora lateralis. Nursery stock, ornamentals, and timber trees are subject to attack. Other species of Chamaecyparis are less susceptible than Port-Orford-cedar, and trees of other genera are not affected.

Port pricing : principles, structure and models

OpenAIRE

Meersman, Hilde; Strandenes, Siri Pettersen; Van de Voorde, Eddy

2014-01-01

Price level and price transparency are input to shippers’ choice of supply chain and transport mode. In this paper, we analyse current port pricing structures in the light of the pricing literature and consider opportunities for improvement. We present a detailed overview of pricing criteria, who sets prices and who ultimately foots the bill for port-of-call charges, cargo-handling fees and congestion charges. Current port pricing practice is based on a rather linear structure and fails to in...

Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring

DEFF Research Database (Denmark)

Kappos, Ludwig; Bates, David; Edan, Gilles

2011-01-01

Natalizumab, a highly specific a4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very...

Ports Primer: 7.1 Environmental Impacts

Science.gov (United States)

Port operations can lead to environmental impacts on air, water and land. Many communities with environmental justice concerns also experience disparities in health outcomes that they attribute to exposure to emissions from port operations.

Ports Primer: 7.0 Environmental Impacts

Science.gov (United States)

Port operations can lead to environmental impacts on air, water and land. Many communities with environmental justice concerns also experience disparities in health outcomes that they attribute to exposure to emissions from port operations.

Update: cholera--Western Hemisphere, and recommendations for treatment of cholera.

Science.gov (United States)

1991-08-16

Epidemic cholera appeared in Peru in January 1991 and subsequently spread to Ecuador, Colombia, Chile, Brazil, Mexico, and Guatemala. Cholera can be a severe, life-threatening illness but is highly preventable and easily treated; however, few health-care practitioners in the United States have experience identifying and treating cholera. This report provides an update on cholera in the Western Hemisphere and provides recommendations on the clinical diagnosis and treatment of cholera in the United States.

Colonial Origins of the Port of Buenaventura

Directory of Open Access Journals (Sweden)

Alonso Valencia Llano

2014-07-01

Full Text Available This article studies the origins of the Port of Buenaventura in the New Kingdom of Granada. It begins with the process of exploration of the coastal territory in order to highlight the different sites in which it was situated, demonstrating that it began as a river port and was later resituated and gradually converted into a maritime port. In addition, this article analyzes the problems it faced, such as the dificulty of communication with the interior of the country, the indigenous resistance that caused the destruction of the town, and inally the necessity of populating the zone with black slaves in order to exploit the mining border. This study also discusses how this port was controlled by the elite of the city of Cali, until the Republican period when it became the sole Colombian port on the Paciic Ocean.

Ports Primer: 3.3 Federal and International Governance

Science.gov (United States)

State and local governments are important players in port governance and in oversight of transportation projects that may affect ports. Private corporations may also play a role if they lease or own a terminal at a port.

An integrated port camera and display system for laparoscopy.

Science.gov (United States)

Terry, Benjamin S; Ruppert, Austin D; Steinhaus, Kristen R; Schoen, Jonathan A; Rentschler, Mark E

2010-05-01

In this paper, we built and tested the port camera, a novel, inexpensive, portable, and battery-powered laparoscopic tool that integrates the components of a vision system with a cannula port. This new device 1) minimizes the invasiveness of laparoscopic surgery by combining a camera port and tool port; 2) reduces the cost of laparoscopic vision systems by integrating an inexpensive CMOS sensor and LED light source; and 3) enhances laparoscopic surgical procedures by mechanically coupling the camera, tool port, and liquid crystal display (LCD) screen to provide an on-patient visual display. The port camera video system was compared to two laparoscopic video systems: a standard resolution unit from Karl Storz (model 22220130) and a high definition unit from Stryker (model 1188HD). Brightness, contrast, hue, colorfulness, and sharpness were compared. The port camera video is superior to the Storz scope and approximately equivalent to the Stryker scope. An ex vivo study was conducted to measure the operative performance of the port camera. The results suggest that simulated tissue identification and biopsy acquisition with the port camera is as efficient as with a traditional laparoscopic system. The port camera was successfully used by a laparoscopic surgeon for exploratory surgery and liver biopsy during a porcine surgery, demonstrating initial surgical feasibility.

Overtopping hazards to port activities: Application of a new methodology to risk management (POrt Risk MAnagement Tool)

International Nuclear Information System (INIS)

Alises, Ana; Molina, Rafael; Gómez, Rebeca; Pery, Pascual; Castillo, Carmen

2014-01-01

In the past 20 years, the need of ports to serve a fleet whose dimensions are continuously increasing due to economies of scale, has derived on a port infrastructures growth with a trend to look for greater drafts at deeper waters and therefore the protection structures built in the last years have been increasingly exposed to severer maritime climate action. Consequently, overtopping phenomenon has been identified as a potential risk factor able to cause structural damages and operative failure modes to vulnerable economic activities located at these port facilities. Port activities must be developed ensuring operative and safety conditions what imply reducing uncertainties of overtopping phenomena by using prediction methods which may allow overtopping risk management. This paper provides a risk assessment methodology which is integrated into an overtopping risk management framework to cope with safety problems in port exploitation. Overtopping risk value is measured by combining probability of occurrence of an undesirable event together with its consequences, estimated in terms of costs or delays and given in base of the vulnerability of the affected port system. The development of this methodology is described and finally applied to a real case study what seems to reinforce the validity of the proposed method to overtopping risk assessment. - Highlights: • Infrastructure risk assessment involves both probabilistic and economic techniques. • Risk equation is posed by the combination of probability, vulnerability and cost. • Port infrastructures' vulnerability level depends on climate agents' action. • Economic value of natural hazards consequences is linked with vulnerability level. • Project planning process should be done taking into account the project's risk distribution

Slewing Port Jib Cranes

OpenAIRE

Boris Visočnik; Stojan Kravanja

2002-01-01

The paper presents slewing port cranes with a luffing jib. The advantages of slewing port jib cranes are high lifting capacities, high speeds of re-loading and excellent mobility since they are capable of load lifting, travelling, luffing and slewing. The paper gives a detailed description of their characteristics such as the highest reached load-carrying capacities, speeds of motion and accelerations. It also presents the crane assembly, driving mechanisms, loads and load cases, transport by...

Securing a port's future through Circular Economy: Experiences from the Port of Gävle in contributing to sustainability.

Science.gov (United States)

Carpenter, Angela; Lozano, Rodrigo; Sammalisto, Kaisu; Astner, Linda

2018-03-01

Ports are an important player in the world, due to their role in global production and distributions systems. They are major intermodal transport hubs, linking the sea to the land. For all ports, a key requirement for commercial and economic viability is to retain ships using them and to remain accessible to those ships. Ports need to find approaches to help them remain open. They must ensure their continued economic viability. At the same time, they face increasing pressure to become more environmentally and socially conscious. This paper examines the approach taken by the Port of Gävle, Sweden, which used contaminated dredged materials to create new land using principles of Circular Economy. The paper demonstrates that using Circular Economy principles can be a viable way of securing a port's future and contributing to its sustainability, and that of the city/region where it operates. Copyright © 2018 Elsevier Ltd. All rights reserved.

Queuing theory models used for port equipment sizing

Science.gov (United States)

Dragu, V.; Dinu, O.; Ruscă, A.; Burciu, Ş.; Roman, E. A.

2017-08-01

The significant growth of volumes and distances on road transportation led to the necessity of finding solutions to increase water transportation market share together with the handling and transfer technologies within its terminals. It is widely known that the biggest times are consumed within the transport terminals (loading/unloading/transfer) and so the necessity of constantly developing handling techniques and technologies in concordance with the goods flows size so that the total waiting time of ships within ports is reduced. Port development should be achieved by harmonizing the contradictory interests of port administration and users. Port administrators aim profit increase opposite to users that want savings by increasing consumers’ surplus. The difficulty consists in the fact that the transport demand - supply equilibrium must be realised at costs and goods quantities transiting the port in order to satisfy the interests of both parties involved. This paper presents a port equipment sizing model by using queueing theory so that the sum of costs for ships waiting operations and equipment usage would be minimum. Ship operation within the port is assimilated to a mass service waiting system in which parameters are later used to determine the main costs for ships and port equipment.

Perceptions of Infertility - A Survey of Urban Residents in Port Harcourt

African Journals Online (AJOL)

Objective: Societal influence on infertile couples usually stems from what is known or perceived about the causes, risk factors and treatment of infertility in the population. This study aimed to investigate perceptions of infertility among urban residents of Port Harcourt. Materials and Methods: A cross-sectional, ...

Adding some context to port marketing: Exploring the content and measurement of market orientation in the port industry

OpenAIRE

Kounoupas, Evangelos; Pardali, Angeliki

2015-01-01

Understanding and responding to customer needs is the essence of the marketing concept and as such it has been discussed in various fields of business and economic literature. Port economics and management literature has thoroughly investigated areas such as port efficiency and effectiveness, understanding and overcoming competitive pressures and identifying the sources of potential sustainable competitive advantage. In line with this discussion, albeit with a significant time delay, port eco...

Consensus Recommendations for Treatment Strategies in Indians Using Botulinum Toxin and Hyaluronic Acid Fillers

Directory of Open Access Journals (Sweden)

Krishan Mohan Kapoor, MCh, DNB

2017-12-01

Conclusions:. These recommendations give physicians treating Indians worldwide a better understanding of their unique facial characteristics and provide treatment strategies to achieve optimal aesthetic outcomes.

A two-temperature model for selective photothermolysis laser treatment of port wine stains

International Nuclear Information System (INIS)

Li, D.; Wang, G.X.; He, Y.L.; Kelly, K.M.; Wu, W.J.; Wang, Y.X.; Ying, Z.X.

2013-01-01

Selective photothermolysis is the basic principle for laser treatment of vascular malformations such as port wine stain birthmarks (PWS). During cutaneous laser surgery, blood inside blood vessels is heated due to selective absorption of laser energy, while the surrounding normal tissue is spared. As a result, the blood and the surrounding tissue experience a local thermodynamic non-equilibrium condition. Traditionally, the PWS laser treatment process was simulated by a discrete-blood-vessel model that simplifies blood vessels into parallel cylinders buried in a multi-layer skin model. In this paper, PWS skin is treated as a porous medium made of tissue matrix and blood in the dermis. A two-temperature model is constructed following the local thermal non-equilibrium theory of porous media. Both transient and steady heat conduction problems are solved in a unit cell for the interfacial heat transfer between blood vessels and the surrounding tissue to close the present two-temperature model. The present two-temperature model is validated by good agreement with those from the discrete-blood-vessel model. The characteristics of the present two-temperature model are further illustrated through a comparison with the previously-used homogenous model, in which a local thermodynamic equilibrium assumption between the blood and the surrounding tissue is employed. -- Highlights: • Local thermal non-equilibrium theory was adapted in field of laser dermatology. • Transient interfacial heat transfer coefficient between two phases is presented. • Less PWS blood vessel micro-structure information is required in present model. • Good agreement between present model and classical discrete-blood-vessel model

Feasibility of Reduced Port Laparoscopic Colectomy for Colon Cancer.

Science.gov (United States)

Tsutsumi, Soichi; Morita, Hiroki; Fujii, Takaaki; Suto, Toshinaga; Yajima, Reina; Takada, Takahiro; Asao, Takayuki; Kuwano, Hiroyuki

2015-06-01

Reduced port laparoscopic surgery has recently emerged as a method to improve the cosmetic results of conventional laparoscopic surgery. We reported our technique of reduced port laparoscopic colectomy using 3-port and short-time outcomes. Between 2005 and 2012, we performed 161 reduced port laparoscopic colectomies using the 3-port technique. Data analyzed in-cluded age, gender, body mass index (BMI), duration of surgery, number of harvested lymph nodes, and duration of hospital stay. All of the cases were successfully performed using the 3-port procedure. The median durations of surgery and postoperative hospital stay were 140 mm (range 75-463 mm) and 9 days (range 5-38 days), respectively. No mortality was associated with this technique. Reduced port laparoscopic colectomy is feasible and may have advantages over conventional laparoscopic colectomy.

[Home anti-cancer therapy with a venous port].

Science.gov (United States)

Muto, A; Ashino, Y; Miyazawa, M; Sato, M; Kanno, A; Kawahara, Y; Fujita, Y; Matsushiro, T

2000-12-01

Home anti-cancer chemotherapy and palliation in the terminal stage were performed for patients with advanced cancer of the digestive system, using a venous port implanted beneath the skin via the subclavian vein. Patients under 75 years of age (5 with esophageal, 61 gastric, 59 colorectal, 5 cholangio, 5 pancreatic, 1 hepatic and 1 ileal cancer) were treated. With two portable balloon pumps, continuous intravenous infusion of 5-FU (300 or 400 mg/body/day) combined low-dose injection of cisplatin (5 mg/body/day) was continued for 10 days, and repeated 3 times for 6 weeks. The response rate was 17.9% in 78 patients according to valuation of the tumor mass. In 119 patients also undergoing a tumor marker evaluation, an effect was seen in 26.1%. No severe side effects such as renal dysfunction or bone marrow suppression were seen, and no special infusion was needed. Therefore, such treatment can be continued for a long time. Use of a venous port should make easy the switchover to HPN and the amelioration of the symptoms of the terminal stage, such as pain, and helps patients cope with the worry. Therefore, the present technique is useful in a series of cancer treatments including surgery, chemotherapy and the amelioration of symptoms.

Classification and prediction of port variables

Energy Technology Data Exchange (ETDEWEB)

Molina Serrano, B.

2016-07-01

Many variables are included in planning and management of port terminals. They can beeconomic, social, environmental and institutional. Agent needs to know relationshipbetween these variables to modify planning conditions. Use of Bayesian Networks allowsfor classifying, predicting and diagnosing these variables. Bayesian Networks allow forestimating subsequent probability of unknown variables, basing on know variables.In planning level, it means that it is not necessary to know all variables because theirrelationships are known. Agent can know interesting information about how port variablesare connected. It can be interpreted as cause-effect relationship. Bayesian Networks can beused to make optimal decisions by introduction of possible actions and utility of theirresults.In proposed methodology, a data base has been generated with more than 40 port variables.They have been classified in economic, social, environmental and institutional variables, inthe same way that smart port studies in Spanish Port System make. From this data base, anetwork has been generated using a non-cyclic conducted grafo which allows for knowingport variable relationships - parents-children relationships-. Obtained network exhibits thateconomic variables are – in cause-effect terms- cause of rest of variable typologies.Economic variables represent parent role in the most of cases. Moreover, whenenvironmental variables are known, obtained network allows for estimating subsequentprobability of social variables.It has been concluded that Bayesian Networks allow for modeling uncertainty in aprobabilistic way, even when number of variables is high as occurs in planning andmanagement of port terminals. (Author)

Occupational hazards to health of port workers.

Science.gov (United States)

Wang, Yukun; Zhan, Shuifen; Liu, Yan; Li, Yan

2017-12-01

The aim of this article is to reduce the risk of occupational hazards and improve safety conditions by enhancing hazard knowledge and identification as well as improving safety behavior for freight port enterprises. In the article, occupational hazards to health and their prevention measures of freight port enterprises have been summarized through a lot of occupational health evaluation work, experience and understanding. Workers of freight port enterprises confront an equally wide variety of chemical, physical and psychological hazards in production technology, production environment and the course of labor. Such health hazards have been identified, the risks evaluated, the dangers to health notified and effective prevention measures which should be put in place to ensure the health of the port workers summarized. There is still a long way to go for the freight port enterprises to prevent and control the occupational hazards. Except for occupational hazards and their prevention measures, other factors that influence the health of port workers should also be paid attention to, such as age, work history, gender, contraindication and even the occurrence and development rules of occupational hazards in current production conditions.

INSTITUTIONAL AND MANAGEMENT STRUCTURE OF RUSSIAN ARCTIC SEA PORTS

Directory of Open Access Journals (Sweden)

P. A. Bryzgalov

2012-01-01

Full Text Available Institutional and management structure of any sea port is a system of interaction between commercial enterprises engaged in cargo operations in port, a subsidiary of Rosmorport FSUE, Sea Port Authority and a number of services (immigration, customs and sanitary-veterinary. Institutional and management structure of some Russian Arctic sea ports is significantly different from the typical one resulting in management problems for these socially significant objects of the Russian Arctic. A plan is proposed to improve the organizational and administrative structure of these ports based on the use of domestic and international experience in port infrastructure management including effective cooperation between the state and the private business.

Peripheral Venous Access Ports: Outcomes Analysis in 109 Patients

International Nuclear Information System (INIS)

Bodner, Leonard J.; Nosher, John L.; Patel, Kaushik M.; Siegel, Randall L.; Biswal, Rajiv; Gribbin, Christopher E.; Tokarz, Robert

2000-01-01

Purpose: To perform a retrospective outcomes analysis of central venous catheters with peripheral venous access ports, with comparison to published data.Methods: One hundred and twelve central venous catheters with peripherally placed access ports were placed under sonographic guidance in 109 patients over a 4-year period. Ports were placed for the administration of chemotherapy, hyperalimentation, long-term antibiotic therapy, gamma-globulin therapy, and frequent blood sampling. A vein in the upper arm was accessed in each case and the catheter was passed to the superior vena cava or right atrium. Povidone iodine skin preparation was used in the first 65 port insertions. A combination of Iodophor solution and povidone iodine solution was used in the last 47 port insertions. Forty patients received low-dose (1 mg) warfarin sodium beginning the day after port insertion. Three patients received higher doses of warfarin sodium for preexistent venous thrombosis. Catheter performance and complications were assessed and compared with published data.Results: Access into the basilic or brachial veins was obtained in all cases. Ports remained functional for a total of 28,936 patient days. The port functioned in 50% of patients until completion of therapy, or the patient's expiration. Ports were removed prior to completion of therapy in 18% of patients. Eleven patients (9.9% of ports placed) suffered an infectious complication (0.38 per thousand catheter-days)-in nine, at the port implantation site, in two along the catheter. In all 11 instances the port was removed. Port pocket infection in the early postoperative period occurred in three patients (4.7%) receiving a Betadine prep vs two patients (4.2%) receiving a standard O.R. prep. This difference was not statistically significant (p = 0.9). Venous thrombosis occurred in three patients (6.8%) receiving warfarin sodium and in two patients (3%) not receiving warfarin sodium. This difference was not statistically significant

Soil contamination issues at U.S. ports

International Nuclear Information System (INIS)

Rice, D.W.; Hagner, D.

1991-01-01

This paper reports that seven large and medium size west coast ports were surveyed during August 1990 to determine their involvement with hydrocarbon contaminated soils and activities associated with the characterization and remediation of these soils. All ports surveyed indicated that hey have hydrocarbon contaminated soil problems. Although other west coast ports do not have the scale of petroleum transfer and storage facilities that the Prot of Los Angeles has, all ports had tenants with bulk oil or fuel storage in aboveground tanks and were undertaking characterization and remediation work. Hydrocarbon contaminated soil problems were associated with these facilities or with decommissioned facilities of this type

Analyzing Growth Opportunity of Port from the Resource-based Perspective The Case of Port of Tanjung Pelepas Malaysia

OpenAIRE

Subhan, Muhammad; Abdul Ghani, Ahmad Bashawir

2008-01-01

Capturing growth opportunity has become a major integral activity of any port to sustain growth and competitive advantage. One of the famous strategies in leveraging sustainable growth and competitive advantage is the resource-based theory application into port strategic management, viewing resources of the port (internal and external) and its capabilities as the sources for achieving competitive advantage. In this study, we attempt to identify, exploit, and analyze growth opportunity of a Ma...

Step-wise integration of single-port laparoscopic surgery into routine colorectal surgical practice by use of a surgical glove port.

Science.gov (United States)

Hompes, R; Lindsey, I; Jones, O M; Guy, R; Cunningham, C; Mortensen, N J; Cahill, R A

2011-06-01

The cost associated with single-port laparoscopic access devices may limit utilisation of single-port laparoscopic surgery by colorectal surgeons. This paper describes a simple and cheap access modality that has facilitated the widespread adoption of single-port technology in our practice both as a stand-alone procedure and as a useful adjunct to traditional multiport techniques. A surgical glove port is constructed by applying a standard glove onto the rim of the wound protector/retractor used during laparoscopic resectional colorectal surgery. To illustrate its usefulness, we present our total experience to date and highlight a selection of patients presenting for a range of elective colorectal surgery procedures. The surgical glove port allowed successful completion of 25 single-port laparoscopic procedures (including laparoscopic adhesiolysis, ileo-rectal anastomosis, right hemicolectomy, total colectomy and low anterior resection) and has been used as an adjunct in over 80 additional multiport procedures (including refashioning of a colorectal anastomosis made after specimen extraction during a standard multiport laparoscopic anterior resection). This simple, efficient device can allow use of single-port laparoscopy in a broader spectrum of patients either in isolation or in combination with multiport surgery than may be otherwise possible for economic reasons. By separating issues of cost from utility, the usefulness of the technical advance inherent within single-port laparoscopy for colorectal surgery can be better appreciated. We endorse the creative innovation inherent in this approach as surgical practice continues to evolve for ever greater patient benefit.

78 FR 24069 - Safety Zone; 12th Annual Saltwater Classic; Port Canaveral Harbor; Port Canaveral, FL

Science.gov (United States)

2013-04-24

... under Executive Order 13045, Protection of Children from Environmental Health Risks and Safety Risks. This rule is not an economically significant rule and does not create an environmental risk to health...-AA00 Safety Zone; 12th Annual Saltwater Classic; Port Canaveral Harbor; Port Canaveral, FL AGENCY...

Research for Foreign Advanced Ports for Protection and Development Experience

Science.gov (United States)

Zhang, Lu; Tian, Mingjing; Zhao, Junjie; Shou, Youping; Wang, Ning; Qiao, Jianzhe; Li, Guanglou

2018-04-01

Into the twenty-first century, the process globalization of economic and trade is getting faster and faster, As of 2014, China's annual port trading amount topped the world, But in the port of environmental protection sustainable development approach with foreign advanced port environmental management concept has a big gap. Combined with the present situation of modern ports in China. Drawing lessons from foreign advanced environmental protection idea of port, in order to promote the protection of port environment in our country. The experience of protection and development of foreign advanced port environment will be discussed and discussed.

The Implications of the Growth of Port Throughput on the Port Capacity: the Case of Malaysian Major Container Seaports

Directory of Open Access Journals (Sweden)

J. Jeevan

2015-12-01

Full Text Available Malaysia, situated between East and West, is an interface in world maritime trade, playing a crucial role in the business of moving container boxes in South-eastern parts of Asia. The prominent container terminals in Malaysia such as Port Klang and Port of Tanjung Pelepas are positioned among the top twenty ports in terms of volume handled. The annual average growth of throughputs in Malaysian container ports increased more than three-fold from the year 2000 to 2010. Within this context, the development of Malaysian seaports has been significantly influenced by three forces: increased use of containerisation, significant growth in domestic economic activities and ever-changing patterns in both supply and demand chains, all of which have led to increased transshipment activities and altered shipping routes. This phenomenon has brought dynamic change to Malaysian container ports, resulting in the establishment of new terminals and adapting emerging technology to enhance the ports' ability to accommodate larger vessels and an increased number of containers. This paper aims to present the development of Malaysian container seaports by addressing changes to acreage size and handling volumes during the last three decades. The results of the analysis suggest that major Malaysian ports are experiencing an exponential growth in container trade with the expansion of port capacity following trade growth and need effective strategies to reduce the operational pressures of Malaysian seaports. The results of this research offer directions for development strategies of seaports by utilising the existing inland freight facilities as an effective strategy for capacity enhancement and develop efficient distribution network to meet future demands.

Vectorization, parallelization and porting of nuclear codes on the VPP500 system (porting). Progress report fiscal 1996

Energy Technology Data Exchange (ETDEWEB)

Nemoto, Toshiyuki [Fujitsu Ltd., Tokyo (Japan); Kawasaki, Nobuo; Tanabe, Hidenobu [and others

1998-01-01

Several computer codes in the nuclear field have been vectorized, parallelized and transported on the FUJITSU VPP500 system at Center for Promotion of Computational Science and Engineering in Japan Atomic Energy Research Institute. These results are reported in 3 parts, i.e., the vectorization part, the parallelization part and the porting part. In this report, we describe the porting. In this porting part, the porting of reactor safety analysis code RELAP5/MOD3.2 and RELAP5/MOD3.2.1.2, nuclear data processing system NJOY and 2-D multigroup discrete ordinate transport code TWOTRAN-II are described. And also, a survey for the porting of command-driven interactive data analysis plotting program IPLOT are described. In the parallelization part, the parallelization of 2-Dimensional relativistic electromagnetic particle code EM2D, Cylindrical Direct Numerical Simulation code CYLDNS and molecular dynamics code for simulating radiation damages in diamond crystals DGR are described. And then, in the vectorization part, the vectorization of two and three dimensional discrete ordinates simulation code DORT-TORT, gas dynamics analysis code FLOWGR and relativistic Boltzmann-Uehling-Uhlenbeck simulation code RBUU are described. (author)

A modified method using a two-port approach for accessing the hilar vasculature without transferring an endostapler from camera port to utility port during thoracoscopic right upper lobectomy.

Science.gov (United States)

Jiao, W; Zhao, Y; Xuan, Y; Wang, M

2015-02-01

For thoracoscopic upper lobectomies, most cutting endostaplers must be inserted through the camera port when using a two-port approach. Access to the hilar vasculature through only the utility port remains a challenge. In this study, we describe a procedure to access the hilar vasculature without transferring the endostapler site during a thoracoscopic right upper lobectomy. A 2.5-cm utility anterior incision was made in the fourth intercostal space. The posterior mediastinal visceral pleura were dissected to expose the posterior portion of the right upper bronchus and the anterior trunk of the right pulmonary artery. The pleura over the right hilar vasculature were then peeled with an electrocoagulation hook. The anterior trunk of the right pulmonary artery was then transected with a cutting endostapler through the utility port firstly. This crucial maneuver allowed the endostapler access to the right upper lobe pulmonary vein. The hilar structures were then easily handled in turn. This novel technique was performed successfully in 32 patients, with no perioperative deaths. The average operation time was 120.6 min (range 75-180 min). This novel technique permits effective control of the hilar vessels through the utility port, enabling simple, safe, quick and effective resection.

Arthroscopic Broström repair with Gould augmentation via an accessory anterolateral port for lateral instability of the ankle.

Science.gov (United States)

Matsui, Kentaro; Takao, Masato; Miyamoto, Wataru; Innami, Ken; Matsushita, Takashi

2014-10-01

Although several arthroscopic surgical techniques for the treatment of lateral instability of the ankle have been introduced recently, some concern remains over their procedural complexity, complications, and unclear clinical outcomes. We have simplified the arthroscopic technique of Broström repair with Gould augmentation. This technique requires only two small skin incisions for two ports (medial midline and accessory anterolateral ports), without needing a percutaneous procedure or extension of the skin incisions. The anterior talofibular ligament is reattached to its anatomical footprint on the fibula with suture anchor, under arthroscopic view. The inferior extensor retinaculum is directly visualized through the accessory anterolateral port and is attached to the fibula with another suture anchor under arthroscopic view via the anterolateral port. The use of two small ports offers a procedure that is simple to perform and less morbid for patients.

Pre-Operative Skin Antisepsis with Chlorhexidine Gluconate and Povidone-Iodine to Prevent Port-Site Infection in Laparoscopic Cholecystectomy: A Prospective Study.

Science.gov (United States)

Spaziani, Erasmo; Di Filippo, Annalisa; Orelli, Simone; Fiorini, Flavia; Spaziani, Martina; Tintisona, Orlando; Torcasio, Angelo; De Cesare, Alessandro; Picchio, Marcello

2018-04-01

Skin preparation with antiseptic agents is commonly recommended for incisional site cleansing before surgery. We present the result of a prospective case series submitted to a scheduled pre-operative antiseptic procedure combining chlorhexidine gluconate and povidone-iodine before elective laparoscopic cholecystectomy. Consecutive patients underwent pre-operative standardized cleansing of the operation site combining chlorhexidine gluconate and povidone-iodine. Patients were reviewed one week and four weeks post-operatively. Post-operative infection was observed in seven patients (4.3%). All observed infections were port-site infections, always located at the level of the umbilical incision. In all cases infections involved skin and subcutaneous tissue. Staphylococcus aureus was isolated in five patients (71.4%) and miscellaneous aerobic gram-positive bacteria in two subjects (28.6%). Post-operative hospital stay was the only factor significantly associated with the development of port-site infections. Port-site infections are a common complication after elective laparoscopic cholecystectomy. The proposed pre-operative disinfection procedure is effective in reducing port-site infections. Reducing hospital stay may contribute to limiting the occurrence of this complication.

The use of environmental assessment in port management: The case of Vancouver, B.C

International Nuclear Information System (INIS)

Georgison, J.P.; Day, J.C.

1991-01-01

The approach adopted to assess the environmental impacts of development proposals in the Port of Vancouver is analyzed. The institutional and regulatory system for managing Canada's largest port is examined to identify opportunities for, and impediments to, application of effective environmental impact assessments. The Exxon Valdez and Nestucca, Washington incidents increased public awareness and concern regarding the magnitude and effect of bulk liquid commodity spills along the Canadian west coast. In September 1990, the federally mandated Public Review Panel on Tanker Safety and Marine Spills Response Capability concluded that environmental assessment and review of terminal expansion proposals must address the impact of expanded liquid cargo shipments on surrounding communities and risk to air and water quality. It is recommended that assessment consistency, comprehensiveness, and objectiveness should be defined through formulation of legally binding regulations under the forthcoming Canadian Environmental Assessment Act. 23 refs., 1 fig

Assessing the port to port risk of vessel movements vectoring non-indigenous marine species within and across domestic Australian borders.

Science.gov (United States)

Campbell, Marnie L; Hewitt, Chad L

2011-07-01

Biofouling of vessels is implicated as a high risk transfer mechanism of non-indigenous marine species (NIMS). Biofouling on international vessels is managed through stringent border control policies, however, domestic biofouling transfers are managed under different policies and legislative arrangements as they cross internal borders. As comprehensive guidelines are developed and increased compliance of international vessels with 'clean hull' expectations increase, vessel movements from port to port will become the focus of biosecurity management. A semi-quantitative port to port biofouling risk assessment is presented that evaluates the presence of known NIMS in the source port and determines the likelihood of transfer based on the NIMS association with biofouling and environmental match between source and receiving ports. This risk assessment method was used to assess the risk profile of a single dredge vessel during three anticipated voyages within Australia, resulting in negligible to low risk outcomes. This finding is contrasted with expectations in the literature, specifically those that suggest slow moving vessels pose a high to extreme risk of transferring NIMS species.

Robotic right middle lobectomy with a subxiphoid utility port.

Science.gov (United States)

Jayakumar, Shruti; Nardini, Marco; Papoulidis, Pavlos; Dunning, Joel

2018-06-01

We present the case of a 74-year-old man with Stage IIa pulmonary adenocarcinoma, for which he underwent a robotic right middle lobectomy. A 4-armed, 5-port approach was used. Four intercostal ports were created above the ninth rib using the Cerfolio's technique. The subxiphoid port was created in the midline, 5 cm down from the xiphisternum. The robot offers higher image quality, depth perception and improved articulation of the instruments, allowing for more accurate dissection and stitching. The usage of a subxiphoid utility port reduces the clashing between instruments, offers a good angle for stapling and provides a direct view of the instruments entering into the chest. Specimen removal through the subxiphoid port may reduce postoperative pain and enhance patient recovery. The use of the subxiphoid approach as a utility port for robotic surgery is promising and may be a suitable replacement for the traditional utility port.

HomePort

DEFF Research Database (Denmark)

Madsen, Per Printz

2009-01-01

In the last couple of year's computer based home control systems are getting more and more common in modern homes. For instance these systems take care of light control, heat control and security systems.  The latest trend is to use wireless communication like Z-Wave and ZigBee to interconnect...... different components in these systems. One of the characteristics is that each system, like for instance heat and light, has their own specific way of using the communication system.   This paper describes a way to connect different home control systems through an intelligent gateway, called a Home......Port. The HomePort consists of a number of Subsystem communication drivers, a virtual communication layer, an interpreter and a PC- based compiler for a high level control language, called GIL (Gateway intelligence language). The focus in this paper will be on the upper two layers in the Home...

Surgeons agree more on treatment recommendations than on classification of proximal humeral fractures

DEFF Research Database (Denmark)

Brorson, Stig; Olsen, Bo Sanderhoff; Frich, Lars Henrik

2012-01-01

Orthopaedic surgeons disagree considerably when classifying fractures of the proximal humerus. However, the clinical implications of low observer agreement remain unclear. The purpose of the study was to compare the agreement on Neer classification with the agreement on treatment recommendations....

The VisPort Project: Visualization of Port Logistics

Science.gov (United States)

Katsioloudis, Petros J.; Watson, Ginger

2011-01-01

There is concern about the diminishing availability of skilled personnel that can operate in the wide variety of disciplines associated with port operations. Increasing cargo volume, combined with a shrinking workforce, could potentially create alarming situations in the future, hence the motivation to publicize to current students the breadth and…

Enabling information sharing in a port

DEFF Research Database (Denmark)

Olesen, Peter Bjerg; Hvolby, Hans-Henrik; Dukovska-Popovska, Iskra

2012-01-01

Ports are integral parts of many supply chains and are as such a contributing factor to the overall efficiency of the supply chain. Ports are also dynamic entities where things changes continuously. The dynamic nature of ports is also a problem when trying to optimise the utilisation of resources...... and ensure a low lead-time. Information sharing is a very important tool to reduce the effect of dynamism. This paper attempts to explain how information sharing is enabled in such an environment, and which considerations are relevant, both in regards to the information and required technology. The paper...

The "diamond port configuration": A standardised laparoscopic technique for adolescent intestinal resection and anastomosis

Directory of Open Access Journals (Sweden)

Richard Hill

2012-01-01

Full Text Available Background: Familiarity with technique and repetition enhance efficiency during laparoscopic surgery. This is particularly important when undertaking complex bowel resections. We report a standardised protocol that includes theatre layout, patient position and port insertion, which we believe facilitates excellent abdominal access and ergonomics and has the potential to shorten the duration of the team-learning curve. Materials and Methods: A strategic unit development plan led to the commencement of a laparoscopic service for adolescents with bowel disorders. A standardised protocol for intestinal resections was agreed upon at a monthly Paediatric Minimal Access Group meeting. This covered patient position, port insertion, technical aspects of intestinal resection and perioperative management. In particular, a diamond configuration for ports was agreed upon. Data were prospectively collected, and included patient demographics, operative times, conversion rates and postoperative outcomes. Unless otherwise indicated, data are presented as medians with ranges. Results: Seven procedures were carried out in six patients (three female aged 14 (11-14 years. Access to the entire abdominal cavity, vision and ergonomics were excellent in all. There were no conversions to open surgery. In all procedures, the technique was considered safe and effective. The length of hospital stay was 6.5 (5.8-14 days. Conclusion: A standardised protocol including the use of the diamond port configuration has several putative advantages for laparoscopic bowel resections and anastomoses. These include efficiency, reproducibility, predictability, good visibility and excellent ergonomics. We recommend this approach as a means to shorten the procedure-specific learning curve of the laparoscopic team.

Port Environmental Management Challenges, Possibilities and Innovations in a Globalization Context

Directory of Open Access Journals (Sweden)

Dione Iara Silveira Kitzmann

2014-12-01

Full Text Available Port activity within an overall port environmental system encompassing the whole coastal area in which ports are situated constitutes an important analytical tool. The considerable potential for controlling and influencing activities that occur in the same geographical area means that ports generate significant positive and negative environmental impacts. This importance and the significant expansion of the Brazilian port sector in recent years gave rise to the need for Port Environmental Management (GAP based on internationally accepted environmental standards. This article discusses nested elements in the concept of port environmental management which take into account new realities of Brazilian ports as well as international standards concerning environmentally appropriate measures for the sector. New international technical proposals are discussed with regard to Brazilian port policy and the port of Rio Grande (Rio Grande do Sul State is used as a case study, highlighting its structures and the model of port environmental management being implemented.

Efficiency analysis of container ports and terminals

OpenAIRE

Liu, Q.

2010-01-01

In the past two decades the steady growth of seaborne trade has resulted in the increase of container ships, container ports and their terminals. The structure of the shipping market is, moreover, continuously evolving. On the carrier side, shipping companies form consortia and alliances; on the port side, global terminal operators and dedicated container terminals are emerging. The aim of this research is to evaluate the efficiency of container ports and terminals and to study...

Laboratory recommendations for scoring deep molecular responses following treatment for chronic myeloid leukemia

DEFF Research Database (Denmark)

Cross, N. C. P.; White, H. E.; Colomer, D.

2015-01-01

Treatment of chronic myeloid leukemia (CML) with tyrosine kinase inhibitors has advanced to a stage where many patients achieve very low or undetectable levels of disease. Remarkably, some of these patients remain in sustained remission when treatment is withdrawn, suggesting that they may be at ...... of sensitivity. Here we present detailed laboratory recommendations, developed as part of the European Treatment and Outcome Study for CML (EUTOS), to enable testing laboratories to score MR in a reproducible manner for CML patients expressing the most common BCR-ABL1 variants....

An analysis of the development of port operation in Da Nang Port, Vietnam

Science.gov (United States)

Nguyen, T. D. H.; Cools, M.

2018-04-01

This paper presents the current operating status in Da Nang Port, Vietnam in the period 2012-2016. The port operation had positive changes that were reflected by a significant increase in total throughputs, especially containerized cargo volumes. Classical decomposition techniques are used to find trend-cycle and seasonal components of monthly throughput flows. Appropriate predictive models of different kinds of throughputs are proposed. Finally, a development strategy towards containerization and investment policies in facilities, equipment, and infrastructure are suggested based on the predictive results.

Nuclear analysis of the ITER Cryopump Ports

International Nuclear Information System (INIS)

Moro, Fabio; Villari, Rosaria; Flammini, Davide; Antipenkov, Alexander; Dremel, Matthias; Levesy, Bruno; Loughlin, Michael; Juarez, Rafael; Perez, Lucia; Petrizzi, Luigino

2015-01-01

Highlights: • Evaluation the shielding effectiveness of the TCPHs by means of 3-D neutrons and gamma maps. • Assessment of the nuclear heating induced by neutron and photons on the TCP and TCPHs. • Calculation of the dose rate at 12 days after shutdown in the maintenance area of the Lower Ports with the Advanced D1S method, in order to verify the design target (100 μSv/h). • Potential improvements of the shielding configuration aimed at the reduction of the dose level in the Port Cell have been proposed and discussed. - Abstract: The ITER machine will be equipped with 6 torus Cryopumps (TCP) that are positioned in their housings (TCPH) and integrated into the cryostat walls at B1 level in the port cells. A comprehensive nuclear analysis of the Cryopump Ports #4 and #12 has been carried out by means of the MCNP-5 Monte Carlo code in a full 3-D geometry, providing guidelines for the design of the embedded components. Radiation transport calculations have been performed in order to determine the radiation field inside the Lower Ports, up the Port Cell: 3-D neutrons and gamma maps have been provided in order to evaluate the shielding effectiveness of the TCPHs. Nuclear heating induced by neutron and photons have been estimated on the TCP and TCPH to assess the nuclear loads during plasma operations. The shutdown dose rate in the maintenance area of the Lower Ports has been assessed with the Advanced D1S method to verify the design limits.

Nuclear analysis of the ITER Cryopump Ports

Energy Technology Data Exchange (ETDEWEB)

Moro, Fabio, E-mail: fabio.moro@enea.it [ENEA, Fusion Technical Unit, Nuclear Technologies Laboratory, Via Enrico Fermi 45, 00044 Frascati, Rome (Italy); Villari, Rosaria; Flammini, Davide [ENEA, Fusion Technical Unit, Nuclear Technologies Laboratory, Via Enrico Fermi 45, 00044 Frascati, Rome (Italy); Antipenkov, Alexander; Dremel, Matthias; Levesy, Bruno; Loughlin, Michael [ITER Organization, Route de Vinon sur Verdon, 13115 Saint Paul-lez-Durance (France); Juarez, Rafael; Perez, Lucia [UNED, Energetic Engineering Department, C/Juan del Rosal 12, Madrid (Spain); Petrizzi, Luigino [European Commission, DG Research & Innovation G5, CDMA 00/030, B-1049 Brussels (Belgium)

2015-10-15

Highlights: • Evaluation the shielding effectiveness of the TCPHs by means of 3-D neutrons and gamma maps. • Assessment of the nuclear heating induced by neutron and photons on the TCP and TCPHs. • Calculation of the dose rate at 12 days after shutdown in the maintenance area of the Lower Ports with the Advanced D1S method, in order to verify the design target (100 μSv/h). • Potential improvements of the shielding configuration aimed at the reduction of the dose level in the Port Cell have been proposed and discussed. - Abstract: The ITER machine will be equipped with 6 torus Cryopumps (TCP) that are positioned in their housings (TCPH) and integrated into the cryostat walls at B1 level in the port cells. A comprehensive nuclear analysis of the Cryopump Ports #4 and #12 has been carried out by means of the MCNP-5 Monte Carlo code in a full 3-D geometry, providing guidelines for the design of the embedded components. Radiation transport calculations have been performed in order to determine the radiation field inside the Lower Ports, up the Port Cell: 3-D neutrons and gamma maps have been provided in order to evaluate the shielding effectiveness of the TCPHs. Nuclear heating induced by neutron and photons have been estimated on the TCP and TCPH to assess the nuclear loads during plasma operations. The shutdown dose rate in the maintenance area of the Lower Ports has been assessed with the Advanced D1S method to verify the design limits.

Relationship beetween city-port-waterfront: complexity and complications

Directory of Open Access Journals (Sweden)

Bianca Petrella

2014-01-01

Full Text Available Water is the basis of human and urban civilization; transport is the basis of trade and therefore of social progress. For many centuries water was by far the most important mode of transport, this is the principle reason why cities with rivers or seaports were predominant over cities without such features.Initially, industrialization, the construction of the railways, the advent of the car and the beginning of air transport challenged the hegemonic role of the cities-port. However, since the introduction of containers in the mid-1950‘s and shortly after the construction of inter-ports the role of water transport has been revitalized.The containers and the enormous ships carrying them need great surface areas and long piers, so ports were moved outside of cities and, thus, the historical relationship between city and port was definitively broken.The decline of large parts of the urban water front triggered redevelopment initiatives, which over time changed their use from industrial to leisure. These initiatives were often given names such as ‘urban recovery’, ‘renewal’, ‘regeneration’, ‘redevelopment’, and so forth.Enormous leisure areas were the common denominator and often the buildings had an exclusive and, for this reason, homologated architecture designed by “archi-star” (famous architects. The new built-up areas were out of the local character and out of the historical city-port relationship.Almost always liberated port spaces remain the property of the Port Authority and for this reason the way of making decisions is difficult. Italian law provides for a set of governing bodies to decide how to plan the interventions in the port areas. However, the law does not impose a co-ordination of the border area between city and port. Thus, the good governance of this area is left to chance and the hope that the various bodies can find mutually satisfying agreements.Some good and bad practices in various cities around the world

Fuzzy MCDM Approach for Evaluating Intangible Resources Affecting Port Service Quality

Directory of Open Access Journals (Sweden)

Ji Yeong Pak

2015-12-01

Full Text Available Intangible resources consist of soft resources such as knowledge, information and capabilities. It is important for ports to enhance intangible as well as tangible resources to obtain sustainable competitive advantage. In this connection, this study aims to identify port intangible resources which may contribute to the delivery of port service quality and to propose a fuzzy TOPSIS approach to solve the port choice problem focusing on intangible resources. Fuzzy TOPSIS is appropriate to assist decision making with ambiguous and uncertain problems such as port choice with respect to intangible resources. In this paper, five port intangible resources were identified and evaluated and five leading container ports in the Asia-Pacific region were assessed in terms of their intangible resources. A survey questionnaire was sent to 21 experts who are working in shipping companies in Korea and involved in the selection of ports. It was found that customer and relational resource contributes most to the delivery of port service quality while Hong Kong appeared to be the port where intangible resources were most highly evaluated. This research helps to enrich the literature on port service quality and port choice evaluation. Its findings can also be used as guidelines for port managers to prioritise resources that may have greater influence on the delivery of port service quality and the subsequent training and education programs.

Rotterdam as a World Port City

NARCIS (Netherlands)

Wouter Jacobs; Menno Huijs; Isabelle Vries

2015-01-01

Most studies and models on the port-city interface focus on the inevitable process in which ports and cities grow apart, both spatially and economically. What is often overlooked is the relationships that remain in the form of maritime business services (finance, insurance, legal). These maritime

Complications after implantation of subcutaneous central venous ports (PowerPortⓇ

Directory of Open Access Journals (Sweden)

Takatoshi Nakamura

2017-05-01

Conclusion: PowerPort is a multifunctional port. Benign disease was a risk factor for postoperative complications. Because many types of subcutaneously implanted ports are used in our hospital, we had to inform the hospital staff about the functions of PowerPort.

Final design of ITER port plug test facility

Energy Technology Data Exchange (ETDEWEB)

Cerisier, Thierry, E-mail: thierry.cerisier@yahoo.fr [ITER Organization, Route de Vinon-sur-Verdon, CS 90046, St Paul-lez-Durance Cedex, 13067 (France); Levesy, Bruno [ITER Organization, Route de Vinon-sur-Verdon, CS 90046, St Paul-lez-Durance Cedex, 13067 (France); Romannikov, Alexander [Institution “Project Center ITER”, Kurchatov sq. 1, Building 3, Moscow 123182 (Russian Federation); Rumyantsev, Yuri [JSC “Cryogenmash”, Moscow reg., Balashikha 143907 (Russian Federation); Cordier, Jean-Jacques; Dammann, Alexis [ITER Organization, Route de Vinon-sur-Verdon, CS 90046, St Paul-lez-Durance Cedex, 13067 (France); Minakov, Victor; Rosales, Natalya; Mitrofanova, Elena [JSC “Cryogenmash”, Moscow reg., Balashikha 143907 (Russian Federation); Portone, Sergey; Mironova, Ekaterina [Institution “Project Center ITER”, Kurchatov sq. 1, Building 3, Moscow 123182 (Russian Federation)

2016-11-01

Highlights: • We introduce the port plug test facility (purpose and status of the design). • We present the PPTF sub-systems. • We present the environmental and functional tests. • We present the occupational and nuclear safety functions. • We conclude on the achievements and next steps. - Abstract: To achieve the overall ITER machine availability target, the availability of diagnostics and heating port plugs shall be as high as 99.5%. To fulfill this requirement, it is mandatory to test the port plugs at operating temperature before installation on the machine and after refurbishment. The ITER port plug test facility (PPTF) is composed of several test stands that can be used to test the port plugs whereas at the end of manufacturing (in a non-nuclear environment), or after refurbishment in the ITER hot cell facility. The PPTF provides the possibility to perform environmental (leak tightness, vacuum and thermo-hydraulic performances) and functional tests (radio frequency acceptance tests, behavior of the plugs’ steering mechanism and calibration of diagnostics) on upper and equatorial port plugs. The final design of the port plug test facility is described. The configuration of the standalone test stands and the integration in the hot cell facility are presented.

Severe Neutropenia at the Time of Implantable Subcutaneous Chest Port Insertion Is Not a Risk Factor for Port Removal at a Tertiary Pediatric Center.

Science.gov (United States)

Hoss, Daniel R; Bedros, Antranik A; Mesipam, Avinash; Criddle, Jared; Smith, Jason C

2017-03-01

To determine if severe neutropenia at the time of chest port insertion is a risk factor for port removal and central catheter-associated bloodstream infection (CCABSI) in pediatric patients. From May 2007 to June 2015, 183 consecutive patients (mean age, 9.9 y; range, 0.75-21 y) had a port inserted at a single tertiary pediatric center. Seventy-two had severe neutropenia at the time of port insertion (absolute neutrophil count [ANC] range, 0-500/mm 3 ; mean, 185/mm 3 ). Follow-up until port removal or death and CCABSI events were recorded. Within the first 30 days, similar incidences of CCABSI (12.5% of patients with severe neutropenia [n = 9] vs 4.5% of patients without [n = 5]), port removal for infection (2.8% [n = 2] vs 2.7% [n = 3]), and local port infection (2.8% [n = 2] vs 0.9% [n = 1]) were observed in both groups (P > .05), but the rate of CCABSI per 1,000 catheter-days was higher for patients with severe neutropenia (P = .045). Overall, similar incidences of CCABSI (18.1% [n = 13] vs 16.2% [n = 18]), port removal for infection (2.8% [n = 2] vs 7.2% [n = 8]), local port infection (2.8% [n = 2] vs 2.7% [n = 3]), and CCABSIs per 1,000 catheter-days (0.332 vs 0.400) were observed in both groups (P > .05). Port placement in patients with severe neutropenia can be performed without an increased incidence of port removal for infection. The majority of CCABSIs were successfully treated without port removal. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

EVALUATING THE COMPETITION DYNAMICS OF CONTAINER PORTS IN THE NORTH ADRIATIC

OpenAIRE

Twrdy, Elen; Batista, Milan

2014-01-01

World trade has changed in the last decade and the container traffic flows are oriented towards several parts of the European continent. A European container port system is not a homogenous set of ports, but is established of several large ports (Rotterdam, Hamburg, Algeciras...) and a large number of medium- and small-sized ports. North Adriatic (NA) ports belong to this category of ports and in this paper we have analysed the container flows and the throughput attained in these ports.

78 FR 36014 - Deepwater Port License Application: Liberty Natural Gas, LLC, Port Ambrose Deepwater Port

Science.gov (United States)

2013-06-14

... timeline for processing an application. When MarAd and USCG determine that an application contains the... that Port Ambrose falls within the proposed area of interest for the New York Power Authority Long Island-New York City Offshore Wind Project. This project will be acknowledged and considered in the...

Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2016 Recommendations of the International Antiviral Society-USA Panel.

Science.gov (United States)

Günthard, Huldrych F; Saag, Michael S; Benson, Constance A; del Rio, Carlos; Eron, Joseph J; Gallant, Joel E; Hoy, Jennifer F; Mugavero, Michael J; Sax, Paul E; Thompson, Melanie A; Gandhi, Rajesh T; Landovitz, Raphael J; Smith, Davey M; Jacobsen, Donna M; Volberding, Paul A

2016-07-12

New data and therapeutic options warrant updated recommendations for the use of antiretroviral drugs (ARVs) to treat or to prevent HIV infection in adults. To provide updated recommendations for the use of antiretroviral therapy in adults (aged ≥18 years) with established HIV infection, including when to start treatment, initial regimens, and changing regimens, along with recommendations for using ARVs for preventing HIV among those at risk, including preexposure and postexposure prophylaxis. A panel of experts in HIV research and patient care convened by the International Antiviral Society-USA reviewed data published in peer-reviewed journals, presented by regulatory agencies, or presented as conference abstracts at peer-reviewed scientific conferences since the 2014 report, for new data or evidence that would change previous recommendations or their ratings. Comprehensive literature searches were conducted in the PubMed and EMBASE databases through April 2016. Recommendations were by consensus, and each recommendation was rated by strength and quality of the evidence. Newer data support the widely accepted recommendation that antiretroviral therapy should be started in all individuals with HIV infection with detectable viremia regardless of CD4 cell count. Recommended optimal initial regimens for most patients are 2 nucleoside reverse transcriptase inhibitors (NRTIs) plus an integrase strand transfer inhibitor (InSTI). Other effective regimens include nonnucleoside reverse transcriptase inhibitors or boosted protease inhibitors with 2 NRTIs. Recommendations for special populations and in the settings of opportunistic infections and concomitant conditions are provided. Reasons for switching therapy include convenience, tolerability, simplification, anticipation of potential new drug interactions, pregnancy or plans for pregnancy, elimination of food restrictions, virologic failure, or drug toxicities. Laboratory assessments are recommended before treatment, and

Single-port laparoscopic myomectomy using a new single-port transumbilical morcellation system: initial clinical study.

Science.gov (United States)

Kim, Yong-Wook; Park, Byung-Joon; Ro, Duck-Yeong; Kim, Tae-Eung

2010-01-01

To evaluate the feasibility of single-port laparoscopic myomectomy with transumbilical morcellation and suturing. Continuing prospective study (Canadian Task Force classification II-3). University hospital. Fifteen patients who underwent single-port laparoscopic myomectomy between September 2008 and October 2009 to remove single or multiple uterine myomas, at least 1 in each patient measuring greater than 4 cm in diameter. All single-port laparoscopic myomectomy procedures were performed by a single surgeon (Dr. Y.W. Kim). Myomas were extracted transumbilically by cutting the myomas into smaller pieces with a knife or a conventional electromechanical morcellator. After making a single 1.5- to 2.0-cm umbilical incision, the single-port system, created with a wound retractor and a surgical glove, was inserted. All operations were performed using conventional rigid straight laparoscopic instruments. Laparoscopic suturing was performed in intramural myomas and some subserosal myomas. Patient mean (SD; range) age was 38.3 (5.6; 29-49) years. The number of myomas per patient was 1.6 (1.4; 1-6). The diameter of the largest myomas was 6.1 (1.5; 4.2-9.6) cm. In 4 patients, only a knife was required for transumbilical extraction of myomas, and in 11 patients, transumbilical morcellation with an electromechanical morcellator with or without a knife was used. Transumbilical drainage tubes were inserted into the pelvic cavity in 11 of 15 patients. Operative time was 96.7 (33.8; 35-150) minutes. The decrease in postoperative hemoglobin concentration was 1.8 (1.2; 0.4-3.6) g/dL. During the operations, no patients required blood transfusion. No patients developed postoperative fever. Neither bowel injury nor urinary tract injury occurred in any patient. The postoperative hospital stay was 3.1 (0.8; 2-4) days. Single-port transumbilical morcellation using a conventional electromechanical morcellator with or without a knife is feasible. Single-port laparoscopic myomectomy is an

Free Port of Vladivostok: Development Conditions, Prospects, Risks

Directory of Open Access Journals (Sweden)

Elena Viktorovna Krasova

2015-12-01

Full Text Available One of the priority directions of Russia’s state policy with regard to territories’ development is the development of the Far Eastern region. The free port of Vladivostok is one of the key projects that are currently being implemented in the southern part of Primorsky Krai and they focus on boosting the socio-economic development of Vladivostok city, Primorsky Krai and the Far Eastern region as a whole. The goal of this research is to consider the conceptual issues of the free port of Vladivostok, to outline the conditions and prospects of its operation and identify risks associated with its future development. The article defines the modern concept of “free port”, characterizes historical experience of the “free port” regime in Vladivostok in the end of the 19th century, substantiates the strategic importance of using the free port of Vladivostok as a tool of intensive growth of Russian Far Eastern territories. The article also discloses the essence of the free port of Vladivostok as a means to promote free entrepreneurship, which is used to increase freight traffic through the port of Vladivostok, increase foreign trade, attract new investments, create new industries and develop the port’s infrastructure. The article provides a review of the main tax benefits and perspectives of the free port of Vladivostok in terms of the gross regional product formation. Analyzing the mechanisms of effective functioning of the free port of Vladivostok, the authors identify the short-term (mid-term and long-term priorities and operational risks for the free port of Vladivostok. The article also touches upon some issues concerning the response of some foreign countries to the creation of the free port of Vladivostok

On Distributed Port-Hamiltonian Process Systems

NARCIS (Netherlands)

Lopezlena, Ricardo; Scherpen, Jacquelien M.A.

2004-01-01

In this paper we use the term distributed port-Hamiltonian Process Systems (DPHPS) to refer to the result of merging the theory of distributed Port-Hamiltonian systems (DPHS) with the theory of process systems (PS). Such concept is useful for combining the systematic interconnection of PHS with the

Intracorporeal hybrid single port vs conventional laparoscopic appendectomy in children

Directory of Open Access Journals (Sweden)

Paul Anthony Karam

2016-12-01

Full Text Available Transumbilical laparoscopic assisted appendectomy combines laparoscopic single port dissection with open appendectomy after exteriorization of the appendix through the port site. Compared to the conventional three-port approach, this technique provides an alternative with excellent cosmetic outcome. We developed a safe and effective technique to perform an intracorporeal single port appendectomy, using the same laparoscope employed in the extracorporeal procedure. Retrospective review of 71 consecutively performed intracorporeal single port appendectomies and 30 conventional three-port appendectomies in children 6 to 17 years of age. A straight 10-mm Storz telescope with inbuilt 6 mm working channel is used to dissect the appendix, combined with one port-less 2.3 mm percutaneous grasper. Polymer WECK® hem-o-lock® clips are applied to seal the base of the appendix and the appendiceal vessels. No intraoperative complications were reported with the hybrid intracorporeal single port appendectomy or three-port appendectomy. There were two post-operative complications in the group treated with the single port hybrid technique: one intra-abdominal abscess and one surgical site infection. Groups did not differ in age, weight, and types of appendicitis. Operative times were shorter for the hybrid technique (70 vs 79 minutes but did not differ significantly (P=0.19. This modified technique to a previously described single port extracorporeal appendectomy is easy to master and implement. It provides exposure similar to a three-port laparoscopic appendectomy, while maintaining virtually scarless results and potentially reduces the risk for surgical site infections compared to the extracorporeal technique.

33 CFR 165.761 - Security Zones; Port of Palm Beach, Port Everglades, Port of Miami, and Port of Key West, Florida.

Science.gov (United States)

2010-07-01

... of the law enforcement boats and cruise ship tenders which will mark a transit lane in channel. (ii... east of the law enforcement vessels and cruise ship tenders, which will mark a transit lane in the..., tug boats and contracted security vessels may assist the Coast Guard Captain of the Port under the...

The Port Service Ecosystem Research Based on the Lotka-Volterra Model

Directory of Open Access Journals (Sweden)

Li Wenjuan

2017-11-01

Full Text Available Under the new normal of China’s economy, the competition among the port enterprises is not only the competition of the core competence of the port, the port industry chain or the port supply chain, but also the competition of the port service ecosystem. In this paper, the concept and characteristics of the port service ecosystem is discussed, a hierarchical model of the port service ecosystem is constructed. As an extended logistic model, Lotka-Volterra model is applied to study the competitive co-evolution and mutually beneficial co-evolution of enterprises in the port service ecosystem. This paper simulates the co-evolution of enterprises in the port service ecosystem by using MATLAB programming. The simulation results show that the breadth of the niche of the enterprises is changing with the change of the competition coefficient and the coefficient of mutual benefit in the port service ecosystem. Based on that, some proposals are put forward to ensure the healthy and orderly development of the port service ecosystem.

FIRST SINGLE-PORT LAPAROSCOPIC PANCREATECTOMY IN BRAZIL

Directory of Open Access Journals (Sweden)

Marcel Autran Cesar MACHADO

2013-12-01

Full Text Available Context Pancreatic surgery is an extremely challenging field, and the management of pancreatic diseases continues to evolve. In the past decade, minimal access surgery is moving towards minimizing the surgical trauma by reducing numbers and size of the port. In the last few years, a novel technique with a single-incision laparoscopic approach has been described for several laparoscopic procedures. Objectives We present a single-port laparoscopic spleen-preserving distal pancreatectomy. To our knowledge, this is the first single-port pancreatic resection in Brazil and Latin America. Methods A 33-year-old woman with neuroendocrine tumor underwent spleen-preserving distal pancreatectomy via single-port approach. A single-incision advanced access platform with gelatin cap, self-retaining sleeve and wound protector was used. Results Operative time was 174 minutes. Blood loss was minimal, and the patient did not receive a transfusion. The recovery was uneventful, and the patient was discharged on postoperative day 4. Conclusions Single-port laparoscopic spleen-preserving distal pancreatectomy is feasible and can be safely performed in specialized centers by skilled laparoscopic surgeons.

Specialization and Flexibility in Port Cargo Handling

Directory of Open Access Journals (Sweden)

Hakkı KİŞİ

2016-11-01

Full Text Available Cargo handling appears to be the fundamental function of ports. In this context, the question of type of equipment and capacity rate need to be tackled with respect to cargo handling principles. The purpose of this study is to discuss the types of equipment to be used in ports, relating the matter to costs and capacity. The question is studied with a basic economic theoretical approach. Various conditions like port location, size, resources, cargo traffic, ships, etc. are given parameters to dictate the type and specification of the cargo handling equipment. Besides, a simple approach in the context of cost capacity relation can be useful in deciding whether to use specialized or flexible equipment. Port equipment is sometimes expected to be flexible to handle various types of cargo as many as possible and sometimes to be specialized to handle one specific type of cargo. The cases that might be suitable for those alternatives are discussed from an economic point of view in this article. Consequently, effectiveness and efficiency criteria play important roles in determining the handling equipment in ports.

Optimal location of dry ports in the Pan-Pearl River Delta

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Wu Qitao

2017-01-01

Full Text Available Dry ports have become a very important part of globalization and a cornerstone in port competitiveness. Based on the analytic hierarchy process, this paper established the dry port index system to evaluate the potential location of dry ports linked to the port system in the Pearl River Delta, in a case study covering 115 cities in the Pan - Pearl River Delta. The results show that it is optimal to locate 21 dry ports in the research region, and each dry port serves different areas. There are 4 optimal transport corridors for the dry port logistic network, including Guangzhou- Kunming transport corridor, Guangzhou-Chengdu transport corridor, Guangzhou-Changsha transport corridor and Shenzhen-Nanchang transport corridor.

Comparison of differences between ports for radioactive material transport

International Nuclear Information System (INIS)

Massey, C.D.; Wheeler, T.A.; Yoshimura, H.R.

1994-01-01

Recent controversy and litigation over the import/export of radioactive materials into and out of the United States via United States ports has centered on differences between ports, especially differences in surrounding population densities, and also whether reliance on one or a few ports poses unacceptable risks for these ports and the surrounding populations. This study examines the results of risk analyses from several recent environmental assessments dealing with import/export of various types of radioactive materials ranging from uranium hexafluoride to spent nuclear fuel. Since an intermodal transfer is always involved, the maritime and intermodal transportation is broken down into its component activities and segments; each is determined separately. The results indicate that most of the potential exposure occurs during routine handling of packages during intermodal transfer. Since handling of containerized cargo is highly standardized at ports around the world, differences between ports are of secondary importance. The risks associated with any overland transport from port to inland destination are primarily a function of distance for a given package type

Simulation model for port shunting yards

Science.gov (United States)

Rusca, A.; Popa, M.; Rosca, E.; Rosca, M.; Dragu, V.; Rusca, F.

2016-08-01

Sea ports are important nodes in the supply chain, joining two high capacity transport modes: rail and maritime transport. The huge cargo flows transiting port requires high capacity construction and installation such as berths, large capacity cranes, respectively shunting yards. However, the port shunting yards specificity raises several problems such as: limited access since these are terminus stations for rail network, the in-output of large transit flows of cargo relatively to the scarcity of the departure/arrival of a ship, as well as limited land availability for implementing solutions to serve these flows. It is necessary to identify technological solutions that lead to an answer to these problems. The paper proposed a simulation model developed with ARENA computer simulation software suitable for shunting yards which serve sea ports with access to the rail network. Are investigates the principal aspects of shunting yards and adequate measures to increase their transit capacity. The operation capacity for shunting yards sub-system is assessed taking in consideration the required operating standards and the measure of performance (e.g. waiting time for freight wagons, number of railway line in station, storage area, etc.) of the railway station are computed. The conclusion and results, drawn from simulation, help transports and logistics specialists to test the proposals for improving the port management.

PC interfacing using Centronics, RS232 and game ports

CERN Document Server

An, Pei

1998-01-01

The main links with your PC and the outside world are the centronic port, used for connecting the printer, the RS232 port, used for the mouse, and the games port for a joystick. This book explores how these input/output (I/O) ports can be put to use through a range of other interfacing applications. This is especially useful for laptop and palmtop PCs which cannot be fitted with internal I/O cards. A novel approach is taken by this book, combining the hardware through which the ports can be explored, and the software programming needed to carry out a range of experiments.Circuits are p

Regional Hub port development : the case of Montevideo, Uruguay

OpenAIRE

Wilmsmeier, Gordon; Martínez Zarzoso, Inmaculada; Fiess, Norbert

2011-01-01

This paper reflects on port development in Uruguay in an environment of trilateral interport competition. The regional characteristics of port development in terms of their geographical, functional and operational characteristics are discussed by analysing the port system’s evolution. The case of Montevideo as the success or failure of a regional hub port development strategy is analysed in detail. Particular attention is given to the evolution and impact of the liner shipping service network...

Three-dimensional reconstruction of port wine stain vascular anatomy from serial histological sections

NARCIS (Netherlands)

Smithies, D. J.; van Gemert, M. J.; Hansen, M. K.; Milner, T. E.; Nelson, J. S.

1997-01-01

Port wine stains (PWSs) treated with a flashlamp-pumped pulsed dye laser show a variability in clinical response that is incompletely understood. To identify any vascular structure that might adversely affect treatment response, we obtained a three-dimensional reconstruction of the vascular anatomy

77 FR 47522 - Special Local Regulation; Port Huron Offshore Gran Prix, St. Clair River; Port Huron, MI

Science.gov (United States)

2012-08-09

... 13045, Protection of Children from Environmental Health Risks and Safety Risks. This rule is not an economically significant rule and does not create an environmental risk to health or risk to safety that may...-AA08 Special Local Regulation; Port Huron Offshore Gran Prix, St. Clair River; Port Huron, MI AGENCY...

Different recommendations for empiric first-choice antibiotic treatment of uncomplicated urinary tract infections in Europe

DEFF Research Database (Denmark)

McQuiston Haslund, Josephine; Rosborg Dinesen, Marianne; Nielsen, Anni Brit Sternhagen

2013-01-01

OBJECTIVE: Uncomplicated urinary tract infection (uUTI) is a common reason for antibiotic treatment in primary health care. Due to the increasing prevalence of antibiotic-resistant uropathogens it is crucial to use the most appropriate antibiotics for first-choice empiric treatment of uUTI....... Particularly, it is important to avoid antibiotics associated with a high rate of antimicrobial resistance. This study compares national recommendations from six European countries, investigating recommendations for first-choice antibiotic therapy of uUTI. SETTING: General practice in six European countries...... at least one antibiotic associated with a low (UTI could not be explained by differences in local bacterial aetiology or by different patterns of antimicrobial resistance. Despite resistance rates exceeding 10...

Ecological risk assessments for the baseline condition for the Port Hope and Port Granby Projects

International Nuclear Information System (INIS)

Hart, D.R.; Kleb, H.

2006-01-01

Baseline ecological risk assessments were completed in and around the areas where cleanup of low-level radioactive waste (LLRW) and marginally contaminated soil (MCS) is planned under the Port Hope Area Initiative (PHAI). Both aquatic and terrestrial environments were assessed, in the vicinity of the proposed waste management facilities near Welcome and Port Granby, in locations potentially influenced by LLRW and MCS that will be cleaned up in future, and in reference locations that are not potentially influenced. The calculated doses and risk quotients suggest potential radiation effects for pre-cleanup benthic invertebrates in Port Hope Harbour, for any ducks feeding exclusively in this area, and for soil invertebrates in some other waste sites. In addition, risk quotients suggest potential baseline effects from some elements, particularly uranium and arsenic, in localized areas that are influenced by LLRW and MCS. (author)

Port Site Infections After Laparoscopic Cholecystectomy

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Mumtaz KH Al-Naser

2017-06-01

Full Text Available Background: Port site infection (PSI is an infrequent surgical site infection that complicates laparoscopic surgery but has a considerable influence in the overall outcome of laparoscopic cholecystectomy. The aim of this study was to evaluate factors that influence PSI after laparoscopic cholecystectomies and to analyze which of these factors can be modified to avoid PSI in a trail to achieve maximum laparoscopic advantages. Methods: A prospective descriptive qualitative study conducted on patients who underwent laparoscopic cholecystectomies. Swabs were taken for culture & sensitivity in all patients who developed PSI. Exploration under general anaesthesia, for patients, had deep surgical site infections and wound debridement was done, excisional biopsies had been taken for histopathological studies, and tissue samples for polymerase chain reaction for detection of mycobacterium tuberculosis was done. All patients were followed up for six months postoperatively. Factors as gender, site of infected port, type of microorganism, acute versus chronic cholecystitis, type of infection (superficial or deep infection and intraoperative spillage of stones, bile or pus were analyzed in our sample. Results: Port site infection rate was recorded in 40/889 procedures (4.5%, higher rates were observed in male patients 8/89 (8.9%, in acute cholecystitis 13/125 (10.4%, when spillage of bile, stones or pus occurred 24/80 (30%, and at epigastric port 32/40 (80%. Most of the PSI were superficial infections 77.5% with non-specific microorganism 34/40 (85%. Conclusion: There is a significant association of port site infection with spillage of bile, stones, or pus, with the port of gallbladder extraction and with acute cholecystitis. Especial consideration should be taken in chronic deep surgical site infection as mycobacterium tuberculosis could be the cause. Most of the PSIs are superficial and more common in males.

Outcomes after endoscopic port surgery for spontaneous intracerebral hematomas.

Science.gov (United States)

Ochalski, Pawel; Chivukula, Srinivas; Shin, Samuel; Prevedello, Daniel; Engh, Johnathan

2014-05-01

Spontaneous intracerebral hemorrhages (ICHs) cause significant morbidity and mortality. Traditional open surgical management strategies offer limited benefit except for the most superficial hemorrhages in select patients. Recent reports suggest that endoscopic approaches may improve outcomes, particularly for deep subcortical hemorrhages. However, the management of these patients remains controversial. We reviewed our experience using endoscopic port surgery to identify characteristics that may predict acceptable outcomes. We completed a retrospective chart and imaging review of patients who underwent endoscopic port surgery for evacuation of spontaneous ICH at a single center. Data were gathered regarding patient demographics, hemorrhage locations, operative findings, and clinical outcomes. From 2007 to 2011, 18 patients underwent evacuation of spontaneous intracerebral hematomas using an endoscopic port. The mean age in years was 62 years (range, 43-84 years). Six of 18 patients (33%) died before discharge, and 2 others (11%) died after at least 1 month of survival. Of 12 initial survivors, all were discharged to a rehabilitation or nursing facility. Complete hematoma evacuation was achieved in 7 of 18 patients, with the remaining 11 having a partial evacuation. The patients who died (n = 6) before discharge were statistically more likely to have a left-sided hemorrhage, partial evacuation, or older age than the survivors; death at least 1  month after evacuation was additionally associated with greater preoperative hematoma volumes. Our series demonstrates that endoscopic port surgery for acute intracerebral hematoma evacuation has the ability to achieve significant decompression of large and deep-seated hematomas. Patient age, extent of evacuation, laterality, and preoperative hematoma volume appear to influence patient outcome. Most overall outcomes remain poor. Future studies are necessary to determine if surgical evacuation is in fact superior to best

Towards port sustainability through probabilistic models: Bayesian networks

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B. Molina

2018-04-01

Full Text Available It is necessary that a manager of an infrastructure knows relations between variables. Using Bayesian networks, variables can be classified, predicted and diagnosed, being able to estimate posterior probability of the unknown ones based on known ones. The proposed methodology has generated a database with port variables, which have been classified as economic, social, environmental and institutional, as addressed in of smart ports studies made in all Spanish Port System. Network has been developed using an acyclic directed graph, which have let us know relationships in terms of parents and sons. In probabilistic terms, it can be concluded from the constructed network that the most decisive variables for port sustainability are those that are part of the institutional dimension. It has been concluded that Bayesian networks allow modeling uncertainty probabilistically even when the number of variables is high as it occurs in port planning and exploitation.

Investigation of barriers to clinical practice guideline-recommended pharmacotherapy in the treatment of COPD.

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Price L

2007-06-01

Full Text Available Background: The adoption of clinical practice guideline recommendations for COPD is suboptimal. Determining the barriers to the implementation of these practice guidelines may help improve patient care.Objective: To determine whether barriers to the use of pharmacotherapy according to practice guidelines are related primarily to patient or prescriber factors.Methods: Retrospective cohort study. Members of a health maintenance organization identified as having spirometry-defined COPD ranging from stage II to IV. Electronic medical records were reviewed for documentation of the following: 1 patient affordability issues, 2 history of an adverse drug reaction, 3 history of inefficacy to therapy, and 4 prescription history.Results: A total of 111 medical records were reviewed. There were 51% of patients who had not filled medications that had been prescribed in accordance with guidelines and 43% did not have the guideline recommended medications prescribed in the previous year. Only 4% and 2% of patients had documented inefficacy and affordability issues, respectively. There were no reported cases of adverse drug reactions. Conclusions: This study provides insight to the acceptance of COPD treatment recommendations by patients and providers. Further research is needed to design interventions to reduce barriers and optimize COPD treatment.

PERFORMANCE ASSESSMENT IN OPERATING DRY PORTS

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Ciortescu Cezar-Gabriel

2010-12-01

Full Text Available In this paper, an approach for recognizing and defining correct and operable performance will be presented with the purpose of evaluating the effectiveness and efficiency of processes in dry ports (inland intermodal hubs. The challenge in evaluating the possible improvements of the underlying processes lies in the special nature and the complex structure of dry ports. It is important to consider that all the processes are highly interconnected and that changes in parameters in one process also have an impact on parameters in other processes. Furthermore, the performance of dry ports, seen as the backbone of the system, has a significant impact on the overall performance of the whole transportation network.

U.S. port commerce in radioactive materials

International Nuclear Information System (INIS)

Marti, B.E.

1987-01-01

Much attention has focused on the movement of radioactive materials over land transport systems. On the other hand, maritime flow and associated throughput studies of such substances have been neglected. Although several peaks and troughs are evident between 1972 and 1981, radioactive tonnage moving through U.S. port facilities steadily increasing. In the ten-year period assessed, total radioactive materials handled at U.S. ports expanded by over 19,000 tons, which amounts to almost a 173 percent growth rate. The purpose of this exploratory research is threefold. First, it identifies all U.S. ports which were involved in loading or discharging radioactive materials. The major goal of the identification process is to broaden public awareness of these types of movement. Second, it classifies U.S. seaports based on the magnitude of radioactive tonnage handled. The function of the classification is to impose some order on the varied data, while at the same time categorizing large, medium, and small facilities. Finally, it seeks to verify whether or not a long term trend exists. The objective of the verification process is to ascertain if the distribution of radioactive materials handled at individual ports has remained constant. Port safety and contingency planning are clearly within the purview of coastal zone management. The results of this preliminary research should form a foundation for future studies which compare and evaluate local, state, and federal regulatory policy pertaining to port operations involving radioactive materials, including waste

Hub port competition and welfare effects of strategic privatization

NARCIS (Netherlands)

Czerny, A.I.; Hoffler, F.; Mun, S.

2014-01-01

Private operation of port facilities is becoming increasingly common worldwide. We investigate the effect of port privatization in a setting with two ports located in different countries, each serving their home market but also competing for the transshipment traffic from a third region. Each

Use of vascular access ports in femoral veins of dogs and cats with cancer.

Science.gov (United States)

Cahalane, Alane Kosanovich; Rassnick, Kenneth M; Flanders, James A

2007-11-01

To evaluate long-term function of vascular access ports (VAPs) implanted in the femoral vein of dogs and cats undergoing cancer treatment. Prospective clinical study. 3 dogs and 6 cats treated via chemotherapy or radiation. VAPs were surgically implanted in the left femoral vein of 3 dogs and 6 cats over a 1-year period. Injection port location was alternated to either a caudal thoracic or ilial location in each patient. Duration of VAP function, ease of infusion, and ease of aspiration through the VAPs were recorded, and associated complications were assessed at each VAP use. Client satisfaction with VAP placement was evaluated by use of a questionnaire. Primary uses of the VAPs included blood sampling and delivering sedative or chemotherapeutic drugs. Median duration of successful infusion was 147 days (range, 60 to 370 days), and median duration of successful aspiration was 117 days (range, 10 to 271 days). The frequency of signs of VAP-related discomfort was low (7% of patient observations). Clients were satisfied with their decision to use VAPs. Complications included partial (n = 7) or complete (2) VAP occlusion, port migration (1), and presumptive infection (1). Results suggested that VAP implantation into the femoral vein provides an acceptable means of chronic venous access in dogs and cats undergoing cancer treatment.

The construction strategy and measures for ecological analysis of China's ports

Science.gov (United States)

Zhang, Lu; Zhao, Junjie; Shou, Youping; Wang, Ning; Qiao, Jianzhe; Tian, Mingjing

2018-04-01

The Port is an important transport hub, one of the important infrastructure of the national economy, the corresponding regional development has a great role in promoting.The construction of the port has been developed rapidly, but it has also brought about more serious environmental problems. Therefore, this paper discusses the nature of ecological ports, summarized the experience of ecological protection measures on the international advanced ports and port construction ecology. The central idea is to explore the construction of ecological port ideas and development countermeasures.

Are we connected? : Ports in Global Networks

NARCIS (Netherlands)

R.A. Zuidwijk (Rob)

2015-01-01

markdownabstractAbstract Global supply chains are built on organizational, information, and logistics networks. Ports are connected via these networks and also need to connect these networks. Synchromodality is an innovative concept for container transportation, and the port plays an important

Environmental impact of the Midia Port - Black Sea (Romania, on the coastal sediment quality

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Catianis Irina

2016-03-01

Full Text Available The aim of the study was to evaluate the impact of potential pollution sources, mainly from the upstream anthropogenic sources and port-related activities. The in-vestigated area covered a wide range of anthropogenic im-pacts (e.g., industrial wastes, storm water runoff, acciden-tal oil spills, intentional discharges and shipping activities. The quality of water and Sediments was assessed us-ing Standard methods, as physical-chemical parameters, chemistry and biology (microbiology, ecotoxicology aim-ing to figure the level of pollution and the effect of port-related activities. Seawater quality results agreed generally with environmental Standards. Though, in some samples the concentrations of sulphates (mg/1 and heavy metals (μg/1, as B, As and Se exceeded the recommended lim-its, without posing a serious environmental concern. Most of the surface sediment samples contain critical levels of hydrocarbons (C>12, (mg/kg, polycyclic aromatic hydrocarbons (ng/g and polychlorobiphenyls (ng/g. For some heavy metals (mg/kg, exchangeable concentrations were found to be very close or above the regulations. The signifi-cance of this study is incontestable taking into account the lack of previous relevant historical data of this area. In this sense, it was possible to indicate, in general, good environmental conditions, despite the industrial and concentrated local port-related activities in the investigated area.

Vectorization, parallelization and porting of nuclear codes. 2001

International Nuclear Information System (INIS)

Akiyama, Mitsunaga; Katakura, Fumishige; Kume, Etsuo; Nemoto, Toshiyuki; Tsuruoka, Takuya; Adachi, Masaaki

2003-07-01

Several computer codes in the nuclear field have been vectorized, parallelized and transported on the super computer system at Center for Promotion of Computational Science and Engineering in Japan Atomic Energy Research Institute. We dealt with 10 codes in fiscal 2001. In this report, the parallelization of Neutron Radiography for 3 Dimensional CT code NR3DCT, the vectorization of unsteady-state heat conduction code THERMO3D, the porting of initial program of MHD simulation, the tuning of Heat And Mass Balance Analysis Code HAMBAC, the porting and parallelization of Monte Carlo N-Particle transport code MCNP4C3, the porting and parallelization of Monte Carlo N-Particle transport code system MCNPX2.1.5, the porting of induced activity calculation code CINAC-V4, the use of VisLink library in multidimensional two-fluid model code ACD3D and the porting of experiment data processing code from GS8500 to SR8000 are described. (author)

Port-site metastasis after laparoscopic surgical staging of endometrial cancer: a systematic review of the published and unpublished data.

Science.gov (United States)

Palomba, Stefano; Falbo, Angela; Russo, Tiziana; La Sala, Giovanni Battista

2012-01-01

Port-site metastases, also called trocar-site metastasis, have been described after laparoscopic surgery for non-gynecological and gynecological cancers. The aim of this review was to obtain evidence for port-site metastases after laparoscopic surgical staging of endometrial cancer. A systematic search of published and unpublished cases of port-site metastases after laparoscopic staging of endometrial cancer was conducted. All the authors responsible for correspondence were contacted to obtain any missing data. The patients' characteristics and oncologic, surgical, and safety data were recorded and analyzed. Twelve cases of port-site metastases were identified and examined. In 4 cases they were "isolated," that is, recurrence without association with peritoneal carcinomatosis, whereas in 8 cases they were "nonisolated." The port-site metastases did not occur as a result of trocar site localization or dimension. No univocal strategy to prevent port-site metastases was adopted. Among patients with nonisolated port-site metastases, an aggressive histologic condition and a high grade were found in 3 of 6 patients and in 3 of 5 patients, respectively. Among patients with isolated port-site metastases, an early-stage endometrioid adenocarcinoma G2 endometrial cancer and a stage IIB G2 endometrioid adenocarcinoma were described in 3 of 4 patients and in only 1 case, respectively. All the patients with nonisolated port-site metastases died of disease. Similarly, among patients with isolated port-site metastases, only 1 was alive and free of disease after 10 months from recurrence diagnosis. Port-site metastases of endometrial cancer are an entity rarely reported but probably the expression of an aggressive disease. The available data do not allow us to draw conclusions or suggestions for their prevention and the treatment. Copyright © 2012 AAGL. Published by Elsevier Inc. All rights reserved.

Long-term Outcome of Peripherally Implanted Venous Access Ports in the Forearm in Female Cancer Patients

Energy Technology Data Exchange (ETDEWEB)

Klösges, Laura, E-mail: l.kloesges@uni-bonn.de; Meyer, Carsten, E-mail: carsten.meyer@ukb.uni-bonn.de; Boschewitz, Jack, E-mail: jack.boschewitz@ukb.uni-bonn.de; Andersson, Magnus, E-mail: magnus.andersson@ukb.uni-bonn.de [Universitätsklinikum Bonn, Department of Radiology (Germany); Rudlowski, Christian, E-mail: c.rudlowski@evk.de [Evangelisches Krankenhaus Bergisch Gladbach, Department of Gynecology (Germany); Schild, Hans H., E-mail: hans.schild@ukb.uni-bonn.de [Universitätsklinikum Bonn, Department of Radiology (Germany); Wilhelm, Kai, E-mail: kai.wilhelm@ek-bonn.de [Ev. Kliniken Bonn, Johanniter-Krankenhaus, Department of Radiology (Germany)

2015-06-15

PurposeThe aim of this retrospective study was to analyze the long-term outcome of peripherally implanted venous access ports in the forearm at our institution in a female patient collective.MethodsBetween June 2002 and May 2011, a total of 293 female patients with an underlying malignancy had 299 forearm ports implanted in our interventional radiology suite. The mean age of the cohort was 55 ± 12 years (range 26–81 years). The majority of women suffered from breast (59.5 %) or ovarian cancer (28.1 %). Complications were classified as infectious complications, thrombotic and nonthrombotic catheter dysfunction (dislocation of the catheter or port chamber, fracture with/without embolization or kinking of the catheter, port occlusion), and others.ResultsWe analyzed a total of 90,276 catheter days in 248 port systems (47 patients were lost to follow-up). The mean device service interval was 364 days per catheter (range 8–2,132, median 223 days, CI 311–415, SD 404). Sixty-seven early (≤30 days from implantation) or late complications (>30 days) occurred during the observation period (0.74/1,000 catheter days). Common complications were port infection (0.18/1,000 days), thrombotic dysfunction (0.12/1,000 days), and skin dehiscence (0.12/1,000 days). Nonthrombotic dysfunction occurred in a total of 21 cases (0.23/1,000 days) and seemed to cumulate on the venous catheter entry site on the distal upper arm.ConclusionPeripherally implanted venous access ports in the forearm are a safe alternative to chest or upper-arm ports in female oncology patients. Special attention should be paid to signs of skin dehiscence and nonthrombotic dysfunction, especially when used for long-term treatment.

Improving treatment of neurodevelopmental disorders: recommendations based on preclinical studies.

Science.gov (United States)

Homberg, Judith R; Kyzar, Evan J; Stewart, Adam Michael; Nguyen, Michael; Poudel, Manoj K; Echevarria, David J; Collier, Adam D; Gaikwad, Siddharth; Klimenko, Viktor M; Norton, William; Pittman, Julian; Nakamura, Shun; Koshiba, Mamiko; Yamanouchi, Hideo; Apryatin, Sergey A; Scattoni, Maria Luisa; Diamond, David M; Ullmann, Jeremy F P; Parker, Matthew O; Brown, Richard E; Song, Cai; Kalueff, Allan V

2016-01-01

Neurodevelopmental disorders (NDDs) are common and severely debilitating. Their chronic nature and reliance on both genetic and environmental factors makes studying NDDs and their treatment a challenging task. Herein, the authors discuss the neurobiological mechanisms of NDDs, and present recommendations on their translational research and therapy, outlined by the International Stress and Behavior Society. Various drugs currently prescribed to treat NDDs also represent a highly diverse group. Acting on various neurotransmitter and physiological systems, these drugs often lack specificity of action, and are commonly used to treat multiple other psychiatric conditions. There has also been relatively little progress in the development of novel medications to treat NDDs. Based on clinical, preclinical and translational models of NDDs, our recommendations cover a wide range of methodological approaches and conceptual strategies. To improve pharmacotherapy and drug discovery for NDDs, we need a stronger emphasis on targeting multiple endophenotypes, a better dissection of genetic/epigenetic factors or "hidden heritability," and a careful consideration of potential developmental/trophic roles of brain neurotransmitters. The validity of animal NDD models can be improved through discovery of novel (behavioral, physiological and neuroimaging) biomarkers, applying proper environmental enrichment, widening the spectrum of model organisms, targeting developmental trajectories of NDD-related behaviors and comorbid conditions beyond traditional NDDs. While these recommendations cannot be addressed all in once, our increased understanding of NDD pathobiology may trigger innovative cross-disciplinary research expanding beyond traditional methods and concepts.

Split lesion randomized comparative study between long pulsed Nd:YAG laser 532 and 1,064 nm in treatment of facial port-wine stain.

Science.gov (United States)

Al-Dhalimi, Muhsin A; Al-Janabi, Murtadha H

2016-11-01

Lasers have been the treatment of choice for Port-wine stain (PWS). However, only one type of laser is not a panacea for all PWS malformations. This is may be due to the great heterogeneity of phenotypic presentation of this congenital anomaly as color, depth, and the site of the lesion. For the treatment of PWS, flash lamp-pumped pulsed dye laser, carbon dioxide, argon, krypton, copper bromide, frequency-doubled neodymium:yttrium-aluminum-garnet (Nd:YAG), and also intense pulsed light sources can be used. To assess and compare the effectiveness of wavelength 532 and 1,064 nanometers (nm) long pulse Nd:YAG laser in the treatment of facial port-wine stain. This was a comparative therapeutic study for the treatment of facial port-wine stain. We divided the lesion into two halves, medial and lateral, and then each half was treated by 532 or 1,064 nm Nd:YAG. The sessions were done every 4 weeks for six sessions and follow-up after 3 months, then assess the response before and after the sessions and at the end follow-up period objectively (degree of improvement, Photo comparison) and subjectively (Patient satisfaction). Fourteen out of nineteen patients completed all sessions of the treatment, and the other five patients were defaulted from the study due to different causes, including marriage, poor compliance for treatment, and for unknown causes. They were 13 (92.85%) females and 1 (7.15%) male. The mean age of patients was 22.07 ± 9.003 years (range 8-44 years). Three patients (21.4%) were Fitzpatrick's skin type III and four patients (78.6%) were typed IV. There was no hypertrophy in any of the lesions. All facial PWSs lie along the distribution of the trigeminal nerve. Four patients (28.6%) have V1 (ophthalmic), 12 patients (85.7%) have V2 (maxillary), and 9 (64.3%) have V3 (mandibular). The color of PWSs was pink-red in eight patients (57.1%), dark-red in four patients (28.6%), and purple-dark two patients (14.3%). The improvement score for the halves of

Cyber security in ports : Business as usual

NARCIS (Netherlands)

Moerel, Lokke; Dezeure, Freddy

2017-01-01

Our paper summarizes the risks and provides concrete and pragmatic proposals to increase substantially the cyber maturity and resilience in the ports by organizing training and awareness raising, fostering cooperation and information exchange both between the stakeholders in the ports and across the

Neutronics analysis for integration of ITER diagnostics port EP10

Energy Technology Data Exchange (ETDEWEB)

Colling, Bethany, E-mail: bethany.colling@ccfe.ac.uk [Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Department of Engineering, Lancaster University, Lancashire LA1 4YR (United Kingdom); Eade, Tim [Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Joyce, Malcolm J. [Department of Engineering, Lancaster University, Lancashire LA1 4YR (United Kingdom); Pampin, Raul; Seyvet, Fabien [Fusion for Energy, Josep Pla 2, Torres Diagonal Litoral B3, 08019 Barcelona (Spain); Turner, Andrew [Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Udintsev, Victor [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France)

2016-11-01

Shutdown dose rate calculations have been performed on an integrated ITER C-lite neutronics model with equatorial port 10. A ‘fully shielded’ configuration, optimised for a given set of diagnostic designs (i.e. shielding in all available space within the port plug drawers), results in a shutdown dose rate in the port interspace, from the activation of materials comprising equatorial port 10, in excess of 2000 μSv/h. Achieving dose rates of 100 μSv/h or less, as required in areas where hands-on maintenance can be performed, in the port interspace region will be challenging. A combination of methods will need to be implemented, such as reducing mass and/or the use of reduced activation steel in the port interspace, optimisation of the diagnostic designs and shielding of the port interspace floor. Further analysis is required to test these options and the ongoing design optimisation of the EP10 diagnostic systems.

Surface sediment quality relative to port activities: A contaminant-spectrum assessment.

Science.gov (United States)

Yu, Shen; Hong, Bing; Ma, Jun; Chen, Yongshan; Xi, Xiuping; Gao, Jingbo; Hu, Xiuqin; Xu, Xiangrong; Sun, Yuxin

2017-10-15

Ports are facing increasing environmental concerns with their importance to the global economy. Numerous studies indicated sediment quality deterioration in ports; however, the deterioration is not discriminated for each port activity. This study investigated a spectrum of contaminants (metals and organic pollutants) in surface sediments at 20 sampling points in Port Ningbo, China, one of the top five world ports by volume. The spectrum of contaminants (metals and organic pollutants) was quantified following marine sediment quality guidelines of China and USA and surface sediment quality was assessed according to thresholds of the two guidelines. Coupling a categorical matrix of port activities with the matrix of sedimentary contaminants revealed that contaminants were highly associated with the port operations. Ship repair posed a severe chemical risk to sediment. Operations of crude oil and coal loadings were two top activities related to organic pollutants in sediments while port operations of ore and container loadings discharged metals. Among the 20 sampling points, Cu, Zn, Pb, and DDT and its metabolites were the priority contaminants influencing sediment quality. Overall, surface sediments in Port Ningbo had relatively low environmental risks but ship repair is an environmental concern that must be addressed. This study provides a practical approach for port activity-related quality assessment of surface sediments in ports that could be applicable in many world sites. Copyright © 2017 Elsevier B.V. All rights reserved.

INSTITUTIONAL BARRIERS TO PORT INFRASTRUCTURE AND HARBOR DEVELOPMENT

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Roger R. STOUGH

2005-01-01

Full Text Available Ports and their regions have experienced at least a century of crisis from wars (e.g., World War I and II, technological change (e.g., containerization and information and computer technology, political change (e.g., end of the Cold War and liberalization of commerce and trade in countries like China and India and globalization. As such ports have needed to adjust to these conditions to maintain their competitiveness. They have done this by adapting their physical and institutional infrastructures and the adoption of new technologies. In this paper it is argued however that institutional adaptation is the most important way in which ports have changed in pursuit of sustained competitiveness. The paper defines institutions in keeping with the view of the new institutional economists and develops an institutional typology for framing the analyses of four case studies of ports and/or their regions that faced crisis conditions. The case studies include an analysis of the problems and responses made by the ports and then an institutional examination and evaluation of the adjustment process pursued. Conclusions are made as working hypotheses about the process of institutional adjustment to competitiveness crises of ports and their regions and directions for future research are presented.

Three port converters used as interface in photovoltaic energy systems

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Sarab Al-Chlaihawi

2018-04-01

Full Text Available The aim of this paper is to derive and study a full-bridge three-port converter. Based on the standard design of full-bridge converter, we have modeled and derived a three port converter. The three port converter can be used in renewable energy scenarios, such as solar cells or wind turbines connected to the input port. The input can be taken from two-ports simultaneously or from one port at a time. In order to balance the power mismatch between the input port and load port, the batteries are attached to the third port, to ensure there are no discrepancies in the power generated at the input and power demand at the load. In order to ensure isolation and reduced voltage stress on the switches, a high frequency transformer is also used in the design. The overall design contains four switches, and four diodes. MOSFETs are the strongest candidate for the switches owing to their high switching speed, lower losses and high resistance to higher voltage. Moreover, a buck-boost structure is modeled in order to ensure that it can work for a wide variety of different applications by adjusting the duty cycle of the switches properly. To minimize the switching losses in the converter, Zero-Voltage Switching (ZVS is also achievable in the modeled system.

Risk factors for venous port migration in a single institute in Taiwan.

Science.gov (United States)

Fan, Wen-Chieh; Wu, Cheng-Han; Tsai, Ming-Ju; Tsai, Ying-Ming; Chang, Hsu-Liang; Hung, Jen-Yu; Chen, Pei-Huan; Yang, Chih-Jen

2014-01-14

An implantable port device provides an easily accessible central route for long-term chemotherapy. Venous catheter migration is one of the rare complications of venous port implantation. It can lead to side effects such as pain in the neck, shoulder, or ear, venous thrombosis, and even life-threatening neurologic problems. To date, there are few published studies that discuss such complications. This retrospective study of venous port implantation in a single center, a Taiwan hospital, was conducted from January 2011 to March 2013. Venous port migration was recorded along with demographic and characteristics of the patients. Of 298 patients with an implantable import device, venous port migration had occurred in seven, an incidence rate of 2.3%. All seven were male and had received the Bard port Fr 6.6 which had smaller size than TYCO port Fr 7.5 and is made of silicon. Significantly, migration occurred in male patients (P = 0.0006) and in those with lung cancer (P = 0.004). Multivariable logistic regression analysis revealed that lung cancer was a significant risk factor for port migration (odds ratio: 11.59; P = 0.0059). The migration rate of the Bard port Fr 6.6 was 6.7%. The median time between initial venous port implantation and port migration was 35.4 days (range, 7 to 135 days) and 71.4% (5/7) of patients had port migration within 30 days after initial port implantation. Male sex and lung cancer are risk factors for venous port migration. The type of venous port is also an important risk factor.

Test Port for Fiber-Optic-Coupled Laser Altimeter

Science.gov (United States)

Ramos Izquierdo, Luis; Scott, V. Stanley; Rinis, Haris; Cavanaugh, John

2011-01-01

A test port designed as part of a fiber optic coupled laser altimeter receiver optical system allows for the back-illumination of the optical system for alignment verification, as well as illumination of the detector(s) for testing the receiver electronics and signal-processing algorithms. Measuring the optical alignment of a laser altimeter instrument is difficult after the instrument is fully assembled. The addition of a test port in the receiver aft-optics allows for the back-illumination of the receiver system such that its focal setting and boresight alignment can be easily verified. For a multiple-detector receiver system, the addition of the aft-optics test port offers the added advantage of being able to simultaneously test all the detectors with different signals that simulate the expected operational conditions. On a laser altimeter instrument (see figure), the aft-optics couple the light from the receiver telescope to the receiver detector(s). Incorporating a beam splitter in the aft-optics design allows for the addition of a test port to back-illuminate the receiver telescope and/or detectors. The aft-optics layout resembles a T with the detector on one leg, the receiver telescope input port on the second leg, and the test port on the third leg. The use of a custom beam splitter with 99-percent reflection, 1-percent transmission, and a mirrored roof can send the test port light to the receiver telescope leg as well as the detector leg, without unduly sacrificing the signal from the receiver telescope to the detector. The ability to test the receiver system alignment, as well as multiple detectors with different signals without the need to disassemble the instrument or connect and reconnect components, is a great advantage to the aft-optics test port. Another benefit is that the receiver telescope aperture is fully back-illuminated by the test port so the receiver telescope focal setting vs. pressure and or temperature can be accurately measured (as

Economic Contribution of Regional Feeder Ports to The Local Economy In Indonesia

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Ibnu Syabri

2017-07-01

Full Text Available Indonesia regional feeder ports’ main function is to serve marine transport activities between regency/city in a province in limited quantities. The intention of the government to make marine transportation as the backbone of national logistic transportation system puts these ports to an important position, as suppliers for the main and/or collector ports and as goods distribution centers for the region from the bigger ports. Not only as a provider of accessibility between regions, regional feeder ports should be seen as an investation to boost regional economy. This study aims to explain the influences of regional feeder ports on regency/city economy, based on the port types: (1 cargo ports, and (2 cargo & passengers ports. Results showed that both types of ports have positive influences on the regency/city economy, although it is not related to region’s economic base sector. Cargo ports which are mainly located on west area of Indonesia, supports the region’s economy more than cargo & passenger ports which are mainly located on the east.

Climate change considerations for the Port Hope area initiative

International Nuclear Information System (INIS)

Kirklady, J.; Morassutti, M.; Tamm, J.; Coutts, P.; Chambers, D.

2006-01-01

The Port Hope Area Initiative (PHAI) is a community-based program intended to develop a safe and long-term (approximately 500 years) solution for the management of historic low-level radioactive waste (LLRW) that has been present in the Port Hope area for many years. The PHAI undertakings involve the construction and management of two Long-Term Low-Level Radioactive Waste Management Facilities (referred to as the LTWMFs) in Port Hope and in Port Granby. These undertakings are currently undergoing detailed examination through the Environmental Screening process under the Canadian Environmental Assessment Act. The purpose of the study described in this paper was to provide information necessary to satisfy the requirements of the Scope of Environmental Assessment for the Port Hope and Port Granby Projects. In particular, the purpose of the study was to satisfy the requirements to evaluate greenhouse gas (GHG) emissions from the proposed PHAI initiatives and to evaluate the potential effect of climate change parameters on the two Projects. The Port Hope and Port Granby Projects will contribute to Ontario's GHG emission inventory due to vehicle exhaust from excavation equipment and haul trucks during the construction phase of the LTWMFs. The construction phase of the Projects is of relatively short duration, and the contribution of GHGs from each Project was determined to be insignificant compared to Ontario's GHG emissions from the Construction and Transportations sectors. The proposed project elements associated with the Port Hope and Port Granby Projects were each evaluated with respect to potential sensitivities to future change in climate parameters. Considering the potential changes to climate, a screening analysis of each element of the LTWMFs was undertaken. Because it is considered likely that the current design level storms will be exceeded within the next 500 years, it was determined that the storm water management system was potentially sensitive to changes

Strategic and Operational Plan Implementation of Seaports (Utilization Jeddah Port

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Akram Elentably

2015-12-01

Full Text Available The Port of Jeddah (Port released the initial version of this Strategic Plan in 2006. It was developed by Port staff, along with input, as a five-year rolling plan designed to guide the Port’s future development while keeping in mind the needs of our tenants, local community members and stakeholders, and the nation. This is the second update to the Strategic Plan since its initial release. While the Port’s overarching principles – commitment to environmental stewardship, addressing tenant needs, goods movement, economic development, and security – have remained largely unchanged, it is important for us to adapt our strategies to meet the challenges of an ever changing local and global environment. The Port is among the world’s premier ports and is a critical hub for global trade. This prominence brings with it responsibilities and expectations for the highest possible standards for efficiency, safety and security, and environmental leadership. The Port is the nation’s busiest container port and part of the world’s busiest port complex, handling 3.7 million twenty-foot equivalent units in 2013. Global trade and goods movement is Western kingdom of Saudi Arabia’s strongest industries in terms of jobs and economic activity. The Port of Jeddah powers these industries, handling almost more than a quarter of the cargo that enters the kingdom of Saudi Arabia annually. Through the Port’s activities, a lot of jobs are created in western kingdom of Saudi Arabia and over five hundred thousand nationwide. In order to maintain our position among the world’ the kingdom of Saudi Arabia premier ports, the Port is continually addressing the demands for providing modern and efficient cargo handling terminals as well as transportation and infrastructure projects. Protecting one of the nation’s most vital economic hubs is also an ongoing challenge. Finally, promoting a sustainable “grow green” philosophy and ensuring that we are the leader

RECOMMENDATIONS ON DIAGNOSIS AND TREATMENT OF URINARY TRACT INFECTIONS IN CHILDREN

Directory of Open Access Journals (Sweden)

T. V. Margiyeva

2016-01-01

Full Text Available Given very high prevalence of urinary tract infection (UTI in the setting of renal pathology in children, timely disease identification, adequate antibacterial treatment and, if necessary, anti relapse therapy are of extreme importance. It is known that recurrent UTI is a risk factor of renal damage progression and development of renal failure. The given clinical recommendations on UTI diagnosis and management are based on the evidence-based approach. This helps to optimize work of pediatricians and pediatric nephrologists.

Recommendations on the diagnosis, treatment and monitoring of late-onset hypogonadism in men - a suggested update.

Science.gov (United States)

Lunenfeld, Bruno; Mskhalaya, George; Kalinchenko, Svetlana; Tishova, Yulia

2013-12-01

Recommendations on the diagnosis, treatment and monitoring of late-onset hypogonadism (LOH) in men were first published by ISSAM in 2002 In 2005, and, in 2008, updated recommendations were published in the International Journal of Andrology, the Journal of Andrology, the Aging Male and European Urology. Towards discussions at the next ISSAM/ESSAM meeting in Moscow, 29 November 2013, we suggest the following update.

Lessons from Hurricane Sandy for port resilience.

Science.gov (United States)

2013-12-01

New York Harbor was directly in the path of the most damaging part of Hurricane Sandy causing significant impact on many of the : facilities of the Port of New York and New Jersey. The U.S. Coast Guard closed the entire Port to all traffic before the...

Working with Nature in Wadden Sea Ports

NARCIS (Netherlands)

Baptist, M.J.; Eekelen, van E.; Dankers, P.J.T.; Grasmeijer, B.; Kessel, van T.; Maren, van D.S.

2017-01-01

Wadden Sea ports are situated at the border of the UNESCO World Heritage site Wadden Sea. Because of the protected status of this area, developing new economic activities is not straightforward. However, maintaining and developing port activities is needed to safeguard the economic viability of the

Ports and innovation

NARCIS (Netherlands)

Taneja, P.; Vellinga, T.; Van Schuylenburg, M.

2012-01-01

A volatile environment, dynamic markets, and challenges created by new environmental and social consideration demand innovative solutions. Innovation is the implementation of ideas to create value. It promises ports resilience into the future. In this paper we trace some recent successful

A Conceptual Model of Excellent Performance Mode of Port Enterprise Logistics Management

Directory of Open Access Journals (Sweden)

Jiang He

2017-11-01

Full Text Available Port as one of the key hubs of international logistics, which has become the main part and the base of global logistics management. The port enterprises, plays an important role in the global supply chain. However, due to the lack of understanding in port supply chain management, coordination between the port enterprises, the integration of business process is not perfect, the lack of information sharing between various organizations, ports enterprises usually failed to fully play its positive role. Based on this, the paper makes the port enterprises as the research object, and introduces the excellent performance mode into the port enterprises. In order to study the port enterprises how to carry out effective quality management, and formation the coordination and integration of upstream and downstream of enterprises, so as to realize the competitive advantage in port logistics.

Incidence and risk factors for central venous access port-related infection in Chinese cancer patients.

Science.gov (United States)

Wang, Ting-Yao; Lee, Kuan-Der; Chen, Ping-Tsung; Chen, Min-Chi; Chen, Yi-Yang; Huang, Cih-En; Kuan, Feng-Che; Chen, Chih-Cheng; Lu, Chang Hsien

2015-11-01

Cytotoxic chemotherapy via central venous access ports is an important part of the standard treatment for most cancers, but it is accompanied with the risk of infections. This study aimed to analyze the incidence and risk factors for central venous access port-related infection (CPI) among Chinese patients receiving cytotoxic chemotherapy. Between January 1, 2002 and December 31, 2005 a total of 1391 cancer patients with 1449 totally implantable central venous access ports were evaluated. The log-rank test and Cox proportional hazards model were used for the analyses of risk factors. The overall CPI incidence rate was 0.21 per 1000 catheter-days. Hematological malignancies and head and neck cancer were associated with an increased risk of CPI (hazard ratio 4.00 and 4.11, respectively, both p risk of infection than for patients in a nonadjuvant setting (p ports. Implementation of an insertion bundle for the prevention of central line-associated bloodstream infections is warranted, especially for those patients with hematological and head and neck cancers, as well as for patients receiving chemotherapy in the metastatic settings. Copyright © 2015. Published by Elsevier B.V.

Single port Billroth I gastrectomy

Directory of Open Access Journals (Sweden)

Jeremy R Huddy

2013-01-01

Full Text Available Introduction: Experience has allowed increasingly complex procedures to be undertaken by single port surgery. We describe a technique for single port Billroth I gastrectomy with a hand-sewn intracorporeal anastomosis in the resection of a benign tumour diagnosed incidentally on a background of cholelithiasis. Materials and Methods: Single port Billroth I gastrectomy and cholecystectomy was performed using a transumbilical quadport. Flexible tipped camera and straight conventional instruments were used throughout the procedure. The stomach was mobilised including a limited lymph node dissection and resection margins in the proximal antrum and duodenum were divided with a flexible tipped laparoscopic stapler. The lesser curve was reconstructed and an intracorporal hand sewn two layer end-to-end anastomosis was performed using unidirectional barbed sutures. Intraoperative endoscopy confirmed the anastomosis to be patent without leak. Results: Enteral feed was started on the day of surgery, increasing to a full diet by day 6. Analgesic requirements were a patient-controlled analgesia morphine pump for 4 postoperative days and paracetamol for 6 days. There were no postoperative complications and the patient was discharged on the eighth day. Histology confirmed gastric submucosal lipoma. Discussion: As technology improves more complex procedures are possible by single port laparoscopic surgery. In this case, flexible tipped cameras and unidirectional barbed sutures have facilitated an intracorporal hand-sewn two layer end-to-end anastomosis. Experience will allow such techniques to become mainstream.

Development of the alternate entry port for the ATF

International Nuclear Information System (INIS)

Parsa, Z.

1993-05-01

We discussed a second entry port for the Accelerator Test Facility (ATF) injection system at Brookhaven National Laboratory, which consists of a photocathode rf gun and a straight - ahead beamline directly into the 50 MeV linac. The proposed second entry port should improve the beam quality and lower the emittance needed for FEL (Free Electron Laser), and laser - acceleration experiments. A discussion on the laser driven high brightness photoelectrons through the primary entry port (a low energy 180 degrees achromatic double bend transport line) now in operation, and a beam analysis for the proposed secondary port is also given

Integration of Land and Sea in a Port Area: A Case Study of the Port of Koper

Science.gov (United States)

Ažman Momirski, Lucija

2017-10-01

The spatial plan for a port based on land reclamation, existing land, or a combination of both should be designed in line with both reliable data for the existing situation and precise goals based on a well-founded vision by the port authority. In ports, human activities are concentrated in the limited space of the coastal belt, where they threaten the vulnerable equilibrium of the environment. Integrated multifunctional planning of ports is necessary for the sustainability of such plans. In this process, the relation between the environment and the economy is often neglected because the ecosystem—the totality of living organisms—which is fully dependent on biological, chemical, and physical factors, prevails. This method, also called building with nature, is the basis for integrated coastal zone development and management. It emphasizes the flexible integration of land and sea, which respects and uses forces and materials present in nature, and which is an essential interaction between man and environment. Strict ecological planning conditions and the public interest obliged the Port of Koper to modify its urban planning strategies and redefine its relationship with all bordering areas. The extension of two piers and construction of a third one was the result of functional factors, infrastructure connections, technical possibilities, and environmental requirements. Solutions that were relevant for distributing cargo on the docks had to adjust to the width of the basins for manoeuvring ships. Various types of construction restrict water flow under piers, thereby accelerating biomass degradation. Environmental aspects created conditions and requirements for pier construction.

Dry Port Location Problem: A Hybrid Multi-Criteria Approach

Directory of Open Access Journals (Sweden)

BENTALEB Fatimazahra

2016-03-01

Full Text Available Choosing a location for a dry port is a problem which becomes more essential and crucial. This study deals with the problem of locating dry ports. On this matter, a model combining multi-criteria (MACBETH and mono-criteria (BARYCENTER methods to find a solution to dry port location problem has been proposed. In the first phase, a systematic literature review was carried out on dry port location problem and then a methodological classification was presented for this research. In the second phase, a hybrid multi-criteria approach was developed in order to determine the best dry port location taking different criteria into account. A Computational practice and a qualitative analysis from a case study in the Moroccan context have been provided. The results show that the optimal location is very convenient with the geographical region and the government policies.

Interface Circuit For Printer Port

Science.gov (United States)

Tucker, Jerry H.; Yadlowsky, Ann B.

1991-01-01

Electronic circuit, called printer-port interface circuit (PPI) developed to overcome certain disadvantages of previous methods for connecting IBM PC or PC-compatible computer to other equipment. Has both reading and writing modes of operation. Very simple, requiring only six integrated circuits. Provides for moderately fast rates of transfer of data and uses existing unmodified circuit card in IBM PC. When used with appropriate software, circuit converts printer port on IBM PC, XT, AT, or compatible personal computer to general purpose, 8-bit-data, 16-bit address bus that connects to multitude of devices.

Port-site metastases following robot-assisted laparoscopic surgery for gynecological malignancies.

Science.gov (United States)

Lönnerfors, Celine; Bossmar, Thomas; Persson, Jan

2013-12-01

To evaluate the incidence and possible predictors associated with port-site metastases following robotic surgery. Prospective study. University Hospital. Women with gynecological cancer. The occurrence of port-site metastases in the first 475 women undergoing robotic surgery for gynecological cancer was reviewed. Rate of port-site metastases. A port-site metastasis was detected in nine of 475 women (1.9%). Eight women had either an unexpected locally advanced disease or lymph-node metastases at the time of surgery. All nine women received postoperative adjuvant therapy. Women with ≥ stage III endometrial cancer and women with node positive cervical cancer had a significantly higher risk of developing a port-site metastasis, as did women with high-risk histology endometrial cancer. Port-site metastases were four times more likely to occur in a specimen-retrieval port. One (0.2%) isolated port-site metastasis was detected. The median time to occurrence of a port-site metastasis was 6 months (range 2-19 months). Six of the nine women (67%) have died and their median time of survival from recurrence was 4 months (range 2-16 months). In women with gynecological cancer, the incidence of port-site metastases following robotic surgery was 1.9%. High-risk histology and/or advanced stage of disease at surgery seem to be contributing factors. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Performance Effects of the Corporatisation of Port of Rotterdam Authority

NARCIS (Netherlands)

P.W. de Langen (Peter); C. Heij (Christiaan)

2013-01-01

textabstractPort of Rotterdam Authority is a publicly owned but corporatized port development company. In 2004, this organisation was transformed from a municipal department to an independently operating company. The corporatisation intended to improve the overall performance of the port of

The short-term outcomes of conventional and single-port laparoscopic surgery for rectal cancer

DEFF Research Database (Denmark)

Levic, Katarina; Bulut, Orhan

2014-01-01

BACKGROUND: Single-port laparoscopic surgery (SPLS) has evolved as an alternative method to conventional laparoscopic surgery (CLS). The aim of this study is to evaluate the results of SPLS compared to CLS in the treatment of rectal cancer. MATERIAL AND METHODS: Prospectively collected data...

The Port Hope area initiative from municipal perspective

International Nuclear Information System (INIS)

Austin, R.

2006-01-01

'Full text:' This paper explores the Municipal perspective of the Port Hope Area Initiative (PHAI). The PHAI is unique in that it emerged from proposals to the Federal Government and subsequently a tri-partite agreement between the Federal Government and the Municipalities of Port Hope and Clarington for the cleanup and management of historic low-level radioactive wastes in long-term waste management facilities in their Municipalities. A key feature of the Port Hope Project is the remediation of many major and small scale sites in the urban area. As part of this Legal Agreement, each Municipality is required to give consent at key milestones for the project to proceed to the next stage. In addition, the Municipality also has veto authority if the preferred option is changed by the federal government during its final review. The Agreement also ensures that the Municipalities have the resources to conduct an independent assessment of the work completed by the federal proponent and to advise the Municipality on related matters. While this Legal Agreement provides the Municipalities with influence over the outcome of the EA and the project description, especially when compared with the typical role of municipalities in other Federal EAs, there are many challenges that Port Hope faces as partner in this process. These include: Balancing Port Hope's interests with those of the Federal Government; Reaching agreement on how clean the remediation sites should be; Considering the interests of future generations while meeting the needs of existing residents; Ensuring that the Project will have a positive legacy for Port Hope; Ensuring that institutional controls are in place and that Port Hope has a partnership role in monitoring the Project performance during the Construction Phase and the long term Maintenance and Monitoring Phase. In this context, this paper presents the unique aspects of the Municipal involvement in the process to finally achieve a safe, environmentally

Port interface requirements

International Nuclear Information System (INIS)

O'Neil, R.

1978-01-01

In a land-based reactor programme the Administration are usually confronted with a specific design in a particular environment. Safety and Reliability criteria necessary to the designer can be specified on the basis of acceptable risk to the population. However for the successful implementation of a nuclear ship programme on a broad commercial basis it is necessary to have agreed standards of risks from ships yet to be designed and agreed standards of acceptable risks to the population at likely ports of call yet to be specified, consulted, or agreed. At first sight it would seem that this double uncertainty must either lead to unnecessarily high safety standards for the ship or unacceptably conservative standards for berth selection. The paper discusses the problem and proposes a possible solution based on the concept of a 'Standard Port' and a 'Standard Ship' and indicates the level of risk implied by such a concept

Modelling the assessment of port wine stain parameters from skin surface temperature following a diagnostic laser pulse

NARCIS (Netherlands)

Gabay, S.; Lucassen, G. W.; Verkruysse, W.; van Gemert, M. J.

1997-01-01

Laser treatment of port wine stains (PWS) has become an established clinical modality over the past decade. However, in some cases full clearance of the PWS cannot be achieved. To improve the clinical results, it is necessary to match the laser treatment parameters to the PWS anatomy on an

Visual Support for Porting Large Code Bases

NARCIS (Netherlands)

Broeksema, Bertjan; Telea, Alexandru

2011-01-01

We present a tool that helps C/C++ developers to estimate the effort and automate software porting. Our tool supports project leaders in planning a porting project by showing where a project must be changed, how many changes are needed, what kinds of changes are needed, and how these interact with

Two-port Laparoscopic-assisted Appendicectomy Under Local ...

African Journals Online (AJOL)

Journal of Surgical Technique and Case Report | Jul-Dec 2011 | Vol-3 | Issue-2. 84. Two-port Laparoscopic-assisted ... appendicectomy (LAA) using the two-port technique under local anesthesia in adults. As a pilot study we .... of failure are the reasons for avoidance of using local anesthesia for surgical procedures.

Spatial Determinants of Import Traffic Distribution At Port Harcourt (Nigeria

Directory of Open Access Journals (Sweden)

Soddy I. Inyang

2013-07-01

Full Text Available This paper highlights the result of a study carried out to examine the Geographic determinants of import traffic distribution at the Port Harcourt Port. A substantial aspect of the study involved building a regression model to estimate import distribution from the Port. The import function was specified in log-linear form. The adequacy of the model was then tested; this, involved statistical experiments to obtain the R-squared, as well as t and f values. Further test on the adequacy of the nwdel was conducted through diagnostic exercises designed to check for inulticollinedrity and heteroscedasticity, in the data used. Results obtained show that road distance and manufacturing industries are significant Geographic determinants of import Cargo distribution at the study Port. It is therefore important to lake the two variables into account in any policy or planning exercise at Port Harcourt Port.

The role of sea ports in end-to-end maritime transport chain emissions

International Nuclear Information System (INIS)

Gibbs, David; Rigot-Muller, Patrick; Mangan, John; Lalwani, Chandra

2014-01-01

This paper's purpose is to investigate the role of sea ports in helping to mitigate the GHG emissions associated with the end-to-end maritime transport chain. The analysis is primarily focused on the UK, but is international in application. The paper is based on both the analysis of secondary data and information on actions taken by ports to reduce their emissions, with the latter data collected for the main UK ports via their published reports and/or via interviews. Only a small number of ports (representing 32% of UK port activity) actually measure and report their carbon emissions in the UK context. The emissions generated by ships calling at these ports are analysed using a method based on Department for Transport Maritime Statistics Data. In addition, a case example (Felixstowe) of emissions associated with HGV movements to and from ports is presented, and data on vessel emissions at berth are also considered. Our analyses indicate that emissions generated by ships during their voyages between ports are of a far greater magnitude than those generated by the port activities. Thus while reducing the ports' own emissions is worthwhile, the results suggest that ports might have more impact through focusing their efforts on reducing shipping emissions. - Highlights: • Investigates role of ports in mitigating GHG emissions in the end-to-end maritime transport chain. • Emissions generated both by ports and by ships calling at ports are analysed. • Shipping's emissions are far greater than those generated by port activities. • Ports may have more impact through focusing efforts on reducing shipping's emissions. • Options for ports to support and drive change in the maritime sector also considered

Pollution prevention at ports: clearing the air

International Nuclear Information System (INIS)

Bailey, Diane; Solomon, Gina

2004-01-01

Seaports are major hubs of economic activity and of environmental pollution in coastal urban areas. Due to increasing global trade, transport of goods through ports has been steadily increasing and will likely continue to increase in the future. Evaluating air pollution impacts of ports requires consideration of numerous sources, including marine vessels, trucks, locomotives, and off-road equipment used for moving cargo. The air quality impacts of ports are significant, with particularly large emissions of diesel exhaust, particulate matter, and nitrogen oxides. The health effects of these air pollutants to residents of local communities include asthma, other respiratory diseases, cardiovascular disease, lung cancer, and premature mortality. In children, there are links with asthma, bronchitis, missed school days, and emergency room visits. The significance of these environmental health impacts requires aggressive efforts to mitigate the problem. Approaches to mitigation encompass a range of possibilities from currently available, low-cost approaches, to more significant investments for cleaner air. Examples of the former include restrictions on truck idling and the use of low-sulfur diesel fuel; the latter includes shore-side power for docked ships, and alternative fuels. A precautionary approach to port-related air pollution would encourage local production of goods in order to reduce marine traffic, greener design for new terminals, and state-of-the art approaches to emissions-control that have been successfully demonstrated at ports throughout the world

Incidence and risk factors of infections complications related to implantable venous-access ports

International Nuclear Information System (INIS)

Shim, Ji Sue; Seo, Tae Seok; Song, Myung Gyu; Cha, In Ho; Kim, Jun Suk; Choi, Chul Won; Seo, Jae Hong; Oh, Sang Cheul

2014-01-01

The purpose of this study was to determine the incidence and risk factors of infections associated with implantable venous access ports (IVAPs.) From August 2003 through November 2011, 1747 IVAPs were placed in our interventional radiology suite. One hundred forty four IVAPs were inserted in patients with hematologic malignancy and 1603 IVAPs in patients with solid tumors. Among them, 40 ports (23 women and 17 men; mean age, 57.1 years; range, 13-83) were removed to treat port-related infections. We evaluated the incidence of port-related infection, patient characteristics, bacteriologic data, and patient progress. Univariable analyses (t test, chi-square test, and Fisher's exact test) and multiple logistic regression analyses were used to determine the risk factors for IVAP related infection. Overall, 40 (2.3%) of 1747 ports were removed for symptoms of infection with an incidence rate of 0.067 events/1000 catheter-days. According to the univariable study, the incidences of infection were seemingly higher in the patients who received the procedure during inpatient treatment (p = 0.016), the patients with hematologic malignancy (p = 0.041), and the patients receiving palliative chemotherapy (p = 0.022). From the multiple binary logistic regression, the adjusted odds ratios of infection in patients with hematologic malignancies and those receiving palliative chemotherapy were 7.769 (p = 0.001) and 4.863 (p = 0.003), respectively. Microorganisms were isolated from 26 (65%) blood samples, and two of the most causative organisms were found to be Staphylococcus (n = 10) and Candida species (n = 7). The underlying hematologic malignancy and the state of receiving palliative chemotherapy were the independent risk factors of IVAP-related infection.

Incidence and risk factors of infections complications related to implantable venous-access ports

Energy Technology Data Exchange (ETDEWEB)

Shim, Ji Sue; Seo, Tae Seok; Song, Myung Gyu; Cha, In Ho; Kim, Jun Suk; Choi, Chul Won; Seo, Jae Hong; Oh, Sang Cheul [Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

2014-08-15

The purpose of this study was to determine the incidence and risk factors of infections associated with implantable venous access ports (IVAPs.) From August 2003 through November 2011, 1747 IVAPs were placed in our interventional radiology suite. One hundred forty four IVAPs were inserted in patients with hematologic malignancy and 1603 IVAPs in patients with solid tumors. Among them, 40 ports (23 women and 17 men; mean age, 57.1 years; range, 13-83) were removed to treat port-related infections. We evaluated the incidence of port-related infection, patient characteristics, bacteriologic data, and patient progress. Univariable analyses (t test, chi-square test, and Fisher's exact test) and multiple logistic regression analyses were used to determine the risk factors for IVAP related infection. Overall, 40 (2.3%) of 1747 ports were removed for symptoms of infection with an incidence rate of 0.067 events/1000 catheter-days. According to the univariable study, the incidences of infection were seemingly higher in the patients who received the procedure during inpatient treatment (p = 0.016), the patients with hematologic malignancy (p = 0.041), and the patients receiving palliative chemotherapy (p = 0.022). From the multiple binary logistic regression, the adjusted odds ratios of infection in patients with hematologic malignancies and those receiving palliative chemotherapy were 7.769 (p = 0.001) and 4.863 (p = 0.003), respectively. Microorganisms were isolated from 26 (65%) blood samples, and two of the most causative organisms were found to be Staphylococcus (n = 10) and Candida species (n = 7). The underlying hematologic malignancy and the state of receiving palliative chemotherapy were the independent risk factors of IVAP-related infection.

CEA engineering studies and integration of the ITER diagnostic port plugs

International Nuclear Information System (INIS)

Doceul, L.; Walker, C.; Ingesson, C.; Ciattaglia, E.; Chappuis, P.; Portafaix, C.; Salasca, S.; Thomas, E.; Tremblay, G.; Bruyere, C.

2007-01-01

Most of the ITER diagnostic system is integrated in port plugs, which are water cooled stainless steel structures inserted into the vacuum-vessel ports. The port plug must perform basic functions such as providing neutron and gamma shielding, supporting the first wall armour and shielding blanket material, closing the vacuum vessel ports, while supporting the diagnostic equipment. CEA has contributed to the engineering activities on the port plugs and has more particularly focused on the design and diagnostic integration in the representative equatorial port plug Eq no. 01. The specific CEA contributions have been the engineering, structural and thermal analysis. These detailed analyses have highlighted some design issues which were worked out through different solutions. This paper contains a description of the engineering activities performed such as: the conceptual design of the Eq no. 01 port plug, the static mechanical calculations, the dynamic calculation to estimate the dynamic amplification factor due to the resonance phenomenon, the thermal assessment under the neutronic load and the seismic response of the port plug inside the vacuum vessel

CEA engineering studies and integration of the ITER diagnostic port plugs

Energy Technology Data Exchange (ETDEWEB)

Doceul, L. [Association Euratom-CEA sur la Fusion Controlee, Centre d' Etudes de Cadarache, F-13108 Saint-Paul-Lez-Durance Cedex (France)], E-mail: louis.doceul@cea.fr; Walker, C. [ITER International Team, Boltzmannstr. 2, D-85748 Garching bei Muenchen (Germany); Ingesson, C.; Ciattaglia, E. [EFDA CSU - Garching, Boltzmannstr. 2, D-85748 Garching bei Muenchen (Germany); Chappuis, P.; Portafaix, C.; Salasca, S.; Thomas, E.; Tremblay, G.; Bruyere, C. [Association Euratom-CEA sur la Fusion Controlee, Centre d' Etudes de Cadarache, F-13108 Saint-Paul-Lez-Durance Cedex (France)

2007-10-15

Most of the ITER diagnostic system is integrated in port plugs, which are water cooled stainless steel structures inserted into the vacuum-vessel ports. The port plug must perform basic functions such as providing neutron and gamma shielding, supporting the first wall armour and shielding blanket material, closing the vacuum vessel ports, while supporting the diagnostic equipment. CEA has contributed to the engineering activities on the port plugs and has more particularly focused on the design and diagnostic integration in the representative equatorial port plug Eq no. 01. The specific CEA contributions have been the engineering, structural and thermal analysis. These detailed analyses have highlighted some design issues which were worked out through different solutions. This paper contains a description of the engineering activities performed such as: the conceptual design of the Eq no. 01 port plug, the static mechanical calculations, the dynamic calculation to estimate the dynamic amplification factor due to the resonance phenomenon, the thermal assessment under the neutronic load and the seismic response of the port plug inside the vacuum vessel.

Engineering activities on the ITER representative diagnostic equatorial port plug

International Nuclear Information System (INIS)

Meunier, L.; Doceul, L.; Salasca, S.; Martins, J.-P.; Jullien, F.; Dechelle, Christian; Bidaud, Pierre; Pilard, Vincent; Terra, Alexis; Ogea, Mathieu; Ciattaglia, Emanuela; Walker, Christopher

2009-01-01

Most of ITER diagnostic systems are integrated in port plugs, which are water cooled stainless steel structures inserted into the vacuum vessel ports. The port plug must provide basic functions such as neutron and gamma shielding, supporting the first wall armour (BSM), closing the vacuum vessel ports, while supporting the diagnostic equipments. ITER diagnostic port plug must resist a severe environment like high temperature due to neutron interaction with the structures and high electromechanical loading during disruptions events. CEA has contributed to the design and integration tasks in the frame of the representative equatorial port plug EQ no. 01, in particular on the engineering, structural and thermal finite element analysis. These detailed analyses have highlighted some design issues which were worked out through different solutions. This paper contains a description of the engineering activities performed such as: -The static mechanical calculations of the top plate closure system under disruption load. -The static mechanical calculations of the BSM attachment to the port plug. These two first studies led to design changes proposals which significantly improved the behaviour of the structures but also showed that the safety margin with respect to design limits is quite low. -The design of a Diagnostic Shield Module (DSM) integrated inside the port plug and a proposition of attachment scheme, with respect to disruption loads. The manufacturing of the DSM has been taken into account, as well as diagnostic integration inside the structure and maintenance aspects. -The thermal assessment of the port plug under neutronic load during normal operation, with the optimization of the cooling system. The maximum temperature calculated in normal operation has been reduced from 900 deg. C to less than 400 deg. C in the front plate; and the cooling arrangement at the back of the port plug has been simplified without important temperature increase.

Engineering activities on the ITER representative diagnostic equatorial port plug

Energy Technology Data Exchange (ETDEWEB)

Meunier, L. [Association Euratom CEA, CEA/DSM/IRFM (France)], E-mail: lmeunier@cea.fr; Doceul, L.; Salasca, S.; Martins, J.-P.; Jullien, F.; Dechelle, Christian; Bidaud, Pierre; Pilard, Vincent; Terra, Alexis; Ogea, Mathieu [Association Euratom CEA, CEA/DSM/IRFM (France); Ciattaglia, Emanuela [EFDA CSU, Garching (Germany); Walker, Christopher [ITER International Organisation (France)

2009-06-15

Most of ITER diagnostic systems are integrated in port plugs, which are water cooled stainless steel structures inserted into the vacuum vessel ports. The port plug must provide basic functions such as neutron and gamma shielding, supporting the first wall armour (BSM), closing the vacuum vessel ports, while supporting the diagnostic equipments. ITER diagnostic port plug must resist a severe environment like high temperature due to neutron interaction with the structures and high electromechanical loading during disruptions events. CEA has contributed to the design and integration tasks in the frame of the representative equatorial port plug EQ no. 01, in particular on the engineering, structural and thermal finite element analysis. These detailed analyses have highlighted some design issues which were worked out through different solutions. This paper contains a description of the engineering activities performed such as: -The static mechanical calculations of the top plate closure system under disruption load. -The static mechanical calculations of the BSM attachment to the port plug. These two first studies led to design changes proposals which significantly improved the behaviour of the structures but also showed that the safety margin with respect to design limits is quite low. -The design of a Diagnostic Shield Module (DSM) integrated inside the port plug and a proposition of attachment scheme, with respect to disruption loads. The manufacturing of the DSM has been taken into account, as well as diagnostic integration inside the structure and maintenance aspects. -The thermal assessment of the port plug under neutronic load during normal operation, with the optimization of the cooling system. The maximum temperature calculated in normal operation has been reduced from 900 deg. C to less than 400 deg. C in the front plate; and the cooling arrangement at the back of the port plug has been simplified without important temperature increase.

Image-guided placement of port catheters: is there an increased risk of infection if the port is immediately accessed and used?

Science.gov (United States)

Salazar, Gloria; Yeddula, Kalpana; Wicky, Stephan; Oklu, Ramhi; Ganguli, Suvranu; Waltman, Arthur C; Walker, Thomas G; Kalva, Sanjeeva P

2013-01-01

To compare complication rates in patients who have port-a-catheters inserted and left accessed for immediate use and those who have ports inserted but not accessed. In this retrospective, IRB-approved study, medical records of patients who received a port catheter between 9/2009 and 2/2010 were reviewed. The data collected included patient demographics, diagnosis, procedure and complications. The patients were categorized into two groups: accessed (patients in whom the port was accessed with a Huber needle for immediate intravenous use and the patient left the procedure area with needle indwelling) and control (patients in whom the ports were not accessed). Complications were classified according to Society of Interventional Radiology guidelines. Results are given as mean ±SD. Statistical analysis was performed with student t test and statistical significance was considered at Pports were placed in 465 patients (Men: 206); 10.7% in the accessed group (n=50, age: 60±13.9) and 89.3% in the control group (n=417, age: 59±13.5). There were no statistically significant differences in patient demographics between the groups. The overall complication rate was 0.6% (n=3). Two complications (hematoma causing skin necrosis and thrombosis of the port) occurred in the control group and one (infection) in the accessed group. Infection rates after procedures were 2% (1/50) in the accessed group and 0% (0/417) in the control group. There was no statistically significant difference in overall complication (P=.1) and infection (P=.1) rates among the groups. Leaving the port accessed immediately after placement does not increase the risk of infection or other complications.

A Comparative Study of Acute and Chronic Pain between Single Port and Triple Port Video-assisted Thoracic Surgery for Lung Cancer

Directory of Open Access Journals (Sweden)

Caiwei LI

2018-04-01

Full Text Available Background and objective Through the comparative analysis of the acute and chronic pain postoperative between the single port and triple port video-assisted thoracic surgery to seek the better method which can reduce the incidence of acute and chronic pain in patients with lung cancer. Methods Data of 232 patients who underwent single port -VATS (n=131 or triple port VATS (n=101 for non-small cell lung cancer (NSCLC on January 1, 2016 to June 30, 2017 in our hospital were analyzed. The clinical and operative data were assessed, numeric rating scale (NRS was used to evaluate the mean pain score on the 1th, 2th, 3th, 7th, 14th days, 3th months and 6th months postoperative. Results Both groups were similar in clinical characteristics, there were no perioperative death in two groups. In the 1th, 2th, 7th, 14th days and 3th, 6th months postoperative, the NRS score of the single port group was superior, and the difference was significant compared with the triple port (P0.05. Univariate and multivariate analysis of the occurrence on the chronic pain showed that the operation time, surgical procedure and the 14th NRS score were risk factors for chronic pain (P<0.05. Conclusion The single port thoracoscopic surgery has an advantage in the incidence of acute and chronic pain in patients with non-small cell lung cancer. Shorter operative time can reduce the occurrence of chronic pain. The 14th day NRS score is a risk factor for chronic pain postoperative.

Clinical predictors of port infections within the first 30 days of placement.

Science.gov (United States)

Bamba, Ravinder; Lorenz, Jonathan M; Lale, Allison J; Funaki, Brian S; Zangan, Steven M

2014-03-01

To identify risk factors for port infections within 30 days of placement. A retrospective chart review of port placements from 2002-2009 was conducted. Patients who had port removals secondary to infection within the first 30 days of placement were included. This group of patients was compared with a control group of patients with ports with no evidence of infection. For every one patient with a port infection, two control subjects were chosen of the same gender and new port placement during the same month as the corresponding patient with an infected port. From 2002-2009, 4,404 ports were placed. Of the 4,404 patients, 33 (0.7%) were found to have a port infection within 30 days of placement. Compared with the control group, the early infection group had a higher prevalence of leukopenia (21.2% vs 6.1%, P = .039) and thrombocytopenia (33% vs 12%, P = .0158). There was also a higher prevalence of an inpatient hospital stay during port placement and high international normalized ratio in the early infection group. Low preoperative white blood cell and platelet counts were risk factors for early infection. Abnormal coagulation profiles and inpatient access of ports after placement could be additional risk factors. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

Status of proton treatment facility at National Cancer Center, Kashiwa

International Nuclear Information System (INIS)

Tachikawa, T.; Kohmura, I.; Kataoka, S.; Nonaka, H.; Kimura, T.; Sato, T.; Nishio, T.; Shimbo, M.; Ogino, T.; Ikeda, H.

2001-01-01

Proton treatment facility at National Cancer Center Hospital East (Kashiwa) has two rotating gantry ports and one horizontal fixed port. In order to provide the same dose distribution at different gantry angles, the beam optics from the accelerator (235 MeV cyclotron) to the entrance of nozzle is specially tuned. Recently developed automatic tuning method of beam alignment can realize a sequential treatment at three irradiation ports. (author)

Strategic port development

DEFF Research Database (Denmark)

Olesen, Peter Bjerg; Dukovska-Popovska, Iskra; Steger-Jensen, Kenn

2012-01-01

This paper proposes a framework for strategic development of a port’s collaboration with its hinterland. The framework is based on literature relevant to port development and undertakes market perspective by considering import/export data relevant for the region of interest. The series of steps...

Port-wine stain

Science.gov (United States)

... About MedlinePlus Show Search Search MedlinePlus GO GO About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Port-wine stain URL of this page: //medlineplus.gov/ency/ ...

Port wine stain on a child's face (image)

Science.gov (United States)

Port wine stains are always present at birth. In an infant, they are flat, pink, vascular lesions. Common locations ... may be present anywhere on the body. Port wine stains may appear in association with other syndromes.

The state-of-the-art port of entry workshop

Energy Technology Data Exchange (ETDEWEB)

Godfrey, B.

1995-05-01

The increased demand for freight movements through international ports of entry and the signing of the North American Free Trade Agreement (NAFTA) have increased freight traffic at border ports of entry. The State-of-the-Art Port of Entry Workshop initiated a dialogue among technologists and stakeholders to explore the potential uses of technology at border crossings and to set development priorities. International ports of entry are both information and labor intensive, and there are many promising technologies that could be used to provide timely information and optimize inspection resources. Participants universally held that integration of technologies and operations is critical to improving port services. A series of Next Steps was developed to address stakeholder issues and national priorities, such as the National Transportation Policy and National Drug Policy. This report documents the views of the various stakeholders and technologists present at the workshop and outlines future directions of study.

Extracorporeal Treatment in Phenytoin Poisoning: Systematic Review and Recommendations from the EXTRIP (Extracorporeal Treatments in Poisoning) Workgroup.

Science.gov (United States)

Anseeuw, Kurt; Mowry, James B; Burdmann, Emmanuel A; Ghannoum, Marc; Hoffman, Robert S; Gosselin, Sophie; Lavergne, Valery; Nolin, Thomas D

2016-02-01

The Extracorporeal Treatments in Poisoning (EXTRIP) Workgroup conducted a systematic literature review using a standardized process to develop evidence-based recommendations on the use of extracorporeal treatment (ECTR) in patients with phenytoin poisoning. The authors reviewed all articles, extracted data, summarized findings, and proposed structured voting statements following a predetermined format. A 2-round modified Delphi method was used to reach a consensus on voting statements, and the RAND/UCLA Appropriateness Method was used to quantify disagreement. 51 articles met the inclusion criteria. Only case reports, case series, and pharmacokinetic studies were identified, yielding a very low quality of evidence. Clinical data from 31 patients and toxicokinetic grading from 46 patients were abstracted. The workgroup concluded that phenytoin is moderately dialyzable (level of evidence = C) despite its high protein binding and made the following recommendations. ECTR would be reasonable in select cases of severe phenytoin poisoning (neutral recommendation, 3D). ECTR is suggested if prolonged coma is present or expected (graded 2D) and it would be reasonable if prolonged incapacitating ataxia is present or expected (graded 3D). If ECTR is used, it should be discontinued when clinical improvement is apparent (graded 1D). The preferred ECTR modality in phenytoin poisoning is intermittent hemodialysis (graded 1D), but hemoperfusion is an acceptable alternative if hemodialysis is not available (graded 1D). In summary, phenytoin appears to be amenable to extracorporeal removal. However, because of the low incidence of irreversible tissue injury or death related to phenytoin poisoning and the relatively limited effect of ECTR on phenytoin removal, the workgroup proposed the use of ECTR only in very select patients with severe phenytoin poisoning. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Structural Analysis for an Upper Port of the ITER Vacuum Vessel

International Nuclear Information System (INIS)

Yun-Seok Hong; Kwon, T. K.; Ahn, H. J.; Kim, Y.K.; Lee, C.D.

2006-01-01

The ITER vacuum vessel (VV) has numerous openings for the port structures including upper, equatorial, and lower ports used for equipment installation, utility feed through, vacuum pumping, and access into the vessel for maintenance. Every upper port, slanted upward slightly, has a trapezoidal/rectangular cross-section and consists of a port stub, a stub extension and a port extension with a connecting duct. To investigate the structural integrity and to increase the structural reliability of the VV and ports, the structural analyses of the upper port structure have been performed. The global structural analysis of the upper port with the in-port components has been carried out. The local analyses of a tangential key, an upper port flange, a connecting duct and a sealing unit have been performed. The design loads are dead weight, normal and abnormal pressure load, electromagnetic load, and seismic load in consideration of the dynamic amplification factors. The stress analyses were performed in a nonlinear elastic approach taking into account the contact surface between port extension flange and port plug flange. Two advanced designs from the ITER international team have been reviewed. To verify the strength of the reinforcing ribs for the connecting duct and of the fastening/sealing units, the local analyses utilizing the sub-modeling technique have been performed. The ASME code and the ITER design criteria were applied for the evaluation of the structural analysis results from the global and local analyses. The clearance between a port and a plug to accommodate the plug deformation has been assessed. The upper port flange based on the original design could withstand design loads, but there could be a gap on the flange surface under the design condition. The modified flange design, which is under the bolt friction only without tangential key was proposed. The deflection of the plug for an advanced design with a removable flange is higher than that for the original

Smartphone audio port data collection cookbook

Directory of Open Access Journals (Sweden)

Kyle Forinash

2018-06-01

Full Text Available The audio port of a smartphone is designed to send and receive audio but can be harnessed for portable, economical, and accurate data collection from a variety of sources. While smartphones have internal sensors to measure a number of physical phenomena such as acceleration, magnetism and illumination levels, measurement of other phenomena such as voltage, external temperature, or accurate timing of moving objects are excluded. The audio port cannot be only employed to sense external phenomena. It has the additional advantage of timing precision; because audio is recorded or played at a controlled rate separated from other smartphone activities, timings based on audio can be highly accurate. The following outlines unpublished details of the audio port technical elements for data collection, a general data collection recipe and an example timing application for Android devices.

Malaria in seafarers. 2. The status of malaria in large ports of the world. Protective measures against malaria in crews of ships.

Science.gov (United States)

Tomaszunas, S

1998-01-01

In 1997, the information was collected in collaboration with WHO on the actual status of malaria in large ports of Africa, Asia, and America, on the level of endemicity, prevailing Plasmodium species and the resistance to antimalarial drugs. The factors determining the risk of infection in seafarers were discussed. The risk is different than it is for other groups of travellers. The strategy of malaria prevention in crews of ships should be based on balancing the actual risk of infection in the visited ports of the tropics with the risk of side effects of antimalarials used for prophylaxis. Five schemes for malaria prevention in seafarers may be recommended, depending on the geographical areas of the ship's voyage.

Current epidemiology of hypertension in Port Harcourt metropolis ...

African Journals Online (AJOL)

Current epidemiology of hypertension in Port Harcourt metropolis, Rivers State ... the University of Port Harcourt Teaching Hospital formed the cohort for this study. ... is high and only a small fraction of hypertensives are aware of their condition.

Characterization of the near-source population around five candidate ports.

Science.gov (United States)

Our results indicate that environmental justice issues continue to be a concern in port areas. Within the 10 km domain of the port boundary, the Ports of Houston and Virginia had the greatest disparities in median income combined with the greater percentages of Blacks (in Virgini...

Treatment of Soft Tissue Filler Complications: Expert Consensus Recommendations.

Science.gov (United States)

Urdiales-Gálvez, Fernando; Delgado, Nuria Escoda; Figueiredo, Vitor; Lajo-Plaza, José V; Mira, Mar; Moreno, Antonio; Ortíz-Martí, Francisco; Del Rio-Reyes, Rosa; Romero-Álvarez, Nazaret; Del Cueto, Sofía Ruiz; Segurado, María A; Rebenaque, Cristina Villanueva

2018-04-01

Dermal fillers have been increasingly used in minimally invasive facial esthetic procedures. This widespread use has led to a rise in reports of associated complications. The aim of this expert consensus report is to describe potential adverse events associated with dermal fillers and to provide guidance on their treatment and avoidance. A multidisciplinary group of experts in esthetic treatments convened to discuss the management of the complications associated with dermal fillers use. A search was performed for English, French, and Spanish language articles in MEDLINE, the Cochrane Database, and Google Scholar using the search terms "complications" OR "soft filler complications" OR "injectable complications" AND "dermal fillers" AND "Therapy". An initial document was drafted by the Coordinating Committee, and it was reviewed and modified by the experts, until a final text was agreed upon and validated. The panel addressed consensus recommendations about the classification of filler complications according to the time of onset and about the clinical management of different complications including bruising, swelling, edema, infections, lumps and bumps, skin discoloration, and biofilm formation. Special attention was paid to vascular compromise and retinal artery occlusion. Clinicians should be fully aware of the signs and symptoms related to complications and be prepared to confidently treat them. Establishing action protocols for emergencies, with agents readily available in the office, would reduce the severity of adverse outcomes associated with injection of hyaluronic acid fillers in the cosmetic setting. This document seeks to lay down a set of recommendations and to identify key issues that may be useful for clinicians who are starting to use dermal fillers. Additionally, this document provides a better understanding about the diagnoses and management of complications if they do occur. This journal requires that authors assign a level of evidence to each

International Standardization in the Design of "Shore to Ship" - Power Supply Systems of Ships in Port

Science.gov (United States)

Tarnapowicz, Dariusz; German-Galkin, Sergiej

2018-03-01

The decisive source of air pollution emissions in ports is the berthed ships. This is primarily caused by the work of ship's autonomous generator sets. One way of reducing the air pollution emissions in ports is the supply of ships from electricity inland system. The main problem connected with the power connection of ships to the inland network is caused by different values of levels and frequencies of voltages in these networks (in various countries) in relation to different values of levels and frequencies of voltages present in the ship's network. It is also important that the source power can range from a few hundred kW up to several MW. In order to realize a universal „Shore to Ship" system that allows the connection of ships to the electricity inland network, the international standardization is necessary. This article presents the current recommendations, standards and regulations for the design of „Shore to Ship" systems.

FHWA operations support : port peak pricing program evaluation

Science.gov (United States)

2009-01-01

This report evaluates the applicability, Federal policy implications, and possible public and private sector roles related to peak pricing strategies at ports and intermodal facilities in the U.S. A number of ports and intermodal terminals are consid...

Vectorization, parallelization and porting of nuclear codes on the VPP500 system (porting). Progress report fiscal 1997

International Nuclear Information System (INIS)

Ishizuki, Shigeru; Nemoto, Toshiyuki; Kawai, Wataru; Watanabe, Hideo; Tanabe, Hidenobu; Kawasaki, Nobuo; Adachi, Masaaki; Ogasawara, Shinobu; Kume, Etsuo

1999-05-01

Several computer codes in the nuclear field have been vectorized, parallelized and transported on the FUJITSU VPP500 system and/or the AP3000 system at Center for Promotion of Computational Science and Engineering in Japan Atomic Energy Research Institute. We dealt with 14 codes in fiscal 1997. These results are reported in 3 parts, i.e., the vectorization part, the parallelization part and the porting part. In this report, we describe the porting. In this porting part, the porting of transient reactor analysis code TRAC-BF1 and Monte Carlo radiation transport code MCNP4A on the AP3000 are described. In addition, a modification of program libraries for command-driven interactive data analysis plotting program IPLOT is described. In the vectorization part, the vectorization of multidimensional two-fluid model code ACE-3D for evaluation of constitutive equations, statistical decay code SD and three-dimensional thermal analysis code for in-core test section (T2) of HENDEL SSPHEAT are described. In the parallelization part, the parallelization of cylindrical direct numerical simulation code CYLDNS44N, worldwide version of system for prediction of environmental emergency dose information code WSPEEDI, extension of quantum molecular dynamics code EQMD and three-dimensional non-steady compressible fluid dynamics code STREAM are described. (author)

Pattern and prevalence of neonatal thrombocytopenia in Port Harcourt, Nigeria

Directory of Open Access Journals (Sweden)

Zaccheaus A Jeremiah

2010-04-01

cases in this region of Nigeria, the majority of which are mild in nature. There is a need to define a safer lower limit for platelet count and to determine which neonates will benefit from treatment.Keywords: neonatal thrombocytopenia, platelet count, thrombocytopenia, Port Harcourt, Nigeria

The “diamond port configuration”: A standardised laparoscopic ...

African Journals Online (AJOL)

This covered patient position, port insertion, technical aspects of intestinal resection and perioperative management. In particular, a diamond configuration for ports was agreed upon. Data were prospectively collected, and included patient demographics, operative times, conversion rates and postoperative outcomes.

Structural Analysis of Port Brand Equity Using Structural Equation Modeling1

Directory of Open Access Journals (Sweden)

Taehwee Lee

2014-12-01

Full Text Available Port competition, especially in the Northeast Asia (NEA region, can be described as a price war. In this price competition, it is necessary to build up the brand concept to acquire higher market share. This paper aims to provide structural relationships for port brand equity (PBE and explore the PBE stages statistically. The stages are divided into three steps: port service quality as the precedent of PBE, the PBE dimensions (brand awareness [BA] and brand loyalty [BL], and the antecedent of PBE (overall value of brand equity [OVBE]. From a survey conducted with port users in Korea, the empirical results revealed several significant relationship: between tangibles (TA dimension of port service quality and BL, between the empathy (EMP dimension of port service quality and both BA and BL, and between BA and BL and OVBE. From the empirical analysis, this study suggests both managerial and academic contributions for port managers and scholars for further policy development and research in this important area.

Extracorporeal treatment for valproic acid poisoning: systematic review and recommendations from the EXTRIP workgroup.

Science.gov (United States)

Ghannoum, Marc; Laliberté, Martin; Nolin, Thomas D; MacTier, Robert; Lavergne, Valery; Hoffman, Robert S; Gosselin, Sophie

2015-06-01

The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup presents its systematic review and clinical recommendations on the use of extracorporeal treatment (ECTR) in valproic acid (VPA) poisoning. The lead authors reviewed all of the articles from a systematic literature search, extracted the data, summarized the key findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and the RAND/UCLA Appropriateness Method was used to quantify disagreement. Anonymous votes were compiled, returned, and discussed in person. A second vote was conducted to determine the final workgroup recommendations. The latest literature search conducted in November 2014 retrieved a total of 79 articles for final qualitative analysis, including one observational study, one uncontrolled cohort study with aggregate analysis, 70 case reports and case series, and 7 pharmacokinetic studies, yielding a very low quality of evidence for all recommendations. Clinical data were reported for 82 overdose patients while pharmaco/toxicokinetic grading was performed in 55 patients. The workgroup concluded that VPA is moderately dialyzable (level of evidence = B) and made the following recommendations: ECTR is recommended in severe VPA poisoning (1D); recommendations for ECTR include a VPA concentration > 1300 mg/L (9000 μmol/L)(1D), the presence of cerebral edema (1D) or shock (1D); suggestions for ECTR include a VPA concentration > 900 mg/L (6250 μmol/L)(2D), coma or respiratory depression requiring mechanical ventilation (2D), acute hyperammonemia (2D), or pH ≤ 7.10 (2D). Cessation of ECTR is indicated when clinical improvement is apparent (1D) or the serum VPA concentration is between 50 and 100 mg/L (350-700 μmol/L)(2D). Intermittent hemodialysis is the preferred ECTR in VPA poisoning (1D). If hemodialysis is not available, then intermittent hemoperfusion (1D) or continuous

Effectively reducing emissions from ports

Energy Technology Data Exchange (ETDEWEB)

Fazlagic, Ismir; Martelin, Marcus; Skinner, Ryan

2010-09-15

Commercial ships calling at more and more ports worldwide can now turn off their diesel engines and tap into cleaner energy sources provided by electrical connections from shore. The technology to make this possible has been in place for over a decade. With a global technology standard due to be ratified by three technical bodies in 2010, high-voltage shore connections will soon get much more attention. Environmentally-minded ports, governments and shipowners are all tuning in to the benefits of supplying electricity to ships at berth. ABB presents the challenge, the technical solution and the business case for all parties involved.

INSTITUTIONAL BARRIERS TO EFFICIENT POLICY INTERVENTION IN THE EUROPEAN PORT SECTOR

Directory of Open Access Journals (Sweden)

Barry UBBELS

2005-01-01

Full Text Available Despite the growing role of private involvement in recent port developments, most maritime trade is still largely handled in ports where investments, pricing and other managerial decisions are, to a varying extent, dependent, or at least influenced by public bodies. This paper shows that the extent and type of public intervention differs considerably between ports in the Hamburg-Le Havre range. The wide variety in ownership, financing and management of ports throughout Europe indicates that there is no level playing field at present. Because ports operate in an increasingly competitive environment (intensified by globalisation trends and the completion of the internal market, this may lead to situations of unfair competition. The European Union emphasises the importance of a more harmonised approach of port regulation by national governments (in terms of financing and pricing of infrastructure. Given the differences in (national port management styles and the low levels of transparency, the creation of a level playing field in the European port industry seems far away. This suggests the presence of a major institutional difference in European transport policy that hampers efficient policy intervention.

Literature-based recommendations for treatment planning and execution in high-dose radiotherapy for lung cancer

International Nuclear Information System (INIS)

Senan, Suresh; De Ruysscher, Dirk; Giraud, Philippe; Mirimanoff, Rene; Budach, Volker

2004-01-01

Background and purpose: To review the literature on techniques used in high-dose radiotherapy of lung cancer in order to develop recommendations for clinical practice and for use in research protocols. Patients and methods: A literature search was performed for articles and abstracts that were considered both clinically relevant and practical to use. The relevant information was arbitrarily categorized under the following headings: patient positioning, CT scanning, incorporating tumour mobility, definition of target volumes, radiotherapy planning, treatment delivery, and scoring of response and toxicity. Results: Recommendations were made for each of the above steps from the published literature. Although most of the recommended techniques have yet to be evaluated in multicenter clinical trials, their use in high-dose radiotherapy to the thorax appears to be rational on the basis of current evidence. Conclusions: Recommendations for the clinical implementation of high-dose conformal radiotherapy for lung tumours were identified in the literature. Procedures that are still considered to be investigational were also highlighted

Ensuring treatment fidelity in a multi-site behavioral intervention study: implementing NIH Behavior Change Consortium recommendations in the SMART trial.

Science.gov (United States)

Robb, Sheri L; Burns, Debra S; Docherty, Sharron L; Haase, Joan E

2011-11-01

The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children's Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11-24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the National Institutes of Health (NIH) Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper, we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in five specific areas: (1) study design, (2) training providers, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature, illustrating the application of BCC recommendations in behavioral intervention studies. Copyright © 2010 John Wiley & Sons, Ltd.

A cost-effective peripheral venous port system placed at the bedside.

Science.gov (United States)

Finney, R; Albrink, M H; Hart, M B; Rosemurgy, A S

1992-07-01

High costs and a paucity of available operating time have led us to seek alternatives to operatively placed vascular access systems. This prospective study is the initial report of a peripheral port system (P.A.S. PORT System, Pharmacia Deltec, Inc.) placed at the bedside. Seventy-nine patients (52 male, 27 female), ages 3-92 years, had ports implanted by surgical residents with attending supervision. Sixty-eight (86%) received the P.A.S. PORT for long-term antibiotics, antifungal, or antiviral therapy; four (5%) for TPN infusion; three (4%) for blood products; two (3%) for chemotherapy; and two (3%) for iv narcotics. Ports were placed in 10 (13%) HIV(+) patients, three (4%) who were fully anticoagulated, and one who was a hemophiliac with a platelet count of zero. Eight patients (10%) developed superficial phlebitis, all of which resolved with nonsteroidal anti-inflammatory agents within 48 hr without port removal. Seven patients (9%) had their port removed due to infection. The average hospital charge to place the P.A.S. PORT System was $1488.00 vs $2811.00 for a tunneled external chest catheter and $3729.00 for the placement of a chest port. Bedside insertion of vascular access devices can be safely performed with acceptable infection rates allowing more efficient use of hospital operating rooms and with substantial cost savings.

SU-E-T-243: Design of a Novel Testing Port for Radiation Protection and Shielding Measurements

International Nuclear Information System (INIS)

Tanny, S; Parsai, E; Harrell, D; Noller, J; Chopra, M

2015-01-01

Purpose: The majority of radiation shielding research utilizes Monte Carlo simulation because of the difficulty in eliminating secondary radiations from measurements. We have designed a test port into a primary barrier of our newest vault to allow for shielding measurements while ensuring adequate protection to the public and staff during normal machine operation. This port allows for measurement of attenuation values of shielding materials, differential dose albedos, and radiation scatter fractions. Methods: The vault design utilized the maze as part of a compound primary barrier. The test port is contained within the maze and is centered along isocenter. The inner 30 cm has a 20×20 cm 2 opening, while the remaining length has a 30×30 cm 2 opening. The block that contains the port has a density of 200 pcf to minimize internal scatter. The 30×30 cm 2 opening is occupied by removable 215 pcf concrete blocks. The innermost and outermost blocks activate an interlock wired into the beam-enable loop. This disallows beam-on in treatment mode if the interlock isn’t closed. The interlock can be overridden in service mode, or by-passed via an override switch in case of circuit failure. Results: The test port was installed in August. The beam is disabled when the interlock is tripped. Measurements taken when the primary beam is not incident on the port are indistinguishable from background. Ambient dose levels surrounding the vault with the designed shielding blocks in place are all within allowable limits for occupational workers. Conclusions: We have designed and installed a unique testing port for radiation protection and shielding measurements. This port is appropriately interlocked and designed to mitigate any risks of incidental exposure to staff or members of the public. The test port design allows measurements with “good geometry” and efficient removal of contaminating sources of radiation present in many shielding measurements. Daniel Harrell and Jim Noller

Shutdown dose rate contribution from diagnostics in ITER upper port 18

Energy Technology Data Exchange (ETDEWEB)

Cheon, M.S., E-mail: munseong@nfri.re.kr [National Fusion Research Institute, Daejeon (Korea, Republic of); Pak, S.; An, Y.H.; Seon, C.R.; Lee, H.G. [National Fusion Research Institute, Daejeon (Korea, Republic of); Bertalot, L.; Krasilnikov, V. [ITER Organization, St Paul-lez-Durance (France); Zvonkov, A. [Agency ITER-RF, Moscow (Russian Federation)

2016-11-01

Highlights: • The Shutdown Dose Rate in the interspace of ITER upper port 18 was evaluated. • VUV spectrometer is the dominant contributor to the average SDR. • The existence and size of the blanket cooling pipes impacts significantly on SDR. - Abstract: D-T operation of ITER plasma will produce high-energy fusion neutrons those can activate materials around the place where human-access is necessary. The interspace of the diagnostic port is one of the area where human-access is necessary for the maintenance of diagnostic systems installed at the port, so it is important to evaluate a dose rate of the interspace area in order to comply with ALARA principle. The shutdown dose rate (SDR) in the interspace of ITER upper port 18 was evaluated by the Direct 1-Step (D1S) method using MCNP5 code. This port contains three diagnostics: Vacuum Ultra-Violet (VUV) Spectrometer, Neutron Activation System (NAS), and Upper Vertical Neutron Camera (UVNC). The contribution of each diagnostic in the port was evaluated by running separate upper port MCNP models those contain individual diagnostic only, and the total dose rate contribution was evaluated with the model which was fully integrated with all the diagnostics. The effect of the opening around the upper port plug and of the other ports was also investigated. The purpose of this assessment is to provide the shielding design basis for the preliminary design of the diagnostic integration in the port. The method and result of the calculation will be presented in this paper.

Port type is a possible risk factor for implantable venous access port-related bloodstream infections and no sign of local infection predicts the growth of gram-negative bacilli.

Science.gov (United States)

Hsu, Jui-Feng; Chang, Hsu-Liang; Tsai, Ming-Ju; Tsai, Ying-Ming; Lee, Yen-Lung; Chen, Pei-Huan; Fan, Wen-Chieh; Su, Yu-Chung; Yang, Chih-Jen

2015-09-30

Implantable venous access port (IVAP)-related blood stream infections (BSIs) are one of the most common complications of implantable venous ports. The risk factors and pathogens for IVAP-related BSIs are still controversial. We retrospectively reviewed all patients who received IVAPs at a Hospital in Taiwan from January 1, 2011 to June 31, 2014. Two types of venous port, BardPort® 6.6 fr (Bard port) and Autosuture Chemosite® 7.5 fr (TYCO port) were used. All patients with clinically proven venous port-related BSIs were enrolled. A total of 552 patients were enrolled. There were 34 episodes of IVAP-related BSIs during the study period for a total incidence of 0.177 events/1000 catheter days. Port type (TYCO vs. Bard, HR = 7.105 (95% confidence interval (CI), 1.688-29.904), p = 0.0075), age > 65 years (HR = 2.320 (95 % CI, 1.179-4.564), p = 0.0148), and lung cancer (HR = 5.807 (95% CI, 2.946-11.447), p port infections. We also found that no local sign of infection was significantly associated with the growth of gram-negative bacilli (p = 0.031). TYCO venous ports, age > 65 years, and lung cancer were all significant risk factors for IVAP-related BSIs, and no sign of infection was significantly associated with the growth of gram-negative bacilli.